Grounded theory of nursing's contribution to inpatient rehabilitation

There is growing awareness of the benefits of rehabilitation both in Australia and overseas. While the provision of rehabilitation services is not new, recognition of this type of health service as an integral part of health care has been linked to changes in the provision of acute care services, advances in medical technology, improvements in the management of trauma and an ageing population. Despite this, little attention has been paid to nursing's contribution to patient rehabilitation in Australia. The aim of this grounded theory study, therefore, was to collect and analyse nurses' reports of their contributions to patient rehabilitation and to describe and analyse contextual factors influencing that contribution. Data were collected during interviews with registered and enrolled nurses working in five inpatient rehabilitation units in New South Wales and during observation of the nurses' everyday practice. A total of 53 nurses participated in the study, 35 registered nurses and 18 enrolled nurses. Grounded theory, informed by the theoretical perspective of symbolic interactionism, was used to guide data analysis, the ongoing collection of data and the generation of a substantive theory. The findings revealed six major categories. One was an everyday problem labelled incongruence between nurses' and patients' understandings and expectations of rehabilitation. Another category, labelled coaching patients to self-care, described how nurses independently negotiated the everyday problem of incongruence. The remaining four categories captured conditions in the inpatient context which influenced how nurses could contribute to patient rehabilitation. Two categories, labelled segregation: divided and dividing work practices between nursing and allied health and role ambiguity, were powerful in shaping nursing's contribution as they acted individually and synergistically to constrain nursing's contribution to patient rehabilitation. The other two categories, labelled distancing to manage systemic constraints and grasping the nettle to realise nursing's potential, represent the mutually exclusive strategies nurses used in response to segregation and role ambiguity. From exploration of the relationship between the six categories, the core category and an interactive grounded theory called opting in and opting out emerged. In turn, this grounded theory reveals nursing's contribution to inpatient rehabilitation as well as contextual conditions constraining that contribution. The significance of these findings is made manifest through their contribution to the advancement of nursing knowledge and through implications for nursing practice and education, rehabilitation service delivery and research.

Assessing for work integrated learning experiences : a pre-service teacher perspective

A critical aspect of the debate about work integrated learning in the university context is the blurring of boundaries and responsibilities in terms of student learning. In an Australian pre-service teacher education program this blurring of boundaries is apparent in stakeholder tensions about the nature and role of assessment during the practicum. In the study reported in this paper students responded positively to the content of assessment tasks but maintained that their efforts to implement the associated planning in the workplace were stymied because of disparate understandings between university and school staff about the purpose of the task.

Valuing practice over theory: How beginning teachers re-orient their practice in the transition from the university to the workplace

This paper is about the experiences of beginning teachers in turning theory learned in universities into practice in the workplace. The research is situated in the context of a pre-service teacher education programme that explicitly and deliberately seeks to bridge the theory-practice gap in teacher education. The paper argues that, despite long-standing awareness of the theory-practice gap as a central issue faced by beginning teachers, attempts by teacher educators to address this issue remain thwarted. The argument draws on interview and focus group data collected via a study of 1st year graduate teachers of an Australian pre-service teacher education programme. The theoretical perspective of symbolic interactionism is used to focus on the meanings that graduates have of their experiences of turning theory into practice. The data suggest that prospective teachers during pre-service training value both the theory that they learn on campus and the practice that they observe in schools. However, once they become practitioners, they privilege the latter. Upon entry to the workplace, graduates come to associate good practice with that of the veteran teacher, whose practice and cache of resources they seek to emulate.

Failure to thrive: mid-career women in higher education

Gender underrepresentation in higher education (HE) is a persistent global phenomenon. The purpose of this research was to re-examine it through symbolic interactionism (SI). Eight women aspiring to leadership were invited to participate in semi structured interviews after attending a leadership programme specifically designed to enhance their prospects. Analysis indicated ambiguities and contradictions surround notions of leadership, as well as opportunities for leadership. This was evidenced by their appraisal of the existing leadership, speculations regarding their leadership capacity, how the participants position themselves and are positioned in their workplace. Actively “paying it forward” was seen as facilitating promotion, and line managers’ familiarity with the work undertaken by aspirants. Formal leadership training was advocated rather than experiential processes. 

