Improving the use of the nursing process: the impact of charting methodology developed from King's conceptual framework on the use of the nursing process

The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

An examination of learning resulting from a transition from a directed to a self-directed work environment

~ This study focuses on the process of self-directed learning that individuals go through as they adapt to new work situations. This is a study of how one critical incident, specifically the transition from a traditional office structure to a home office structure, affected employees and what their learning process was as they adapted to the new environment. This study has 3 educational foundations: adult learning, self-directed learning, and the social context from which the learning will occur. Six women and 2 men were interviewed approximately 1 year following the transition. Analysis of the data revealed 5 themes of: impacts of the self-directed environment on participants' personal lives, their roles, skill set, productivity, and the physical environment; support offered by the organization, family, and office administration; personal development, specific learning needs, and personal skills; boundaries as they relate to family and work; and skill set and orientation requirements of new home office employees. The findings revealed the learning processes of the 8 participants. The learning processes of these participants were discussed within a theoretical framework of the learners, their immediate surroundings, and the larger social environment. The results indicated that the transition from a directed work environment to a self directed work environment is a complex, interrelated process. An element found throughout the theoretical framework is that of control. A second critical element is the need for participants to have a clearly defined work role and an opportunity to engage in discussion with peers and the community. Further findings reinforced the importance of climate and found that the physical environment is a key factor in a successful selfdirected work environment. The findings of this study revealed that no one factor makes an individual function successfully in a self-directed work environment, but that it is a complex interplay among the leamer, their immediate surroundings, and the social environment that will have the greatest impact on success. Recommendations are made which can be used to guide organizational leaders in facilitating employees' transition from a directed to a self-directed work environment. Additionally, recommendations are made for further research in the area of self-directed work environments.

Construing social dimensions of personality development: nurses as educators

A convenience sample of twenty registered nurses was recruited from two' general hospitals and two community college nursing schools. Kelly's (1955) Personal Construct Theory provided the theoretical framework to discover how nurses perceived themselves as educators. The nurses completed a self-administered Self-Perception Inventory (Soares, 1983) to determine their perception of self as nurse and ideal self as nurse. In an interview, each of the nurses constructed a rank-order repertory grid adapted from Kelly's (1955) Role Repertory Construct Test. Twelve constructs derived from the Self-Perception Inventory (Soares, 1983) were ranked according to a list of ten elements common to a teaching situation. Rank order correlations among the constructs were determined with Spearman's rho. Using a dependent samples t-test, significant differences were found between perceptions of current and ideal self for staff nurses. Significant differences were also found between nurse educators' perceptions of self and ideal self as nurse. No significant differences were determined in perceptions of self as nurse and ideal self as nurse between the staff nurse and nurse educator groups with an independent samples t-test. However, observations of single constructs revealed that although several constructs are shared between the groups in the perception of self in a teaching situation, both groups hold constructs that operate exclusively in their separate domains. The nature and strength of the relationships between the common and unique constructs are different for each group. Nurses I self-perceptions appear to be influenced by the historical development of nursing, role socialization during nursing education, social expectations and gender issues in the health care system.

Factors affecting treatment decision making for women with breast cancer

This study examined the factors affecting treatment decision making for young women with early stage breast cancer. Thirty women, aged 35 to 52 years, were presented information about two equally effective chemotherapy treatments following surgery for breast cancer using an educational instrument called a "decision board." Although equally effective, the treatments differ with regards to side effects and treatment schedule. The purpose of this research was to investigate what factors affect the decision-making process. Following administration of the decision board, women were given a take-home version to review and asked to return one to two weeks later with a decision, at which time they completed a questionnaire. theoretical framework for this study was constructed from the literature on self-directed learning and critical thinking. The Overall, the factors rated most important to the treatment decision were related to quality of life, side effects, and length of treatment. Five factors were found to be rated significantly different by the women who chose one treatment versus the other in terms of importance to their decision. These were side effects in general, vomiting, hair loss, family role, and the number of trips to the cancer centre required for treatment.Implications and recommendations for patient education, research, and practice evolved from the findings of this study.

