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Results for “Repertory grid technique”

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PubMed1985

Prediction of treatment response in pain patients: the illness self-concept repertory grid and EMG feedback.

Eighteen patients with chronic musculoskeletal pain completed a trial of EMG feedback where each subject was exposed to biofeedback, a control condition and a waiting list. Pain scores were determined pre- and posttrial, and the percentage change calculated for each subject. EMG activity and present pain measured during the trial gave an EMG/pain correlation for each patient. A repertory grid was completed by each patient at the pretrial evaluation. Repertory grid technique is a highly flexible way of measuring subjective data such as attitudes. The specific test used involved the patient in rating a series of 6 self-concepts across 8 'constructs' or concepts concerning illness and emotional distress. The resulting matrix of 48 ratings was analysed to produce a measurement of 'distance' between the self and ideal-self concepts. The major finding was that the self-ideal-self distance was significantly positively correlated with pain score changes by rank correlation. The self-ideal-self distance is essentially a measure of self-satisfaction or dissatisfaction and the results imply that patients who show a relatively greater degree of self-dissatisfaction are more likely to respond well to EMG feedback. In addition, patients with high EMG/pain correlations had a better outcome and this measure also correlated with pain scores. The relationship between self-concepts and EMG/pain correlations is discussed. The Illness Self-Concept Repertory Grid appears capable of predicting treatment outcome and shows promise as a prognostic tool.

Adolescent↗

PubMed1982

Personal constructs of anxiety under the 1,5-benzodiazepine derivative clobazam related to trait-anxiety levels of the personality.

In an initial interview, 20 volunteer subjects provided 32 personal constructs of anxiety, using Kelly's repertory grid technique. The bipolar ends of the anxiety constructs were then separated by 10-point rating scales. Subjects could then indicate the degree of anxiety feeling on their own personal constructs. The 20 subjects were divided into high and low trait-anxiety sub-groups, on the basis of Speilberger trait-anxiety (personality) scores. Subjects were administered acute single doses of 20 mg clobazam or matching placebo, in a counterbalanced double-blind design. Anxiety levels on the individual personal constructs of anxiety were measured 2 h after drug administration. There was a significant ANOVA interaction effect between drug condition and trait-anxiety. Of the ten subjects in the high trait-anxiety sub-group, eight demonstrated reduced levels of personal construct anxiety under clobazam (three significantly). In contrast, of the ten subjects in the low trait-anxiety sub-group, nine demonstrated increased levels of personal construct anxiety (eight significantly). The present results are discussed in relation to previous similar findings. Clobazam and other benzodiazepine derivatives (such as diazepam) are effective anxiolytics with the clinically anxious and with normal volunteers having high trait-anxiety personalities. However, normal subjects with low trait-anxiety personalities often produce paradoxical increases in anxiety feelings.

Adolescent↗

PubMed1992

Chronic pain, relationships and illness self-construct.

A standardised illness self-construct repertory grid was used to evaluate relationships between people with chronic pain and the person to whom they felt closest. The 'Closest Other' was used to evaluate a wider range of relationships than generally included in research on 'spouse' reactions to chronic pain. The illness self-construct repertory grid indicated that closest others tended to place illness more centrally in the life of the individual with pain than did the person who had pain. The repertory grid provided information about the relationship which was not available from responses to open-ended questions. The statistical and theoretical assumptions of repertory grid technique make it ideal for intensive study of small groups or individuals best suited to clinical settings and not for screening large numbers of subjects.

Adult↗

PubMed2004

Perceptions of meal convenience: the case of at-home evening meals.

Perceptions of a range of evening meal situations eaten in the home were explored in a female consumer population. The investigation was carried out using the repertory grid technique and using written scenarios as the research stimuli. The nine scenarios successfully manipulated perceived convenience, time and effort. A consumer-generated vocabulary pertaining to food-related convenience was derived and revealed that while elements of both time and effort contributed to perceived convenience, these two 'dimensions' were highly interdependent. The presence of terms related to planning, shopping, preparation, cooking and clean-up illustrated that all stages in the food provisioning process influenced perceived convenience. Some evidence was established of perceptual differences between individuals varying with respect to convenience orientation in meal preparation.

Adult↗

PubMed2003

Behavioral activity associated with onset in chronic tic and habit disorder.

Seventy-six people (aged 18-62 years) diagnosed with either a chronic tic disorder or a habit disorder, entering a treatment study, kept a baseline daily diary for at least ten days, noting tic frequency and activity at time of onset. Together with an evaluator, participants completed a form ranking three high-risk activities where the tic or habit was likely to appear, and three low-risk activities where the tic was absent or barely present. Subjective appraisals distinguishing the two types of activities were also elicited and their relevance to the tic was measured on a seven-point scale using an adaptation of Kelly's repertory grid technique. Overall, the most frequent high-risk and low-risk activities were, respectively, passive attendance and physical activity. There were, however, significant differences in types of high-risk activities amongst the tic and habit disorders. Conversely, appraisals of the high-risk activities seemed to center on negative evaluations of tenseness, boredom, dissatisfaction, and disinterest.

