Situation-specific Theory Research Articles

Correlates of Hepatitis B Virus Health‐Related Behaviors of Korean Americans: A Situation‐Specific Nursing Theory

The purpose of this article is to explain the evolution of a situation-specific theory developed to enhance understanding of health-related behaviors of Korean Americans (KAs) who have or are at risk for a chronic hepatitis B virus (HBV) infection. The situation-specific theory evolved from an integration of the Network Episode Model, studies of health-related behaviors of people with HBV infection, and our studies of and practice experiences with Asian American individuals with HBV infection. The major concepts of the theory are sociocultural context, social network, individual-level factors, illness experience, and health-related behaviors. The major propositions of the theory are that sociocultural context, social network, and individual-level factors influence the illness experience, and that sociocultural context, social network, individual-level factors, and the illness experience influence health-related behaviors of KAs who have or are at risk for HBV infection. This situation-specific theory represents a translation of abstract concepts into clinical reality. The theory is an explanation of correlates of health-related HBV behaviors of KAs. The next step is to develop and test the effectiveness of a nursing intervention designed to promote behaviors that will enhance the health of KAs who have or are at risk for HBV infection, and that takes into account sociocultural context, social network, individual-level factors, and illness experience.

Well-Being in Refugee Women Experiencing Cultural Transition

This article presents a situation-specific theory of well-being in refugee women experiencing cultural transition. The theory resulted from 2 studies, an ethnography and a community-based collaborative action research project, with refugee women from South Sudan, who were resettled to the United States. The theory extends the middle-range theory of transition to include cultural transition as a distinct type of transition with a unique set of properties and conditions including 3 phases-separation, liminality, and integration. Community action research is discussed as a culturally relevant intervention for nurses working with immigrants and refugee populations to foster well-being in resettlement.

Crisis Emergencies for Individuals With Severe, Persistent Mental Illnesses: A Situation-Specific Theory

This article presents an extension of Ball's midrange theory of crisis for individuals with severe, persistent mental illnesses (SPMI) by placing Balls' model in the specific situation of the individual seeking help in an emergency setting, creating the situation-specific theory of crisis emergencies for individuals with SPMI. There is a large and growing presence of clients with SPMI in crisis engaging nurses in emergency departments. Through application of an integrative approach, a situation-specific theory for nurses in emergency departments to distinguish between a need for mental health crisis intervention and mental health emergency intervention has been developed, with implications for nursing practice, policy, and research.

A situation-specific theory of Asian immigrant women's menopausal symptom experience in the United States.

In this article, a situation-specific theory that explains the menopausal symptom experiences of Asian immigrant women in the United States is presented. Using an integrative approach, the theory was developed on the basis of the transitions theory, a review of the relevant literature, and a study on Asian immigrant women's menopausal symptom experience in the United States. The proposed theory includes transition conditions, patterns of response, and nursing therapeutics as major concepts and explains the relationships among these major concepts. This theory should be further validated and developed in intervention studies and nursing practice with this specific population.

Diabetes Mellitus and the Importance of Self-care

Self-care is believed to play an important role in diabetes mellitus (DM) management, and the relationship between DM self-care and glycemic control has been extensively examined in the literature. However, most existing DM self-care literature focuses on patients' routine health behaviors. The literature has not examined in detail the relationship between health outcomes and patient decision making/nonroutine responses to signs and symptoms of DM. This article adopted Riegel and Dickson's situation-specific theory of heart failure self-care [J Cardiovasc Nurs. 2008;23(3):190-196], which incorporates an examination of patient decision making and nonroutine behaviors in their working concept of self-care, and used it as a framework for reviewing the research literature relevant to how DM self-care influences health outcomes.

