The concept of theme is critical to the accurate interpretation of qualitative data. A literature review of qualitative research methodology and nursing research studies reveals considerable diversity in the identification of themes, the interpretation of the concept, and its function in data analysis. Part of the problem is the transfer of research methods from other disciplines to the study of nursing phenomena. The transfer often results in a blending of distinct research methods that compromises methodological rigor in data analysis and theory generation. A definition of theme is developed from the literature review and interdisciplinary definitions and descriptions. Five aspects of a theme and criteria foundational to the definition and concept of theme are identified. Implications of the concept of theme are presented for the conduct and application of research findings to the practice and development of nursing science.
Cultural competence in nursing education is receiving renewed emphasis. Curricular input to incorporate such knowledge, attitudes, and skills encompasses a wide variety of teaching and learning methods. Five are described here: specialty focus, required courses, models, immersion experiences, and distance learning or simulation. Despite progress in incorporating cultural content into nursing curricula, several issues characterize all levels of nursing programs, including lack of consensus on what should be taught, lack of standards, limited and inconsistent formal evaluation of effectiveness, a decline of curricular specialty courses on culture, a focus on the microlevel of the nurse-patient encounter, and the need for, support of, and preparation of faculty.
A taxonomy of the adolescent sibling bereavement process was developed from the responses of 157 bereaved adolescents to the question "If you could ask or tell your dead sibling something, what would it be?" The taxonomy had six mutually exclusive categories: regretting, endeavoring to understand, catching up, reaffirming, influencing, and reuniting. Pervasive throughout the taxonomy was the theme of "ongoing attachment"; that is, the emotional and social bond with the deceased sibling remains continuous throughout the bereavement process. The notion of ongoing presence illustrates the timelessness of adolescent bereavement and the infiniteness of the sibling bond. The phenomena of "ongoing presence" and timelessness challenge current medical science conceptualizations of bereavement that postulate that grief is time bound and that healthy recovery depends on severance of emotional bonds with the deceased. Qualitative and quantitative studies are needed to develop a substantive theory of adolescent sibling bereavement that is developmentally appropriate, accounts for variability by cause of and circumstances surrounding the death, and is culturally relevant.
Bach ® Original Flower Essence (BFE) Rescue ® Remedy, a modality used since 1930 but not yet thoroughly investigated scientifically, was evaluated for the reduction of acute situational stress. A double-blind clinical trial comparing a standard dosage of BFE Rescue Remedy against a placebo of identical appearance was conducted in a sample of 111 individuals aged 18 to 49, randomized into treatment (n = 53) and control (n = 58) groups. The Spielberger State-Trait Anxiety Inventory (STAI) was administered before and after the use of Rescue Remedy or placebo. Downward trends in anxiety level measurements were discovered in both the treatment (Rescue Remedy) and control (placebo) groups. Statistical analyses indicated that only the high-state anxiety treatment subgroup demonstrated a statistically significant difference between pretest and posttest scores. The results suggest that BFE Rescue Remedy may be effective in reducing high levels of situational anxiety.
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