The Importance and achievement of work values and locus of control as factors in work motivation

The present research study examined the relationships in a work motivation context among perceived importance and achievement of work values, locus of control and internal work motivation. The congruence of a work value was considered to be the discrepancy between the importance of a work value and the perceived achievement of that value. The theoretical framework utilized was based on a self-perpetuating cycle of motivation which included the perceived importance and achievement of work values and internal work motivation as separate and distinct, yet interrelated factors. It was hypothesized that individuals who experienced high congruence of work values would experience higher levels of internal work motivation than individuals who had low congruence of work values. It was also hypothesized that individuals who had an internal locus of control would experience more internal work motivation individuals well, the and have higher congruence of work values than who had an external locus of control. As possibility of locus of control as a moderator between importance of work values and internal work motivation was explored. Survey data were collected from 184 managerial level employees of the XYZ company during an ongoing training session. The following instruments were employed to measure the variables: Elizur's (1984) Importance of Work Values, Hunt and Saul's (1985) Achievement of Work Values, Hatfield, Robinson and Huseman's (1975) Job Perception Scale, a modified version of Rotter's (1966) I-E Locus of Control Scale and the Internal Work Motivation Scale (Hackman & Oldham, 1980) which is a part of the Job Diagnostic Survey. The findings indicated that locus of control was not a significant factor in determining congruence between work values or internal work motivation for this sample. Furthermore, locus of control was also found not to be a moderator between the importance of work values and internal work motivation. All individuals in this study had relatively high levels of internal work motivation. However, individuals who had higher congruence of work values did have significantly higher internal work motivation than those who had low congruence of work values for a majority of the 21 values. This was particularly true for the intrinsic values which included responsibility, meaningfulness and use of abilities. In addition, the data were analysed into a hierarchy of needs to indicate possible organizational development or human resource development needs for the XYZ corporation.

The relationship between creativity and moral judgment

A sample of 50 male and female subjects ranging in age from 12 to 73 were divided into three groups according to the scale of maturity of moral judgment developed by Lawrence Kohlberg. Subjects were also tested on a measure of creativity developed by Torrance after the formulations of Guilford in order to test the hypothesis that the re^- lationship between creativity and maturity of moral judgment is curvilinear. Researchers have failed to develop any working hypothesis concerning the relationship between creativity and moral judgment or postulate any consistent theoretical framework concerning the possible relationship between these two constructs. The empirical investigation involved a scientific testing of a random selection of elementary subjects9 high school adolescents, and creative adults. Tests included Kohlberg8s Moral dilemmas and Guilford's Product Improvement Task. A trend analysis was conducted to reveal whether or not a curvilinear relationship existed between the independent variable (Moral Maturity Stages) and the de~ pe dent variable (creativity performance under each level). Curvilinear trends were observed in two out of four creativity subscales but were not statistically significant. It was concluded that these contradictory findings were due to the relatively small number of subjects tested, the narrow range or moral judgment scores, and the limited conception of creativity defined by the creativity measure used (The Product Improvement Task). It was suggested that an instrument assessing an identity status would be most useful as well as a creativity measure better suited for a theory of creativity essentially developmental in perspective.

Continuing education learning preferences and styles of legal clinic lawyers /

The purpose of this qualitative research was to study the learning preferences and styles of management lawyers who work in Ontario's legal aid clinics. Data were gathered from two sources and analyzed using the constant comparison method. A preand postconference survey provided the principal data on clinic lawyers' learning preferences. Follow-up interviews were then conducted with 3 purposefully selected survey participants to explore their personal learning styles. Kolb's experiential learning theory provided the theoretical framework for discussing personal learning styles. The findings showed a general consistency among the lawyers to learn by listening to lectures and experts. This preference may suggest a lingering influence from law school training. The lawyers' more informal learning associated with daily practice, however, appeared to be guided by various learning styles. The learning style discussions provided some support for Kolb's model but also confirmed some shortcomings noted by other authors. Educators who design continuing education programs for lawyers may benefit from some insights gained from this exploratory research. This study adds to a limited but growing body of work on the learning preferences and styles of lawyers and suggests new questions for future research.