Valuing practice over theory : how beginning teachers re-orient their practice in the transition from the university to the workplace

This paper is about the experiences of beginning teachers in turning theory learned in universities into practice in the workplace. The research is situated in the context of a preservice teacher education program that explicitly and deliberately seeks to bridge the theory-practice gap in teacher education. The paper argues that, despite long-standing awareness of the theory-practice gap as a central issue faced by beginning teachers, attempts by teacher educators to address this issue remain thwarted. The argument draws on interview and focus group data collected via a study of 1st year graduate teachers of an Australian preservice teacher education program. The theoretical perspective of symbolic interactionism is used to focus on the meanings that graduates have of their experiences of turning theory into practice. The data suggest that prospective teachers during preservice training value both the theory that they learn on campus and the practice that they observe in schools. However, once they become practitioners, they privilege the latter. Upon entry to the workplace, graduates come to associate good practice with that of the veteran teacher, whose practice and cache of resources they seek to emulate. The paper concludes that background knowledge and occupational socialization remain key influences on teacher development and continue to play a key role in ensuring the continued transmittal of the cultural heritage. In particular, it proposes the need for innovative disruptions to the conventional model of teacher education.

The "theory-practice gap": Turning theory into practice in a pre-service teacher education program

his thesis investigates the theory-practice gap using the exemplar of teacher education. The research is situated in a pre-service teacher education program that explicitly seeks to bridge the theory-practice gap so that it produces “learning managers” who can negotiate the contemporary knowledge society in ways different to those of their predecessors. The empirical work reported in this thesis describes and interprets the experiences of preservice and beginning teachers in turning theory into practice. In order to accomplish this outcome, the thesis draws on Mead’s theory of emergence and symbolic interactionism to provide a theoretical perspective for meaning-making in social situations. Data for the study were collected through interviews and focus groups involving a sample of first-year graduate teachers of an Australian pre-service teacher education program. The main finding of this thesis is that the theory-practice gap in pre-service teacher education under present institutional arrangements is an inevitable phenomenon arising as individuals undergo the process of emergence from pre-service to graduate and then beginning teachers. The study shows that despite the efforts of the program developers, environmental, social and cultural conditions in teacher education processes and structures and in schools inhibit the trainee and novitiate teacher from exercising agency to effect change in traditional classroom practices. Thus, the gap between theory and practice is co-produced and sustained in the model that characterises contemporary preservice teacher education in the perspectives of lecturers, teachers and administrators.

International students in transnational mobility: intercultural connectedness with domestic and international peers, institutions and the wider community

International students’ connectedness with their peers, institutions and the broader community significantly affects their learning and wellbeing. It is important to understand their multiple desires for intercultural connectedness in order to nurture it. This paper analyses the motives and nature of international students’ intercultural connectedness. It is based on a study that includes more than 150 interviews and fieldwork with international students and staff from 25 vocational education colleges in Australia. Drawing on Blumer’s symbolic interactionism theory as a conceptual framework, the study found international students’ motivation to engage in intercultural connectedness is linked to not only their desire for respect and recognition for intellectual, cultural and linguistic capacities and diversities but also for employment aspirations. The research shows various dimensions in which intercultural engagement is seen to encompass not only empathy, sociability and equity but also employability. The findings suggest meaningful interaction is essentially bound to reciprocal learning.

The essential role of social theory in qualitative public health research

OBJECTIVE: To define the role of social theory and examine how research studies using qualitative methods can use social theory to generalize their results beyond the setting of the study or to other social groups. APPROACH: The assumptions underlying public health research using qualitative methods derive from a range of social theories that include conflict theory, structural functionalism, symbolic interactionism, the sociology of knowledge and feminism. Depending on the research problem, these and other social theories provide conceptual tools and models for constructing a suitable research framework, and for collecting and analysing data. In combination with the substantive health literature, the theoretical literature provides the conceptual bridge that links the conclusions of the study to other social groups and settings. CONCLUSION: While descriptive studies using qualitative research methods can generate important insights into social experience, the use of social theory in the construction and conduct of research enables researchers to extrapolate their findings to settings and groups broader than the ones in which the research was conducted.

