Fieldwork Phase Research Articles

Family caregivers’ perceived value of caring for older patient: A hybrid model of concept analysis

Purpose: The purpose of this study was to define and clarify the concept of the family caregivers’ perceived value of caring for older patients. Methods: The hybrid model of Schwartz-Barcott and Kim was used to perform the concept analysis of perceived value of caring. Concept analysis was conducted in three phases: the theoretical phase, fieldwork phase, and final analysis phase. Results: The perceived value of caring was found to have four dimensions and nine attributes. The providing care dimension consisted of two attributes—care behavior and care attitude—and the goals and expectation dimension included three attributes—social norms, family norms, and personal norms. The other two dimensions consisted of two attributes each: a belief in usefulness and a belief in meaning in the building beliefs dimension and life expansion and insight into the future in the suffering sublimation dimension. Finally, perceived value of caring can be defined as the personal belief that behavior or attitude of providing physical, mental, and social services to those in need of care is usefulness and important based on one’s goals and criteria, and with the personal effort of sublimating suffering that arises from care. Conclusion: Based on the study findings, it is suggested that the use of the perceived value of caring should expand in nursing phenomena.

Body acceptance in women with breast cancer: A concept analysis using a hybrid model

Women with breast cancer undergo drastic physical changes which can impact their body image. Accepting the altered body has recently been highlighted as the key to body image improvement, however, there is no clear definition or conceptualization of it. This study clarified the concept of body acceptance in women with breast cancer, using a hybrid model. In the theoretical phase, the attributes and working definitions of the concept were identified through an extensive literature review. Individual in-depth interviews were conducted during the fieldwork phase to elucidate the concept and verify the attributes derived from the theoretical phase. Finally, in the final analytic phase, the findings were compared and integrated. The theoretical and fieldwork phases included 20 out of the 579 articles extracted from the literature search and five women who had undergone breast cancer surgery, respectively. Body acceptance was defined as "acknowledging, normalizing, and overcoming changes in body appearance and function caused by breast cancer and its treatment". Body acceptance has been identified as a key factor directly related to the overall quality of life. This study provides a theoretical basis for developing effective interventions and consequently facilitates their provision in practice.

Concept analysis of adoption: A hybrid model.

Adoption is a multidimensional concept affected by cultural and social factors. On the other hand, the number of adoptees has recently increased indicating the need to pay more attention to this issue. However, no clear definition of this concept has been provided so far. The objective of this study was to analyze the concept of adoption. The present study was an analysis using a hybrid model in three phases. During the theoretical phase, using the keyword "adoption,"pertinent articles published between 2010 and 2022 were searched. In the field work phase, eight adoptive parents as the participants were interviewed and the data were analyzed using conventional content analysis method. In the final analysis phase, a general analysis of the two previous phases was performed and a final definition was presented. Adoption is one of the ways of having children that helps infertile couples to experience parental pleasure. If adoption is done wisely based on the abilities of parents, it can provide the best care setting for the child's growth leading to the consolidation of the family and a purposeful life. In adoption, all of the rights and responsibilities of the child are transferred from the biological parents to the adoptive parents, which is affected by religious and cultural beliefs. The analysis of the concept of adoption provided a good basis for identifying the various dimensions of adoption and its challenges. The parents need to pay attention to all dimensions of adoption before selecting this path. It also provided a good platform for future research in the field of adoption.

Delirium in a surgical context from a nursing perspective: A hybrid concept analysis.

