Encyclopedia of Nursing Research, Second Edition potx

Aroian, PhD, RN, Dean & Professor Emeritus APRN, BC FAAN Uniformed Services Associate Professor and Katharine Faville ProfessorUniversity of the Health Associate Dean for of Nursing Rese

Encyclopedia of

Editor-in-Chief

Associate Editor

is the Elizabeth Brooks Ford Professor of Nursing, FrancesPayne Bolton School of Nursing, Case Western ReserveUniversity in Cleveland Ohio where she was Dean from

1982 through 1997 She has received numerous honors

and awards including the American Journal of Nursing

Book of the Year Award 18 times Dr Fitzpatrick is widelypublished in nursing and health care literature She is

senior editor of the Annual Review of Nursing Research

series, now in its 23rd volume In 1998 Dr Fitzpatrick

was senior editor of the first volume of the classic pedia of Nursing Research as well as a series of Research Digests, including Nursing Research Digest, Maternal Child Health Nursing Research Digest, Geriatric Nursing Research Digest, and Psychiatric Mental Health Nursing Research Digest She has coedited four books focused on nurses and the internet: Internet Resources for Nurses (2000) and Nurses Guide to Consumer Health Web Sites (2001), Essen- tials of Internet Use for Nurses (2002) and Internet for Nursing Research (2004) Dr Fitzpa-

Encyclo-trick has provided consultation on nursing education and research throughout the world,including universities and health ministries in Africa, Asia, Australia, Europe, Latin America,and the Middle East

MEREDITHWALLACE,PHD,APRN-BC,has been anurse since she completed her BSN degree Magna CumLaude at Boston University in 1988 Following this, sheearned an MSN in medical-surgical nursing with a spe-cialty in geriatrics from Yale University and a PhD innursing research and theory development at New YorkUniversity During her time at NYU she was awarded apredoctoral fellowship at the Hartford Institute for Geriat-ric Nursing In this capacity she became the original author

and editor of Try This: Best Practices in Geriatric Nursing

series In 2001, she won the Springer Publishing CompanyAward for Applied Nursing Research She was the Manag-

ing Editor of the Journal of Applied Nursing Research

and is currently the research brief editor for the journal.She is the author of numerous journal articles and book

chapters Dr Wallace published Prostate Cancer: Nursing Assessment Management and Care,

in April 2002, which won the American Journal of Nursing Book of the Year Award Preceding this, she was the Associate Editor of The Geriatric Nursing Research Digest, which also won the American Journal of Nursing Book of the Year Award in 2002 She is the recent recipient

of the Eastern Nursing Research Society/John A Hartford Foundation junior investigatoraward Dr Wallace is currently an Associate Professor and the Elizabeth DeCamp McInerneyChair in Health Sciences at Fairfield University School of Nursing, in Fairfield, CT

Encyclopedia of

All rights reserved.

No part of this publication may be reproduced, stored in a trieval system, or transmitted in any form or by any means, elec-tronic, mechanical, photocopying, recording, or otherwise, withoutthe prior permission of Springer Publishing Company, Inc

re-Springer Publishing Company, Inc

11 West 42nd Street

New York, NY 10036

Acquisitions Editor: Ruth Chasek

Production Editor: Sara Yoo

Cover design by Joanne Honigman

Typeset by International Graphic Services, Inc., Newtown, PA

05 06 07 08 09 / 5 4 3 2 1

Library of Congress Cataloging-in-Publication Data

Encyclopedia of nursing research / Joyce J Fitzpatrick and

Meredith Wallace [editors] — 2nd ed

C ONTENTS

Appendix: Contributors to the First Edition 755

v

Portland, OR The Ohio State University and

Rutgers University

Marie J Cowan, PhD, RN, FAAN Columbus, OH and Newark, NJ

Professor and Dean

School of Nursing Diana Taylor, PhD, RN, FAAN

Professor Emeritus University of California Los Angeles

University of California, San

Barbara Given, PhD, RN, FAAN Francisco

College of Nursing

Michigan State University Nancy F Woods, PhD, RN, FAAN

Professor and Dean Lansing, MI

P REFACE

This second edition of the Encyclopedia of Nursing Research (ENR), like the first, is a

comprehensive, yet concise and authoritative guide to existing nursing research literature It

charts the course of nursing research since 1983 when the first edition of the Annual Review

of Nursing Research (ARNR) was published.