The effects of language complexity in a counterattitudinal appeal to laypeople : an application of the elaboration likelihood model of persuasion to a legal issue

The effects of a complexly worded counterattitudinal appeal on laypeople's attitudes toward a legal issue were examined, using the Elaboration Likelihood Model (ELM) of persuasion as a theoretical framework. This model states that persuasion can result from the elaboration and scrutiny of the message arguments (i.e., central route processing), or can result from less cognitively effortful strategies, such as relying on source characteristics as a cue to message validity (i.e., peripheral route processing). One hundred and sixty-seven undergraduates (85 men and 81 women) listened to eitller a low status or high status source deliver a counterattitudinal speech on a legal issue. The speech was designed to contain strong or weak arguments. These arguments were 'worded in a simple and, therefore, easy to comprehend manner, or in a complex and, therefore, difficult to comprehend manner. Thus, there were three experimental manipulations: argument comprehensibility (easy to comprehend vs. difficult to comprehend), argumel11 strength (weak vs. strong), and source status (low vs. high). After listening to tIle speec.J] participants completed a measure 'of their attitude toward the legal issue, a thought listil1g task, an argument recall task,manipulation checks, measures of motivation to process the message, and measures of mood. As a result of the failure of the argument strength manipulation, only the effects of the comprehel1sibility and source status manipulations were tested. There was, however, some evidence of more central route processing in the easy comprehension condition than in the difficult comprehension condition, as predicted. Significant correlations were found between attitude and favourable and unfavourable thoughts about the legal issue with easy to comprehend arguments; whereas, there was a correlation only between attitude and favourable thoughts 11 toward the issue with difficult to comprehend arguments, suggesting, perhaps, that central route processing, \vhich involves argument scrutiny and elaboration, occurred under conditions of easy comprehension to a greater extent than under conditions of difficult comprehension. The results also revealed, among other findings, several significant effects of gender. Men had more favourable attitudes toward the legal issue than did women, men recalled more arguments from the speech than did women, men were less frustrated while listening to the speech than were ,vomen, and men put more effort into thinking about the message arguments than did women. When the arguments were difficult to comprehend, men had more favourable thoughts and fewer unfavourable thoughts about the legal issue than did women. Men and women may have had different affective responses to the issue of plea bargaining (with women responding more negatively than men), especially in light of a local and controversial plea bargain that occurred around the time of this study. Such pre-existing gender differences may have led to tIle lower frustration, the greater effort, the greater recall, and more positive attitudes for men than for WOlnen. Results· from this study suggest that current cognitive models of persuasion may not be very applicable to controversial issues which elicit strong emotional responses. Finally, these data indicate that affective responses, the controversial and emotional nature ofthe issue, gender and other individual differences are important considerations when experts are attempting to persuade laypeople toward a counterattitudinal position.

Analyzing the learning of the taking personal and social responsibility model within a new physical education undergraduate degree program in El Salvador

EI Salvador presents an unfortunate history that includes a military regime and a civil war that together created a legacy of violence in which the country still struggle nowadays. Salud Escolar Integral (SEI) was created in 2005 as a program to combat youth violence throughout the re-formulation of physical education (PE) classes in public schools, promoting life skills learning that supports the resolution of conflicts with nonviolent ways. In 2007, SEI supported the creation of a physical e~ucation teacher education (PETE) degree at the Universidad Pedag6gica de EI Salvador (UPES), having the goal to assist pre-service teachers with a better understanding of humanistic principles. The present research analyzed if after attending all three years ofUPES PETE program, students presented high self-perception levels of competence and confidence related to attitude, skills and knowledge to teach PE within humanistic principles. Taking Personal and Social Responsibility (TPSR) was the theoretical framework used to analyze the development of humanistic principles. The study had a mixed-method longitudinal design that included questionnaires, reflection templates and interviews. In conclusion, although it is suggested that UPES should provide better support for the development of the teaching principles of empowering students and transfer learning, most of the humanistic principles were highly promoted by the program. At last, it is suggested that future research should track teachers' progress while teaching in schools, in order to analyze if the theory of promoting humanistic principles have also become a daily practice.