The term delirium has been defined in medical diagnosis criteria as a multidimensional disorder, and the term acute confusion is included in nursing classifications. Delirium can be a serious complication assessed in a patient after a surgical procedure. Still, the patient's delirium frequently remains unrecognised. Care of patients with delirium after surgical procedure is complex, and it challenges nursing expertise. From the nurses' viewpoint, delirium is associated with ambiguity of concepts and lack of knowledge. Therefore, reseach on how nurses perceive patients with delirium in a surgical context is needed. The aim of this study was to describe the concepts of delirium and acute confusion, as well as the associated dimensions, in adult patients in a surgical context from the nursing perspective. The study used Schwartz and Barcott's hybrid concept analysis with theoretical, fieldwork, and final analytical phases. Surgical wards, surgical intensive care units, and post-anaesthesia care units. A systematic literature search was performed through Pubmed (Medline), Cinahl, PsycInfo, and Embase. Registered nurses and licensed practical nurses (n=105) participated in the fieldwork phase. In the theoretical phase, the concepts' working definitions were formulated based on a systematic literature search with the year limitations from 2000 until February 2021. At the fieldwork phase, the nurses' descriptions of patients with delirium were analysed using the deductive content analysis method. At the final analytical phase, findings were combined and reported. The concepts of delirium, subsyndromal delirium, and acute confusion are well defined in the literature. From the perspective of the nurses in the study, concepts were seen as a continuum not as individual diagnoses. Nurses described the continuum of delirium as a process with acute onset, duration, and recovery with the associated dimensions of symptoms, symptom severity, risk factors, and early signs. The acute phase of delirium was emphasised, and preoperative or prolonged disturbance did not seem to be relevant in the surgical care context. Patients' compliance with care may be decreased with the continuum of delirium, which might challenge both patients' recovery from surgery and the quality of nursing care. In clinical practice the nurses used term confusion inaccurately. The term acute confusion might be used when illustrating an early stage of delirium. Nurses could benefit from further education where the theoretical knowledge is combined with the clinical practice. The discussion about the delirium, which covers the time both before surgery and after the acute phase should be increased.

Concept analysis of patient safety in home care: a hybrid model

BackgroundPatient safety in home care is a fundamental and complex concept in nursing. This concept includes a number of challenges in patient care. Studies have shown that there is no...

School Nurse–Parent Partnership in School Health Care for Children with Type 1 Diabetes: A Hybrid Method Concept Analysis

To define school nurse-parent partnerships in school health care for children with type 1 diabetes (T1D) and determine its attributes using a hybrid model. This method involves a three-phase process: theoretical, fieldwork, and analytical. A literature review was conducted during the theoretical phase. A literature search of articles from January 1991 to February 2020 was conducted using relevant electronic databases. Eighty-three articles that met the inclusion criteria were completely read. Fieldwork data were collected through individual interviews from February to July 2019 in South Korea. In the fieldwork phase, interviews were conducted individually with 22 mothers of students with T1D and 20 school nurses recruited by purposeful sampling. Inductive content analysis was conducted. The findings from the theoretical phase were integrated with those from the fieldwork phase, and the final concept was derived. School nurse-parent partnership in school health care for children with T1D has been defined as an interactive process of maintaining a balanced responsibility and providing tailored care to meet needs by establishing trusting relationships and communicating transparently and openly. This analysis yielded four attributes: trusting relationships, transparent and open communication, balanced responsibility, and providing tailored care to meet needs-this entails providing nursing actions by advocating for students and performing a negotiated role together or individually for student and family. The findings of this study add to the importance of an attribute of balancing responsibility for partnership in school health care. The results show that this partnership could contribute to the development of a scale, theory, and nursing intervention in school health care for children with T1D.

Health misinformation: protocol for a hybrid concept analysis and development

Background: Misinformation represents a serious and growing concern in public health; and has attracted much interest from researchers, media, and the public over recent years. Despite increased concern about the impacts of misinformation on health and wellbeing, however, the concept of health misinformation remains underdeveloped. In particular, there is a need to clarify how certain types of health information come to be designated as “misinformation,” what characteristics are associated with this classification, and how the concept of misinformation is applied in public health interventions. Aim: Developing a shared understanding of what it means for health information to be “misinformation” is an important first step to accurately identifying at-risk groups, clarifying pathways of vulnerability, and agreeing goals for intervention. It will also help to ensure that misinformation interventions are accessible, acceptable, and of benefit to the populations to which they are directed. We will therefore examine the characteristics, measurement, and applications of misinformation in public health. Methods: We will undertake a hybrid concept analysis, following a framework from Schwartz-Barcott & Kim (2000). This framework comprises three phases: a theoretical phase, fieldwork phase, and final analysis phase. In the theoretical phase, a search of seven electronic citation databases (PsycInfo, socINDEX, JSTOR, CINAHL, Scopus, PubMed, and ScienceDirect) will be conducted in order to identify original research, review, and theoretical papers, published in English between 2016 and 2022, which examine “health misinformation.” Data from the literature will be synthesised using evolutionary concept analysis methods from Rodgers (2000). In the fieldwork phase, a purposive sampling strategy will be employed to recruit stakeholders for participation in semi-structured interviews. Interviews will be analysed using thematic analysis. The final phase will integrate findings from the theoretical and fieldwork analyses.

