Cynthia Peden-McAlpine

Phenomenological Research Among Canadian and United States Indigenous Populations: Oral Tradition and Quintessence of Time

Researchers conducting phenomenological studies among indigenous peoples in the United States and Canada have identified a seamless link between phenomenology and indigenous oral tradition. Phenomenology is compatible with indigenous peoples, because it is synchronous with holistic indigenous cultural lifeway and values. Phenomenology, as a research method, assists indigenous people in reproducing, through narrative communication, features of the past, present, and future. In the narrative process, this method elicits significant implicit meaning of indigenous culture and assists with recording the essence of experiences and events of indigenous societies. A product of the telling of narrative stories is the capacity to reflect on change that will enhance health in a holistic and culturally acceptable manner.

The role of the nurse as advocate in ethically difficult care situations with dying patients

The concept of advocacy in nursing is broadly defined, and the actual practice of advocacy in nursing varies from nurse to nurse. It is imperative for the profession of nursing to understand and apply the concept of nursing advocacy in the intimate, interpersonal nature of nurse-patient relationships. The purpose of this qualitative study was to identify and illustrate the key activities of expert nurses who act as patient advocates in ethically difficult care situations involving dying patients. A hermeneutic phenomenological approach was used in this study because it is in the narratives of nurses who have experienced ethically difficult care situations with dying patients that the meaning of advocacy can be discovered. For nurses to act as strong advocates for dying patients means that they are guides, liaisons, and supporters during this experience.

The experience of community-living women managing fecal incontinence

Although many women suffer from fecal incontinence (FI), little is known about their day-to-day experiences. The aims of this phenomenological study were to understand the experience of women living with FI from their perspective and to elicit womens self-care and management strategies for FI. Ten women participated in audiotaped, unstructured interviews that were transcribed into a written text. The text was analyzed using Van Manens approach for deriving themes. The findings display the womens experience of lived time, lived space, lived relationships, and lived body and the essential theme of “controlling the body out of control.” The findings demonstrate that FI is a problem that affects women in all dimensions of their lifeworld experience and describes the continual attention and self-management FI requires.

Clinical nurse specialist participation on a collaborative research project. Barriers and benefits.

Clinical nurse specialists are expected to contribute to the development of new nursing knowledge through research activities. Competing demands require constant juggling of time and priorities, and activities, such as research, often do not receive the attention they deserve. Research requires specific skills and knowledge and significant time expenditure. Collaborative research is an appropriate way for the clinical nurse specialist to both contribute to research and improve his or her research skills. This article discusses two pediatric critical care clinical nurse specialists’ participation in a collaborative research team led by university faculty. The study was designed to reduce family uncertainty and stress and to increase staff nurse competency in providing family care. The ability of the clinical nurse specialists to contribute to the research team was enhanced by knowledge of the research process, good communication skills, and clinical expertise in the specific population of interest. Challenges for the clinical nurse specialists included limited experience in conducting clinical research and balancing clinical and research priorities. Both clinical nurse specialists and the university faculty benefited from this collaboration. The clinical nurse specialist, with expertise in a clinical specialty, is able to bridge the gap between the academic and clinical sites, making clinical research more likely. At the same time, working with expert researchers allows the clinical nurse specialist to increase his or her research skills.

Diet strategies used by women to manage fecal incontinence.

Fecal incontinence occurs in community-living women who are elderly, as well as younger women, particularly after vaginal childbirth. Little is known about how women manage fecal incontinence in their everyday lives. Ten women who had fecal incontinence for at least 1 year participated in an audio-taped interview in a phenomenological study. Diet modification was identified as a key strategy for managing fecal incontinence. Various food types were avoided, restricted, or used as remedies. The meanings that the women applied to the diet strategies for managing fecal incontinence had 4 themes: restricting diet and eating patterns, eating and dealing with the consequences, treating fecal incontinence with foods and fluids, and lacking therapeutic guidance regarding diet modifications for fecal incontinence. The results of this study suggest that the continence nurse specialist recognize the important role and meaning of diet as a self-care strategy for women with fecal incontinence and address diet in their assessment and management recommendations.