A situation-specific theory of Midlife Women's Attitudes Toward Physical Activity (MAPA)

This paper presents a situation specific theory-the Midlife Women's Attitudes Toward Physical Activity (MAPA) theory-that explains how women's attitudes toward physical activity influence their participation in physical activity. Using the integrative approach of Im, the theory was developed based on the Attitude, Social Influence, and Self Efficacy Model; a review of the related literature; and a study of women's attitudes toward physical activity. As a situation-specific theory, the MAPA theory can be linked easily to nursing practice and research projects related to physical activity in midlife women, especially interventions aimed at increasing midlife women's participation in physical activity.

The Situation-Specific Theory of Pain Experience for Asian American Cancer Patients

Studies have indicated the need for theories that explain and target ethnic-specific cancer pain experiences, including those of Asian Americans. In this article, I present a situation-specific theory that explains the unique cancer pain experience of Asian Americans. Unlike other existing theories, this situation-specific theory was developed on the basis of evidence, including a systematic literature review and research findings, making it comprehensive and highly applicable to research and practice with Asian American patients with cancer. Thus, this theory would strengthen the interconnections among theory, evidence, and practice in pain management for Asian American cancer patients.

The Sociocultural Context of Breast Cancer Screening Among Korean Immigrant Women

Korean immigrant women, who compose 1 of 6 major subpopulations in Asian Americans in the United States, are reported to have far lower rates of breast cancer screening than do women in general. Despite the sporadically reported cognitive, affective, and environmental constraints to the screening practices, to date, no research has been conducted to investigate the sociocultural contexts within which women in this population seek help for breast health. The purpose of this study is to explore and interpret the sociocultural processes of breast cancer screening among Korean immigrant women using the grounded theory method. Twenty Korean immigrant women, aged between 20 and 81 years, participated in a set of 2 consecutive qualitative interviews conducted in the Korean language. The qualitative data were transcribed and analyzed using the constant comparison technique. "Balancing relationships within a discordant world" is the core concept of the process of breast cancer screening among Korean immigrant women. There are sociocultural discord in perceptions of breast cancer and screening procedures between Asian ways of thinking and Western biomedical premises. The elicited situation-specific theory sheds light on what Western healthcare professionals have missed and what they should consider in caring for culturally diverse populations.

A Situation-Specific Theory of Heart Failure Self-care

Heart failure, a common syndrome in developed countries worldwide, is associated with poor quality of life, frequent rehospitalizations, and early death. Self-care is essential to improving outcomes in this patient population. The purpose of this article is to describe a situation-specific theory of heart failure self-care in which self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability (maintenance) and the response to symptoms when they occur (management). Self-care maintenance is further defined to encompass routine symptom monitoring and treatment adherence. Self-care management is characterized as a process initiated by symptom recognition and evaluation, which stimulates the use of self-care treatments and treatment evaluation. Confidence in self-care is thought to moderate and/or mediate the effect of self-care on various outcomes. Four propositions were derived from the self-care of heart failure conceptual model: (1) symptom recognition is the key to successful self-care management; (2) self-care is better in patients with more knowledge, skill, experience, and compatible values; (3) confidence moderates the relationship between self-care and outcomes; and (4) confidence mediates the relationship between self-care and outcomes. These propositions were tested and supported using data obtained in previous research. Support of these propositions provides early evidence for this situation-specific theory of heart failure self-care.

Seeking What's Best During the Transition to Adult Day Health Services

Family caregivers provide more than 80% of the long-term care for elders in the United States and experience a variety of transitions that are intertwined with those of their elders. Previous research on health care transitions documents problems elders and family caregivers encountered following hospitalization, following nursing home admission, and in adjusting to home health care. Little is known about the transition to adult day health services (ADHS). The purpose of this study was (a) to examine family caregivers' perspectives on the transition to ADHS and (b) to develop a situation-specific theory to guide interventions for elders and their family caregivers during the transition. Semistructured interviews were conducted with 16 family caregivers 1 month and 3 months following the elder's enrollment in ADHS. The constant comparative method was used in analyzing the data. The findings indicate that family caregivers consistently sought what was best for elders throughout the transition.

