Registered nurses who return to school in a nurse practitioner program undergo role transition throughout the educational process and into the postgraduate period. This study examined the role transition that occurs in family nurse practitioner (FNP) students. A descriptive, qualitative design was used with in-depth telephone interviews of 9 female FNPs who had recently graduated. A conceptual model was generated that described the role transition from RN to FNP. Two phases of role transition occurred and were depicted by the central categories that emerged: extrinsic obstacles, intrinsic obstacles, turbulence, positive extrinsic forces, positive intrinsic forces, and role development. Although the central categories were found to be the same in Phase I and Phase II, the defining characteristics differed. This study has implications for FNPs, students, and educators regarding role transition. It presents new findings not identified in prior research: personal commitments and sacrifices were identified as specific obstacles encountered during the educational process, and differences were found between inexperienced and experienced RNs in relation to the FNP role transition during the educational period.
Data extracted from health records are commonly used in studies to address a variety of questions raised by health researchers. However, concern about the reliability and validity of such data generally is limited to an assessment of interrater reliability. Less attention has been paid to the reliability of the health record itself, and to the validity of both the health record and the data extracted from it. This article reviews the distinctions and overlaps among these types of reliability and validity and the factors that influence the validity and reliability of research data obtained from health records. Recommendations to investigators who use health record data in their research projects are offered.
Health diaries have been used in research and clinical practice to examine the daily symptoms of healthy and ill people, responses to symptoms, and efficacy of symptom response. This article describes current uses of health diaries in nursing research and practice, the types of typical health diaries, factors affecting the quality of diary data, and the costs and analytic issues related to health diaries. The implications of health diaries for nursing education, practice, and research are considered.
Less than 20% of stroke survivors enter rehabilitation or long-term care facilities after their stroke. Stroke recovery is extremely variable and the resulting uncertainty places a heavy burden on the survivors' family caregivers. According to the trajectory framework, chronic conditions have a defined course that can be shaped and managed. This grounded theory study, part of a larger research project, explored the expectations of family caregivers of the stroke trajectory and their management strategies. Thirteen family caregivers of stroke patients in a sparsely populated area participated in semi-structured interviews. The caregivers were without ideas about what the recovery of their loved ones would be like and had difficulty making projections about the trajectory. They used several strategies, however, in attempts to manage the stroke trajectory. They constructed a positive recovery, reconstituted family life, maintained family routines, created a safety net, and redoubled self-reliance. The findings have implications for how nurses support family caregivers of stroke survivors.
Despite changes in social and cultural structure, the family has remained a consistent provider of in-home care needs for the chronically and terminally ill. The experience of a terminal illness is not limited to the individual patient and creates a myriad of challenges for the family, including the struggle to adjust and respond to the demands of the situation. The purpose of this study was to assess the caregivers' sense of emotional well being and their ability to transcend and find meaning in the caregiving experience. The participants in this study were all caregivers of a family member who had died six to 12 months prior to the interview. They were able to find meaning as a result of their caregiving experience within the context of supportive networks, caregiving actions, grief and loss, fatigue, financial burdens and multiple challenges. Finding meaning involved "being with" or "doing for" their loved one as death approached. Finding meaning had positive consequences for the caregivers. They described a new life view and were able to reach out to help others as a result of their caregiving.
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