Jill Peltzer

Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

Purpose: In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Organizing Construct: Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. Findings: The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Conclusions: Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Implications for Practice: Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.

Psychogenic Nonepileptic Seizures: A Pilot Study of a Brief Educational Intervention

PURPOSE Attending to psychological support and education from the time of diagnosis will assist patients in their acceptance of the need for psychological services. DESIGN AND METHODS An intervention was provided at the time of diagnosis of psychogenic nonepileptic seizures. This randomized control pilot study examined outcomes 6-8 weeks after discharge from the hospital. FINDINGS All subjects in the treatment group made and/or kept an appointment with a psychotherapist or psychiatrist within 6-8 weeks of discharge from the hospital as compared with 50% of the control group. PRACTICE IMPLICATIONS This supportive approach assists patients to accept the functional or nonorganic nature of their symptoms and the need for psychological services.

Infected Lives Lived Experiences of Young African American HIV-Positive Women

This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes—Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal—emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma.

Exploring leadership roles, goals, and barriers among Kansas registered nurses: A descriptive cross-sectional study

OBJECTIVES The Institute of Medicines Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs). METHODS Data were collected through an online survey and analyzed using quantitative and qualitative methods. RESULTS Nearly 1,000 Kansas RNs participated. Most reported holding one or more leadership positions. Prevalent leadership goals were health care organization volunteer administrative roles. The most frequently identified barrier to developing leadership roles was time constraints. Many wanted to develop skills to serve on a board, 20% were interested in personal leadership development, and 19% in policy development. CONCLUSIONS Based on the findings, the Kansas Action Coalition leadership team is developing programs to address the leadership needs of Kansas RNs. By building capacity in advanced leadership roles, RNs will be better prepared serve as full partners and lead efforts to promote the health of Kansans.

Strategies for Building Advocacy Skills Among Undergraduate and Graduate Nursing Students.

BACKGROUND Nursing faculty are challenged to create learning experiences that both reflect the complexities of the current health care system and are relevant. Experiential learning opportunities should promote engagement in health care that extends beyond direct patient care to advocacy in larger systems. METHOD To meet this challenge, faculty developed course assignments for students at baccalaureate, masters, and doctoral levels in which students worked with state Action Coalitions to implement the Institute of Medicine Future of Nursing reports eight recommendations. With faculty guidance, student teams developed and implemented projects or conducted research to assist the coalitions in their grassroots initiatives. RESULTS Students at all program levels reported high levels of satisfaction and engagement with these unique projects. Students reported understanding the importance of the Future of Nursing recommendations and intended to continue participating in statewide initiatives. CONCLUSION Experiential learning opportunities at all program levels can engage students in learning more about advocacy, health care trends, and leadership.

Perceptions of health among Black adults living in a diverse urban community

Objective: The Robert Wood Johnson Foundations culture of health initiative advocates for making health a shared value. Health cannot be a shared value without an understanding of how health is defined and perceived. The purpose of this qualitative descriptive study was to examine community members’ perceptions of health and influencing factors, including health care services. Design and Sample: Data were collected through a purposive sample of nine focus groups with 52 participants who were primarily Black (94%) and female (65%). The mean age was 50 years. The average education was 14 years. Data were analyzed using inductive content analysis. Results: Four themes were developed: health is resilience to deal with lifes challenges describes health as necessary to deal with daily challenges; external perceptions affect community identity represents perceptions that other metropolitan counties are flourishing while this county remains depressed, negatively impacting individual and community identity; structural barriers negatively impact health describes a lack of adequate resources to achieve or maintain health, as defined by the participants; and mistrust influences health‐seeking behaviors reflects perceptions of differential treatment. Conclusions: This study provides unique information to nurses and other health care providers about urban‐residing community members’ perceptions of health and health care services. Providing a voice to residents regarding personal, family, and community health is imperative in making health a shared value to achieve the goals of population health, well‐being, and equity.

A Qualitative Description of HIV-Infected African American Women's Experiences of Psychological Distress and Their Coping Strategies

&NA; HIV‐infected individuals are at risk for psychological distress, including depression, sadness, and suicidality. The purpose of this qualitative descriptive study was to examine 22 HIV‐infected African American womens experiences of psychological distress and use of coping strategies. Data were collected through in‐person one‐on‐one interviews until conceptual saturation was reached. Data were analyzed using inductive content analysis. Four themes were found: (a) psychoemotional suffering, (b) contextual factors negatively influence the everydayness of living with HIV infection, (c) HIV‐related stigma perpetuates isolation and loneliness, and (d) creating a safe haven. Implications for nurses and other health care providers include (a) holistic assessment to include evaluation of emotional and mental state, and (b) coping strategies. Integration of spiritual practices into plan of care is also important. Development and evaluation of individualized coping interventions that address stigma and psychological distress through holistic modalities is warranted.

Relationships among Substance Use, Multiple Sexual Partners, and Condomless Sex: Differences between Male and Female U.S. High School Adolescents.

Male and female students manifest different behaviors in condomless sex. This cross-sectional, exploratory, correlational study examined the differences in risk factors for condomless sex between male and female high school students, using secondary data from 4,968 sexually active males and females participating in the 2011 National Youth Risk Behavior Survey. Results in descriptive statistics and multivariate binary logistic regressions revealed that condomless sex was reported as 39.70% in general. A greater proportion of females engaged in condomless sex (23.26%) than did males (16.44%). Physical abuse by sex partners was a common reason for failure to use condoms regardless of gender. Lower condom use was found in (1) those experiencing forced sex by a partner in males, (2) female smokers, and (3) female with multiple sex partners. Thus, sexual health education should address the different risk factors and consider gender characteristics to reduce condomless sex.

The development of a comprehensive community health center in a rural community: A qualitative case study

Purpose – This paper seeks to identify strategies that promote the development and sustainability of a successful comprehensive community health center located in a rural Mid‐western state.Design/methodology/approach – The authors used a qualitative case study methodology, using a purposive sample of 15 employees and board members of a rural community health center. Semi‐structured interviews were conducted, transcribed, and analyzed for common themes and sub‐themes that would describe the strategies used to develop and sustain the successful center.Findings – Leading with Consideration was identified as the dominant theme in the interviews, field notes and archival data. Four sub‐themes: Living the Mission, Fostering Individual Growth, Building a Community, and Encouraging Innovation, emerged from the narratives. Leadership was the most important theme that emerged from the data, resulting in a workforce culture that upholds the mission of the center, leadership that seeks to inspire the growth of both e...

Religiosity and Health: A Holistic Biopsychosocial Perspective:

The resurgence of interest in the influence of religion and spirituality on health is examined within the context of the holistic paradigm and historical connection between nursing and spirituality. While nursing and spirituality often intersect with end-of-life considerations, this article presents findings from studies that demonstrate that religious involvement favors health and longevity across the life course. Examples include protective associations with stress, depression, self-rated health, and infant birth weight. Theoretical and empirical explanations for this relationship are offered, such as social and psychological resources and healthy behaviors. The effects of religion on biological functioning, including allostatic load and telomere length, are also discussed, although this area is understudied. Considerations for the “dark-side” of religious involvement are also offered. Suggestions for nurses wishing to protect and promote the health of their patients using a holistic approach include expanding knowledge of research on religion and health and advocating for patients’ spiritual needs by conducting a comprehensive spiritual assessment in primary, secondary, and tertiary clinical settings.