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Biomedical subjects

J L Bottorff

Publications and source records attributed to J L Bottorff.

At least 37 records · Page 2Linked to original sources
PubMed1995

Comforting: exploring the work of cancer nurses.

In a study to identify and describe nurses' use of comforting strategies, techniques of qualitative ethology were used to analyse videotaped recordings of nurse-patient interactions on an active cancer treatment ward. Comforting strategies nurses were observed to use included gentle humour, physical comfort measures, emotionally supportive statements, and comforting and connecting touch. In addition they increased physical proximity, provided patients with information, supported patients' active participation in decisions regarding their care, and offered opportunities for patients to engage in social exchange. These strategies appeared to play a major role in helping cancer patients endure the discomforts associated with their illness and/or treatment. Various combinations of comforting strategies were used in four different contexts, including: helping patients put experiences into perspective; helping them stay in control; providing opportunities to function as normally as possible; and providing emotional support. The findings of this study support conceptualizations of comforting that extend beyond measures related to symptom control and indicate that comforting strategies used by cancer nurses comprise a significant part of their work.

Adaptation, Psychological↗
PubMed1994

The interaction effects of gender within the health promotion model.

A male-female stacked version of Pender's Health Promotion Model (HPM) was used to evaluate whether the causal mechanisms underlying health promotion behaviors are the same for men and women. Indicators of the conceptual variables in the HPM were obtained from the National Survey of Personal Health Practices and Consequences, 1979-1980--a telephone sample survey of 3,025 noninstitutionalized adults. All coefficients to be estimated were initially constrained to be equal for men and women, except for six direct effects originating from marital status. The estimates obtained via the LISREL VI program indicated that the stacked model did not fit the data and that additional gender interactions were required between gender and other concepts within the HPM. Based on model diagnostics and with the relaxation of some equality constraints, a modified stacked model was constructed that fit the data. The explanatory power of the model was poor, calling into question the validity of the HPM. Theorists and researchers of health promotion should not assume that the causal mechanisms underlying health promotion behaviors in men and women are identical, but must forge ahead with an exploration and clarification of possible differences.

Adult↗
PubMed1994

The phenomenology of comfort.

From patient narratives, the phenomenological literature and reflection of patients' autobiographical accounts of illness, nine themes reflecting the phenomenological concept of corporeality were used to identify the ways patients achieve comfort. The themes were: the dis-eased body, the disobedient body, the vulnerable body, the violated body, the resigned body, the enduring body, the betraying body and the betraying (neurotic) mind. The process of achieving comfort is based on the patients' needs to live with illness or injury without being dominated by their bodies. The authors argue that while the role of nursing is to provide comfort to the sick, the goal of total comfort is unattainable in patient care. However, if the goal is to enhance comfort, to ease and to relieve distress, comfort remains central to the role of nursing.

Adaptation, Psychological↗
PubMed1994

Identifying types of attending: patterns of nurses' work.

Verbal and nonverbal behaviors of nurses during interactions with cancer patients were examined by analyzing videotapes of caregiving. Using techniques of qualitative ethology, four types of attending were identified: doing more, doing with, doing for, and doing tasks. The findings provide support for an alternative method of classifying nurse-patient interactions that captures patterns of caring.

Communication↗
PubMed1994

Development of an observational instrument to study nurse-patient touch.

A detailed analysis of videotaped data of nurse-patient interactions (NPIs) was used to identify the structure of NPIs and the important behaviors comprising touching interactions that could serve as a basis for the development of an observational instrument to study nurse-patient touch. The resulting coding system enabled observers to record types of nurse attending, eye gaze, proximity, nurse-patient dialogue, nurse activity, patient condition, presence of others in the room, and characteristics of nurse-patient touch. To evaluate this instrument, two samples of videotaped NPIs were selected and coded by three observers. Acceptable levels of interobserver and intraobserver agreement and observer reliability were established and maintained throughout the coding process, with the exception of two categories (i.e., nurse activity and intensity of touch). The two samples were compared to provide further support for the content validity of the coding system and to evaluate the sensitivity of the measure to the same behaviors in different samples of NPIs. It was concluded that this instrument has potential for use in describing the patterns of touch nurses use in a more comprehensive and detailed way than has been done in the past and that this instrument warrants further study in other clinical contexts.