Empowerment in School Nursing Practice: A Grounded Theory Approach

Professional empowerment is vital to nurses' productivity and job satisfaction. A grounded theory study was conducted to describe the basic social process experienced by school nurses in relation to professional empowerment. Interviews with 10 school nurses led to the development of a situation-specific theory of school nurse empowerment, Making a Difference: The Role of the School Nurse in the Health of Children in Schools. This theory was derived from four theoretical constructs: (a) enlisting support, (b) getting through the day, (c) maintaining control over practice, and (d) adjusting to challenges. Interviews revealed that knowing at the end of each school day that they made a difference in the health of children resulted in feelings of empowerment. Participants cited various areas in which their sense of empowerment was limited, including salaries and workload. Despite these issues, they believed they had a positive impact on the health of children, leading to job satisfaction and feelings of value.

A Situation-Specific Theory of Migration Transition for Migrant Farmworker Women

This article proposes a situation-specific theory of migration transition for migrant farmworker women (MFW). The following themes were identified: (a) migration patterns, (b) awareness of critical markers, (c) time between awareness and engagement, (d) decision making, (e) differences between expected and actual transition experiences, and (f) personal identities. Participants identified conditions that supported and prevented a healthy migration transition including personal identities, family support, faith-based and community health outreach services, immigration/documentation status, and respect. Women recognized a sense of peace as a healthy transition response. The proposed theory offers an understanding of migration transition and provides a practical theoretical perspective for nurses and other health care professionals who implement and coordinate health care for MFW.

A Situation-specific Theory of Caucasian Cancer Patientsʼ Pain Experience

Situation-specific theories can explain a population's unique health/illness experience with a limited scope of generalizability, but with more specificity that can provide a more close and comprehensive view on and explanation of a nursing phenomenon. In this article, a situation-specific theory explaining the unique cancer pain experience of Caucasian cancer patients is presented, along with the theory development process that was taken to develop the theory. First, the method used to develop the theory is concisely described. Then, the theory development process is described step by step. Finally, the situation-specific theory that was developed through the process is presented.

Toward a Situation-Specific Theory of Breastfeeding

This article reports a preliminary situation-specific theory of breastfeeding developed using an integrative, inductive approach (Im & Meleis, 1999). The theory purports varying levels of conflict versus congruity existing between the mother/infant dyad, a mother and her support networks, and both between and within the networks, all of which either block or facilitate breastfeeding. The theory proposes that to decrease conflict, professionals need to carefully consider their approach to promoting and supporting breastfeeding so as to respect the right of maternal decision-making and to avoid semblances of coercion or paternalism. "Salutary breastfeeding" is proposed as a new, ideal breastfeeding experience that is positive, healthy, and fulfilling, yet encompasses acknowledgement of diversity in maternal/infant dyads and situational context.

Development of Situation-specific Theories

One type of "ready-to-wear" theories that can bring about better nursing care outcomes regardless of their philosophical bases is situation-specific theories proposed by Im and Meleis in 1999. In this paper, some propositions for an integrative approach to the development of situation-specific theories are made. First, situation-specific theories are described as practice theories while they are compared with middle-range theories. Then the integrative approach is detailed, which includes (a) checking assumptions for theory development; (b) exploring through multiple sources; (c) theorizing; and (d) reporting, sharing, and validating. Finally, the paper concludes with suggestions for further development of the integrative approach.

The concept of protection: a dimensional analysis and critique of a theory of protection.

Dimensional analysis clarifies the concept of protection, which has a commonly understood definition but is used inconsistently in research literature. Concepts such as protective factors and protective behaviors are often used interchangeably without adequately representing the phenomenon of protection itself. This article critiques a situation-specific theory of protection and presents dimensions of a model with an ecological view of protection. It uses dimensional analysis methods to derive the social construction of protection from its use in a broad range of literature; vigilant management and vigilant communication are salient dimensions of protection. The article compares conceptual literature with research literature to identify inconsistencies in use.

A situation-specific theory of Korean immigrant women's menopausal transition.

