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PubMed2005

Gossip and emotion in nursing and health-care organizations.

PURPOSE: The purpose of this paper is to examine the relationship between gossip and emotion in health-care organizations. It draws on findings from empirical research exploring the characteristics and function of gossip which, to date, has been a relatively under-researched organizational phenomenon. DESIGN/METHODOLOGY/APPROACH: A multidisciplinary approach was adopted, drawing on an eclectic range of discipline-based theories, skills, ideas and data. Methods included repertory grid technique, in-depth interviews and structured diary records of work-related gossip. The sample comprised 96 qualified nurses working in a range of practice areas and organizational settings in the UK. FINDINGS: Template analysis was used to integrate findings across three phases of data collection. The findings revealed that gossip is used to express a range of emotions including care and concern about others, anger, annoyance and anxiety, with emotional outcomes that include feeling reassured and supported. It is the individual who gossips, while the organization provides the content, emotional context, triggers and opportunities. RESEARCH LIMITATIONS/IMPLICATIONS: Nurses were chosen as an information-rich source of data, but the findings may simply reflect the professional culture and practice of nursing. Future research should take into account a wider range of health-care organizational roles and perspectives in order to capture the dynamics and detail of the emotions and relationships that initiate and sustain gossip. PRACTICAL IMPLICATIONS: Because gossip makes people feel better it may serve to reinforce the "stress mask of professionalism", hiding issues of conflict, vulnerability and intense emotion. Managers need to consider what the emotions expressed through gossip might represent in terms of underlying issues relating to organizational health, communication and change. ORIGINALITY/VALUE: This paper makes a valuable contribution to the under-researched phenomenon of gossip in organizations and adds to the growing field of research into the role of emotion in health-care organizations and emotion work in nursing.

Communication↗
PubMed1990

Personal construct systems of psoriatic patients.

Repertory grid techniques were employed to assess the personal construct systems of psoriatic patients (n = 35), controls with other skin conditions (n = 28) and controls with no skin condition (n = 29). A grid was designed with six supplied constructs representing previously reported subjective experiences of psoriatics, and 12 elements representing typical social conditions. Social adjustment was defined as the relationship between constructs. The results suggest that psoriatics are less well socially adjusted in highly visible situations. There was no difference in social adjustment between males and females specific to the psoriatic group, but body awareness in female psoriatics correlated positively with the severity of the condition.

Adult↗
PubMed1985

A study of nurse tutors' conceptualization of their ward teaching role.

It is generally agreed by the nursing profession that the art and science of nursing can only be learnt in the direct delivery of patient care and that, in order to do this, students need to identify with a practitioner role-model in the clinical area. This research arose from the belief that nurse educationalists are failing to provide these learning opportunities for their students. The focus of the study was to identify factors in the nurse teacher's work role which mitigate against their teaching in the clinical area. The methodology was chosen in order to demonstrate the nurse teacher's conceptualization of her work role. In the first stage of the project this involved the repertory grid technique. From the results, a semantic differential questionnaire was built up and used for an attitude survey of a second sample of nurse teachers. The research samples consisted mainly of nurse tutors but a small group of both clinical teachers and senior tutors was included for comparison studies. Results showed that the main factors leading to a lack of clinical teaching by educational staff include lack of control and a sense of conflict, stress and anxiety in the ward-teaching situation, lack of peer support and an inability to plan ahead for such work. The most pervasive feature which emerged, however, was the felt lack of available time for clinical work vis-a-vis their other duties. This is discussed in terms of role strain. Differences in response between teacher grades were studied and showed that all the problems found appear to be greater among the nurse tutor group. This may be a consequence of a further finding that clinical teachers are more likely to make finer and more frequent distinctions between the aims and problems of ward- and school-based teaching.

Faculty, Nursing↗
PubMed1989

Nursing and caring: a personal construct theory study of some nurses' self-perceptions.