Negotiating Aspirations in Displacement

Abstract This article explores women’s aspirations during different stages of seeking asylum and settling in Norway and how their aspirations were influenced by each stage’s characteristics and circumstances. Two ethnographic fieldwork phases involved following nine women during approximately one and a half years through the asylum process and the early stages of settlement in Norway (2017–2019). The data show that while living in an asylum centre, the women’s narratives about their aspirations were permeated primarily by their uncertain circumstances. After settling in the municipalities, they began to encounter multiple limitations to their aspirations, which led them to become demotivated and eventually readjust their aspirations. This article shows the effects that the experience of being an asylum seeker and that of resettling in a new country has on people’s aspirations and motivation, something which can in turn have an influence on how they decide to incorporate into the new society.

How Do the New Residential Areas in Bucharest Satisfy Population Demands, and Where Do They Fall Short?

In recent years, Bucharest’s residential dynamics have thrived, fueled by growing demand and an insufficient housing fund. This study aimed to analyze the residential satisfaction of those living in newly built dwellings. Its objectives were to identify the characteristics of three new residential areas and analyze the satisfaction level among residents regarding both their dwellings and neighborhoods. The investigation employed direct observations during the fieldwork phase (through observation sheets and mapping methods) and surveys (through questionnaires with residents and interviews with developers). Its results highlighted spaces that exhibit an increase in residential constructions, with a tendency to expand toward suburban areas, without necessarily meeting legislative requirements. When measuring the population’s residential satisfaction level, the study observed a general satisfaction regarding dwellings’ modernity and price but noticeable differences within the sample residential nuclei. The solutions proposed by residents mainly target authorities, who were held responsible for developing the urban infrastructure prior to granting building permits, as well as for vetting developers better and requiring them to respect the legislation. Hence, scientists, local authorities, real-estate developers and the local population represent the beneficiaries of the current study’s results.

A Concept Analysis of Illness Intrusiveness in Chronic Disease: Application of the Hybrid Model Method.

This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a working definition was devised through a systematic review. In the fieldwork phase, individual in-depth interviews were conducted with nine participants with chronic diseases. In the final analytic phase, the results were integrated through comparison and review. There are four domains and eleven attributes of illness intrusiveness in chronic disease. The domains include physical, psychological, social/contextual, and spiritual. The physical domain consists of four attributes: pain, fatigue, physical malfunction, and change of body image. The psychological domain consists of three attributes: psychological weakness, uncertainty, and stigma. The social/contextual domain is made up of three attributes: withdrawal of role play, limit of daily life, and burden of changing health habits. Finally, the spiritual domain had one attribute: unstable spiritual state. Thus, based on the study findings, it is necessary to develop a suitable illness intrusiveness in chronic disease assessment scale to assess chronic disease patients.

Deploying an Ethnographic Sensibility to Understand Climate Change Governance: Hanging Out, Around, In, and Back

AbstractWhat can an “ethnographic sensibility” contribute to research on climate change governance? With its emphasis on meaning making and understanding what may lie beneath more obvious interactions and processes, ethnographic methodologies, particularly collaborative event ethnography, are increasingly deployed to address complex questions and achieve conceptual leverage on issues related to climate governance. Drawing on literature in climate anthropology, material geography, and political ethnography, and with examples from our own fieldwork experiences, we devise a heuristic typology underpinned by an ethnographic sensibility to help guide the fieldwork phase of a research project. Building on the well-established practice of hanging out, we introduce hanging around, which attends to spatiality and matter; hanging in, which addresses issues of access and trust; and hanging back to guide the practice of reflexivity. We articulate what fieldwork with an ethnographic sensibility entails and discuss its potential and implications for climate governance research.

