Application of the Roy Adaptation Theory to a care program for nurses

Early Post-Transplant Adaptation Experience in Young and Middle-Aged People With Kidney Transplant in China: A Qualitative Study

BACKGROUND

Successful adaptation to post-transplantation life in patients who have undergone kidney transplants is crucial. The psychosocial needs of people with kidney transplants are closely related to the health of the transplanted kidney. If transplant recipients cannot adapt to the effects of the transplant, their physical and mental health will be seriously impaired.

OBJECTIVE

The purpose of this study was to explore the early post-transplant adaptation experience of young and middle-aged persons with kidney transplants in China based on the Roy adaptation model.

METHODS

A qualitative descriptive study was conducted using semi-structured interviews. Fifteen young and middle-aged persons with kidney transplant were recruited from a tertiary hospital in China between September 2022 and March 2023 through purposive sampling. Data were analyzed using a thematic analysis approach.

RESULTS

This study identified 4 themes: (1) "two-sided" changes in physiological functioning, (2) "dawn and darkness" (conflicting perceived emotions about the future), (3) role functioning adaptation conflict and impairment, and (4) social isolation and the challenges of coping.

CONCLUSIONS

This study found that early post-transplant adaptation in young and middle-aged people with kidney transplant included both positive and negative experiences, and these findings can provide new insights into research related to successful post-operative adaptation.

Falling and rising in the vortex of cancer: children's adaptation with cancer: a qualitative study

BACKGROUND

Cancer is a considerable health problem worldwide and the second leading cause of death in children. It has many physical, psychological, and social consequences for children and their families. The ability to adapt to cancer plays a vital role in the recovery and quality of life of affected children. This study aimed to explain the adaptation of children with cancer to their disease.

METHODS

This qualitative study adopted the directed content analysis approach based on the Roy nursing model. The participants were nine children with cancer aged 6-18 years old, five family members, four nurses, one doctor, one teacher, and two charity association members, recruited by purposive sampling method. The information was collected via individual semi-structured interviews, a focus group discussion, and field notes. The data were analyzed simultaneously with data collection using the Elo and Kyngäs method. The study rigor was ensured based on the Guba and Lincoln criteria.

FINDINGS

Of the four categories of physical challenges, fragile self-concept, the difficulty of role transition, and disruption of the path to independence, the theme of Falling and rising in the cancer vortex was abstracted.

CONCLUSION

Based on the Roy model, the children in the present study were at the compensatory level of adaptation. This research demonstrates that the adaptation of children being treated for cancer is fragile and not constant. With each hospitalization and exacerbation of the disease, they made efforts to adapt to their disease using regulatory and cognitive subsystems. Paying attention to different stimulants and the effects of support systems on physical challenges, fragile self-concept, difficult role transition, and disruption of the path to independence for each child, as well as providing individualized care for these children, can help their adaptation to and healthy transition from the vortex of cancer. The Roy adaptation model was helpful and efficient for elucidating the adaptation of children with cancer. Providing care for children by healthcare specialists, especially nurses, should be theory-based and individualized.

Clinical validation of the terminological subset for people with chronic kidney disease undergoing conservative treatment

OBJECTIVE

To clinically validate a terminological subset of the International Classification for Nursing Practice (ICNP®) to care for people with chronic kidney disease undergoing conservative treatment.

METHOD

Prospective study of clinical validation assessment of 117 nursing diagnoses/outcomes statements and 199 nursing intervention statements. It was operationalized through the following steps: implementation of the Nursing Process in an outpatient clinic in Southeast Brazil; preparation of case studies; analysis of agreement between specialist nurses. The Kappa. Kruskal-Wallis coefficient of agreement and intraclass correlation coefficient (ICC) were used.

RESULTS

The sample consisted of 50 people with chronic kidney disease. Diagnoses/outcomes and interventions were evaluated with almost perfect/perfect agreement and excellent ICC. The Kruskal-Wallis test showed that there was no significant difference between the assessments. The study allowed the clinical validation of a subset with 110 nursing diagnoses/outcomes and 195 nursing interventions.

CONCLUSION

Care for people with chronic kidney disease undergoing conservative treatment based on the proposed subset has become applicable to clinical practice.

Reducing Anxiety Among Nurse Leaders Through Virtual Animal-Related Engagement

This project explored the relationship between virtual animal-related engagement (ARE) and anxiety in nurse leaders. A quality improvement project used a valid and reliable visual analog scale from 0 to 100 for self-reporting of anxiety in nurse leaders. Baseline and intervention group data were collected for 2 weeks at 15 and 5 minutes before the daily leadership huddle. Differences in anxiety levels 5 minutes before the huddle for baseline with the use of the intervention were significant. Within the intervention group, anxiety levels at 15 and 5 minutes were significant. Project outcomes suggest a difference in self-reported anxiety of nurse leaders based on ARE.

Learning to Fly in the Time of COVID-19: Nurse Resident Experiences During the First Surge

This qualitative study, designed by nursing professional development specialists, explored novice nurses' experiences working during the first COVID-19 surge of 2020. Semistructured focus group interviews were conducted in June-December 2020 with 23 novice nurses who cared for patients with COVID-19 in March-April 2020. Sixteen themes were identified under three broad categories (viz., stimuli, coping, and adaptation). These themes and participant exemplars are shared along with recommendations on how best to support novice nurses working through the ongoing pandemic.