I must walk through the gate : an ontological necessity

This research is a self-study into my life as an athlete, elementary school teacher, leamer, and as a teacher educator/academic. Throughout the inquiry, I explore how my beliefs and values infused my lived experiences and ultimately influenced my constructivist, humanist, and ultimately my holistic teaching and learning practice which at times disrupted the status quo. I have written a collection of narratives (data generation) which embodied my identity as an unintelligent student/leamer, a teacher/learner, an experiential learner, a tenacious participant, and a change agent to name a few. As I unpack my stories and hermeneutically reconstruct their intent, I question their meaning as I explore how I can improve my teaching and learning practice and potentially effect positive change when instructing beginning teacher candidates at a Faculty of Education. At the outset I situate my story and provide the necessary political, social, and cultural background information to ground my research. I follow this with an in depth look at the elements that interconnect the theoretical framework of this self-study by presenting the notion of writing at the boundaries through auto ethnography (Ellis, 2000; Ellis & Bochner, 2004) and writing as a method of inquiry (Richardson, 2000). The emergent themes of experiential learning, identity, and embodied knowing surfaced during the data generation phase. I use the Probyn' s (1990) .. metaphor of locatedness to unpack these themes and ponder the question, Where is experience located? I deepen the exploration by layering Drake's (2007) KnowlDo/Be framework alongside locatedness and offer descriptions of learning moments grounded in pedagogical theories. In the final phase, I introduce thirdspace theory (Bhabha, 1994; Soja, 1996) as a space that allowed me to puzzle educational dilemmas and begin to reconcile the binaries that existed in my life both personally, and professionally. I end where I began by revisiting the questions that drove this study. In addition, Ireflect upon the writing process and the challenges that I encountered while immersed in this approach and contemplate the relevance of conducting a self-study. I leave the reader with what is waiting for me on the other side of the gate, for as Henry James suggested, "Experience is never limited, and it is never complete."

Teachers' processes of negotiating meaning of new curriculum

This qualitative study addresses the question of how teachers negotiate meaning of new curriculum to better understand how curriculum is transformed from a theoretical construct to a practical one. Through interviews with 5 teachers, their experiences were examined as they negotiated the process of implementing new curriculum. Three theoretical constructs provided the entry point into the study: epistemology, teacher knowledge, and teacher learning. Using inductive analysis, 4 points or attributes of negotiation emerged: reference, growth, autonomy, and reconciliation. These attributes provided a theoretical framework from which a constructivist conceptualization of teacher learning and teacher knowledge could serve to understand the process of how teachers negotiate meaning of curriculum. Studied and theorized in this way, teacher knowledge and teacher learning are seen to be inextricably linked in a relationship that is dynamically changed by forces of stability and instability. Theorizing the negotiation of meaning from a constructivist epistemology also strengthened the assertion that negotiating meaning is a unique structural process, and that knowledge construction is therefore unique to each knower and subject to experience in a particular time and place. The implications for such a theory are, first, that it questions the legitimacy of privatized teacher practice and, second, that it calls for a renewed conceptualization of collegial network and relationship to strengthen the capacity for negotiating meaning of curricular initiatives. Understanding the relationship of curricular theory and negotiating meaning also has implications for curriculum development. In particular, the study highlights the necessity of professional discretion and the generative process of negotiating meaning.