Patient-Nurse Partnerships to Prevent Medication Errors: A Concept Development Using the Hybrid Method.

Medication safety is the most patient-centered aspect of nursing, and the medication process needs patients’ active participation to effectively prevent medication errors. The aim of this study was to develop the concept of a patient–nurse partnership for medication safety activities. The study design used the three-phase hybrid model for concept analysis: the theoretical phase, fieldwork phase, and final phase for integration. The results of a study define the concept of patient–nurse partnership for medication safety as “a fair cooperative relationship of mutual responsibility in which patients and nurses share information and communicate with each other through mutual trust.” Seven attributes were derived: mutual trust, mutual respect, mutual sharing, mutual communication, mutual responsibility, fair relationship, and mutual cooperation. The conclusion of the study of patient–nurse partnerships for medication safety was that it is necessary to ensure a balance in power between patient and nurse. This balance can be established through patient-centered nursing by implementing the active transfer of authority from nurses as professionals to patients.

Concept development of "Aging in place": Application of hybrid model.

There are various methods and services which help elders protect their independency and ability and take care. Like aging in place (AIP), that is a home and community-based model. Despite its importance, this concept is still ambiguous and there is no comprehensive definition for it. This study aims to clarify and conceptualize the meaning of AIP and to develop a context-based definition. In this qualitative study, the concept was developed using a hybrid model during three theoretical phases, fieldwork and final analysis. In the theoretical phase, 30 selected articles, following a systematic search in Web of sciences-Scopus-PubMed databases using the keywords "Aging in place", "Aging at home" and "Aging in community", during 2000-2019 were screened and analyzed. After providing the working definition, the fieldwork phase directed qualitative content analysis was performed on interviews conducted with seven eligible elderly. Finally, in the final phase, after comparing the findings of the previous two phases, the final definition was presented. The results of the hybrid model extracted and identified various definitions of AIP and attributes, antecedent and consequences of AIP. attributes included; independency, belonging to the place, maintaining network, living in one's own home and community, safety, comfort, non-institutionalization, first preference, and life routines continuity. Antecedents included; health, physical environment, financial ability, socialization, information support, technology, AIP antecedent prediction, community services and transportation. Finally, Consequences included; Individual acceptability and community acceptability. Also final definition was provided. If the AIP and its related factors are known and provided so that elders can stay in their homes, then they do not have to choose a nursing home and thus stay out of the community. As a result, following the AIP, both the elderly and community will be satisfied.

Burn self-stigma: A hybrid concept analysis

AimAs burn self-stigma has not been addressed fully, the purpose of current study is to analyze dimensions of the concept using literature and lived experiences in burn survivors. MethodsUsing hybrid concept analysis method, we investigated self-stigma in three phases (i.e. theoretical, fieldwork, and final analytical phase). In the first phase we reviewed the literature using PubMed, SCOPUS, Web of Science, Cochrane Library, OVID, SID and Google Scholar. Thirteen semi-structured interviews with burn survivors were conducted during the fieldwork phase. Two extra interviews with health care providers were undertaken for the aim of data triangulation. Textual content analysis and inductive content analysis were used to analyze the data of the first and second phases of this study, respectively. The findings of both phases were combined in the final analytical phase and a comprehensive definition was emerged. ResultsWe assigned all our findings into three content areas (i.e. antecedents, properties and consequences), which are dimensions of self-stigma. In final analytical phase antecedent, properties and consequences of the concept were formed in one (society's misconception about burns), three (negative definition of self, emotional responses, and behavioral responses), and three (negative individual effects, negative social effects, and negative familial effects) categories, respectively. Based on these categories and their corresponding subcategories, a comprehensive definition of the concept was presented. ConclusionBurn self-stigma is a state in which burn survivors experience unfavorable thoughts and feelings about themselves as a result of society's misconceptions about them. They give emotional and behavioral responses that define them in a negative way. In the end, the burn survivor's individual, familial, and social dimensions are significantly impacted.

