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At least 19 recordsLinked to original sources

PubMed1996

Understanding the basis of treatment choices for varicose veins: a model for decision making with the repertory grid technique.

OBJECTIVES: To use the repertory grid technique as a method for identifying and rating the criteria that clinicians use to make a choice between the different treatment options for patients with a common condition such as varicose veins. DESIGN: The "expert panel" consensus method for rating the appropriateness of clinical procedures was modified with an existing psychometric method, the repertory grid technique. To identify the criteria used to decide about treatment, the panel members compared and contrasted a range of nine "treatment prototypes". They were then required to rate each criterion for its relevance to each treatment prototype. SETTING: The panel was selected from different geographical locations in the South Western Regional Health Authority. SUBJECTS: The expert panel was composed of six vascular surgeons, three from teaching and three from non-teaching hospitals; two general practitioners who were also clinical assistants in vascular surgery; and one honorary senior lecturer in general practice. MAIN MEASURES: Decision making criteria were categorised according to their content. Their frequency of replication was noted-that is, how many clinicians used the same criterion. Computer analysis of the rating scores for the nine panel members identified the relative importance of each treatment criterion for each treatment option. RESULTS: 161 criteria for the treatment of varicose veins were elicited from the nine participants. These criteria were wide ranging, from clinical indications (48% of those used), to social (32%), and organisational factors (20%). Clinical indications were more likely to be used when deciding about surgery as a high priority, whereas social and organisational criteria were more likely to be applied in decisions about surgery as a low priority, day case surgery, and cosmetic surgery. CONCLUSIONS: The repertory grid technique proved to be effective in modelling decision making for a condition such as varicose veins: its use enabled both the identification of the wide range of criteria underlying the decision to treat and the exploration of the relative importance of these criteria in relation to several treatment options. Its potential as a method for reducing variation in clinical decision making and thus improving distribution of high quality care lies in its ability to pinpoint dilemmas of decision making rather than as the basis for drawing up guidelines to regulate decision making practice.

Algorithms↗

PubMed1986

An introduction to the use of repertory grid technique as a research method and clinical tool for psychiatric nurses.

This paper outlines a technique, the repertory grid technique, which offers the opportunity for psychiatric nurses to document information gained in an interview setting. The method, which consists of structured and systematic questioning, allows exploration of individual's systems of meanings. Data collection is separated from inference, hence the criticism that the nursing data is impressionistic and opinionated is avoided. The controlled conversational format of the technique provides an enhanced awareness of receiving information and interpreting it, and the primary data is clearly presented and available for discussion about conclusions. These data can be subjected to qualitative and quantitative analysis and the method is to be recommended as a research technique which could be of value to psychiatric nurses at the clinical level.

Data Collection↗

PubMed1995

[Changes in the internal object world in an obsessive-compulsive patient during 3 years ambulatory psychotherapy. A study with the Repertory Grid Technique].

The significance of the repertory-grid technique, which is based on Kelly's theory of personal constructs for the analysis of course and change of behavioral abnormalities, is assessed in a case report on the psychotherapy of an obsessive compulsive patient. The method delineates judgements regarding herself, significant other persons, and disease conceptualizations. This idiographic method, situated between empirical and hermeneutic techniques, is particularly valuable for the detection of psychotherapeutic changes. Traditional procedures that aim at invariance of values can be lacking in sensitivity. The repertory grid follows the individual's own constructs and idiosyncratic views. This obviates doubts on the relevance of terms and factorial dimensions for the proband. In this case, study of the combination of the idiographic grid technique and nomothetic questionnaires was useful for validation and interpretation of findings. The dimensions of the individual grid test are not covered by questionnaires and belong to a different level of cognitive processes.

Adult↗

PubMed1995

Some reflections on the use of repertory grid technique in studies of nurses and social workers.

This paper discusses the repertory grid technique, from its development by George Kelly as a means of demonstrating cognitive/perceptual systems in individuals, as postulated in his Personal Construct Theory, to its use in studies in nursing and social work. The original concept having focused on the uniqueness of, and differences between, individuals' perceptions of the world, in recent years it has been applied to the examination of characteristics within groups. The theoretical basis for this is discussed, with reference to a selection of studies of nurses and social workers, including a small comparative study of psychiatric nurses, general nurses and social workers. The degree to which the findings of these studies may be generalized is discussed. In retrospect, some of the applications are considered to be outside the paradigm of the Personal Construct Theory which underlies the repertory grid technique.

Clinical Competence↗

PubMed1990

An example of the use of repertory grid technique in assessing nurses' self-perceptions of caring.

This paper describes how the repertory grid technique was used to structure interviews with ward sisters and charge nurses to explore their perceptions about the nature of caring in nursing practice. Informants were also asked to assess themselves as carers. The interviews generated both qualitative and quantitative data and the findings which emerged were used to guide further qualitative interviews with nurses and patients in the next stage of the study.

Attitude of Health Personnel↗

PubMed1996

[Evaluation of the therapeutic process in inpatient psychotherapy with the Repertory Grid technique].

