Beth L. Rodgers

AHCPR clinical practice guideline on surgical pain management: adoption and outcomes.

Pain management practices and short-term patient outcomes in nine acute care hospitals in Milwaukee, Wisconsin, were studied at two points in time. One-and-a-half years after the Agency for Health Care Policy and Researchs (AHCPR) Clinical Practice Guideline on Acute Pain Management was published, data from 330 adult surgical patients were collected (Time I). These data were contrasted with data from 373 adult surgical patients collected 2 years later (Time II). There were significant increases in the percentage of patients who reported being taught how to report pain using a pain rating scale and about setting a pain goal preoperatively; in the percentage of patient hospital records with at least one documented numeric pain rating; and in the percentage of patients who received analgesics by intravenous administration. However, pain management practices continued to differ from recommendations in the AHCPR guideline. No significant improvement was noted in the short-term outcomes of patient-rated pain or patient satisfaction with pain management. Availability of well-published guidelines alone may be insufficient to ensure comprehensive adoption of guidelines that are multidimensional in nature and to obtain improvements in patient outcome.

Using concept analysis to enhance clinical practice and research.

Describing human responses in critical care nursing is fundamental to the implementation and evaluation of therapeutic interventions. This article explains how concept analysis facilitates care planning, communication, nursing diagnoses, and clinical nursing research in critical care.

Family members' experiences with the nursing home placement of an older adult

Although there is substantial literature available on a variety of aspects of nursing home placement, relatively little is known about the experiences of family members confronted with this challenge. This study involved in-depth interviews with nine adult family members within 2 weeks of the relocation of the older adult relative. Factors related to recognition of the need for placement, selection of a facility, managing the relocation, and effects of placement on the family decision-makers were explored. Results have significant implications for nursing practice related to the lack of advanced planning, needs for time and information, and supportive interventions.

The concept of grief: An analysis of classical and contemporary thought

Abstract Grief has been a topic of focused inquiry for a number of years. However, in spite of the attention given to this significant aspect of human existence, progress in gaining a clear understanding of grief has been relatively slow. This situation is at least partially due to the existence of a conceptual problem concerning the definition of grief making it difficult to identify a grief response and to differentiate among grief and a variety of related concepts. Persons interested in grief have had to rely on their individual interpretations of the concept and, as a result, have generated a plethora of confusing terms to address the experience. In this article, the results of a systematic inquiry to define grief as a concept are presented. The findings provide a synthesis of existing thought, suggestions for the reconceptualization of grief and grief outcomes, and guidelines for further study.

Family Management of a Chronic Health Condition Perspectives of Adolescents

A growing number of adolescents and their families are dealing with a chronic health condition that impacts their daily life. Research using the Family Management Style Framework (FMSF) has added much to our understanding of how the family integrates chronic condition management into family life. Less clear, however, is the adolescent perspective of the FMSF components. The purpose of this secondary qualitative analysis was to explore 25 interviews of adolescents with spina bifida to uncover the adolescent’s perspective of the three major FMSF components: Definition of the Situation, Management Behaviors, and Perceived Consequences. Adolescents were able to articulate their perspectives and their observations of their parents’ behaviors that related to the three components and related dimensions of the framework. Data from this analysis led to proposed expansion of the FMSF definitions from an adolescent perspective. Implications for integrating the adolescent perspective into future research and clinical practice are discussed.

When a loved one has AIDS: care for the significant other.

1. The significant others of persons with AIDS, whether they assume the role of primary caregiver or not, have a number of unique experiences, concerns, and needs specifically related to their situations. 2. During the initial period following the diagnosis of a loved one, the significant others indicated their primary needs as sensitivity to their situations, assistance in securing appropriate information, and psychological support in dealing with uncertainty, and a general sense of dread. 3. Other common concerns and needs expressed by the significant others included support and reassurance, assistance in adjusting to a myriad of personal relationship changes, and help in meeting needs for active involvement in some form of AIDS-related work.

Breaking Through Limbo: Experiences of Adults Living With Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a potentially devastating condition that diminishes quality of life and leads to serious consequences without treatment. Diagnosis often is delayed and, once diagnosed, adherence to prescribed therapy tends to be a major barrier to management. This grounded theory study was focused on the experiences of a diverse group of 82 adults who were at various points in the process of obtaining a diagnosis and living with OSA. Participants described being in “limbo” and needing to break through that limbo to be successful at managing their OSA. Results provide new insights into the experience of living with OSA that can be beneficial in promoting treatment and shaping effective management of the condition.

Evolutionary Analysis of the Concept of Comfort

Although comfort is cited as an important component of nursing care, a definition that provides a firm conceptual foundation for research and nursing science is still needed, particularly in nursing classifications and taxonomies. This article provides a clear and evidence-based definition, improving research, development, and implementation of specific nursing interventions.

Optimistically Engaging in the Present

This study explores the experiences of aging among gay men to further explain the phenomenon of gay male aging in contemporary terms, to put those experiences into a historically relevant context, and to expand upon previous findings on aging within the gay male population. Nineteen self-identifying gay men from a metropolitan area in South Florida were interviewed. The data collected were analyzed using grounded theory method. Findings from the study indicated that a great deal of optimism was revealed by the participants of the study in spite of their past adversarial experiences related to their sexuality and current challenges related to gay male sexuality and aging. Based on these findings, professionals working with an older population should consider the supportive environments that can most benefit this population in the community and even consider partnering with lesbian, gay, bisexual, and transgender (LGBT) oriented organizations to better serve the needs of their clients.

Spiritual Coping: A Focus of New Nursing Diagnoses: Spiritual Coping: A Focus of New Nursing Diagnoses

OBJECTIVE To define the antecedents, consequents, and attributes of spiritual coping. METHODS Rodgers’ evolutionary model for concept analysis was used to guide an integrative literature review of qualitative research. FINDINGS Six qualitative articles were included and elements that define and contextualize the concept were identified. CONCLUSIONS Three new nursing diagnoses are proposed, based on qualitative findings. IMPLICATIONS FOR PRACTICE These new diagnoses should be submitted to clinical validation in different cultural and religious backgrounds, but the inclusion in the taxonomy highlights a holistic perspective concerning the spiritual dimension of patients’ responses in life and health transitions, and so, bringing the approach to spirituality into nursing practice. OBJECTIVO Definir os antecedentes, os consequentes e os atributos de coping espiritual. METODOS Modelo evolucionario de analise de conceitos de Beth Rodgers baseado numa revisao integrativa de literatura de pesquisa qualitativa. RESULTADOS Seis pesquisas qualitativas foram incluidas e os elementos que definem e contextualizam o conceito foram identificados. CONCLUSOES Sao propostos tres novos diagnosticos de enfermagem, baseados na evidencia de estudos qualitativos. IMPLICACOES PARA A PRATICA Estes novos diagnosticos devem ser submetidos a estudos de validacao clinica em diferentes contextos culturais e religiosos, e quando incluidos na taxonomia estarao a enfatizar uma perspectiva holistica das respostas dos pacientes relacionada a dimensao espiritual e, assim, promovendo a inclusao da espiritualidade na pratica clinica.