RESUMEN
The overall purpose of this qualitative study was to describe how patients with AIDS (PWAs) transcend the emotional and physical suffering of their illness. Content analysis of the interviews of 5 PWAs resulted in 3 main themes: creating a meaningful life pattern, connectedness, and self-care. The results of this study provide presumptive evidence that PWAs can transcend the suffering associated with a life-threatening illness and live meaningful and productive lives. Nurses who anticipate actual and potential growth in PWAs will be able to validate such experiences and feelings and encourage further development.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/psicología , Adaptación Psicológica , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pennsylvania , Satisfacción Personal , Autocuidado , Apoyo SocialRESUMEN
A study was undertaken to describe the meaning, process, and consequences of nurse caring from the perspective of persons with spinal cord injuries (SCI) during rehabilitation. The constant comparative method, or grounded theory, was used in this prospective, exploratory project. In-depth tape-recorded interviews were conducted with 22 participants throughout their initial rehabilitation stay. A process of knowledge acquisition and decision making, facilitated by nurses and therapists in special caring relationships with the persons with SCI, resulted in outcomes of well-being, self-care, autonomy in decision making, independence, and hope, all of which contributed to the persons with SCI's reintegration of self before their discharge from inpatient rehabilitation.
Asunto(s)
Empatía , Relaciones Enfermero-Paciente , Satisfacción del Paciente , Enfermería en Rehabilitación/métodos , Traumatismos de la Médula Espinal/enfermería , Traumatismos de la Médula Espinal/psicología , Actividades Cotidianas , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Metodológica en Enfermería , Autocuidado , Autoimagen , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
Pulmonary complications are the major contributor to mortality and morbidity following spinal cord injury (SCI), especially during the first year. Patients who are at increased risk of pulmonary complications include SCI individuals with cervical and high thoracic injuries, patients with unstable injuries who must be immobilized, patients with multiple injuries and individuals over the age of 65 years. Although research exists on many of the elements of pulmonary hygiene, there is a paucity of systematic research linking therapeutic interventions with patients outcomes during the acute phase following SCI. This area is rich for the development of collaborative empirical studies which contribute to the science of preventing pulmonary complications following acute SCI. Research is needed which tests specific pulmonary hygiene protocols in relation to patient outcomes during the acute phase of SCI and in the early months after the patient returns home.
Asunto(s)
Neumonía/enfermería , Atelectasia Pulmonar/enfermería , Insuficiencia Respiratoria/enfermería , Traumatismos de la Médula Espinal/enfermería , Terapia Combinada , Humanos , Traumatismo Múltiple/complicaciones , Traumatismo Múltiple/enfermería , Evaluación en Enfermería , Neumonía/prevención & control , Atelectasia Pulmonar/prevención & control , Insuficiencia Respiratoria/prevención & control , Traumatismos de la Médula Espinal/complicacionesRESUMEN
The establishment of special caring relationships between spinal cord injured individuals (SCI) and nurses or therapists during rehabilitation creates unique ethical dilemmas. This paper will explore the practical and ethical implications for health care professionals who feel a moral imperative, compelled by their special relationship with a particular SCI individual, to "break the rules" within a rehabilitation bureaucracy in order to provide individualized health care. From the staff perspective two issues will be examined: the status of special relationships in a health care organization and the ability to maintain one's personal and professional standards in a managed care environment. From the administrative perspective two ethical issues will be explored: the challenge of pursuing the good of the patient and the organization while navigating between the public and private spheres of health care in a health care system that values standardization.