With a sample of 155 patients undergoing psychoanalytic inpatient psychotherapy, the clinical relevance of nomethetic measures derived from Repertory Grids (Role Construct Repertory Test; Kelly 1955) shall be demonstrated. Results lead to the conclusion that valuable findings concerning the psychotherapeutic process can be obtained from the grid without necessarily recurring to the framework of Personal Construct Psychology. In general, cognitive differentiation seems to diminish as therapy goes on. Successful patients start to deal with their parental imagines earlier in the therapeutic process than less successful ones. Moreover, they adapt the construction of their Self to the one of their Ideal Self, just as they construe the treating therapist increasingly similar to their Ideal Self. This points to the eminence of the therapeutic relationship for successful therapy outcome. Finally, the paper presents some possibilities to demonstrate transference processes within the scope of inpatient psychotherapy by means of grid measures. All in all, we consider the repertory grid technique as a promising tool for the evaluation of therapeutic processes, but it requires considerable expenditure to fit into clinical routine.

Adolescent↗

PubMed2000

[Self concept and object relations of patients with affective disorders--individual centered diagnosis with the repertory-grid technique].

Significant dimensions of the self concept and the object relations of 127 depressive patients and 34 orthopaedic patients were investigated with the repertory-grid-technique. Self concept and object relations were compared by means of nomothethically used idiographic results after recovery from manifest depression. The object relations of the depressive sample were characterised by the dimension "symbiotic near"; "ambivalent" and "indifferent" partnership relationships were found much more frequently in the controls. The idiographic results contribute to a differentiation of the spectrum of affective disorders. They underline the importance of the interpersonal dimension of depression and may be used as a basis of a therapeutic orientation.

Adult↗

PubMed1998

A & E nurses' constructs on the nature of nursing expertise: a repertory grid technique.

The concept of nursing expertise has been the focus of considerable debate since the early 1980s, yet an agreed definition of the concept and the precise criteria by which it can be evaluated remains elusive. This paper will describe an exploratory study into A & E nurses' constructs of the nature of nursing expertise. Seven first level Accident and Emergency (A & E) nurses were interviewed using Kelly's Repertory Grid Technique. Each was asked to provide examples of nurses with whom they are working or have worked, to match eight given examples designed to represent varying levels of clinical expertise. The informants were asked to consider in what way two of their chosen examples were alike and differed from a third in their clinical practice. A total of 55 bi-polar constructs emerged which were clustered under four main headings. These suggested that A & E nurses perceived expert practice to be characterized by a high level of empirical knowledge, supportive team building, assertive clinical leadership and patient-focused involvement.

Attitude of Health Personnel↗

PubMed2000

Personality and object relations in patients with affective disorders: idiographic research by means of the repertory grid technique.

BACKGROUND: This paper presents an idiographic approach to evaluate the self concept and the self-object-relationship of patients suffering from affective disorders. METHODS: Significant dimensions of the personality and the object relations of 127 depressive patients and 34 orthopaedic patients were investigated with the repertory grid-technique. The self concept and the object relations were compared by means of nomothetically used idiographic results after recovery from manifest depression. RESULTS: 'Low self esteem' was frequently found in patients with a long lasting course of illness and the ICD-10-diagnoses of 'bipolar affective disorder' and 'dysthymia'. The object relations of the depressive sample were characterised by the dimension 'symbiotic near'; 'ambivalent' and 'indifferent' partnership relationships were found much more frequently in the controls. CONCLUSIONS: The idiographic results help to differentiate the spectrum of affective disorders. They underline the importance of the interpersonal dimension of depression and may be used as a basis of a therapeutic appraisal. LIMITATIONS: The repertory grid-technique may not be used as a diagnostic instrument. However, the combination of idiographic results with further clinical informations enables the multidimensional assessment of the self concept and psychosocial coping mechanisms.

Adaptation, Psychological↗

PubMed2003

[Personality and donor-recipient relationships of potential donors before living donor liver transplantation--diagnostics with the repertory-grid technique].

BACKGROUND: Living-donor liver transplantation (LDLT) is developing into an established therapy for terminal liver diseases in adults. Potential donors are faced with the risk of postoperative complications and are subject to a high level of psychological pressure and ambivalent feelings. Our assumption is that ambivalent feelings before donation are crucially influenced by the personality and the quality of the donor-recipient relationship. In highly motivated donors we expected a positive description of the recipient and a similarity in the characterisation of the donor and recipient. METHODS: 58 potential living donors were evaluated between March 2000 and June 2001. On the basis of the clinical interview 10 were rated as unsuited for donation. Among those potential donors assessed as unsuited, we found a high level of ambivalent feelings. For 50 potential donors we gained a set of completed psychometric diagnostic questionnaires. A Repertory-grid investigation was conducted with a total of 28 potential donors. Seven of them were not recommended as living donors. The relationship between donors and recipients was analysed concerning constructs that were most important to the characterisation of the donor or recipient. By means of inter-element distances self-concept of donors and donor-recipient relation were analysed. RESULTS: Ambivalent candidates who were not recommended as living donors tended to describe the recipient negatively (selfish, carping, and unable to take criticism) and did not show a similarity in the characterisations of self and ideal-self. Whereas the highly motivated candidates were marked by a closeness of self and ideal-self concepts. Both groups saw the recipient as indifferent. CONCLUSION: Closeness between self and ideal-self-indicating satisfaction with the decision to donate seems to be one suitable criterion to distinguish between highly motivated potential donors on the one hand and ambivalent candidates on the other hand. Another criterion appears to be a description of the recipient that indicates either a functioning or ill-functioning communication between donor and recipient with respect to the donation.

Adult↗

PubMed1967