D.Cur. / There is currently lack of mobilization of the advanced psychiatric nurse as a resource person in the mental health services of the Gauteng Province. This lack of mobilization of the advanced psychiatric nurse as a resource person in the mental health services, is associated with her supervisors who are the psychiatric nurse managers. The purpose of this research was to develop and describe a model that could be implemented to guide the mobilization of the advanced psychiatric nurse as a resource person in the mental health services in order to facilitate her mental health. The research also focused on developing guidelines for the implementation of the model for the mobilization of the advanced psychiatric nurse as a resource person. The model: "Mobilization of the advanced psychiatric nurse as a resource person: an interactive process", together with its operational guidelines was developed by using a theory generative design, that is, qualitative, explorative, descriptive and contextual in nature. This model was developed according to Chinn and Kramer's (1995) approach to theory generation, namely: identification of the central concepts for the model by conducting a field study to explore and describe the views of the advanced psychiatric nurse and those of the psychiatric nurse managers with regard to the mobilization of the advanced psychiatric nurse as a resource person in the mental health services of Gauteng; analysing the data gathered through focus groups interviews from the sample of the advanced psychiatric nurses and form the sample of psychiatric nurse managers using Strauss and Corbin's (1990) open, axial, and selective coding approach to guide data analysis; analysing the data by identifying, defining, classifying the concepts and placing them into relationship with each other to form relationship statements as the conceptual framework for the model; describing the model using strategies proposed by Chinn and Kramer (1995) and then subjecting the model to evaluation by experts in theory generation; describing the guidelines for the implementation of the model in the clinical setting.

M.Cur. / Please refer to full record to view abstract

D.Cur. / South Africa, like many other countries, is charged with ensuring that her adolescents are mobilised to believe in the power of their own dignity in order for their life-world to change. Hundreds of thousands of adolescents were forced to experience political upheavals, violence, neglect, incarceration and family disorganisation. Many of these adolescents were forced onto the margins of society in their strive for understanding and survival. Many dropped out of school, are unskilled and therefore unemployed. They feel hopeless as they struggle for a place in society, because society has no faith in them - "they are lost to society". The purpose of this study was to generate a psychiatric nursing model to facilitate the reintegration of marginalised adolescents into the community. This study therefore has profound social, political and economic implications for the South African community. Through this model, which is a theoretical framework to be utilized by the advanced practitioner in psychiatric nursing, adolescents will be empowered to believe in themselves, to engage in meaningful relationships and activities with their families, peer groups and the broader community. The model provides a theoretical framework that attempts to rekindle and inspire the adolescents from a state of hopelessness and disillusionment, to integrated individuals who are respected, valued and accepted as integral members of their families, peer groups and communities. The model will assume a problem solving and preventative approach. Based on this discussion, the following questions were addressed in this research: What obstacles exist that hamper marginalised adolescents' reintegration into the community? What could be done to assist marginalised adolescents' reintegration into the community? A theory generative, qualitative, contextual, exploratory and descriptive design was followed. The research was conducted in four steps with a pilot-study that preceded step one of the research. In step one, focus group discussions were conducted with five groups of respondents to explore and describe obstacles that hamper the reintegration of marginalised adolescents into the community, as well as their views on how marginalised adolescents can be assisted to be reintegrated into the community. Data was analysed using Tesch's method. Based on the results of analyzed data, disempowerment, characterized by hopelessness, alienation/isolation, anger, frustration and worthlessness - related to poor socialisation, lack of support and services, family disorganisation, peer pressure and fragmented services - was identified as a main theme among stumbling blocks. Empowerment, characterized by improved self-image, feelings of worth, belief in own dignity - related to a sense of wellbeing, belonging and respect - resulting in personal growth and societal change with ultimate reintegration, was identified as major strategy to address marginalisation. In step two, the defined concepts were related to each other to show interrelationships. Classification of central and relational concepts followed to formulate relationship-statements, the result being to depict related concepts in structural form. In step three, a visual model to be utilized as a theoretical framework by the advanced psychiatric nurse practitioner to facilitate the marginalised adolescents as recipients and the advanced psychiatric nurse as agent, was designed to facilitate reintegration into the community. The model was evaluated by a panel of experts. Step four dealt with guidelines to operationalise the model in practice, education and research. Recommendations and limitations of the research were also discussed.

