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Biomedical subjects

Donna Schwartz-Barcott

Publications and source records attributed to Donna Schwartz-Barcott.

9 recordsLinked to original sources
PubMed2006

Pain assessment in the perspective of action science.

Pain assessment is examined in the perspective of action science with the aim to discover espoused theories and theories-in-use for pain assessment. In action science there are 2 sets of theories of action: espouse theories and theories-in-use, which often exist in practice inconsistently with each other resulting in haphazard actions. Espoused theories of pain and pain assessment and a set of theories-in-use were revealed. Alignments between the espoused theories and the theories-in-use, and disparities between these theories were found in the pain assessment situations. The findings point to possible explanations regarding problems in pain assessment, and provide insights into our understanding of nursing practice especially in relation to pain assessment.

Attitude of Health Personnel↗
PubMed2005

The nature of hope in hospitalized chronically ill patients.

BACKGROUND: Hope as a universal human phenomenon has been studied from various perspectives often conceptualized as having a unified set of attributes. In this study however hope is viewed to be experienced by people in various patterns structured by different orientations and emphases depending upon their life circumstances. There is a paucity of studies in the literature examining patterns of hope experienced by people in chronic illness or in special life circumstances. OBJECTIVES: The aim of this study was to discover patterns of hope in hospitalized chronically ill patients and to identify the major threads that structure various patterns of hope experienced by them. DESIGN: Q-methodology, which is an approach designed to discover patterns in various subjective experiences, was used as the method for data collection and theory generation. Q-methodology involves five steps in its approach, the first two as the first phase and the last three as the second phase. The study was carried out at a general acute-care, tertiary hospital in a New England state in the US. The study obtained data from a convenient sample of 12 chronically ill patients and 16 oncology nurses for the first phase, and a different convenient sample of 20 chronically ill patients for the second phase. RESULTS AND CONCLUSIONS: Five patterns of subjective experiences of hope emerged as: (a) externalism orientation, (b) pragmatism orientation, (c) reality orientation, (d) future orientation, and (e) internalism orientation. This means that chronically ill patients experience hope in various ways by focusing on different dimensions of meaning, suggesting the conceptualization of hope as a unitary construct may not reflect people's experiences of hope accurately. The major implication of the study is to rethink ways to assess patients' hope in terms of pattern differences rather than in terms of quantity.

Activities of Daily Living↗
PubMed2005

Strategies of pain assessment used by nurses on surgical units.

The purpose of this study was to identify the criteria nurses actually used to assess postoperative pain and the kind of knowledge they drew on from past experience. A series of semistructured interviews were performed with 10 nurses while they conducted pain assessments with 30 postsurgical patients. Data were analyzed on the basis of Dahlgren and Fallsberg's (1991) analytic approach called phenomenography. Findings were compared with Sjostrom's 1995 study of nurses in Sweden. Nurses in this study, much like the group in Sweden, used three categories of criteria (i.e., how the patient looked, what the patient said, and experience with similar circumstances) and drew on their past experiences in four different ways (i.e., in terms of a typology of patients, a focus on listening to patients, what to look for, and what to do for patients) when assessing postoperative pain. In the most frequently reported strategy, nurses relied on criteria related to the patient's appearance and drew on their past experience in terms of what physical signs to look for (e.g., facial expressions, bodily movement, and heart rate). The variety of strategies used by nurses in this study opens an avenue for further investigating the linkage between underlying conceptions of pain (as essentially subjective vs. objective phenomenon) and the quality and effectiveness of nurses' assessments of pain and its management in postoperative and other contexts across nursing.

Attitude of Health Personnel↗
PubMed2002

From practice to theory: tightening the link via three fieldwork strategies.

