Until recently patients were expected to be the passive recipients of nursing care. This passive role has been changing, and nurses are now being actively encouraged to promote the inclusion of patients in decision-making. However, this stance is being taken with very little empirical evidence to support it, and the evidence that does exist appears to indicate that patients do not always welcome this more active role. A modified grounded theory approach was utilized in order to discover how patients feel about participating in decision-making about nursing care. Eight informants were interviewed informally, 7-10 days following discharge from hospital after undergoing surgical intervention. A state of category saturation was not achieved and the analysis of the data can only tentatively suggest the existence of three 'second order' categories that describe situations that effect patient choice and participation in decision-making about their nursing care. The first category, 'If I am well enough...', describes the states of 'Being too ill' to be involved in decision-making to 'Being well' which allows greater involvement. The second category, 'If I know enough...', describes situations that, first, require technical knowledge, 'Nurse knows best', where patients prefer to take a passive role in decision-making; secondly, less technical matters about which patients require information but still prefer to be passive; and finally an 'I know best' situation where patients prefer to be actively involved in activities of living. The third category, 'If I can...', describes the organizational constraints or freedom that can either restrict or encourage choice and participation in decision-making. Limitations and recommendations that arise from the study are discussed.
When a life is struck by cancer the very foundations of that life are shaken. The safety of 'everydayness' is replaced with a fear and uncertainty of tomorrow and the human need to make sense of life is the driving force behind coping. After initial diagnosis patients must begin to piece together their lives and build new and stronger foundations. This paper identifies a growing awareness of the role that narratives can play in helping cancer patients cope with their illness. Narratives can be used to objectify and distance oneself from problems in order to gain understanding, establish meaning, develop greater self-knowledge and decrease emotional distress. This review concludes that narratives can help patients cope with their cancer and urges nurses to incorporate the use of narratives into their practice.
There is mounting evidence to suggest that those who keep pets are likely to benefit from various improvements in health. Despite founders of nursing such as Florence Nightingale advocating the importance of animals within the care environment, their integration into hospitals and other health care settings has been slow. The literature on animal-induced health benefits is reviewed and the conclusion is drawn that the potential benefits of pet therapy are considerable. It is suggested that nurses can assume an active role in advocating ward pet or pet-visiting schemes.
This article, from a keynote address, is the result of some of the things which I learned about qualitative research during my many years of doing and teaching it. The main point I make is that qualitative researchers should present a good story which is based on evidence but focused on meaning rather than measurement. In qualitative inquiry, the researchers' selves are involved, their experiences become a resource. Researchers cannot distance themselves from the other participants, although they cannot fully present their meaning and experience. I also discuss voice, paradigm, and innovation as potentially problematic issues in qualitative research. These are terms often used but not always examined for their meaning in qualitative inquiry. If researchers are aware and sensitive, rather than overemotional or self-absorbed, qualitative research can be enlightening, person-centered, and humanistic.
The widespread inclusion of companion animals into the homes and lives of humans has prompted a considerable amount of research into the health benefits of such relationships. Findings seem to confirm that if humans interact with companion animals they are likely to experience various health benefits. Programmes that encourage and facilitate pet visiting schemes in hospitals have developed and animals can often be found in in-patient and long-term care facilities, with the aim of contributing towards a positive therapeutic milieu. Despite supportive research evidence, the adoption of such a therapeutic activity may have been restricted by the belief that client safety could be compromised by an increase in the risk of infection acquired from animals, allergic responses and bites. This paper explores the literature on these risks and concludes that, in a controlled health care environment in urban Europe or North America and with responsible human behaviour the potential benefits of sharing our lives with companion animals, either at home or hospital, far outweigh the apparently insignificant risks. Recommendations aimed at limiting the potential risk of infection and guidelines for the safe management of pet therapy are developed.
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