Background: Several nursing theorists emphasize the importance of establishing the so-called therapeutic relationship between the nurse and the patient in order to facilitate and provide better results of the treatment. Aim: The aim of this study was to investigate how nurses working in out-patient psychiatric care describe the concept of therapeutic relationship and its usage when working with patients. Method: Semi structured interviews were performed and the material was analyzed through qualitative content analyzis. Result: Four main categories that describe the different aspects of the therapeutic relationship emerged. These were: What the nurse does to establish the therapeutic relationship, The functions and definition of the therapeutic relationship, The qualifications of the therapeutic relationship and Challanges in establishing the therapeutic relationship. Conclusion: The therapeutic relationship was described as a tool in working with the patient, and individualized treatment, trust, sufficient time and the use of one's own personality was described as important factors in establishing this relationship.

In the late 1980s, references to postmodernism, post-structuralism, and Michel Foucault started to appear in nursing journals. Since that time, hundreds of journal articles and dozens of books in the discipline of nursing have cited these continental-philosophical ideas—in substantial or minor ways—in nurses’ analyses of topics in nursing practice, education, and research. Key postmodern and post-structural notions including power/knowledge, discourse, the clinical gaze, disciplinary power, de-centering of the human subject as the originator of “meaning,” and the challenge to grand narratives and binary thinking—all found their place on the pages of journals such as the Journal of Advanced Nursing, Nursing Inquiry, and Nursing Philosophy and in a predominantly American journal Advances in Nursing Science among a few other periodicals. In my dissertation, I assemble this voluminous body of publications into a “field of study.” Taking a comparative approach to this field, I argue that we can understand postmodern/post-structural scholarship in nursing as characterized by a marked difference between its non-American (in this case, Australian and New Zealand, British and Irish, and Canadian) and American domains. While each domain is heterogeneous, peculiar features distinguish American postmodern/post-structural nursing literature from its non-American counterparts. I build on a recent systematic critique of so-called American “unique nursing science” and (meta)theory by Mark Risjord (2010), who surfaced the unacknowledged legacy of the logical positivist philosophy of science on contemporary American nursing conceptions of science and theory. These influences, according to Risjord, have had profound and lasting intellectual impact on nursing theoretical work manifesting in the notions of “unique science,” a caution toward “borrowed theory,” a hierarchical model of theory, the language of metaparadigms, incommensurable paradigms, and so on. These ideas and related practices of theorizing have culminated in what I call the American disciplinary nursing matrices that shape the visibility and intelligibility of alternative practices of theorizing in the discipline of nursing. I show the ways in which these matrices are consequential for how postmodern and post-structural philosophical ideas are understood, discussed, and deployed (or not) in American nursing literature; indeed, I argue that these continental ideas, vital for nurses’ ability to critically reflect on the discipline and the profession—are unintelligible as a form of nursing knowledge within the American nursing theoretical matrices. / Graduate / 2017-09-29 / 0569 / 0344

Os enfermeiros têm se mostrado mais conscientes da necessidade e do compromisso no estabelecimento do cuidado centrado na criança e na família. Entretanto, reconhecem dificuldades para o engajamento inicial com os familiares presentes no hospital, prejudicando a implementação dessa prática. Acreditamos que estratégias para esse engajamento devam incluir a criação de um contexto para que enfermeiras e famílias possam estabelecer uma relação de reciprocidade na qual a confiança, a comunicação regular, a transparência e a cooperação para atender as necessidades da família, sejam asseguradas. A Teoria do Cuidado Humano de Jean Watson permite ao enfermeiro desenvolver um relacionamento de ajuda e confiança com as famílias de crianças no contexto do cuidado. Este estudo teve