BACKGROUND: Theory that is directly linked with clinical experience has far greater relevance for nursing practice; however, problems continue to persist with the establishment of that linkage. The use of fieldwork as a strategy for developing and linking theory has enormous potential for enhancing the number of theories that truly fit the clinical practice realities of nursing. Traditionally, fieldwork has been conducted in contexts that are unfamiliar to the researcher. However, nurses have a wealth of clinical understanding in their areas of practice. Conduct of inquiry in a familiar practice area may facilitate identification of significant, clinically relevant concepts and expedite theory development that is closely linked to nursing practice. AIM OF THE PAPER: wo-step fieldwork approach and three specific strategies are presented that have been found useful for developing theory that is tightly aligned with nursing practice. The strategies of theoretical selectivity, theoretical integration, and theory creation are described and an example of each presented. The strategies are an extension of the Hybrid Model of Concept Development. These strategies identify alternative paths for concept clarification and theoretical congruence through fieldwork in clinical settings. The focus of theoretical selectivity is elaboration of concept definition with selection among theories. In contrast, the focus of theoretical integration is the linking of a central concept with an existing theory or perspective in the prefieldwork phase and then using the full fieldwork to evaluate its usefulness. Lastly, the theory creation strategy emphasizes describing a phenomenon of interest, identifying influencing factors, and beginning to create relational statements. It is closest to standard inductive theory development.

Anthropology, Cultural↗
PubMed2002

The conceptual structure of hwa-byung in middle-aged Korean women.

The term hwa-byung (HB) as a culture-bound syndrome of Koreans has been used to refer to certain types of symptom complexes. However, there is an ambiguity in relation to what sorts of experiences and personal attributes can be identified for describing HB. Our study was designed to reexamine the conceptual structure of HB through a qualitative analysis of interview data with six middle-aged women experiencing HB. The emerging common themes of HB were identified in three dimensions: (a) those related to personal attributes or life situations such as quick-temperedness, strong commitment to traditional values, a hard or unhappy life, and conflicted marital relationship; (b) those related to experiential accounts such as deep sorrow (hahn in Korean), a feeling of victimization, anger, and enduring; and (c) HB symptoms. "Enduring" as one of the core concepts of HB viewed as the only way of life for these women needs further examination.

Anger↗
PubMedDate not supplied

Behavioral maintenance: a closer look.

TOPIC: Behavior maintenance. PURPOSE: To discover the descriptive picture of how an individual with type 2 diabetes self-managed and adapted the necessary behavior changes into her daily lifestyle. SOURCES: Personal research and literature review. CONCLUSION: Behavioral maintenance to self-manage a specific regimen for people with type 2 diabetes is complex and difficult. It is important for nurses "not to jump to conclusions" and assume the client has not made the necessary changes to incorporate the behavior changes into a life style routine. Nurses need to be cognizant of the differences and unique situations of their clients when teaching them about managing their disease.

Attitude to Health↗
PubMedDate not supplied

Visiting hours in the ICU: finding the balance among patient, visitor and staff needs.

TOPIC: Visiting hours. PURPOSE: To explore the experience of nurses who have been identified as experts at working with visitors in a critical care setting. METHODS: A qualitative research design incorporating in-depth interviews of eight intensive care nurses, limited participant observation, and a review of selected documents was used to investigate how expert nurses incorporate visitors into their daily practice. CONCLUSION: Incorporating visiting family members in to the plan of care is complex and requires balancing the visitors' needs for information and access to a loved one with the nurse's need to safely manage the care of a critically ill individual.

Critical Care↗
PubMedDate not supplied

Overcoming obstacles to behavior change in diabetes self-management.

PURPOSE: This study describes how 5 individuals with type 2 diabetes overcame obstacles that interfered with maintaining behavior changes in diet, exercise, and self-monitoring of blood glucose (SMBG). METHODS: In-depth interviews provided the framework for this descriptive study. During audiotaped, face-to-face, follow-up structured and unstructured interviews, the participants shared their experiences about obstacles encountered and strategies used to overcome them. Each case was examined independently, and all cases were then compared with each other. RESULTS: Obstacles that interfered with maintaining a diet plan were hunger, planned and unplanned meal events, and the desire for new foods. Physical illness and unexpected life events were obstacles to maintaining an exercise and SMBG plan. CONCLUSIONS: Health professionals who assist patients who are beginning behavior change or having difficult maintaining changes need to have an understanding of the various obstacles and how patients can maintain behavior changes over time.

Behavior↗