To extend the previous model of transitions by including the experiences of low-income Korean immigrant women in the United States during their menopausal transition. The extension results in a situation-specific theory of Korean immigrant women's menopausal transition. Findings from a study of menopausal transition among Korean immigrant women were used as a main source for modification of the conceptual properties of transitions, conditions shaping the transitions, and indicators of healthy transitions. The study was cross-sectional with methodologic triangulation. Quantitative analysis was based on data from 119 first-generation Korean immigrant women who engaged in low-status or low-income work outside their homes; qualitative study using theoretical sampling method included 21 women. Analyses included descriptive and inferential statistics and thematic analysis. Integrative conceptual analysis using deductive and inductive reasoning was conducted to determine modifications in theory based on the descriptions of menopausal transition of Korean immigrant women. Three main themes were identified: (a) the women gave their menopausal transition far less attention than they did to their immigrant and work transition; (b) menopause was a hidden experience in cultural background; and (c) the women "normalized," ignored, and endured symptoms. The findings indicated additions of the following concepts: (a) number, seriousness, and priority of transitions; (b) socioeconomic status; (c) gender; (d) context; (e) attitudes toward health and illness; (f) interrelationships among all conditions shaping transitions; and (g) symptom management. The proposed situation-specific model is limited in scope. However, it provides understanding of the menopausal transition of Korean immigrant women in context, and is a guide for nursing interventions for immigrant women experiencing transition.

Theoretical Nursing: Development and Progress

Inspire your students to be theoretical thinkers, innovative advocates, and agents for change. Focused on cultivating the next generation of scholars, this highly respected classic demystifies theory, charts strategies to use in developing and advancing theory, and provides tools and best practices in evaluating progress in the discipline. Based on the feedback of nursing students, this edition was updated to be more accessible without losing the necessary rigor to foster critical thinking. Meleis provides a developmental and historical review of theoretical nursing and helps readers develop analytic skills and integrate knowledge into a coherent whole. By embarking on the journey of nursing theory, practicing nurses will find ways to improve everyday practice, as well as develop theories that capture their expertise. Highlights of the Sixth Edition Key Topics Paradigms that influenced nursing thought, such as feminism and post-colonialism Nursing Theories, including need , interaction , and outcome theories Social and health care transitions and their influence on advancing nursing knowledge The most updated global definitions of the discipline of nursing and the future of nursing Critical discussions on how different classifications of theories may lead to productive explorations and explanations of the process of clinical judgment and decision making Key Features New online journal articles and case studies give students an opportunity to apply theory to practice. Chapter-ending Reflective Questions expand students' understanding of theory and its impact on nursing today. Separate chapters covering Middle Range Theory and Situation-Specific Theory . text is complemented by and frequently used with Peterson & Bredow's Middle Range Theories: Application to Nursing Research and Practice . A new two-column design that enhances readability. Doody's Review Services gives this title a Weighted Numerical Score: 89 - 3 Stars! This is the most exemplary nursing theory title available and it is particularly useful because it is a treasure trove of classic and emerging theorists and their work. The breadth, comprehensiveness, and historical grounding make this a must-have title that is a relevant reference for emerging nursing theorists and researchers, faculty, graduate students, and policy makers. - Doody's Review Service

The Factorial Validity of the Adult Selfexpression Scale with American Indians

A commonly used self-report assertion measure, the Adult Self-Expression Scale (ASES) was factor analyzed to shed light on the structure of the instrument and dimension of assertion with an American Indian population. Data were analyzed using a principal factors solution. The occurrence of considerable unique factor variance differed from the findings of earlier factor analytic studies with non-Indian populations. The situation-specific theory of assertive behavior of previous validation studies was supported. Items comprising the factors of this analysis provide the clinician and social skills trainer with precise information of the salience of situationally-specific issues of American Indian assertion. The results not only support the use of the ASES as a screening and outcome instrument for assertion training with American Indian clients, but also point to the need for greater specificity concerning the ethnicity of the personal component of the scale.