Exploring tacit knowledge based on an expert nurse's practice for stroke patients

This study explored tacit knowledge based on an expert nurse's practice who cares for stroke patients by using the hermeneutic phenomenological approach. The participant ('Ms. A') was a nursing researcher and college faculty member involved in the education of advanced practice nurses; her specialty was stroke rehabilitation nursing. She was asked to describe the meaning and value she gained from her memorable nursing experiences. Four interviews-approximately 1 h each-were conducted, and the associated data were interpreted together with the participant based on the method of interpretive circulation. Notably, the analysis was ended when a fusion of horizons was recognized. The participant recalled her nursing experiences based on six model cases. During the analysis, the following five elements were extracted: [belief in the ability of vulnerable people to survive]; [being together]; [respect for human dignity]; [preparedness to respond to and bear suffering together]; and [theoretical knowledge base approaches true understanding of patient experience]. Further, the nursing model-the Roy Adaptation Model-utilized by Ms. A in the process of recognizing humans as whole beings was deeply interpreted and implemented as a guideline for her implicit advanced practice. Moreover, her deep understanding and utilization of theoretical knowledge base also built the foundation for her implicit advanced practice. In conclusion, Ms. A's tacit knowledge and the elements support the process of tacit knowledge acquisition. Her narratives, hermeneutic attitude as an interpreter, and learning attitude throughout interaction with others will strongly help her knowledge development. We intend to continue the study with multiple participants and explore the structure of tacit knowledge possessed by advanced practitioners. Future endeavours will include the development of a tacit knowledge learning strategy.

Nursing students' perceptions and experiences of learning and using nursing theories: A qualitative study

BACKGROUND

No study has addressed the experiences of Iranian nursing students learning and using nursing theories.

PURPOSE

We investigated the experiences of Iranian postgraduate nursing students learning and using nursing theories.

METHODS

A qualitative study was conducted on 25 Master's degree nursing students who had completed the course of nursing theories in three selected nursing schools in Iran. Semistructured interviews were conducted. Data analysis was performed using a content analysis approach.

RESULTS

Most of the students had positive experiences of learning and using nursing theories. Three main categories emerged from the data namely "a refreshing opening," "needing support," and "clinical usefulness." Nursing theories refreshed the students' view of the nursing profession, strengthened their professional values, helped them recognize professional boundaries, and practice a comprehensive care.

CONCLUSION

The nursing education system should prepare expert teachers for teaching nursing theories. Nursing managers should support nurses to implement these theories.

The effects of Roy's adaptation model and the forgetting curve in the clinical instruction of operating room nursing interns

OBJECTIVE

To investigate the effects of Roy's adaptation model combined with the forgetting curve in the clinical instruction of operating room nursing interns.

METHODS

115 nursing students in our hospital were randomized and allocated into two groups: the observation group (n=60) and the control group (n=55). The control group underwent the traditional nursing instruction method, and the observation group underwent a new instruction mode guided by Roy's adaptation model combined with the forgetting curve method. The learning effects of the two groups of nursing students and their satisfaction with the nursing instruction were compared.

RESULTS

The observation group's theoretical examination score was (96.18±3.94) points, and the group's skill examination score was (83.78±5.19) points, which were higher than the corresponding scores in the control group (83.78±5.19) and (81.32±3.66), with statistical significance (all P<0.05). The operating doctors' scores on the operating room nursing students' psychological adaptability in the operating room, their proficiency in common operation cooperation, their aseptic concepts, their ability to prepare and dispose of instruments and articles, and their work and learning initiatives were significantly higher than they were in the control group, and the differences were statistically significant (P<0.05). The nursing students' professional level, interpersonal communication ability, and teaching ability scores and their total score in the observation group were significantly higher than they were in the control group (P<0.05).

CONCLUSION

The new instruction method which combines Roy's adaptation model with the forgetting curve can not only effectively improve the nursing students' learning abilities and adaptability, but it also has an important significance in improving the relationship between doctors and nurses, the instruction relationship, and in improving the quality of the nursing instruction and the comprehensive ability of the nursing staff in the operating room.

An effective in-hospital chaplaincy-led care program for nurses: Tea for the soul a qualitative investigation

Tea for the Soul (TFS) is an understudied care model, addressing bereavement and other emotional needs of nurses related to impactful patient care experiences. Nurses are at high risk for compassion fatigue, moral distress, and burnout. Facilitated by a Chaplain, the TFS program provides participants a venue to express their feelings and explore ways of adapting effectively with the death of a patient, and other traumatic workplace experiences. In this qualitative grounded theory study, hospital nurses (N = 7) who participated in TFS were interviewed. IRB approval was obtained. Questions were constructed within the context of the medical center research council and asked if TFS: (a) was personally beneficial, (b) helped nurses feel better about their work, and (c) affected job satisfaction. Four core themes emerged: (a) Nurses' Self-Care, (b) Professional Practice, (c) Community, and (d) Improved Patient Care Outcomes. The Roy Adaptation Model, Group Identity Mode was applied to the content analysis. Overarching themes were Compassionate Service, Ministry of Presence, Reflective Practice, and Sacred Encounters. Nurses reported that TFS facilitated a spiritual respite and a sense of enhanced community and was a source of strength and coping, thus may aid in the promotion of nurse well-being and the amelioration of moral distress, compassion fatigue, and burnout.