Using a voice-centered relational method of data analysis in a feminist study exploring the working world of nursing unit managers

Sources and perceptions of hope: A qualitative study involving younger people with dementia

Hope is an important but overlooked phenomenon in dementia studies. Few studies have examined how people with dementia experience or perceive hope, possibly because it is seen as a diagnosis without hope. In this article, we report on a doctoral study, the aim of which was to examine the phenomenon of hope from the perspective of younger people with dementia to generate new understanding and enable community-based healthcare professionals to support well-being. The study was conducted in the Midlands, England, and used a modified diary-interview method. Six participants were given a camera and asked to take pictures of whatever made them feel hopeful. During a post-diary semi-structured interview, a conversation about hope took place. Interviews were transcribed and interpreted using the 'Voice-Centred Relational Method'. Findings show that hope is important to younger people with dementia. Sources of hope were the surrounding environment, keeping connected, taking action, and drawing on internal resources. An over-arching theme was 'defying dementia' and participants demonstrated resistance to negative stereotypes. Living with dementia did not curtail hope, although it could be weakened when participants felt 'cast adrift' by services. The In vivo codes generated were fear of dementia, threats to identity, disconnection from others, and frustrations and restrictions. It is concluded that hope should be a more central part of practice-based conversations with people with dementia.

How do nurse managers describe clinical nurses' work arrangements? A qualitative study

Aim

The researcher sought to understand how nurse managers describe nurses in alternative work arrangements.

Design

The researcher conducted this study using grounded theory.

Method

Semi-structured interviews. A theoretical sample of 26 baccalaureate-prepared nurse managers located across the United States participated in the study.

Results

A typology of five work arrangements provides descriptors that contribute toward greater conceptual clarity on nurses' work arrangements. The data reveal that the typology is fluid because nurses can easily switch across work arrangements. Because the rise in alternative work arrangements means that nurses can leave permanent positions-or explore different work arrangements-when circumstances permit or necessitate, nurses who do not receive continued mentoring will likely bring their deficiencies in skill and/or knowledge to facilities where they find future employment. Hence, inadequate mentoring at the unit level has practical consequences for the quality of patient care at the institutional level.

Telling digital stories as feminist research and practice: A 2-day workshop with migrant women in London

In this article, we look at Digital Storytelling (DS) as a specifically feminist epistemology within qualitative social research methods. Digital Storytelling is a process allowing research participants to tell their stories in their own words through a guided creative workshop that includes the use of digital technology, participatory approaches, and co-production of personal stories. The article draws on a 2-day Digital Storytelling workshop with migrant women which was set up to understand the life stories and work trajectories of volunteers working in the women’s community and voluntary sector in London. By outlining this innovative approach, the article highlights its potential and makes a case for Digital Storytelling as a feminist approach to research while taking into account epistemological, practical, and ethical considerations.

Nurses' Experiences of Managing and Management in a Critical Care Unit

In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem.

Psychometric analysis of the Brisbane Practice Environment Measure (B-PEM)

PURPOSE

To undertake rigorous psychometric testing of the newly developed contemporary work environment measure (the Brisbane Practice Environment Measure [B-PEM]) using exploratory factor analysis and confirmatory factor analysis.

METHODS

Content validity of the 33-item measure was established by a panel of experts. Initial testing involved 195 nursing staff using principal component factor analysis with varimax rotation (orthogonal) and Cronbach's alpha coefficients. Confirmatory factor analysis was conducted using data from a further 983 nursing staff.

RESULTS

Principal component factor analysis yielded a four-factor solution with eigenvalues greater than 1 that explained 52.53% of the variance. These factors were then verified using confirmatory factor analysis. Goodness-of-fit indices showed an acceptable fit overall with the full model, explaining 21% to 73% of the variance. Deletion of items took place throughout the evolution of the instrument, resulting in a 26-item, four-factor measure called the Brisbane Practice Environment Measure-Tested.

CONCLUSIONS

The B-PEM has undergone rigorous psychometric testing, providing evidence of internal consistency and goodness-of-fit indices within acceptable ranges. The measure can be utilised as a subscale or total score reflective of a contemporary nursing work environment.

CLINICAL RELEVANCE

An up-to-date instrument to measure practice environment may be useful for nursing leaders to monitor the workplace and to assist in identifying areas for improvement, facilitating greater job satisfaction and retention.

Relationships between humor, subversion, and genuine connection among persons with severe mental illness

Although humor has been linked to resilience among many populations, little is known regarding the role of humor in the coping of individuals with severe mental illness (SMI). In this study, a series of interviews focused on humor was completed by 15 individuals with SMI, with narratives analyzed using grounded theory methods.The marginalized and stigmatized social position occupied by persons with SMI was found to affect both the use and meanings of humor. Humor was described as being the subject of clinical scrutiny. Humor was also emphasized as a means of subverting power differentials revolving around the identity of SMI with, for many, the primary goal being the development of "real" and genuine connections with service providers.