Ph.D. (Nursing Education)--University of the Witwatersrand, Faculty of Health Sciences, 2012 / The sciences of restorative nursing are unknown in South Africa, leaving patients with restorative needs with rather unpredictable outcomes. This study investigated the validity of four prospective nursing scales to be used for patients requiring nursing where the focus is to improve their functionality. Such patients are usually found in sub- and non-acute nursing units and suffering with chronic debilitating diseases, mental illness or recovering from trauma. Typically they are in need of rehabilitation, palliative care, geriatric services or long-term care to restore or maintain their functional independence. Inspired by the theories of nursing pioneers such as Florence Nightingale, the definitive nurse who was also an astute healthcare reform statistician, as well as Ida Jean Orlando, better known as the originator of the nursing process, the researcher, a general medical practitioner, has explored the intuitive knowledge of experienced nurses to document the links between their observations, interpretations and predictions of patient functioning. This information was used to develop four interrelated nursing scales to be used routinely by nurses to provide raw patient scores on patient functional changes. As nursing intuition was used to develop the measures, the working hypothesis was that the scales are considered valid. Therefore, the approach towards the study was deductive in nature, seeking the evidence to confirm this assumption. As the purpose of the study was to offer nurses useful scales to provide validated empirical evidence of human functional status, the research question was how scientific evidence can be used to conclude that these four scales have indeed the integrity to deliver a measurement function to the nurses. The researcher’s hypothesis of validating routine nursing measures is supported by two concepts: nursing utility and constructs validity. If nursing utility fail, construct validity is of no value to the nursing profession. With this in mind, the v study objectives were to first validate nursing utility using a qualitative design to collect descriptive data from nurses who have implemented the scales. Once positive findings were reported on the usefulness of the scales to the nursing profession, then construct validity was explored using the Rasch measurement model to qualitatively analyse the scale’s raw data collected in various sub- and non-acute nursing facilities. One scale was discarded, and three showed good to excellent results on both utility and construct validity. It has provided the restorative nursing sciences with a methodology to routinely collect patient-based empirical evidence for parametric analysis. In so doing, it delivered the missing link in Orlando’s nursing process theory; it also confirmed Nightingale’s theory that healthcare evidence provided routinely by nurse is the stepping stone for healthcare reform, provided it is useful, meaningful and valid. The ultimate beneficiaries of this new knowledge are patients who previously would have had unpredictable outcomes resulting in a poor prognosis.

Thesis (Ph. D.)--University of Washington, 1995. / Vita. Includes bibliographical references (leaves [66]-70).

Zugl. Diss.

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--Medical College of Ohio, 2004. / "In partial fulfillment of the requirements for the degree of Master of Science in Nursing." Major advisor: Debra Buchman. Includes abstract. Document formatted into pages: ix, 112 p. Title from title page of PDF document. Bibliography: pages 91-97.

Thesis (Ph. D.)--University of Massachusetts Worcester and University of Massachusetts Amherst, 2002. / Title from opening page (viewed Oct. 10, 2007). "February 2002, Collaborative PhD in Nursing Program, Worcester and Amherst." Includes bibliographical references (p. 86-97).

