Class 8 Penz, K. & Duggleby, W. (2011). Flashcards
Identification of the phenomenon
- Hope is what
- how much is known
Hope is a “multidimensional dynamic life force characterized by a confident yet uncertain expectation of achieving a future good, which to the hoping person is realistically possible and personally significant” (Dufault & Martocchio, 1985)
Little is known about the concept of hope from the perspective of community practicing RNs
Research Purpose/ Study Question
- What is the purpose
- what are the three specific aims
The purpose of this study was to explore the hope experience of registered nurses (RNs) who provide palliative care in community settings
Three Specific Aims:
- Describe their hope experience
- Develop a reflexive understanding of the processes of their hope
- Construct a substantive theory of hope of palliative care RNs
Literature Review3
Hope is a multidimensional and dynamic entity
-Associated with: positive feelings, spirituality, future, interprofessional relationships, mediator of positive work outcomes
Contrasting viewpoints also evident
-Recovery from illness, lack of disease progression, remission
Majority of studies do not include palliative care RNs (warrants further study in this population)
Research Design
- What theory
- what methodology
Constructivist Grounded Theory (Charmaz, 2006, 2000)
Qualitative Methodology
Sample
- what kind of sampling
- what is the eligibility criteria: 5
14 RN participants (27 interviews total, Journals completed by 9 participants)
Table 2: Characteristics of participants (e.g., Age, ethnicity, location of practice, nursing position)
Purposeful theoretical sampling
Eligibility criteria:
- RNs who are currently providing direct P/EOL care services in community settings
- Currently employed in SK from a variety of geographic areas
- Experienced in pall care
- Rural and/or urban
- Willing to participate in the study
Legal and ethical issues
- What had to be done first
- what did they use
- where did they display the info
- how was anonymity and confidentiality maintained
Study was approved by an institutional behavioural ethics review board before it was initiated
Use of recruitment collaborators
Information display at a provincial palliative care conference
Anonymity/ Confidentiality
-No identifying information in quotes used
Data Collection
- How did they collect info
- what was in the interview guide
- what kind of sampling
Demographic form, open-ended telephone interviews, journal entries, interview notes
Interview guide (how do they define hope, what hope means to them, how hope influences their caregiving, positive/negative influences on their hope)
Theoretical sampling (rural and urban, leadership and front line nurses, different health regions)
Data Analysis
- how did they record the data
- when was collection and analysis done
- what software was used
- what kind of coding
- how was Data trustworthiness or rigour maintained
Interviews and journal entries transcribed verbatim
Data collection and analysis simultaneously
NUD*IST software to manage open ended data
Initial, focused and theoretical coding
-Compare where theory fits in relation to the literature
Data trustworthiness or rigour (CGT criteria used)
Findings
- what is the social context of hope
- What was the main concern
- What is the basic social process
- What are the subprocesses of harmonizing home 4
Social context of hope (consistent with CGT approach)- Who I am, Resigning myself to the system, Feeling valued/respected, Managing grief and loss
Main concern- Keeping Hope
Basic Social Process- Harmonizing Hope
Subprocesses of Harmonizing Hope
- Looking both ways
- Connecting with others
- Seeing the bigger picture
- Trying to make a difference
Discussion
- presents what
- discovers what
Presents a developing theory which provides a process by which palliative care RNs are able to consider the hopes of others, but still remain true to their own hope
Discover hopes of others, reconcile differences, shared understanding, staying positive, finding meaning and purpose in their work
Recommendations 3
Future research opportunities (What fosters their hope? What hinders their hope? How can hope be sustained over time?)
Consider the potential role that hope plays (e.g., benefits to providing care, and assist with dealing with work life challenges)
Important not to overlook the internal resources of the palliative health care professional
Limitations 3
Potential vested interest of study sample related to the topic of hope and the importance of hope in their work and personal lives
Only females participants (efforts made to access male participants were unsuccessful)
Findings may not resonate with male RNs who provide palliative care
Use of telephone interviewing techniques
Observations of nonverbal communication were not possible