This report outlines the results of a survey of trained nurses' perceptions about themselves as professional carers. Twenty-five nurses of charge nurse grade were interviewed using Kelly's personal construct theory and repertory grid technique. Nurses were asked to elicit eight bipolar constructs and to rate eight elements, including a 'myself as a carer' element and an 'ideal self as a carer' element, on a seven-point rating scale. A simple difference score was calculated to measure the degree of discrepancy between these two elements. Observed differences were assumed to be indicative of the need for personal change. Differences emerged for each of the 25 informants. Some possible explanations for these findings are provided, in particular the personal cost of caring for the carer is emphasized. Further research in this area must take account of this new finding.

Empathy↗
PubMed1990

An examination of nurses' feelings about patients with specific feeding needs.

Repertory grid technique was used to study nurses' feelings about longstay patients, with specific reference to the patients' feeding needs. Interviews and direct observation were used to supplement the data. It was found that, although nurses claimed a high degree of satisfaction from caring for all patients, there were some people who were viewed less positively. Overall, those patients who were easier to feed came closer to the nurses' conceptions of the 'ideal'. Possible reasons for this are discussed, and some of the implications for practice are outlined.

Attitude of Health Personnel↗
PubMed1996

Introducing a lecturer-practitioner: the management perspective.

The West Midlands Regional Health Authority Department of Nursing funded a 1-year study to look at 'Implementation aspects of the lecturer-practitioner role (in nursing)'. A feasibility study was carried out from November 1992 to October 1993 to address the issue and highlight areas requiring more in-depth study. Twenty-nine subjects working as or with lecturer-practitioners were interviewed using a semi-structured questionnaire. The interview was divided into two discrete parts. The first section contained a mixture of open and closed questions and the second section adopted a modified repertory grid technique. This paper provides the main results from the first half of the interview. The study describes in practical terms how managers need to plan for the introduction of a lecturer-practitioner post; the key responsibilities of the role; and a person specification. The work identifies clear prerequisite criteria for job role and gives guidance on lecturer-practitioner management and function.

Clinical Competence↗
PubMed2004

Reasons underpinning patients' preferences for various angina treatments.

OBJECTIVE: To elicit patients' preferences for the treatment of angina. DESIGN: Angina patients were interviewed in order to elicit their personal reasons underlying preferences for various treatment options. Interviews followed a general repertory grid technique, in which seven treatment options were presented to patients in triads. Treatments considered ranged from medication to invasive revascularization therapies, with a 'no treatment' option. SETTING: Two general practices in Norwich, Norfolk. SUBJECTS: Twenty-one patients with diagnosed angina, which was both mild and stable. MAIN OUTCOME MEASURES: Treatment preferences verbalized by patients during interview, and the underlying reasons for these. RESULTS: Attitudes voiced towards the range of treatments for angina were diverse; 27 different reasons underlying patients' preferences were identified. Patients' preferences were largely justified by reasons associated with the conditional effectiveness or otherwise of treatments. When presented with treatment triads, medication (drug) treatments were over 2.5 times more likely to be chosen as a most preferred option than invasive or surgical treatments. Although surgical treatments were generally considered to be 'effective', it was perceived that they were more appropriate for situations when the condition became life-threatening. There were occasions, however, when preferences were driven by other reasons, such as a desire to avoid surgery because it was perceived negatively as 'invasive' and 'frightening'. Drug treatments were viewed as 'quick', 'easy' and reversible. Personal experiences of the effectiveness or otherwise of treatments were frequently cited as reasons for stated preferences. However, patients often commented that they would prefer the doctor to make the decision about their treatment. CONCLUSIONS: Patients choices among treatments was largely driven by perceptions of their effectiveness or otherwise. Although surgery was perceived as 'effective' it was also seen as conditionally so, dependent upon severity of the condition - which is not necessarily the case, as the risks of adverse events and surgical complications increase for emergency cases. As such, access to better information about the effectiveness and timeliness of interventions is needed. Although respondents held anxieties about treatment, particularly invasive or surgical treatments, fewer choices were driven by emotional and lifestyle factors unrelated to 'effectiveness', such as fear or ease of treatment.