M.Cur. / The purpose of this study is to establish guidelines for the utilization of narratives in popular literature in nursing education in order to facilitate reflective thinking with nursing students. The purpose of nursing education is to equip the prospective nursing practitioner to be able to function independently and effectively in a multicultural, technological and scientific nursing practice where caring is important. Quality nursing care demands critical analytical thinking (cognitive skills) and moral values (affective skills) of the nursing practitioner. This study investigates firstly the "what" of reflective thinking and concludes that reflection accommodates both thinking skills and values that should be facilitated at the prospective nursing practitioner. The facilitation of reflective thinking is demanding as it is a complex cognitive and affective thinking skill. The research focuses secondly on the way in which the narrative in popular literature can be applied to facilitate reflective thinking in nursing education. According to the constructivist learning approach meaningful learning and reflective thinking occur when coupled to previous knowledge and experience. The nursing student as adult learner has at his/her disposal certain advance knowledge and previous experience. Narratives and popular literature form part of the adult learner's advance knowledge and previous experience. The research design is a philosophical inquiry in which the following research strategies are used namely philosophical analysis as well as qualitative, exploratory, descriptive and contextual strategies. In order to meet the purpose of the research, four goals were set and which were executed in four phases. At first the term reflective thinking was subjected to the process of concept analysis in order to clarify it's specific meaning (connotations and denotations). A theoretical definition of reflective thinking was formulated for the study from the connotations whereas denotations were used as the basis of learning outcomes for the Programme of Euthanasia as an Ethical Issue in Nursing Education (the Programme).

Indiana University-Purdue University Indianapolis (IUPUI) / The role of the nurse has changed dramatically in the past twenty years with increasing complexity of patient care and a rapidly changing health care environment. In addition to the challenges noted regarding patient care, problems with increasing medical errors were noted in the literature specific to graduates in their first year as a nurse. Research in particular to nursing education provides a way for nurse educators to become more astute at addressing problems pervading the role of the new nursing graduate. Narrative Pedagogy was identified as a research-based nursing pedagogy and has been researched and enacted for more than a decade. Out of the Narrative Pedagogy research, the Concernful Practices emerged identifying what was considered meaningful to nursing education by teachers, students, and clinicians. Listening was one of the Concernful Practices and became the focus of this study. The research question addressed the “How do nurse educators who enable Narrative Pedagogy experience Listening: knowing and connecting?” This was a hermeneutic phenomenological study in which ten nurse educators shared their experiences. The two themes that emerged from the study included: Listening as Dialogue and Listening as Attunement. The findings of this study provided a different way of thinking about teaching and learning that encompasses so much more than merely a strategy or outcome-based approach. The implications of this study offer nurse educators insight about opening a dialogue that draws attention to the realities of the role of the nurse responding to multiple patients with complex health conditions.

Indiana University-Purdue University Indianapolis (IUPUI) / Despite outstanding employment opportunities and high demand to address the global nursing shortage, men who consider becoming nurses are less likely to enroll in and to graduate from nursing programs. Many barriers that men commonly encounter during nursing education have been found in the literature; however, there is a lack of theoretically based research that examines factors that help men succeed as they study nursing. Based on a conceptual model derived from O’Lynn’s construct of male friendliness in nursing education and Frankl’s theory of will to meaning and purpose in life, this study examined facilitators for men during nursing education. This was accomplished through the development and psychometric testing of the Survey of Facilitators for Men (SFM) in a sample of 145 men in nursing. Strong evidence of reliability and validity was provided for the SFM consisting of three subscales (Internal facilitators, External Connections facilitators, and Institutional facilitators). Internal facilitators consist of intrapersonal strengths, experiences, and motivators. External Connections facilitators are interpersonal connections that emerge from relationships that men develop. Institutional facilitators involve structural or organizational aspects of institutions that ease barriers. Testing provided satisfactory evidence of internal consistency (α = .85) and test-retest reliability (intraclass coefficient = .72; confidence interval = 0.57–0.83). Dimensionality of three facilitator subscales was supported by Principle Axis Factoring with Varimax rotation and satisfactory factor loadings (.49–.72). Support for the conceptual model was provided using multiple regressions explaining 17% of the variance in purpose in life [F(4, 140) = 6.99, p < .001], 13% of the variance in GPA [F(6, 114) = 2.88, p < .01], and 49% of the variance in perception of nursing success [F(9, 128) = 13.42, p < .001]. Purpose in life was associated with Internal facilitators and comfortable income, GPA was associated with External Connections facilitators and age at BSN, while perception of nursing success was associated with purpose in life, holding an MSN, having a comfortable income, and having children. Future research is warranted to determine the usefulness of the SFM in designing strategies to recruit and retain men in nursing programs.