Adolescent↗

PubMed1999

How students experience professional socialisation.

The question of how a nurse becomes socialised into the nursing profession remains of critical importance. An exploration of the literature relating to professional socialisation reveals a shift from the notion that it is a reactive process, to proactive. Our research explores this issue from a personal constructivist perspective using the repertory grid technique. Our findings show that the professional socialisation process is complex and diverse. During their educational preparation community nursing students make a radical reappraisal of their role perceptions. In their transition to becoming a graduate practitioner they gain a greater understanding of their specialist role whilst becoming less rigid in their thinking. We conclude that the impact nurse education has on professional socialisation will depend on the students' past experiences, the reflective nature of the process and the beliefs and values promoted in the course.

Community Health Nursing↗

PubMed1998

Self-concept and mood: a comparative study between depressed patients with and without borderline personality disorder.

Within the framework of Self-Structure Theory, this study investigated the relationship between depressed mood and Borderline Personality Disorder (BPD) on self and others descriptions, with a special emphasis on the self-structure's valence, that is, its affective, negative and/or positive content. Seventeen DSM-III-R unipolar depressed patients with associated BPD (DSM-III-R axis II) and twelve unipolar depressed patients without BPD were compared to eighteen non-psychiatric controls on four measures of evaluation and of affective discrepancy of descriptions of self and others. Subjects were administered the grid repertory technique. The analysis of the resulting two-way valence matrix, with attributions as columns, and self and others as rows, showed that depressed patients with and without BPD differed from the non-psychiatric controls with regard to negativity of the descriptions. As compared with the two other groups, depressed patients with BPD showed a distinctive pattern characterised by the joint presence of a negative view of self and a larger affective discrepancy for others, with others being conjunctively assigned positive and negative attributes. Despite some limitations, the distinctive pattern evidenced corroborates the conflicted interpersonal relationship and is in keeping with clinical theorising on BPD.

Adult↗

PubMed2004

The Multi-Center Dilemma Project: an investigation on the role of cognitive conflicts in health.

The Multi-Center Dilemma Project is a collaborative research endeavour aimed at determining the role of dilemmas--a kind of cognitive conflict, detected by using an adaptation of Kelly's Repertory Grid Technique--in a variety of clinical conditions. Implicative dilemmas appear in one third of the non-clinical group (n = 321) and in about half of the clinical group (n = 286), the latter having a proportion of dilemmas that doubles that of the non-clinical sample. Within the clinical group, we studied 87 subjects, after completing a psychotherapy process, and found that therapy helps to dissolve those dilemmas. We also studied, independently, a group of subjects diagnosed with social phobia (n = 13) and a group diagnosed with irritable bowel syndrome (n = 13) in comparison to non-clinical groups. In both health related problems, dilemmas seem to be quite relevant. Altogether, these studies, though preliminary (and with a small group size in some cases), yield a promising perspective to the unexplored area of the role of cognitive conflicts as an issue to consider when trying to understand some clinical conditions, as well as a focus to be dealt with in psychotherapy when dilemmas are identified.

Cognition↗

PubMed1996

Nurses' conceptualizations of caring attitudes and behaviours.

This paper outlines a study, which provided a pilot for part of a larger research project, to investigate nurses' conceptualizations of caring. The report gives an overview of previous work related to defining the concept of care before outlining the study undertaken. A sample of nine qualified nurses was used and Kelly's repertory grid technique employed to elicit constructs within the concepts of caring attitudes and caring behaviours. Grid data were analysed using cluster analysis and nine common themes were identified. These themes were largely supportive of previous research studies. It is proposed that in developing a theory of care, a synthesis should occur between nurses' conceptualizations of the concept and their professional practice.

Attitude↗

PubMed1996

The important attributes of a nurse from the perspective of qualified and student nurses.

The studies described here set out to discover what student and qualified nurses understand to be the important attributes of a nurse. The first study was exploratory and used a repertory grid technique to ask 72 students, qualified nurses and nurse lecturers to compare themselves (as a nurse) with a number of other nurses and carers of their own choosing. The constructs that the participants used to make these comparisons were then categorized into attributes. Those attributes that had been used by more than 10% of any of the subgroups were used in the second study as the basis of a questionnaire in which nurses were asked to put these categories in order of importance. The questionnaire was completed by 565 qualified and student nurses. The responses showed a remarkable level of agreement between nurses, irrespective of rank or student status. The only attribute over which there were large differences was intelligence. The study provides strong evidence that the view of the important attributes of a nurse remain unchanged right across the nursing profession, and the discovery of these attributes has important implications for nurse selection and training.