como objetivo compreender a experiência dos enfermeiros sobre o desenvolvimento da relação de ajuda e confiança com famílias de crianças em unidades de pediatria, à luz da Teoria do Cuidado Humano de Jean Watson. Para tanto, adotou-se a abordagem qualitativa descritiva, utilizando o modelo híbrido de análise temática como referencial metodológico e a Teoria do Cuidado Humano como arcabouço teórico. A coleta de dados ocorreu em três etapas: apresentação de conteúdo teórico e material de apoio; vivência do relacionamento de ajuda e confiança; entrevista semi estruturada, realizada com doze enfermeiras de um hospital particular na cidade de São Paulo. Os resultados apontam para fatores internos e externos aos enfermeiros, relacionados com os dez caritas processes da teoria de Watson, que influenciam no estabelecimento da relação de ajuda e confiança no cuidado de famílias de crianças internadas, bem como os benefícios que essa teoria agrega na prática desses profissionais. A partir da compreensão dos enfermeiros sobre esse relacionamento, vimos que o referencial de Jean Watson pode ajudá-los a aproximarem-se da família de forma autêntica, consciente e intencional. Assim, a prática da relação de ajuda e confiança contribui para um melhor gerenciamento do cuidado ao reconhecerem o potencial que esse encontro tem para beneficiar as famílias de crianças no enfrentamento de uma situação de doença. / Nurses have been more aware of the need and commitment in establishing a centred care on the child and their family. However, they recognize difficulties in an initial engagement with the family present at the hospital, hindering the implementation of such practice with them. We believe that strategies to promote this engagement should include the creation of a context which enables nurses and families to establish a reciprocal relationship in which trust, regular communication, honesty, as well as cooperation to attend the families needs, can be guaranteed. Jean Watson\'s Human Caring Theory allows nurses to develop a helping-trusting caring relationship with children and families within the caring context. This study aimed to understand nurses experience about the development of the helping-trusting caring relationship with families of children in pediatric units, in the light of Jean Watson\'s Human Caring Theory. We adopted the descriptive qualitative approach, using the hybrid model of thematic analysis as methodological framework and the Human Caring Theory as a theoretical framework. Data collection occurred in three stages: presentation of theoretical content and support material; experience in helping-trusting relationship; semi-structured interviews, with twelve nurses, from a private hospital in São Paulo. The results pointed to nurse´s intrinsic and environmental factors, related with the caritas process of Watson´s theory, that influence not only the development of a helping-trusting caring relationship with the families of hospitalized children, but also the benefits that this theory brings to nursing practice. From the nurses\' perspectives on this relationship, we noticed that this theory can help them willingly approach the families, with authenticity, knowledge and awareness. Hence, the helping-trusting caring relationship contributes to improve the families´ welfare, when they recognize the benefic potential that this meeting has for the childrens families in facing an illness situation.

Thesis advisor: Dorothy A. Jones / Understanding Chief Nurse Executive (CNE) influence is essential for the discipline of nursing. There are approximately 5000 CNEs in the United States, all are tasked with being the primary identifiable leader representing organizations in which they are employed and the nursing profession of which they are a part. In this capacity, the CNE is the gatekeeper for the advancement of the majority of the 2.4 million nurses practicing in the U.S. Literature suggests that early CNEs lacked influence and often were not recognized members of organizational executive teams. Today, after two decades of struggle, CNEs are identified as essential executive team members. However, they still self identify as being less influential than their C-suite counterparts, leaving us to question, "Having gotten to the table, now what?" This study was designed as an initial step toward answering this question through Validation of the Adams Influence Model (AIM). The AIM is a framework that can be used to understand the influence of the CNE in the acute care setting. The study exposed the AIM to a qualitative