Adult↗
PubMed1979

The structure of delinquent values: a repertory grid investigation.

Two experiments are reported, employing repertory grid technique and designed to test predictions derived from Matza & Sykes' (1961) account of the relationship between delinquent and conventional values. These predictions were confirmed. In addition, following the demonstration of equivalence in the structure and content of value systems in delinquents and non-delinquents, certain differences between the groups were observed, which were eventually attributed to delinquency rather than socio-economic status. On the basis of the results, a two-component structural hypothesis of delinquent values is advanced. Implications for theories of delinquency are discussed and directions for further research suggested.

Adolescent↗
PubMed1985

Cognitive and affective aspects of boredom.

It is argued that previous research may have been mistaken in assuming that monotony in sensory stimulation is a necessary and sufficient cause of boredom. Five investigations are reported which used personal construct theory and repertory grid techniques to investigate three hypotheses: that boredom is associated with subjective monotony, that boredom is associated with a high degree of frustration and that boredom arises when stimulation lacks meaning for the individual. Results supported hypotheses (1) and (2) but no evidence was found to support hypothesis (3).

Adult↗
PubMed2002

Assessing the therapeutic impact of a community group on a secure hospital ward.

The constructs of ward staff and patients in a medium secure rehabilitation ward were assessed before and after an eight-month trial of a twice weekly community group. One of the aims of this group was to address day-to-day interpersonal issues and to encourage patients to take social responsibility for their actions and to learn to support one another. Another aim was to encourage staff and patients to consider the possibility of applying some therapeutic community principles on the ward. These aims were assessed using repertory grid techniques. The results were that over the eight-month pilot both staff and patient groups shifted towards viewing their ideal ward as a therapeutic community (TC). However qualitative information suggested that considerable difficulties arose in bringing about the necessary cultural changes. As a result both staff and patients felt confused and disempowered. Future attempts are highly recommended, however better resourcing, particularly in the form of employing a trained full-time individual to co-ordinate activities, is essential.

Adult↗
PubMed1999

Service quality attributes of maternity care services: the prospective consumer's perspective.

The application of the repertory grid technique made it possible to capture the mental categorization by which maternity care services are judged. Conceptualization of the expectation standard, defined as estimates of anticipated performance, led to the identification of 14 attributes. These include: reliability, responsiveness, competence, access, courtesy, communication, credibility, security, relationship, tangibles, control, cost, naturalness and quality. The definitions made use of the prospective consumer's own verbal labels. In addition, it was found that maternity care services were not perceived as one continuous process. Three distinct categorizations were identified, that is: before, during, and after the birth of the baby. This suggests that prospective consumers employ the service quality attributes, according to one of the above.

Delivery Rooms↗
PubMed1998

Assessing the competence of student nurses.

Competence is difficult to define. Continuous assessment of practice, which involves reviewing the literature, is complex. The study involved developing a suitable tool for assessing competent practice of student nurses. The problem was investigated using Personal Construct Theory and Repertory Grid Technique. The findings suggest that trained staff assess the socialisation process of becoming a children's nurse rather than the level of competence.

Attitude of Health Personnel↗
PubMed2001

Body experience and mental representation of body image in patients with haematological malignancies and cancer as assessed with the Body Grid.

The domain of body image plays a central role in the quality of life of patients with haematological malignancies and metastasized cancer, since the disease itself as well as the enrolled therapies interfere with psychological and bodily well-being. We approached this highly subjective field by using the repertory grid technique and hypothesized that patients would display a restricted body image, focusing on functional aspects of the body. In all, 55 in-patients (27 men, 28 women, M age = 45.7 yrs, N = 46 with haematological malignancies, N = 9 with metastasized cancer), at the time of initial diagnosis, were included in the study and assessed with the Body Grid, an instrument specifically designed by us for the exploration of body image. The data were analysed by principal component analysis (PCA) and construct categorization. Further, 42 chronic tinnitus sufferers (20 male, 22 female, M age = 46.5 yrs) served as a comparison group. Based on the constructs elicited, six construct categories were formulated in the sense of a first attempt of a hierarchical model (emotion, control, activity, strength, function, appearance). The central constructs (373 construct pairs) were assigned to these categories by three inter-raters. The categories appeared in the following order of frequency: function (27.1%), emotion (20.4%), strength (20.1%), activity (15%), control (10.2%) and appearance (7.2%). PCA indicated that the patients mainly demonstrated a restricted view of their body. In the tinnitus group, the most frequent category proved to be activity (21.3%), closely followed by function (21.1%) and control (20.9%). The body image was also restricted (PCA). The restriction of body image, together with the specific construct choice, seen in the haematology and cancer patients reflects the existential threat of the disease and may serve as a coping strategy. The high percentage of emotional constructs may mirror the patients' need for further support. The distinct distribution of construct categories in the two different patient samples supports the applicability of the proposed preliminary model.