Asunto(s)
Ética en Enfermería , Relaciones Enfermero-Paciente , Personal de Enfermería en Hospital/normas , Rehabilitación/enfermería , Conflicto Psicológico , Humanos , Enfermeras Administradoras , Investigación Cualitativa , Rehabilitación/normas , Estados UnidosRESUMEN
Nurses and other healthcare providers have little research to guide them on specific interventions and attitudes which expedite the attainment of rehabilitation outcomes by spinal cord injured (SCI) individuals and their successful return to the community (Fuhrer, 1994; Whiteneck, 1994). Acquisition of knowledge is required during rehabilitation to learn self-care and decision-making which is essential to long term survival following SCI. However, skills that patients and families are able to accomplish in rehabilitation are often not able to be translated into the home environment (White & Holloway, 1990). The process of learning self-care and decision-making needs to be more clearly elucidated, so more effective interventions can be designed which can improve problem-solving and lead to enhanced well-being and quality of life. The purpose of this qualitative study was to describe the meaning, process and consequences of caring during rehabilitation from the perspective of the SCI individual. This paper will report on the findings from one research question: How is the process of a developing caring relationship perceived by SCI individuals during rehabilitation? The theoretical foundation of caring for this study was synthesized from philosophical, ethical, feminist, and nursing literature. A purposive sample of adults with traumatic SCI were interviewed at least once during their initial rehabilitation stay. Twenty interviews were conducted with fifteen participants at various times during their rehabilitation stay over a six month period. The core category of "getting back together" or reintegration of self, which was the major work of rehabilitation, was accomplished with nurses and therapists who were perceived as caring. The process of a developing caring relationship was conceptualized, from participants' descriptions in three phases: learning the other, learning what I need to know, and letting me find out. During each phase reciprocal behaviors occurred between the patient and the caregiver resulting in intermediate outcomes, which facilitated movement to the next phase. Consequences of these caring relationships were: well-being, self-care, autonomy, independence, and hope. Caring by rehabilitation professionals was perceived by SCI individuals as central to recovery and to a positive attitude toward disability.
Asunto(s)
Actitud Frente a la Salud , Toma de Decisiones , Empatía , Relaciones Enfermero-Paciente , Educación del Paciente como Asunto , Participación del Paciente , Traumatismos de la Médula Espinal/psicología , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Metodológica en Enfermería , Traumatismos de la Médula Espinal/enfermería , Encuestas y CuestionariosRESUMEN
Continuous cerebral blood flow monitors are being used in critically ill neuroscience patients to assess blood flow in vulnerable regions of the brain and to evaluate the effects of treatments on these areas. Neuroscience nurses need to interpret cerebral blood flow values in relation to the many other physiologic parameters which are monitored in this population. Case studies are used to illustrate various patterns of regional blood flow in response to brain insults and therapeutics. Research implications of continuous cerebral blood flow monitoring are explored.
Asunto(s)
Lesiones Encefálicas/fisiopatología , Isquemia Encefálica/fisiopatología , Encéfalo/irrigación sanguínea , Ataque Isquémico Transitorio/fisiopatología , Monitoreo Fisiológico/enfermería , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Velocidad del Flujo Sanguíneo/fisiología , Lesiones Encefálicas/enfermería , Isquemia Encefálica/enfermería , Femenino , Humanos , Ataque Isquémico Transitorio/enfermería , Masculino , Persona de Mediana Edad , Examen Neurológico , Evaluación en Enfermería , Complicaciones Posoperatorias/enfermería , Complicaciones Posoperatorias/fisiopatología , Valores de ReferenciaRESUMEN
Understanding the contribution of clinical nurse specialists (CNSs) to quality patient care is important for educators and administrators as they plan for the care of patients in an increasingly complex health care system. The purpose of this study was to describe the clinical practice of CNSs as reported by practicing CNSs. Grounded theory methodology was used in collecting and analyzing the data. The subjects consisted of a theoretical sample of 17 Master's prepared CNSs who had functioned in the role of the CNS for a minimum of 1 year, and three recorded case studies from the literature. In-depth, semi-structured interviews were conducted by the principle investigator. Using the constant comparative method, the data were line-coded and clustered to form groups of data that could be labeled as constructs. When theoretical saturation was reached, no further interviews were conducted. The investigators proposed that caring was the basic social psychological process (BSP), which was validated in a literature review. Scientific caring included investigating and teaching. Humanistic caring included creating-the-new, showing-the-way, working-with-others, and taking-care-of-the-environment. CNSs took care of the caretakers as well as the patients and their families.