data set collected as part of an academic medical center's Survey of the Professional Practice Environment. Directed content analysis was used to categorize survey responses and identify influence content toward validation and refinement of the AIM's operational definitions. Study results validated AIM influence factors and influence attributes with some refinement. In addition to development of a refined AIM, study findings also helped identify continued research opportunities. These research potentials included the exploration of; influence instrument development, the influence process, differences between influence and power, and the relationship between CNE influence, practice/ work environments and patient outcomes. As a discipline, nursing must continue to understand the influence of the CNE. These individuals are leading the profession, at what pace and in what direction cannot be left to chance. / Thesis (PhD) — Boston College, 2008. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O conforto à esperado por toda mulher que entra em trabalho de parto, na forma de ajuda, atenÃÃo, presenÃa e solicitude da enfermeira obstetra e da presenÃa de familiares, do acompanhante, da doula e de toda a equipe que està direcionando para ela toda espÃcie de cuidado. Objetiva-se desvelar o cuidado confortador à parturiente, como meta de enfermagem para a promoÃÃo da saÃde, nos contextos, fÃsico, ambiental social e psicoespiritual. Estudo descritivo, com abordagem qualitativa, sobre o conforto à parturiente que se encontra em trabalho de parto. O local para o desenvolvimento do estudo foi o centro de parto normal de uma maternidade-escola pÃblica de grande porte, em Fortaleza, CearÃ. Os sujeitos foram nove parturientes admitidas ao centro de parto normal, em trabalho de parto, sem apresentar risco obstÃtrico, e que aceitaram por espontÃnea vontade participar do estudo. Os dados foram coletados nos meses de setembro a dezembro de 2009. Foram usadas como tÃcnicas a observaÃÃo livre e a entrevista semiestruturada. Para a manutenÃÃo de registros, usou-se o diÃrio de campo. Para anÃlise dos dados empregou-se o mÃtodo proposto por Bogdan e Biklen (2006). Com o tratamento e operacionalizaÃÃo da anÃlise dos dados, identificaram-se as seguintes categorias: Significado do conforto ambiental, significado de desconforto, significado de sentir-se confortÃvel, significado do conforto recebido. Acredita-se na conscientizaÃÃo dos trabalhadores de Enfermagem quanto à descoberta que a pesquisa revelou. à oportuno que os enfermeiros reflitam sobre o conforto com visÃo ampliada. Conforme os resultados obtidos e jà com a ideia amadurecida, elaborou-se um roteiro identificando as necessidades de conforto nÃo satisfeitas pelas parturientes, deste modo, direcionamos o cuidado de enfermagem obstÃtrica, tendo como foco o conforto à parturiente na promoÃÃo da saÃde no centro de parto normal. A tese defendida atendeu e respondeu ao que foi focado: o conforto como subsÃdio para a constituiÃÃo da prÃtica da Enfermagem ObstÃtrica voltada à parturiente, em uma nova visÃo - a inserÃÃo do cuidado de Enfermagem ObstÃtrica na promoÃÃo da saÃde tendo como base o conforto à parturiente nos contextos fÃsico, ambiental, psicoespiritual e social. / Comfort is expected for every woman going into labor in the form of aid, attention, presence and care of the obstetric nurse and the presence of family, the attendant, the doula and the entire team that is driving her to all kinds of care. It aims to uncover the comforting care for women during childbirth as a goal of nursing to health promotion in the contexts, physical, environmental, social and psycho. A descriptive study, qualitative approach, on the comfort women giving birth that is in labor. The place for the development of the study was the delivery center of a large public maternity hospital, in Fortaleza, CearÃ. The subjects were nine pregnant women admitted to the Birth Center, in labor, without providing obstetric risk, and who agreed to voluntarily participate in the study. Data were collected from September to December 2009. Techniques were used as free observation and structured interviews. For the maintenance of records, it was used the field diary. Data analysis employed the method proposed by Bogdan and Biklen. With treatment and operation of the data analysis yielded the following categories: Significance of environmental comfort, Meaning of discomfort, Meaning of feeling comfortable, Meaning of comfort received. We believe in the awareness of the nursing workers as the discovery that the