Clinical Nursing Research↗
PubMed1992

Exploring empathy: a conceptual fit for nursing practice?

After three decades, the efficacy of empathy in the clinical setting remains undocumented. Recently, concerns have been raised that the concept may be inappropriate and even harmful to the nurse-patient relationship. An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain phases of the illness experience. Directions for future research are suggested.

Behavior↗
PubMed1991

Nursing: a practical science of caring.

Knowledge development related to caring is examined from the epistemological perspective of nursing as a practical science. Four stages of knowledge development for a practical science of caring are proposed and then used as a basis for evaluating efforts to develop a body of knowledge related to caring. Issues that need to be addressed to facilitate the advancement of nursing as a practical science of caring are identified.

Humans↗
PubMed1990

The use of ethology in clinical nursing research.

Although the pragmatic implications for observational research in nursing are profound, these techniques are underused. In this article the methods of ethology, or the systematic detailed study of behavior, and its application to clinical nursing research are described. The authors suggest that ethology may be used to explore behavior in cognitively impaired, elderly patients, psychiatric patients, and infants. The authors also suggest that ethology is suited for examining subconscious or transitory phenomena, such as pain responses, that are unsuited to self-report methods.

Clinical Nursing Research↗
PubMed1990

Concepts of caring and caring as a concept.

If caring is to be retained as the "essence" of nursing, and if research in this area is to advance, then the various perspectives of caring must be clarified, the strengths and the limitations of these conceptualizations examined, and the applicability of caring as a concept and theory to the practice of nursing identified. Examination of the concept of caring resulted in the identification of five epistemological perspectives: caring as a human state, caring as a moral imperative or ideal, caring as an affect, caring as an interpersonal relationship, and caring as a nursing intervention. Two outcomes of caring were identified: caring as the subjective experience and as the physiologic responses in patients. The authors concluded that knowledge development related to caring in nursing is limited by the lack of refinement of caring theory, the lack of definitions of caring attributes, the neglect to examine caring from the dialectic perspective, and the focus of theorists and researchers on the nurse to the exclusion of the patient.

Altruism↗
PubMed1990

Persistence in breastfeeding: a phenomenological investigation.

The experience of mothers who continue to breastfeed when other alternatives are available has received little attention. To examine the underlying meaning of the reality of persisting with breastfeeding, a phenomenological approach is used. Based on interviews with breastfeeding mothers, the author explores the meaning of continuing to breastfeed in relation to a mother's decision to breastfeed, the problems encountered, the relationship between mother and baby, being committed and choosing a time to stop. The aim of the author is to stimulate thinking beyond taken for granted attitudes towards breastfeeding and to enhance understanding of what breastfeeding and continuing to breastfeed is like for mothers in a deeper more meaningful way.

Attitude↗
PubMed1984

Towards inclusive notions of 'patient' and 'nurse'.

Nursing is commonly characterized by the process of caring in the context of nurse-patient interactions in clinical and non-clinical settings. This interactive context of nursing however should not be seen to only involve encounters of an interpersonal nature but also must be extended to include interactions set in a social-relational context. (The growing realization that most health problems in our society cannot be fully understood as only an individual phenomena lends support to this notion.) Continuity and quality of time are described as being important aspects of nursing, which make possible a holistic and unified approach to care that is quite unique to nursing. A patient-centred approach to nursing is contrasted with an illness/disease-based approach. Growing recognition of the positive outcomes of an approach to nursing which is responsive to patients (rather than primarily focused on illness/disease) suggests that patterns of nursing care should be more closely aligned with this model. The authors believe this can be accomplished through a supportive emotional atmosphere of interpersonal and social-relational involvement. The modes by which nurses will be accountable to the community will then necessarily need to reflect this broader, more inclusive context.

Humans↗