Indiana University-Purdue University Indianapolis (IUPUI) / Clinical nursing faculty members often work with students who underperform in the clinical area. Underperforming students are those who exhibit deficits in nursing knowledge, the application of nursing knowledge, psychomotor skills, motivation, and/or interpersonal skills. The outcomes of faculty work with underperforming students have implications for patient safety and the nursing workforce, yet little is known about how faculty work with underperforming students. The purpose of this project was to develop a theoretical framework that describes how clinical faculty work with underperforming students in the clinical area. Twenty-eight nursing faculty who had worked with underperforming nursing students during clinical rotations were interviewed and invited to tell stories about working with these students. Their narratives were analyzed using constant comparison analysis, and a theoretical framework was developed. The framework included three stages that unfolded as faculty worked with underperforming students over time. The first stage, Being Present, was the process by which faculty came to know students were underperforming. They did this by noticing red flags, taking extra time with students, working side-by-side with students, and connecting with students "where they were at." The second stage, Setting a New Course, was the process by which faculty attempted to provide remedial experiences to improve the performance of those students determined to be underperforming. The participants did this by beginning a new course of instruction for the students, bringing in new people to help the students, and creating new learning experiences for them. This process could result in students turning it [their performance] around, making it through [the clinical rotation], or not making it. The final stage, Being Objective, was the process by which participants made negative progression decisions. They did this by relying on objective indices, documenting problematic student behaviors, and obtaining validation for their decisions.

Optimizing meaningful engagement of older adults with multimorbidity and their caregivers as partners in health care research / Background: The importance of engaging older adults (> 65 years) with multimorbidity and their caregivers as partners in health care research has been widely recognized. Inclusion of patients as research partners has resulted in largely positive effects. However, little is known about how best to engage and support them in this role. The objective of this study was to examine how to optimize meaningful engagement of older adults with multimorbidity and their caregivers as research partners. Methods: The research objective was addressed using the persona-scenario method. Study participants were older adults with previous experience as a research partner or a research participant. Participants worked in pairs to create a persona and a scenario about how their persona(s) was involved on the research team. Analysis was conducted in two phases: (a) identification of themes, subthemes, and codes using a qualitative descriptive approach, and (b) interpretation of themes and subthemes into design specifications (actions and products). Results: Four persona-scenario sessions were held with 8 patient participants. Three major themes emerged from the data: (a) recruitment of patient or caregiver research partners (PCRPs); (b) planning for meaningful engagement; and (c) establishing collaborative relationships. These major themes contained 15 corresponding subthemes, and design specifications (52 actions and 37 products). Findings highlight key factors influencing the engagement of older adults with multimorbidity and their caregivers as research partners, such as the need for: early engagement of PCRPs; clarification of PCRPs’ roles and responsibilities; a flexible patient-centred approach to PCRP involvement; identifying and addressing barriers to their engagement (e.g., caregiving support, transportation); training about research; and continued dialogue and feedback to clarify roles and manage expectations. The results are important for identifying ways to promote greater patient engagement in research and ensure that the research reflects the needs of the patients it strives to serve. / Thesis / Master of Science (MSc) / The importance of engaging patients with multimorbidity and their caregivers as partners in health care research has been widely recognized. However, little is known about how to best engage and support them in this role. The objective of this study was to examine how researchers can best engage and support older adults with multimorbidity and their caregivers as research partners in health care research teams. The persona-scenario method was used for participants to create fictional stories. These stories were analyzed to shed light on specific strategies that can support older adults and their caregivers as partners on health care research teams, such as a patient-centred approach, identifying and addressing barriers to engagement, and clarifying roles and responsibilities on the research team. The results from this study can be used to inform research, policy, and education on supporting older adults with multimorbidity and their caregivers as research partners.

Health Studies / D. Litt. et phil. (Advanced Nursing Sciences)

The purpose of this study was to describe the perceptions/views of student nurses, nurse educators and unit supervisors on accompaniment of student nurses in clinical settings of the Northern Province of the RSA A quantitative descriptive cross-sectional survey was used in this study to describe the perceptions/views of student nurses, nurse educators and unit supervisors on apcompaniment of student nurses in clinical settings. Data was collected during February and March 200 I when student nurses, nurse educators and unit supervisors in the Northern Province completed questionnaires. The study revealed positive and negative perceptions regarding accompaniment of student nurses in clinical settings, including that: • accompaniment in the clinical settings enhanced student nurses' clinical learning experiences • the presence of nurse educators in the clinical settings improved student nurses' accompaniment • facilitators played an important role in the accompaniment of student nurses • accompaniment enhances correlation of theory and practice / Health Studies / MA (Advanced Nursing Sciences)