Clarifying the concept of conscience in nurses' ethical performance in Iran: a concept analysis study.

Although conscience, as an ethical concept, has emerged widely in the field of nursing, its functional meaning and its effects on nurses' performance are not clear. Therefore, the present study aimed to analyze the concept of conscience in the context of Iranian nurses’ ethical performance. This study used a hybrid model including theoretical, fieldwork, and final analytic stages. In the theoretical phase, English and Persian articles published up to 2020 and indexed by scientific databases were analyzed. In the fieldwork phase, semi-structured in-depth interviews were conducted on nurse participants. The last two stages were jointly considered to draw the study’s conclusions. In the theoretical phase, conscience was considered as a context-dependent concept, an inner voice, and a criterion for distinguishing right from wrong. The fieldwork phase’ results were categorized into three themes: “perception of conscience”, “commands of conscience”, and “obedience to conscience. The final definition was reached by merging the theoretical and field stages. This article aimed at investigating the relevance of conscience to ethical practice in the nursing field. Findings show that conscience is an inner feeling or voice that plays a vital role in providing ethical care by nurses.

Diagnostic Protocol of Warm and Cold Uterine Temperaments Based on Persian Medicine: A Qualitative Study

Objective: Uterus is an important body organ in women responsible for purifying blood and carrying fetus. In Traditional Iranian Medicine (TIM), identifying the uterine temperament (mizaj) is necessary for prevention, diagnosis and treatment of this organ’s diseases. Many gynecological disorders in TIM including infertility, oligomenorrhea, amenorrhea, hypermenorrhea, vaginitis, cervicitis, urinary incontinence and pelvic pain are related to uterine distemperament (Su-e mizaj). Therefore, their appropriate treatment depends on the correct diagnosis and treatment of uterine distemperament. Criteria for uterine distemperament in TIM resources are qualitative with no method for precise measurement of its symptoms. This study aims to develop a standard diagnostic protocol of uterine temperament and distemperament for diagnostic and therapeutic purposes. Methods: This is a qualitative study using hybrid concept analysis including three phases: theoretical, fieldwork, and final analytical. In the theoretical phase, TIM resources were reviewed. In the fieldwork phase, experts in TIM and patients were interviewed to extract concepts related to uterine temperaments and distemperaments. Results: In the final analytical phase, major and minor criteria for determination of uterine temperament were presented. Then, we had a several meetings with a panel of experts in TIM in order to design the protocol which led to the development of a standard diagnostic protocol of warm and cold uterine temperament/distemperament. Conclusion: The proposed protocol is an important step towards harmonizing the methods of diagnosis and treatment in TIM, and can be used for treatment or research purposes.

Narrative Imagination and Social Change: Instructors in Agricultural Colleges in Ethiopia Address Sexual and Gender-Based Violence

Ethiopia has one of the highest rates of sexual and gender-based violence (SGBV) in the world, making female students particularly vulnerable in its post-secondary institutions. Although there is extensive literature that describes the problem, mainly from the students' perspectives, what remains understudied is the role of instructors, their perception of the current issues, and what they imagine they can do to address campus-based SGBV, particularly in rural settings. In this study, we used the concept of narrative imagination to work with instructors in four Ethiopian agricultural colleges to explore how they understand the SGBV issues at their colleges and what they imagine their own role could include in efforts to combat these problems. Using qualitative narrative-based methods such as interviews and an interactive storyline development workshop, as well as cellphilming (cellphone + film) as a participatory visual method, the data were collected across several fieldwork phases. We consider how we might broaden this framework of narrative imagination to include the notion of art for social change.

