Using grounded theory methodology, six intensive care patients were interviewed regarding their perceptions of their own needs, concerns and wants and how nurses responded to those. Each patient was interviewed three times to detect any change in responses during the hospitalization. A theme of patient-nurse negotiation emerged. Patients came into the health care setting with a "generative source," the issues and beliefs they had regarding health-care and nurses in general. This affected patients' definition of themselves, their situation, the caregiver, their relationship with the caregiver, and their own needs and expectations. When a patient's definitions of self or situation varied form the nurse's, negotiation would occur. Two main categories of negotiation were used by both patient and nurse: Personal knowledge & Strategies. If negotiation failed to bring consensus, resulting actions were negative feelings and dissatisfaction, and a sense of vulnerability for the patient. This in turn impacted negatively on the patient's generative source and definitions. As the patient progressed through the hospital system toward discharge, the greatest changes were noted in how they defined themselves and the caregiver, and in the style of negotiation they used.

The primary purpose of this study was to describe relationships between the concepts of caring behaviors of nurses, adolescent hopefulness and adolescent health care outcomes. The secondary purpose was to test and refine instruments developed to index those concepts. The conceptual framework used for the study was derived from two sources: an existential theory of nursing, Humanistic Nursing, as developed by Paterson and Zderad (1976). and a set of inductive studies on nurse-adolescent patient interactions (Hinds, 1983). A longitudinal, descriptive-correlational design having three data collection points was used. The study sample consisted of 25 adolescents (x age 15.6 years) receiving inpatient treatment for substance abuse. The data collection points occurred at 24-48 hours after admission (T₁), 96-120 hours before discharge (T₂), and 4-5 weeks after discharge (T₃). Adolescents completed visual analogue instruments and responded to a set of open-ended questions indexing the study concepts. Instrumentation data were analyzed using descriptive and correlational statistics and tests of significance for change. Qualitative data resu1ting from the interviews were content analyzed. Findings included statistically significant positive relationships between the concepts of caring behaviors of nurses and adolescent hopefulness at T₁, and T₂. Secondly, the relationship between adolescent hopefulness and adolescent health care outcomes was statistically significant at T₃. The concepts of caring behaviors of nurses and adolescent hopefulness changed significantly in a positive direction from T₁ to T₂. Content analysis findings indicated the concept of adolescent hopefulness was qualitatively different at each of the data collection points. Findings provide support for the theorized link between nurse-patient relationships and positive patient change. The purposeful use of a caring self for positive patient change represents the blend of art and science that defines the nursing profession.

D.Cur. / Lifecare, like any other corporate business, in the current environment, has to change all the time. Companies need new customers, innovative products, expanded market and cutting edge technologies. The Company has the potential to shape the behaviour, reinforce common beliefs, and encourage members to apply their efforts to accomplish important Company objectives of providing care for chronic mentally ill patients. The psychiatric nurses are therefore an essential requirement for the success of the Company in a competitive environment. On the other side, psychiatric nurses face the difficult task of confronting the challenges involved in the nature of care required among chronic psychiatric patients. Whilst striving for quality patient care, they find themselves faced with some breakdowns within the environment in which they are interacting, resulting in their resorting to negative media publicity. This type of publicity can lead to damaging the Company’s reputation and can retard the Company’s growth strategy, which the psychiatric nurses might not seem to understand. There was also high staff turnover which hampered quality patient care. This could also affect the Company in terms of what affects the competitiveness of the quality care which the Company aims to deliver. The researcher believes that for clinical care to take place, psychiatric nurses need to be in sound mental health and understand the dynamics within the Company in order to deal with it in an effective way. The following research questions posed were addressed in this research: • What are the psychiatric nurses’ experiences whilst being employed by the Company? • In what way can the formulation of the model be of assistance in the promotion of the psychiatric nurses’ mental health as an integral part of health? The research objectives were: • To explore and describe the experiences of the psychiatric nurses whilst employed by Lifecare.• To use the results to generate the concepts for the model that would serve as a framework for the psychiatric nursing specialist to facilitate the implementation of guidelines that would assist the psychiatric nurses to be in a sound mental state. • To describe the guidelines that would serve as a framework for operationalising the model in nursing education, psychiatric nursing practice and nursing research. Methods to ensure trustworthiness were ensured throughout this research. Ethical consideration as outlined in the Position Statements published by the Democratic Nursing Association of South Africa (1998: 2-21), was adopted. The researcher utilized the assumptions of the Theory for Health Promotion in Nursing in this research. This theory focuses on the whole person, that is, the mind, body and spirit as well as on the parameters of nursing and the beliefs about the person, health, illness and nursing. The emphasis in this theory is on mental health promotion of the psychiatric nurses within the Company. This research consisted of three stages as follows: In stage one a qualitative design was used to explore and describe the psychiatric nurses’ inner world experiences of the Company’s culture. Indepth semi-structured interviews were utilized to obtain data from these psychiatric nurses. These interviews were conducted by an independent interviewer, and were audio-taped. These were transcribed and were analysed by the researcher. Tesch (1990) in Cresswell (1994: 154) outlined eight steps, which are referred to as decontextualisation and contextualisation, which were adopted in analyzing the results. A description of the results was given. This was followed by literature control which highlighted the similarities to and contributions to this research. Themes that emerged highlighted the experiences that the psychiatric nurses had of the Company culture which affected their mental health. In stage two the research design and theory generation was employed to formulate a model which could be used in nursing education, nursing research and nursing practice. The model formulated was based on the resultsobtained on the inner world experiences of psychiatric nurses. A combination of stages of theory generation by Chinn and Kramer (1991:79-104) and Dickoff, James and Wiedenbach (1968: 431-434) were employed by the researcher to identify the central concepts that guided the identification of the main theme. A tentative model was formulated and was submitted to the independent experts for consultations and clarification. The model was named and presented in its final form to the independent experts. In stage three the researcher formulated the guidelines for operationalising the implementation of the model in clinical practice, nursing education and recommendations were made for further research.

M.Cur. / Currently an increasing awareness of human rights exists in South Africa, which can be ascribed to fundamental human rights being spelt out in the Constitution of the Republic of South Africa, 1993 (Act number 200 of 1993). Events such as strikes by nurses presently focus the attention on human rights in health care. Incompatibility between the rights of the nurse and those of the patient leads to conflict. However, rights should not be perceived in isolation and, of necessity, they entail explicit or implied responsibilities ...

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Laurie Grubbs, Florida State University, School of Nursing. Title and description from dissertation home page (viewed June 16, 2004). Includes bibliographical references.

Thesis (D.N. Sc.)--Catholic University of America. / Typescript. eContent provider-neutral record in process. Description based on print version record. Bibliography: leaves 279-290.

Thesis (Ph. D.)--New York University, 1972. / Includes bibliographical references (leaves [69]-81).

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