Inserção de pessoas com deficiência intelectual: um estudo em empresas situadas na região metropolitana de São Paulo

Esta dissertação teve origem no questionamento sobre as reais possibilidades de inclusão das pessoas com deficiência intelectual (PCDI), cada vez mais frequentemente inseridas nas organizações brasileiras. O objetivo principal é analisar a maneira como tem acontecido a inserção de PCDI em cinco grandes empresas situadas na região metropolitana de São Paulo, a partir das perspectivas das pessoas diretamente envolvidas. Isso implica, primeiramente, em uma contextualização das políticas de inserção adotadas pelas organizações participantes. Além disso, a partir da análise dos temas mais abordados pelas pessoas entrevistadas, pretende-se identificar os significados da inserção das pessoas com deficiência intelectual e suas implicações mais relevantes para as pessoas envolvidas: os sujeitos com deficiência intelectual, seus chefes, pares hierárquicos de convivência direta, profissionais de gestão de pessoas e pessoas vinculadas a organizações externas, mas que de alguma forma influenciam ou interferem nas atividades de inserção e inclusão no ambiente organizacional. Como arcabouço teórico foram abordados os conceitos de inclusão, inserção e diversidade nas organizações; preconceito, estigma e demais barreiras atitudinais à inclusão; questões familiares e educacionais; as concepções de deficiência ao longo da história, além de aspectos demográficos e regulatórios relacionados ao tema. A pesquisa foi realizada por meio de entrevistas com baixo grau de estruturação e as transcrições analisadas conforme a abordagem de análise de conteúdo proposta por Bardin (1977), a partir dos pressupostos do interacionismo simbólico estrutural (STRYKER, 2006). A partir da discussão dos temas que emergiram da análise de conteúdo e da contextualização e comparação das políticas de inserção adotadas pelas organizações, pôde-se concluir que é possível incluir as pessoas com deficiência intelectual, tendo em vista as fronteiras organizacionais em que elas se inserem.

Vivendo o bem estar no desconhecido: experiência da mulher com a presença do acompanhante no processo de parto

The humanization of the birth process is a current health policy priority. Within that perspective, the presence of a partner during the birth is a benefit guaranteed by the Law 111008/05. The purpose of this study is to comprehend the woman s experience with the presence of a birth partner as a legal right. It is a qualitative descriptive study based on Symbolic Interactionism and conducted using the grounded theory methodology. Data were collected by semi-structured interviews conducted during August to December 2006, with women that had the presence of a partner during their birth experience and that were in the first 24 hours of puerperium. Data analysis resulted in the identification of the phenomena: FEELING GOOD, RECOGNIZING THE BOND WITH THE PARTNER, RECOGNIZING THE IMPORTANCE OF THE EXPERIENCE and NOT KNOWING THE RIGHT. These enabled the identification of the central phenomenon LIVING THE WELL-BEING IN THE UNKNOWN. The study demonstrated that the birth experience with the presence of partner is a positive one, resulting in benefits such as tranquility, support, and assurance, which, in that context, signify well-being. However, the women do not visualize the experience as a right, therefore remaining alienated from their civic practice. The understanding of the experience was enabled by the conceptual construction obtained from the categories of the interactions between the women and their birth partners during the event. The explanation of the phenomenon LIVING THE WELL-BEING IN THE UNKNOWN reflects the theoretical structure obtained from the integration of the identified concepts. The study points out the need for health professionals to improve the information given to women during the birth process and to work the civic duties of the women in reproductive health

Interação entre a equipe de enfermagem e a gestante com diagnóstico de pré-eclâmpsia