Effects of reflexology on fibromyalgia symptoms: A multiple case study

PURPOSE To explore the effects of reflexology on pain and other symptoms in women with fibromyalgia syndrome [FM]. METHODS Multiple case study method as developed by Stake was used to investigate the effects of reflexology on six cases of women with FM which were given ten sessions of weekly reflexology. Data were collected with observation, interviews and diary and then analyzed within cases and across cases. RESULTS Reflexology affected the symptom of pain in multiple areas such as head, neck and arms. Pain started to isolate and decrease. CONCLUSION Reflexology may be helpful to decrease fibromyalgia symptoms. Qualitative research methods and individually tailored interventions are important when researching complementary and alternative therapies.

Electronic feedback messages for home spirometry lung transplant recipients

BACKGROUND Lung transplant recipients use a telemedicine device known as the electronic home spirometer to gauge the function of their lungs when they are away from the hospital or clinic setting. Health care providers review transmitted spirometry tests and users symptom responses to detect early signs of infection and or rejection. Current home spirometry users have questions, concerns, and preferences about spirometry that may influence their daily adherence. A spirometer with two-way electronic messaging has the capability to deliver feedback messages to potentially address these questions and concerns. OBJECTIVES The purpose of this study was to identify the type of messaging content users prefer to receive and recognize as positively influencing their spirometry use. METHODS The study design followed a qualitative approach investigating the experiences, perceptions, preferences, and realities of home spirometry. Three focus group sessions were used to generate opinions and interests about automatic messaging content. RESULTS The focus group approach revealed the nature of six categories and five subcategories for feedback messaging content. These include education (general, lifestyle, and infection), goals, timing, technique, monitoring, and reminders (time sensitive, positive). Messages were created according to length, feasibility, past experience, and neutrality for electronic implementation. CONCLUSION The narrative content served as the primary source of electronic feedback messages. Actual quotes were used when applicable. It is believed that pertinent automated electronic feedback messages will enhance home spirometry connection, raise confidence in spirometry use, and influence daily adherence to the spirometry protocol. The content also serves as a foundation for establishing a plan of care individualized to each home spirometry user.

Development of the Family Nurse Caring Belief Scale (FNCBS)

Measurement of family nursing practice phenomena needs particular attention. This study develops a new instrument, Family Nursing Caring Belief Scale (FNCBS), that measures nurse attitudes regarding provision of family-sensitive care to families in crisis and establishes initial psychometric properties. Classical test theory was used to construct a discriminative, summative instrument for measuring nurse attitudes. Internal consistency reliability in a randomly selected sample (N = 163) of pediatric intensive care unit and neonatal intensive care unit nurses was estimated at .81 (Cronbachs α) and .78 (Guttman split half). A four-factor structure was revealed: ethical caring practices, systems orientation to family, child advocacy, and normalizing milieu. The FNCBS demonstrated concurrent (r = .57) and criterion-related validities. The FNCBS demonstrated sound psychometric properties with a child-rearing population of families and has the potential for future use in family nursing research, education, and practice. It requires further assessment before testing with an adult population.

How expert home care nurses recognize early client status changes.

This qualitative study examined the characteristics of early recognition of client status changes by expert home care nurses. A text comprised of transcribed interviews with expert nurses about their early recognition experiences was analyzed using a Phenomenological approach. A model of early recognition and three distinct themes are discussed: building a therapeutic relationship, knowing/sensing the moment of early recognition, and the temporal dimension of knowing. Implications for home care nursing practice and education are highlighted.

Designing a Measure of Complexity Compression in Registered Nurses

Researchers in Minnesota have described and validated the phenomenon of Complexity Compression in qualitative studies of registered nurses. Analysis of themes from this research led to the design of a survey to assess nurses’ agreement with variables that contribute to their experience of Complexity Compression. The survey was administered to a random sample of 199 registered nurses in Minnesota. Exploratory factor analysis was used to evaluate the attributes of Complexity Compression and its underlying structure. Three factors emerged that explained 51.4% of the variance in responses: work of nursing, systems, and personal factors. Internal consistency of the factors ranged from .79 to .89. Validity of the survey for assessment of Complexity Compression in hospital-based nurses was supported. The construct of Complexity Compression and its contributing factors will be tested in future studies with nurses in a variety of health care settings.