Adult↗

PubMed1998

Evaluation of the role of the health care assistant within a community mental health intensive care team.

BACKGROUND: Recent changes in UK legislation concerning community care of mentally ill people have initiated comprehensive changes in the delivery of healthcare. The NHS and Community Care Act (Department of Health 1990) added impetus to the run down of residential facilities and the speed of development of community mental health services. A community mental health intensive care team was established in Essex and employed a high ratio of unqualified to qualified staff. At a time of tension within the Health Service around issues such as skill mix and unemployment among qualified nurses, it was perhaps not unreasonable that the introduction of healthcare assistants might be viewed with suspicion, as a way of diluting the workforce with a less expensive alternative. The importance of evaluating new services is self-evident. OBJECTIVE: The growth of consumerism has led to acknowledgement that mental health service users' views have a role in shaping service provision. An attempt was made to determine the service users' evaluation of the role of the healthcare assistant within a community mental health intensive care team. RESULTS: The use of Kelly's (1955) repertory grid technique and theoretical sampling provided rich descriptions of the role of the healthcare assistant as experienced by service users. Analysis of the healthcare assistant-client relationship demonstrated a client-centred approach was apparent with considerable emphasis placed on the personal qualities of the care provider, supporting Roger's (1961) view that 'healing' comes not so much from the therapists 'techniques', as from their personality. CONCLUSION: It is self-evident that the clients' expressed satisfaction with the care provided by healthcare assistants argues against the professional ideology of nursing, which proposed that nursing may only be given by those with a statutory qualification. A complementary role for healthcare assistants in the provision of mental health care is proposed.

Community Health Workers↗

PubMed2003

The psychological contracts of National Health Service nurses.

AIMS: Following the psychological contract model of the employee-employer exchange relationship is offered as a means of understanding the expectations of a UK sample of 223 National Health Service (NHS) nurses in association with their leaving intentions. DESIGN AND METHODS: A pilot study involving 21 NHS nurses, using the repertory grid technique was conducted to elicit contract expectations. Twenty-nine categories of expectation were identified through content analysis. The study proper, employed a survey developed on the basis of results from the pilot study to identify contract profiles among 223 nurses from three London/South-east NHS hospitals, using the Q-sort method. Type of contract held (relational/transactional), satisfaction (job and organization), and leaving intentions were also examined. RESULTS: Q-analysis yielded four contract profiles among the nurses sampled: 'self-development and achievement'; 'belonging and development'; 'competence and collegiality' and 'autonomy and development'. Correlation analysis demonstrated that leaving intentions were associated with a need for personal autonomy and development, and the violation of expectations for being appreciated, valued, recognized and rewarded for effort, loyalty, hard-work and achievement, negative endorsement of a relational contract, positive endorsement of a transactional contract, and job and organizational dissatisfaction. CONCLUSION: Findings illustrate the diagnostic utility of the term psychological contract for understanding the expectations of NHS nurses. The potential significance of these findings for managing nurse retention is highlighted.

Adult↗

PubMed2002

An exploratory qualitative study to investigate how patients evaluate complementary and conventional medicine.

OBJECTIVE: We wish to determine the constructs used by patients to evaluate conventional and complementary medicine (CAM), prioritise these constructs and determine how these characterise patients' choice for CAM and conventional medicine. METHODS: A repertory grid technique was employed, in interviews of 20 patients, 10 from a general practice and 10 from a CAM clinic. RESULTS: CAM was used with greater frequency in chronic illness and generated more constructs than conventional medicine, although the constructs were similar. The priorities for these constructs were different: specificity of treatment and severity of illness were prioritised for conventional medicine and lack of science was prioritised for CAM. The CAM characteristic most commonly cited was non-chemical. CONCLUSION: This exploratory initial study suggests that people use very similar criteria to evaluate CAM and conventional medicine. Their choice of treatment was based largely on the type of illness from which they were suffering. Further research is needed in this area.

Adolescent↗

PubMed2004

The role perception questionnaire (RPQ): a tool for assessing undergraduate students' perceptions of the role of other professions.