만성질환 노인의 약물이행에 대한 개념분석: 혼종모형

Purpose: This study aimed to define and clarify the concept of medication adherence in the elderly with chronic diseases. Methods: This study employed the hybrid model of Schwartz-Barcott and Kim (2000), which consists of three phases: an initial theoretical phase, a fieldwork phase and a final analytical phase. In the fieldwork stage, data were collected from interviews of 11 elderly people taking prescription medications for one or more chronic diseases in G city. Results: Concept of medication adherence in the elderly with chronic diseases was identified as four dimensions and seven attributes in the final analytical phase: 1) cognitive dimension: mindfulness of taking medication, 2) psychological dimension: expectation of medication, acceptance of taking medication effect, 3) behavioral dimension: spontaneity of taking medication, practice according to prescription or instructions, persistence of taking medication, 4) interpersonal: interaction with healthcare professional. Conclusion: This
 conceptual analysis improves the understanding of the concept of medication adherence in the elderly with chronic diseases, and could be used as a basis for the development of a measurement tool and nursing intervention of medication adherence in the elderly.

중환자실 간호사가 임종간호 시 경험하는 양가감정의 개념분석

Nurses in an intensive care unit (ICU) often play key roles to improve the quality of end-of-life care. During those times, many nurses report they feel ambivalent in the caring between life and death. The purpose of this study was to analyze the concept of ambivalence that ICU nurses often experienced in end-of-life care. As a method, this study was conducted with the concept analysis using the hybrid model Schwartz-Barcott and Kim (1986) presented, naming the complex and dual feelings nurses experience during end-of-life care in ICU as ambivalence. In the theoretical phase and from the literature review, characteristics of ambivalence were identified. During the fieldwork phase, in-depth interviews were conducted with five nurses. In the final phases, a theoretical description was extracted of ambivalence in ICU nurses during end-of-life care. In terms of results, external factors (i.e., realistic context, contradictions in nursing activities themselves) and internal factors (i.e., personal tendencies, conflicting perceptions of dying, occupational awareness of nurses, role conflicts) were derived as antecedents of ICU nurses’ ambivalence during end-of-life care. Attributes were divided into intrinsic and existential dimensions. Intrinsic dimensions resulted in "coexistence of opposing equivalent values," "uncertainty," "hiddenization," "value confrontation may occur sequentially," and "absence of willingness to resolve." In existential dimensions, the following conflicts were derived: "pressure on work versus sympathy about family grief," "helplessness due to failure of medical care versus sadness for patient death" and "role as a nurse versus sadness felt during end-of-life care.” The results are organized into negative assessments of oneself and adaptations to ambivalence. In conclusion, through this concept analysis, the hope is that ICU nurses will be able to prevent progressing to burnout by accurately and actively facing and managing their own feelings during end-of-life care. Furthermore, this research is expected to serve as the cornerstone of developing theories for clinicians who provide end-of-life care.

Eco-friendly performance as a determining factor of the Adoption of Virtual Reality Applications in National Parks

The purpose of this study is to find the key factors of influence for the use and acceptance of Virtual Reality (VR) by tourists visiting National Parks in Costa Rica. The aim is to find whether tourists are willing to use VR to contribute to the eco-friendly performance of the area they visit and to determine whether they are willing to use VR in environmental tourism to protect flora and fauna. This study is quantitative and uses the theoretical Unified Theory of Acceptance and Use of Technology (UTAUT) Model and a survey as the research instrument to obtain data. Data analysis was carried out using a PLS-SEM statistical analysis. The data collection procedure consisted of 50 people being surveyed in the initial pre-test phase and later 455 tourists in the fieldwork phase with national or foreign people over the age of 18 who visit or have visited the national parks of Costa Rica. The results show that there is a positive relationship between eco-friendly performance and the intention to use VR technology, as well as the actual use of VR for the benefit of the environment. The UTAUT2 model was used to find the effect of eco-friendly performance on the intention to use VR, as well as the use of this technology during visits to tourist destinations. The originality of the work is in answering the question of how to develop sustainable tourism in Costa Rica with the use of VR devices and applications that also allow the conservation of flora and fauna.