The objective of this exploratory descriptive study with a qualitative approach was to analyze the perception of the nursing team and the pregnant women hospitalized with pre-eclampsia regarding the interactive process occurring in the care relationship. Data were collected by semi-structured interview with twenty nursing professionals that work in the high-risk ward and ten pregnant women with the diagnosis of pre-eclampsia. The discourses were analyzed using the content analysis method, in the modality of thematic identification. Three categories were identified that describe the perception of the interaction by the nursing professionals: recognizing the needs of the hospitalized pregnant woman, understanding the woman with pre-eclampsia, and presenting difficulties in the interactive process. With regards to the pregnant women, four categories emerged: recognizing the clinical care, feeling the lack of information, experiencing feelings during the hospitalization, and envisioning the interaction process. The meaning of the discourses was analyzed according to the principles of symbolic interactionism. The results indicate that both, the nursing professionals and the pregnant women, have a limited perception of their interaction, suggesting a need for further reflection about this reality in the health service units and in the nursing education environment

Experienciando a ausência do companheiro nas consultas de pré-natal

This research aimed to understand pregnant general meaning about consort absence in prenatal care. It s an exploratory and descriptive qualitative approach, developed at Centro de Saúde de Jardim Lola, São Gonçalo do Amarante / RN. Participated in investigation 20 pregnant enrolled in prenatal program, their aged over 18 years, guidance of mental faculties and who survive together her partner. Data were collected from March to May 2009, through semi-structured interview. The analysis was processed according to grounded theory and symbolic interactionism as theoretical and methodological references. To support discussions were used literature findings involving political aspects of women humanization in health care and gender relations within family. Following footsteps of points it were adopted derived following sub categories: ¨Realizing involvement of consort during prenatal¨, ¨Expressing feelings during prenatal¨ and ¨Manifesting attitudes during prenatal period¨. These, when they had their properties and dimensions analyzed, resulted in the main category ¨ Experiencing absence of compeer in clinical prenatal¨. The construction of this theory leads to conclusion that women understand absence of her partner, attributing this to even work at the moment prenatal care or does not like to attend health institutions. However, this does not mean that his presence is dismissed, because desire to be with him in prenatal care was mentioned by most interviewees. So, partner absent at time, leads women to experience desires, feelings, attitudes, perceptions and expectations about studied phenomenon. This reality, induce that absence of them partner in prenatal care predisposes women to strengthening of discomforts arising from pregnancy and therefore goes against wellbeing of pregnant, and ensure the possibility of marital discord. This requires professional nursing measures to get in inclusion of partner in daily pre-natal care in humanization perspective.

O homem na estratégia de saúde da família

The research aimed to understand the general perception of men about their health care in a health unit família. This is an exploratory and descriptive qualitative approach, developed at the Center for Health Dr Vulpiano Cavalcante in the City of Parnamirim / RN. Participated in the investigation 12 men enrolled in the Estratégia de Saúde da Família ESF (Family Health Strategy), in the age-group 20 to 59 years lived in the catchment area of one of the ESF teams unit above. Data were collected from July to August 2009, through structured interviews, which, after transcription have undergone a process of identifying meaning units, coded and categorized according to the precepts of content analysis according to Bardin. Following in the footsteps of this method, originated the following themes: "Revealing what motivates men to seek assistance in the Estratégia de Saúde da Família," "Expressing knowledge of the Estratégia de Saúde da Família ", "an opinion about the care health and relationship with the ESF. The analysis was processed according to the principles of symbolic interactionism as Blumer. To support the discussions were used literary themes about man in the context of public health policies and the man in the family and the influences of gender. These, when they had their properties and dimensions analyzed, raised the central category Man on the Estratégia de Saúde da Família . The results show that respondents have limited knowledge about the ESF, your actions turn to use the service when no obligation arising from discomforts and accuracy of care. Moreover, delivering the opinion of the care with your health, even need, but recognizing that do not perform self-care. Given this reality, we can conclude that the perception of the man about his health in the ESF permeates gender issues that influence their behavior toward disease prevention and health promotion. This situation requires that the professionals and managers of health initiatives for the inclusion of man in the actions of the ESF assistance starting from the understanding of their conceptions of health care.

