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A Situational Grounded Theory Study ...

Clark, Laurel L.

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A Situational Grounded Theory Study of Critical Care Nurses' End-Of-Life Decision-Making with Family.

Record Type:	Electronic resources : Monograph/item
Title/Author:	A Situational Grounded Theory Study of Critical Care Nurses' End-Of-Life Decision-Making with Family./
Author:	Clark, Laurel L.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
Description:	343 p.
Notes:	Source: Dissertations Abstracts International, Volume: 82-04, Section: B.
Contained By:	Dissertations Abstracts International82-04B.
Subject:	Nursing. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28150075
ISBN:	9798678184276

A Situational Grounded Theory Study of Critical Care Nurses' End-Of-Life Decision-Making with Family.
Clark, Laurel L.

A Situational Grounded Theory Study of Critical Care Nurses' End-Of-Life Decision-Making with Family. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 343 p.

Source: Dissertations Abstracts International, Volume: 82-04, Section: B.

Thesis (Ph.D.)--Barry University, 2020.

This item must not be sold to any third party vendors.

Background: Decision-making in healthcare has shifted from a paternalistic, physician-centered approach to a shared clinician-patient/family decision-making model. With this shift and the rapid advancement of medical technology, end-of-life decision-making with family members has become even more relevant and rigorous for critical care nurse (CCN) practice. The CCN's voice in end-of-life (EOL) decision-making with family members is essential to providing patient-centered goal concordant care at EOL. There has been ambiguity surrounding the CCN's participation in shared EOL decision-making with family members. Purpose: The purpose of this constructivist Situational Grounded Theory (SGT) study was to generate a theory of CCN's voice in EOL shared decision-making with family members and increase situational awareness of the CCN's voice in EOL shared decision-making with family members. Philosophical Underpinning: This constructivist SGT methodology as articulated by Charmaz and Clarke was guided by an interpretivist postmodern paradigm and the philosophical tenets of symbolic interactionism and pragmatism. Methods: Purposive, theoretical, and snowball sampling of CCNs in the U.S. was used. Semi-structured interviews and extant and elicited discourse material provided data for coding, categorizing, analyzing, mapping and thematizing the data. The conceptual categories generated a theory concerning the CCN in EOL decision-making with family members. Results: A Situational Standing Praxis theory and Situational Analysis (SSP-SA) was co-constructed from the voices of experienced CCNs. Three conceptual categories: situational standing, symphonology work, and addressing systems, and a situational analysis further explicated the CCN processes and situatedness in EOL decision-making with family members. A middle-range theory and situational analysis provide a means for greater understanding and application in CCN EOL care and decisional support for family members. Conclusions: The CCN voice is intrinsic and instrumental in a family member's acquiescence towards EOL decisions for their loved one. The SSP-SA provides additional means and a mechanism for developing theory for EOL nurse practice, policy, education, and research. SSP-SA is positioned to advance health policy and enhance the care offered to family members of dying patients in the critical care setting.

ISBN: 9798678184276Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

End-of-Life

A Situational Grounded Theory Study of Critical Care Nurses' End-Of-Life Decision-Making with Family.
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500 $a Source: Dissertations Abstracts International, Volume: 82-04, Section: B.
500 $a Advisor: Colin, Jessie M.;Morton, Jamelah.
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506 $a This item must not be sold to any third party vendors.
520 $a Background: Decision-making in healthcare has shifted from a paternalistic, physician-centered approach to a shared clinician-patient/family decision-making model. With this shift and the rapid advancement of medical technology, end-of-life decision-making with family members has become even more relevant and rigorous for critical care nurse (CCN) practice. The CCN's voice in end-of-life (EOL) decision-making with family members is essential to providing patient-centered goal concordant care at EOL. There has been ambiguity surrounding the CCN's participation in shared EOL decision-making with family members. Purpose: The purpose of this constructivist Situational Grounded Theory (SGT) study was to generate a theory of CCN's voice in EOL shared decision-making with family members and increase situational awareness of the CCN's voice in EOL shared decision-making with family members. Philosophical Underpinning: This constructivist SGT methodology as articulated by Charmaz and Clarke was guided by an interpretivist postmodern paradigm and the philosophical tenets of symbolic interactionism and pragmatism. Methods: Purposive, theoretical, and snowball sampling of CCNs in the U.S. was used. Semi-structured interviews and extant and elicited discourse material provided data for coding, categorizing, analyzing, mapping and thematizing the data. The conceptual categories generated a theory concerning the CCN in EOL decision-making with family members. Results: A Situational Standing Praxis theory and Situational Analysis (SSP-SA) was co-constructed from the voices of experienced CCNs. Three conceptual categories: situational standing, symphonology work, and addressing systems, and a situational analysis further explicated the CCN processes and situatedness in EOL decision-making with family members. A middle-range theory and situational analysis provide a means for greater understanding and application in CCN EOL care and decisional support for family members. Conclusions: The CCN voice is intrinsic and instrumental in a family member's acquiescence towards EOL decisions for their loved one. The SSP-SA provides additional means and a mechanism for developing theory for EOL nurse practice, policy, education, and research. SSP-SA is positioned to advance health policy and enhance the care offered to family members of dying patients in the critical care setting.
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