Adult↗
PubMed1990

Personal constructs of fluency: a study comparing stutterers and nonstutterers.

The personal construct systems relating to fluency of a group of five stutterers and a group of five nonstutterers were examined using the repertory grid technique. The results support findings that stereotypical notions about stuttering were characteristic of both stutterers and nonstutterers and did not support Fransella's 1972 assumption that constructs relating to fluency differ in the communication subsystems of stutterers and nonstutterers.

Adult↗
PubMed1993

[Analysis of clinical cases adopting three-mode factor analysis].

The purpose of the present study was to examine sequentially the evaluations of the self and others in psychotherapy using the Rating Grid Method, one of the Repertory Grid Techniques. A construct system of Subject A was composed of "pleasant-painful", "steady-hopeless", "stable-anxious", "comfortable-irritable", "feeling of freedom-feeling of pressure", "specific-vague", "strong-week", and "refreshing-gloomy". That of Subject B consisted of "fearful-not fearful", "composed-restless", "pleasant-painful", "dignified-undignified", "eager-lazy", "realistic-mysterious", "perfectionism-slipshod", and "decisive-irresolute". The evaluations of the two subjects in the Rating Grid Method were analyzed using three-mode factor analysis. These results were then compared with diagnoses obtained through psychotherapy.

Adult↗
PubMed2001

Interrelations between the small isolated groups with homogeneous and heterogeneous composition.

Increase in the heterogeneity of a space crew's composition (cultural and gender differences) is a risk factor that can negatively influence the formation of a cohesive crew, which depends on a common way of perceiving one's social environment, goals and values. Method. Three groups working in isolation from 110 to 240 days, all with different cultural and gender composition were analysed using a modification of Kelly's repertory grid technique during a space simulation at the Institute for Biomedical Problems, Moscow. Subjects assessed themselves and each other monthly. Results. National Russian and international groups failed to create a single cohesive crew. Members of both groups considered people from their group as "us" and their neighbours as "them". Their relations became more negative during the mission, with attitudes changing from neutral to poor. Subjects began to perceive each other as "different and distant". Cultural and language differences prevented national (Russian) and international groups from forming a common understanding of behavioural rules and establishing close emotional contacts. Conclusions. Differences in perception of the interpersonal environment, group goals and values in national and international groups hindered the formation of a joint cohesive crew.

Adaptation, Psychological↗
PubMed1999

The characteristics of traumatic events experienced by nurses on the accident and emergency ward.

Nurses who work in high-risk areas, such as emergency wards, are susceptible to traumatic stress. The present study is an exploratory one, which attempts to describe and interpret some event characteristics of traumatic incidents identified by nurses. Nine nurses from the Accident and Emergency wards of two New Zealand hospitals were interviewed using the repertory grid technique. Qualitative analysis was used to compare event characteristics across participants and four underlying themes were identified: personal issues, contextual issues, control issues, or organisational issues. Comparison of these results with previous work with high stress occupations suggests that although event characteristics from all groups can be broadly grouped under four themes, there are some distinct differences in the traumatic impact of some event characteristics for nurses. The results have implications in the development of measures of traumatic stress for nurses and have immediate implications for organisational practice.

Burnout, Professional↗