Orientadores: Aloisio Jose Bedone, Maria Helena Baena de Moraes Lopes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-13T02:24:07Z (GMT). No. of bitstreams: 1 Reis_MariaJosedos_M.pdf: 2056405 bytes, checksum: f7013d96992d70a949827a536179cc21 (MD5) Previous issue date: 2008 / Resumo: O objetivo deste estudo foi descrever algumas características do atendimento prestado pelo (a) enfermeiro (a) no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (Caism/UNICAMP), às mulheres que sofreram violência sexual e as vivências presentes na fala destes profissionais no desenvolvimento desta atividade. Foi realizado um estudo descritivo e retrospectivo para descrever as caracteristicas do atendimento prestado pelo (a) enfermeiro (a), e a metodologia clinico-qualitativa para identificar as suas vivências. Foram analisados prontuários de atendimentos realizados no período de junho de 2006 a maio de 2007 e calculadas as freqüências absolutas e relativas das variáveis. Para comparar o atendimento entre o período diurno e o noturno foi utilizando o teste qui-quadrado ou exato de Fisher. Junto aos (às) enfermeiros (as), usou-se a técnica da entrevista semidirigida de questões abertas e o tamanho da amostra foi estabelecido pelo critério de saturação das informações colhidas. Para análise, utilizou-se a técnica da Análise Qualitativa de Conteúdo e construtos da psicologia da saúde. Foram analisados 146 prontuários que correspondiam a 84,9% dos atendimentos realizados. A maioria dos atendimentos ocorreu no período diurno e os instrumentos foram preenchidos completamente. Houve coerência das intervenções com os diagnósticos de enfermagem e problemas colaborativos identificados e a maioria das mulheres referiu que receberam as orientações de acordo com o protocolo do Programa. O tempo de consulta de enfermagem foi maior no período noturno e as mulheres atendidas neste período mais freqüentemente conheciam os riscos de saúde; faziam uso dos medicamentos ARV em horários adequados às suas atividades diárias e estavam mais orientadas quanto à finalidade das sorologias para DST e HIV. Foram entrevistados(as) seis enfermeiros(as) e após várias leituras do corpus das entrevistas, elegeram-se quatro categorias: a) o que pensam b) o que sentem, c) como agem e d) como reagem. Os(as) enfermeiros(as) consideram que o acolhimento é um fator fundamental para uma assistência humanizada e individualizada e no estabelecimento de vínculo, realizar esse atendimento aflora sentimentos diversos, de acordo com vivência pessoal e profissional de cada indivíduo e demonstram diversos tipos de reação. Concluiu-se que o atendimento de enfermagem é adequado, aderente ao protocolo do serviço, sendo alguns indicadores melhores no plantão noturno. Os profissionais entrevistados apresentaram diferentes sentimentos; ao mesmo tempo em que aparece o desejo de fugir do atendimento ocorre a vontade de dar o melhor de si e a utilização de mecanismos internos no sentido de minimizar a dor e o sofrimento / Abstract: The objective of this study was to describe some characteristics presented by nurses at the Center for Integral Attention to Women's Health of the University of Campinas (CAISM/UNICAMP) regarding the nursing care to women with sexual assault history, as well as to interpret the nurses' experiences while developing their activities. Using the clinical-qualitative methodology, a retrospective and descriptive study was carried out to evaluate the care provided by the nurses, identifying their experiences. Medical records from June 2006 to May 2007 and the absolute and relative frequencies of variables were estimated. In order to compare the care between the daytime and nighttime periods, the Chi-square or Fisher's exact test was used. In order to assess the nurses' speech, the semi-directed interview technique was used, the sample size was established by the saturation criterion of information, and the qualitative content analysis technique and the health construct psychology were used. One-hundred and forty-six medical records were analyzed, corresponding to 84.9% of the consultations conducted. The data showed that the majority of assistance care occurred during the day and the instruments were completely filled. There was consistency among interventions nursing diagnoses and the collaborative problems identified; most women reported receiving the guidelines in accordance with the program protocol. The time for nursing consultation was higher during the night period, and the women assisted during this period most often knew the health risks arising from sexual assault, used ARV drugs at times appropriate to their daily activities, and were more focused on the purpose of STD and HIV serology. The six nurses were interviewed and, after several readings, divided into four categories: a) what they think, b) what they feel, c) how to act end react as nurses. The nurses believe that the humanized and individualized assistance and the establishment of ties are crucial factors. This type of assistance arise different feelings and reactions, in accordance with the professional experience of each nurse. It was concluded that the nursing care is adequate, consistent with the service protocol, and the night nursing group presented the best indicators. The professionals interviewed showed different feelings; the desire to escape from the assistance appears along with the need to make the best, and to use internal mechanisms to minimize their pain and suffering / Mestrado / Tocoginecologia / Mestre em Tocoginecologia

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

This study uses a descriptive survey design to describe and examine the relationship among school nurses’ level of education, years of experience, knowledge of asthma and identification of the school nurse’s level of proficiency based on Benner’s (1984) model of Novice to Expert. A convenience sample of school nurses employed in public schools within the state of Massachusetts with an RN degree (registered nurse) were sampled. The demographic data revealed that of the 325 participants who participated in the study, the majority of school nurses were female ranging in age from 40 to 50 (M=47.0). The majority of nurses had a bachelor’s degree in nursing and were employed in the nursing profession on an average of twenty-two years and in school nursing for ten years. Since the majority of the school nurses did not have a master’s degree, they were not certified by a national certifying body. The majority of participants indicated that they had received certification through the Board of Education in Massachusetts. Most school nurses worked full time in a public school and were responsible for between six hundred and a thousand students. The majority of nurses indicated that they did not have a school-based clinic on site, nor did they have a school-based health center or clinic to refer students. There was little variability among sample characteristics with school nurses employed in Massachusetts being a fairly homogenous group. Those surveyed were sent a packet containing four questionnaires including one on demographics, as well as an asthma questionnaire, a questionnaire assessing chronic health problems in the schools, and a self-reporting questionnaire based on Benner’s (1984) model. Further results of this study revealed that the majority of the school nurses had an average to above average knowledge of asthma. The three most common interventions performed by school nurses as well as non medical personnel for those students with chronic illness are nebulizations, inhalers, and peak flow meters. Based on the self-report model of Benner’s (1984), these same nurses viewed themselves as expert in their level of practice. Mezirow’s Adult Learning Theory as well as Benner’s (1984) model of Novice to Expert were used to support the nurses level of practice based on experience, intuition and a constellation of meaning schemes developed from previous exemplars. Results of the study indicated that although the nurses surveyed were expert in their knowledge of basic nursing concepts, none had advanced practice level courses in advanced health assessment or clinical decision making in order to effectively manage the complexities of chronic illness such as ADHD, diabetes, and epilepsy, as well as asthma, the most common chronic illness in schools today.