research has brought. It is appropriate that nurses reflect on the comfort with larger view. Depending on the outcome and has matured with the idea is to draw up a roadmap identifying the needs for comfort not satisfied by pregnant women, therefore, we direct the provision of midwifery care, focusing on the comfort women giving birth in health promotion Birth Center. The thesis argues attended and responded to that was made: the comfort and benefits to make up the practice of Obstetric Nursing focused on the parturient, a new vision - the addition of Obstetric Nursing care to promote health of the mother, based on the comfort women giving birth in physical contexts, environmental, psycho and social.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A dor à frequente em crianÃas com paralisia cerebral (PC), sendo provÃvel que a lesÃo altere a capacidade de compreender e comunicar a dor. Objetivamos compreender a vivÃncia da mÃe/cuidadora frente à dor da crianÃa com paralisia cerebral. Estudo descritivo, qualitativo realizado no NÃcleo de Tratamento e EstimulaÃÃo Precoce (NUTEP) com 21 mÃes/cuidadoras de crianÃas com diagnÃstico de PC tetraparÃtica espÃstica, selecionadas a partir de uma amostra nÃo-probabilÃstica intencional por saturaÃÃo de dados, durante o mÃs de novembro de 2010. Utilizamos, como suporte metodolÃgico, a Teoria de Enfermagem HumanÃstica, seguindo as fases da enfermagem fenomenolÃgica de Paterson e Zderad: preparaÃÃo da enfermeira para vir-a-conhecer; a enfermeira conhece intuitivamente o outro; a enfermeira conhece cientificamente o outro; a enfermeira sintetiza de forma complementar as realidades conhecidas e a sucessÃo interna da enfermeira a partir de muitos para um Ãnico paradoxal. Para a coleta de dados, preparamo-nos previamente atravÃs de leituras, introspecÃÃo, ambientaÃÃo no local do estudo e interaÃÃo com as mÃes. Em seguida, efetivamos a coleta de dados atravÃs da observaÃÃo participante e da entrevista semi-estruturada, registrada por gravador. Para a anÃlise, realizamos leituras exaustivas dos depoimentos, seguidas de leitura analÃtica para sÃntese e comparaÃÃo das realidades conhecidas a partir das quais emergiram as seguintes categorias: reaÃÃes da crianÃa com paralisia cerebral tetraparÃtica espÃstica à dor: o chamado de ajuda; a singularidade do diÃlogo da crianÃa com paralisia cerebral tetraparÃtica espÃstica; reaÃÃes das mÃes à dor da crianÃa tetraparÃtica espÃstica e ausÃncia de dor na crianÃa com paralisia cerebral tetraparÃtica espÃstica. As principais reaÃÃes à dor evidenciadas por relatos das mÃes/cuidadoras foram irritaÃÃo, agitaÃÃo, choro, testa franzida, mudanÃas no movimento e no tÃnus muscular da crianÃa. Percebemos que a comunicaÃÃo nÃo verbal da crianÃa no momento da dor expressa as manifestaÃÃes comportamentais, enquanto que a comunicaÃÃo verbal atravÃs do autorrelato complementa as alteraÃÃes comportamentais com base na confirmaÃÃo da presenÃa de dor e suas caracterÃsticas. As mÃes/cuidadoras reagem, identificando se realmente a dor està presente na crianÃa, bem como procurando sua localizaÃÃo. Para tanto, realizam a observaÃÃo, o toque, avaliam as mudanÃas de comportamento, alteraÃÃes nas expressÃes faciais e questionam a crianÃa onde à a fonte da dor, quando esta consegue indicar ou comunicar-se verbalmente e para aliviar a dor oferecem medicamentos, promovem massagem, fornecem conforto, carinho e contato, e quando nÃo percebem melhora procuram a opiniÃo e ajuda mÃdica. A maioria das mÃes/cuidadoras expressou que se sentem com vontade de chorar, preocupadas, tristes, angustiadas, desesperadas, nervosas e, em geral, descrevem o momento em que seu filho està com dor como horrÃvel, sendo uma das piores situaÃÃes vivenciadas no cuidado. Assim, concluÃmos que a vivÃncia materna frente à dor da crianÃa com paralisia cerebral tetraparÃtica espÃstica se estabelece por meio da interaÃÃo contÃnua entre a dÃade mÃe-crianÃa, quando ocorre identificaÃÃo das reaÃÃes comportamentais e vocalizaÃÃes, caracterizando a comunicaÃÃo, e da realizaÃÃo de medidas de alÃvio farmacolÃgicas e nÃo-farmacolÃgicas, envolvidas por sentimentos da mÃe que perpassam a preocupaÃÃo, medo, angÃstia e culpa.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 76-81). Also available on the Internet.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 125-141). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Thesis (Ph.D. in Nursing) -- University of Colorado, 2005. / Typescript. Includes bibliographical references (leaves 225-249). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;