Atividades profissionais da enfermagem no contexto hospitalar: influências nas relações de trabalho

The present study is based on an analysis of professional work relationships in the nursing team from the task/skills of its members as a contribution to understanding the work process in nursing. It is aimed to identify the skills of the nursing team members through the vision of nurses, technicians and nursing assistants, thus it attempts to find strategies to improve the health assistance to patients. It is a descriptive and analytical study with a qualitative approach grounded in theoretical and methodological framework of Symbolic Interactionism. The research was carried out in the participant work place, a Public Hospital of Reference for the SUS, located in the eastern health district of Natal/RN. Nineteen nursing professionals participated in the study, which seven was nurse and twelve nursing technician. As procedure to collect data we used an unstructured interview accompanied by a standard topic guide which was recorded and later transcribed. The content analysis was chosen as the main methodology to analyze the discussion, which gave rise to thematic categories that were considered relevant based on the theoretical framework of this study, and the interactionist theory. This study was in accordance with the ethical principles of the Resolution nº. 196/96, it has obtained an appropriate consent of the UFRN Research Ethics Committee. The results indicate that the professionals seen the nursing as a profession strongly attached to the health care process and as a profession that acquired a scientific status very recently. Regarding to the nursing functions in the work process in nursing, the professionals they identified the manage/administer category as the main activities developed by these professionals, thus the education and complex care in nursing categories. Concerning to the technicians and nursing assistants functions, it was figured out in the professional s opinion that there is not distinction among the attribution of these categories. The interviewed were unanimous in report that these professionals are more involved in direct patient health care through performance of basic duties in nursing care. Finally, with regard to the work relationship among nursing team members, the majority of those interviewed see this relationship as disharmony and quarrelsome and in general, there is not bond between categories that comprise the process of work in nursing. On the basis of our results we consider the importance of knowing the meaning of nursing given by these professionals; also their skills could be useful as basis to identify problems, which source could be detected in the power relationship, deviations of functions, gap between design (knowledge) and performance (doing) work, besides the loss of the global activities view in the process of nursing work

Vivência de mulheres no puerpério : significado atribuído à revisão pósparto

The consultation for women during the postpartum period should occur between the seventh and tenth days, and 42 days after childbirth, to decrease the incidence of maternal and neonatal morbidity and mortality. However, the effectiveness of such assistance in primary health care has not been achieved, especially in the forty-second day of puerperium. Facing this reality, the research aimed to understand the views of women about postpartum consultation. This is an exploratory and descriptive research with qualitative approach, developed in the municipality of Lajes/RN, Brazil, with women inscribed on the four teams that make up the Family Health Strategy. Data were collected through semistructured interviews with 15 women who met the following criteria: be enrolled in ESF; have health mental preserved, have been entered in the Humanization Program of Prenatal and Birth, and that was, at maximum, 60 days postpartum. The data were organized according to the precepts of content analysis according to Bardin, generating three categories: prevention of puerperal complications, feelings related to life changes after childbirth, and postpartum care. This process of coding and categorizing a central theme emerged: the experience of women in the postpartum period. The data were analyzed according to the principles of symbolic interactionism, according to Blumer. The study revealed that the meanings attributed to the postpartum period for prevention of complications were directly related to home, to the consultation and postpartum care provided by family members and health professionals. The interviewees strictly complied with the rest under the influence of the context in which they were entered. But that has not happened with the postpartum revision because few mothers underwent this procedure. Therefore, the interaction of the interviewed people in their living standard as well as the feelings that permeated the post-partum were crucial to consider whether or not the post-partum visit as significant. According to the results, it was noted that disability guidelines and counter-references has impaired the access of women to postpartum review. Thus, further studies are needed on the subject, as well as a reorientation of health care activities in view of the consolidation of postpartum consultation in primary care