O presente estudo constituiu-se em uma pesquisa quantitativa, não experimental, do tipo survey, de natureza descritiva. Teve como objetivos analisar a avaliação que enfermeiros e enfermeiros chefes fazem em relação à formação conferida pelo curso de graduação em enfermagem, bem como identificar, segundo esses mesmos enfermeiros, os pontos fortes – pontos de luz - e os pontos fracos – buracos negros - dessa formação. Foram sujeitos deste estudo, 53 enfermeiros, atuantes profissionalmente em Instituições de Saúde de um município do interior paulista, que concluíram o curso de graduação em enfermagem nos anos de 2000, 2001, 2002 e 2003, e 31 enfermeiros, seus respectivos chefes. Para a coleta de dados construímos um instrumento, utilizando a escala analógica visual, contendo a descrição de 45 (quarenta e cinco) competências inerentes à atuação profissional do enfermeiro e uma questão sobre o estímulo fornecido, durante o curso de graduação, para a participação em entidades de classe. Após a validação (aparente e de conteúdo) do instrumento de coleta de dados e aprovação do projeto de pesquisa pelo Comitê de Ética, demos inicio ao presente estudo. A análise dos resultados foi feita utilizando-se o Programa SPSS (Statistical Package for Social Science), versão 11.5. De acordo com os resultados, o presente estudo nos possibilitou concluir que: o preparo conferido pela graduação ao enfermeiro para organizar e dirigir serviços de enfermagem e/ou de saúde, em especial, foi considerado pouco adequado pelos dois grupos estudados; para os enfermeiros chefes, o preparo para a liderança da equipe de enfermagem é inadequado, o que contradiz a percepção dos enfermeiros; o preparo para a pesquisa que tenha impacto e possa intervir na prática profissional do enfermeiro foi considerado pouco adequado pelos dois grupos; quanto às competências educativas, também foram consideradas pelos dois grupos, como pouco adequadas; em especial, para a questão de programas de capacitação, recrutamento e seleção de pessoal, o preparo foi praticamente considerado como inadequado; para todas as competências, de todas as 31 categorias utilizadas nesse estudo, os enfermeiros avaliam-se melhor preparados pela graduação do que avaliam os enfermeiros chefes; tanto para o grupo de enfermeiros chefes, como para o grupo de enfermeiros, os pontos altos – “pontos de luz" - da graduação se referem, principalmente, às competências assistenciais; sob a avaliação dos dois grupos - enfermeiros e enfermeiros chefes - os pontos fracos – “buracos negros" - se referem, majoritariamente, às competências políticas; o processo formativo ainda nos parece desvinculado da prática profissional, levando a um descompasso entre o que se aprende e o que se vivencia; o discurso de formarmos um profissional crítico, reflexivo, capaz de atuar e promover mudanças na realidade que os rodeia, continua apenas na retórica; as várias reformas curriculares dos cursos de enfermagem têm levado apenas a alterações de aspectos pontuais; a utilização da pesquisa como “norte" da formação do enfermeiro, ainda está muito distante; a graduação deixa a desejar também quanto ao preparo do enfermeiro para desempenhar a função de ensinar/educar. / The present work was made up of a quantitative, non experimental, survey type study of a descriptive nature. Its aims were to analyse what the nurses and their nursing chiefs do in relation to the preparation given by the graduate courses of nursing, as well as identify, according to these same nurses, the strong points – or points of light- and the weak points or black holes in this training. The study subjects were 53 nurses, professionally active in health institutions in a municipality in the interior of São Paulo State, that concluded their graduate nurses training in the years of 2000,2001,2002 and 2003, and 31 nurses who were their respective nurse managers. For data collection an instrument composed of the visual analogue scales containing 45 questions was used containing 45 inherent competencies to the professional activities of the nurse and a question about the stimulus given during the graduate course for participation in professionally linked entities, After the validation (appearance and content) of the data collecting instrument and the approval of the project by the ethics committee the present study began. For analysis of the results the SPSS (Statistical Package for Social Science) programme was used. According to the results, this study allowed us to conclude that: the preparation given to the nurses for organizing and managing nursing and/or health services by their graduate courses was considered somewhat inadequate by both the groups studied; for the head nurses the preparation for team leadership is inadequate, which contradicts the nurses perception; the preparation for research that would have an impact on and would alter professional practice was considered slightly inadequate by both groups; as far as educative competency is concerned, both groups indicated this to be a little inadequate also; in relation to the question of qualification programmes, selection and recruitment of personnel, the preparation was practically considered to be inadequate; for all competencies in all of the categories used in this study the nurses assessed themselves as better prepared by the 34 graduate course than did their counterparts, the head nurses; both the head nurses and the nurses indicated the high points - “points of light" in the graduate course refer principally to assistance competency; both groups also agreed that the weak points – “black holes" refer, in the majority, to political competence; the formative process to us, still seems to be separated from professional practice, leading to a huge difference between what you learn and what you experience; the discourse about training the critical, reflexive professional, capable of performing and promoting changes in reality what surrounds us, continues to be only rhetoric; the various curricular improvements of nurses' undergraduate courses has taken into account only the immediate aspects; the use of research as a guide to the training of nurses is still very distant; the graduate studies leave a lot to be desired as far as the preparation for the carrying out of teaching and educational functions.