KNOWING THE PATIENT: AN EMPIRICALLY GENERATED PROCESS MODEL FOR INDIVIDUALIZED INTERVENTIONS (EXPERT NURSES).
Contributors: Boston College.
Published: 1993
Number of pages: 263
Subjects: Health Sciences, Nursing.
Description: A grounded theory method was used to identify, describe, and provide a theoretical analysis of the strategies a purposively selected sample of expert nurses used while making decisions in the care of acutely ill cardiac patients. Data were collected at an urban teaching hospital and were comprised of participant observation fieldnotes, text from eighteen in-depth semi-structured interviews, written exemplars, and hospital documents. The constant comparative method of data analysis included open, axial, and selective coding as outlined by Strauss and Corbin (1990). Verification methods to enhance the analysis included use of the literature and collegial and informant feedback.

A beginning process model emerged from the analysis of data. The core process, knowing the patient, is a purposeful action whereby the nurse uses her understanding of the patient's experiences, behaviors, feelings, and/or perceptions to select individualized interventions. Individualized interventions are therapies by which the patient is treated as a unique person. Familiarity and intimacy are identified as two properties of the core process; the patient-nurse interaction is the context. Three conditions of the core process are delineated: time, the nurse's experience, and other nurses' input. Four strategies facilitate the core process: empathizing, matching a pattern, developing a bigger picture, and balancing preferences with difficulties. Different strategies may be used as time and familiarity vary.

Findings from this study contribute to nursing knowledge by describing one process whereby nurses make therapeutic decisions. The model differs from theories which have predominantly guided clinical decision-making research. The findings have implications for further nursing research and offer insights for nursing education and practice.
Notes: Source: Dissertation Abstracts International, Volume: 55-01, Section: B, page: 0079.

Thesis (PH.D.)--BOSTON COLLEGE, 1993.

School code: 0016.