This article discusses how existential phenomenology may serve as a frame in a mixed‐methods study of changes in weight and body composition among women in adjuvant treatment for breast cancer. In accordance with ontologically and epistemologically fundamental assumptions in nursing, we link mixed‐methods and existential phenomenology from the perspective of the French philosopher Maurice Merleau‐Ponty and his notion of a unified body subject. Letting this perspective permeate our philosophy, methodology and issues at the method level in mixed‐method research undermines the (...) distinction between first‐ and third‐person perspective when applying and integrating different data sources in a mixed‐methods study. Applying Merleau‐Ponty's third way, the women's bodily experiences appear as gestalt; a ‘figure’ against a ground of existential threats that are grasped through insight from data integrating in joint displays, which revealed the women's experiences on a deep existential level. Existential phenomenology as a frame in mixed‐method studies can speak not only to nurses but also to a multidisciplinary audience in a shared attempt to deepen the understanding of a patient's healthcare problem. (shrink)

Background: ICU patients’ family members are in a new, uncertain, and vulnerable situation due to the patient’s critical illness and complete dependence on the ICU nurses and physicians. Family members’ feeling of being cared for is closely linked to clinicians’ attitudes and behavior. Aim: To explore ICU nurses’ and physicians’ bedside interaction with critically ill ICU patients´ families and discuss this in light of the ethics of care. Research design: A qualitative study using participant observation, focus groups, and thematic narrative (...) analysis. Participants and research context: Data were gathered from July 2017 to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven focus groups with ICU nurses and physicians. Ethical considerations: The Regional Committee for Medical and Health Research Ethics and the Norwegian Centre for Research Data approved the study. Findings: Quality of ICU family care depends on nurses’ and physicians’ attitudes, behavior, and personality traits. Three main themes were identified: being attentive, an active approach, and degree of tolerance. Discussion: The findings are discussed in light of the ethics of care and empirical research from the intensive care environment. Conclusions: This study shows that attentive, active, and tolerant clinicians represent a culture of ethical care that gives families greater freedom of action and active participation in patient care. Clinicians must not bear sole responsibility for this culture; it must have a firm basis in the hospital and ICU and be established through training, interprofessional reflection, and support of clinicians. (shrink)

Spirituality is as an individual, dynamic, and a complex concept. Meleis's theory includes spirituality in many aspects, and looking at this dimension within this specific theory may help in understanding spirituality as a critical dimension in transitions, as processes, but also as a dimension of self–transition as individual development and growing. Therefore, spirituality is an inherent and integral element of the several foundations of this theory, especially in nursing therapeutics, patterns of responses and transition conditions (facilitators and inhibitors).

ABSTRACT Objective: to discuss the use of the H-index as an indicator for the evaluation of the Nursing area researcher in the light of Thomas Kuhn's disciplinary matrix. Method: this is a reflective study, conducted between March and April 2018, which identifies the elements that underlie the H-index and criticizes it as an indicator for the evaluation of the researcher in the nursing scientific community. Results: the Nursing area is in the normal science phase and has a disciplinary matrix. It (...) consists of theories, research methods and experiments; establishes procedures; indicates the problems to be studied and determines the scientific agenda; provides modular solutions for the scientific community; it has epistemic values that legitimize and justify the research practice. The values are of a quantitative and qualitative nature, namely: accuracy, consistency, range, simplicity, objectivity, originality and fruitfulness. The H-index cannot display the qualitative values of science. Conclusion: the quantitative and qualitative epistemic values form an amalgam, making it impossible to separate them, for it is in axiological complementarity that science is founded. From its evaluative approach with the so-called mature sciences, it is inferred that the Nursing area should consider these values for itself. The H-index is limited for the evaluation of the researcher. Care should be taken to harbor it, so as not to hinder the insertion of new candidates to be researchers into the postgraduate teaching staff, thus preventing generational sharing among peers, given that the index does not can measure the category made up by young researchers. (shrink)

Telemedicine changes clinical practice and introduces new ways of distributing tasks between physicians and nurses, and particularly the delegation of sensory assessments during remote physical examinations. As nurses become more involved in patient assessment and clinical decision‐making, the quality of physician–nurse collaboration has been recognized as essential to ensure quality patient care. However, few studies have examined physician–nurse interactions during teleconsultations. This article presents the results of an empirical study of nurse–physician communication during remote physical examinations. In partnership with a (...) university‐affiliated hospital in Ontario, Canada, we observed and recorded 10 simulated postsurgical consultations in orthopedics (involving a physician, a patient, and an on‐site nurse) and conducted auto‐confrontation interviews with physicians. The results of the thematic analysis of the interviews informed the selection of consultation sequences for in‐depth interaction analysis. The findings demonstrate the nurse's essential role during remote physical examinations and reveal specific practices accomplished by the nurse to ensure successful nurse–physician collaboration. The interview data shows how physicians view the nurse's role and contributions. The findings contribute to our understanding of the collaborative nature of sensory assessments during remote physical examinations in telemedicine and can inform the development of training programs for professionals focusing on communication skills. Implications for clinical practice are discussed. (shrink)

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and (...) families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person‐centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions. (shrink)

Texts about theory in nursing often refer to theory construction by using inductive methods in a rigid way. In this paper, it is instead argued that theories are created, which is in line with most philosophers of science. Theory creation is regarded as a creative process that does not follow a specific method or logic. As in any creative endeavour, the inspiration for theory creation can come from many sources, including previous research and existing theory. The main idea put forward (...) is that deductive qualitative research approaches should play a key role in theory creation. Furthermore, there is a need to differentiate between theory creation and theory justification. A model that emphasizes the creative aspects of theory creation and theory justification using qualitative approaches is presented. The model suggests that knowledge development is a deductive trial‐and‐error process where theory creation is followed by testing. Scientific theory creation and justification are presented as an iterative process that is deductive in that a testable hypothesis is derived from the theory. If the hypothesis is falsified, then the theory needs modification or might be altogether wrong. Several factors can block the creative process, both in theory development and in finding ways to test a theory in the justification phase. Some of these blockers are the idea of ‘building blocks’ and the inductive view of science often brought forward in nursing. Other blockers include striving for consensus and adherence to existing nursing philosophies and existing theories. Research and knowledge development are creative processes, and following predefined methods is not enough to ensure scientific rigour in qualitative nursing research. (shrink)