Voices of the Undereducated in Adult Education and Training in Ontario: A Phenomenographic Approach

This doctoral study was an exploration of the qualitatively different ways in which undereducated adults (at or below a high school level of formal education) reported their experiences of participation in adult education and training (AET) programmes offered by publicly funded school boards or their arms-length affiliate in the province of Ontario. In light of a low participation rate in the Canadian AET system by undereducated adults, the rationale was to examine whether or not AET programmes are meeting the needs of undereducated adults beyond a narrow focus on an instrumental approach associated with human capital development. This study was located in a theoretical framework consisting of (a) learning theory, (b) motivations for participation, (c) general barriers to participation, (d) structural barriers to participation, and (e) transformative learning. The purposive sample consisted of 11 participants between the ages of 18-58 who were drawn from service providers in 4 geographic regions of Ontario. Data collection consisted of (a) demographics, (b) voice recordings from face-to-face participant interviews, (c) participant weekly critical incident reports, and (d) researcher reflexive journal notes. Data were analyzed in accordance with a phenomenographic approach within a constructivist/interpretivist research paradigm. Findings revealed 4 qualitatively different ways in which undereducated adult learners reported their experiences of participation in AET and were reported as the voice of (a) security, (b) engagement, (c) relationship, and (d) competency. Implications to theory and practice and to further inquiry were outlined.

"I'm Your Biggest Fan, I'll Follow You ... " Lady Gaga, Little Monsters and the Religious Dimension of Fandom in Pop Music

This thesis examines the religious dimension of fandom in popular music, taking as an object of reflection Lady Gaga and her fans. I combine fan studies with theories of immanence as well as Deleuze and Guattari's notion of the process of becoming, and provide a theoretical reading of the relationship between Lady Gaga and her most fervent fans, the 'little monsters.' Both fandom and religion promise a stable sense of identity and authentic community to devotees. Performing deconstructive discourse analysis on three of Lady Gaga's music videos, I demonstrate how fandom, like organized religion, can simultaneously be an emancipatory practice and a practice that seeks to deny individual subjects their agency. This thesis provides a new theoretical framework for understanding fandom, and illustrates how the purported benefits of both fandom and religion can only be gained when the figureheads of each group are symbolically destroyed by the members themselves.

An Exploration of Male Adolescents' Body Image Perceptions

There has been an increasing concern among researchers and the general population of our culture's increasing emphasis on "ideal" physical attractiveness-for both females and males. Despite this growing concern, research on body image has focused primarily on women and girls, with little research aimed specifically for males. Prior research (Grogan & Richards, 2002; Hargreaves & Tiggemann, 2006) stated that body image was a "feminine" or a "gay" issue, according to men and boys. The present study investigates this issue, particularly within the theoretical framework of multiple selves and gender theories. This exploratory case study involved semi-structured interviews with six male adolescents between the ages of 13 and 18 years. Researcher's fieldnotes were taken after the interviews. Content analysis of the interviews and fieldnotes revealed that for these six male adolescents, body image is not relevant to them, as they think about and discuss their issues of physical appearance with family and close peers. Traditional stereotypic notions of masculinity and what it means to be an adolescent male for the participants are discussed within the context of developmentally appropriate and gender-inclusive curriculum.

Understanding Continuance Intentions of Physicians with Electronic Medical Records (EMRS): An Expectancy-Confirmation Perspective

This thesis examines physicians’ satisfaction with electronic medical records (EMRs) in the post-adoption phase. More specifically, the study examines how physicians’ satisfaction with EMRs impacts on their intention to continue using as well as extend their adoption of additional functions of EMRs. Expectation-confirmation theory is used with the incorporation of perceived risk as the theoretical framework. The extended theoretical model is used to formulate eight hypotheses to aid in the understanding of physicians’ continuance intentions. A field survey of 135 Canadian physicians that utilize EMRs was performed to test the model empirically. The study found that physicians are willing to continue using and adopting additional components of EMRs. In addition, the empirical results suggest that physicians’ perceived usefulness and perceived risk impacts satisfaction, which in turn influences physicians’ continuance intentions. As well, perceived risk has an influence on physicians’ continuance intentions directly.