A systematic review of interprofessional education (Freeth et al., 2002) revealed that there were many weaknesses in the current body of knowledge of interprofessional education outcomes. One reason for this was the lack of good quality study designs for evaluating the outcomes of interprofessional education. This paper discusses the range of tools that were found in the literature and describes the production and validation of two questionnaires that can be used as part of an interprofessional evaluation strategy. Firstly, a Generic Role Perception Questionnaire which can be used for measuring the perception of the role of a range of professions and a Nursing Role Perception Questionnaire used specifically for measuring the perception of the role of a nurse. Repertory grid technique was selected to elicit constructs from a multiprofessional group of final year undergraduate students. This pool was then used to develop the two questionnaires. Factor analysis, internal consistency and test re-test measures are used along with evidence of validity. The questionnaires were found to have acceptable validity and reliability and could be used as part of an IPE evaluation strategy to measure changes in professional role perception in an undergraduate population.

Attitude of Health Personnel↗

PubMed1997

Measuring general practitioner psychology: the personal construct perspective.

BACKGROUND: According to personal construct theory (PCT), psychological processes are determined by the way in which individuals perceive differences and similarities between aspects of their environment and by the way this information is used to assist in the prediction of events. The important discriminations made by individuals are called "constructs'. OBJECTIVE: This article seeks to introduce PCT as a psychological measurement procedure to complement traditional standardized scales in research in general practice. METHOD: The repertory grid technique is a method of eliciting the content of the individual's constructs and determining their structure and inter-relationships. PCT and traditional measurement procedures are compared and contrasted, and the relevance of PCT to general practice psychology is discussed.

Attitude of Health Personnel↗

PubMed2001

Effective leadership behaviour: leading "the third way" from a primary care group perspective. A study of leadership constructs elicited from members of primary care group management boards.

The UK National Health Service (NHS) is undergoing cataclysmic change following the election of the first Labour Government in 18 years. This is primarily embodied in the implementation of the White Paper The New NHS Modern-Dependable, which has resulted in the creation of primary care groups (PCGs) and primary care trusts (PCTs). The task facing both PCGs and PCTs is a radically new and complex one, requiring a new set of leadership skills to the traditional command and control style management. Leadership theories have evolved over the past 70 years. However, it was not until the 1980s that a major change in the paradigm of thinking around what is the nature of leadership occurred. The interaction between the leader and his/her followers is explored in what has become known as transformational leadership theories, developed by Bass and Avolio. Recent studies have, however, questioned the applicability of leadership models derived in the USA, to other cultures. This paper explores the leadership behaviours required for the management boards of PCGs and PCTs. A qualitative research method "Grounded Theory" approach was chosen for this study of leadership. The Repertory Grid technique was used to collect data. There are a number of implications arising from the findings of this study for both leadership models in general, and more specifically, for the development of leadership skills in both PCGs and PCTs.

Data Collection↗

PubMed2001

How do directors of public health perceive leadership?

This study examines how directors of public health (DsPH) perceive effective leadership. Kelly's repertory grid technique is used. A total of 13 out of a possible 14 DsPH in one NHS region of England were interviewed. Qualitative and quantitative analysis were carried out. The findings show that male DsPH (n = 8) rate their leadership ability more highly than do female DsPH (n = 5). Qualitative analysis produced a number of categories of constructs, some of which are perceived to be indicative of effective leadership, these being "working for others", "personal attributes", "vision and innovation" and "courage and integrity" Some categories appear to be applicable only to the UK (or to public health) and not to the existing dominant US models of leadership. In general, DsPH perceptions of effective leadership converge with current theories; most specifically the UK-based theories. This study therefore refutes any simple extrapolation of US theories of leadership to UK health organisations.

Administrative Personnel↗

PubMed2004

Leading with integrity: a qualitative research study.

This research paper gives an account of a study into the relationship between leadership and integrity. There is a critical analysis of the current literature for effective, successful and ethical leadership particularly, integrity. The purpose and aim of this paper is to build on the current notions of leadership within the literature, debate contemporary approaches, focussing specifically on practices within the UK National Health Service in the early 21st century. This leads to a discussion of the literature on ethical leadership theory, which includes public service values, ethical relationships and leading with integrity. A small study was undertaken consisting of 18 interviews with leaders and managers within a District General HospitaL Using the Repertory Grid technique and analysis 15 themes emerged from the constructs elicited, which were compared to the literature for leadership and integrity and other studies. As well as finding areas of overlap, a number of additional constructs were elicited which suggested that effective leadership correlates with integrity and the presence of integrity will improve organisational effectiveness. The study identified that perceptions of leadership character and behaviour are used to judge the effectiveness and integrity of a leader. However, the ethical implications and consequences of leaders' scope of power and influence such as policy and strategy are somewhat neglected and lacking in debate. The findings suggest that leaders are not judged according to the ethical nature of decision making, and leading and managing complex change but that the importance of integrity and ethical leadership correlated with higher levels of hierarchical status and that it is assumed by virtue of status and success that leaders lead with integrity. Finally, the findings of this study seem to suggest that nurse leadership capability is developing as a consequence of recent national investment.

Delivery of Health Care↗