The original edition of ENR, published in 1998, grew from a long-standing commitment

of the publisher, Dr Ursula Springer, to the field of nursing, and my commitment to nursescholars around the globe The original encyclopedia followed 15 years of publication of theARNR series This second edition of ENR follows publication of 22 volumes of ARNR andincorporates the research topics included in the ARNR series Through these formative years

of nursing science, I have had the privilege of serving as editor of the ARNR series andwitnessing the rapid growth of knowledge and expertise in nursing research Having served

as editor for the first edition of ENR, I am joined in this edition by Meredith Wallace, theAssociate Editor

Nurse researchers and graduate students in nursing will be the primary audience for thisedition of ENR Yet, as with the first edition, nurses in all phases of education, from basic todoctoral, from formal university and college-based programs to continuing education offerings,within all health systems, will find this an important introduction to current nursing researchtopics The alphabetical list of entries is provided to assist the reader in quickly finding therelevant term While every effort was made to include the most comprehensive list of entries,based on both a literature review of key terms in journals and the ARNR series and the expertadvice of the Advisory Board members, we are cognizant of the fact that some terms mayhave been overlooked Thus, we encourage readers to advise us of new terms that should beadded to the already extensive list

This project has been one of the most rewarding endeavors of my professional career Ithas been met with a great deal of professional interest and, most importantly, an extra measure

of enthusiasm by students at all levels The References section lists the most critical references

on each topic It is this attention to key references that may be of most use to graduate studentswho wish to pursue a topic in more depth

This publication would not have been possible without the experts in nursing research whoauthored the hundreds of entries Each author, some of whom have contributed multipleentries, deserves thanks for the written entries, for the willingness to respond to strict guidelinesand page and reference limitations, and, of course, for adhering to a very demanding timeline for publication Distilling one’s life work into a few hundred words is often the mostdifficult accomplishment

We also are indebted to the colleagues who served as members of the Advisory Board forboth the first and second editions of ENR I thank each of you for your input into the terms

to be included here, the suggestions of potential contributors, and your willingness to plungeinto yet another publishing project with me

ix

As with any large continuing project such as this, a true team effort is necessary for aquality project First, my thanks to Dr Ursula Springer for conceiving the project and asking

me to undertake the editing at a time when my commitments were at a peak I am glad that

I did not hesitate To the Springer staff who facilitated the production at the many levels, Iowe a huge thank you, most especially to Ruth Chasek, Senior Nursing Editor, who saw theproject through its many stages I also acknowledge the endless energy, dedication, andexpertise of Meredith Wallace, Associate Editor for this edition There was never too daunting

a task for Meredith as we worked tirelessly over the past 2 years to complete the project Anumber of students assisted Meredith and me in our activities for this edition of ENR I wouldlike to thank Ali Salman and Yi-Hui Lee, PhD candidates at Case Western Reserve University,Frances Payne Bolton School of Nursing, and Kara Diffley, Lindsey Neptune, and ChristineMcGurk, undergraduate students at Fairfield University School of Nursing I am certain thatthere are numerous other graduate students who assisted the authors in completing theirentries We hope that this edition of ENR will continue to be rewarding to them in theirfuture academic and professional careers

Joyce J FitzpatrickEditor-in-Chief

C ONTRIBUTORS

Lauren S Aaronson, PhD, Donna L Algase, PhD, Ida Androwich, PhD,

Professor Josephine M Sana Professor

University of Kansas Collegiate Professor of School of Nursing

School of Nursing Nursing Loyola University MedicalKansas City, KS University of Michigan Center

Maywood, ILSchool of Nursing

Data Analysis; Fatigue;

Ann Arbor, MI

Sampling Activities of Daily Nursing Information

Systems Living

Faye G Abdellah, EdD,

ScD, RN, FAAN Elaine J Amella, PhD, Karen J Aroian, PhD, RN,

Dean & Professor Emeritus APRN, BC FAAN

Uniformed Services Associate Professor and Katharine Faville ProfessorUniversity of the Health Associate Dean for of Nursing ResearchSciences Research Wayne State UniversityGraduate School of

Medical University of College of NursingNursing

South Carolina Detroit, MIBethesda, MD

College of Nursing Immigrant Women

History of Nursing Charleston, SC

Case Western Reserve

Kay C Avant, PhD, RN, Suzanne Bakken, DNSc, Sandra C Garmon Bibb,

DNSc, RN

Assistant ProfessorAssociate Professor Alumni Professor of

Uniformed ServicesUniversity of Texas Nursing & Professor of

University of the HealthSchool of Nursing Biomedical Informatics

SciencesAustin, TX Columbia University

Graduate School ofSchool of Nursing

Concept Analysis;

NursingNew York, NY

Nursing Diagnosis

Bethesda, MD

Formal Nursing

Cynthia Guerrero Ayres, Languages; SNOMED Leininger’s Theory of

Culture Care Diversity

PhD, RN International; Unified

and Universality;

Director Language Systems

Population Health

Health Systems and

Collaborations—New Jane Barnsteiner, PhD, RN, Carol E Blixen, PhD, RN

American Cancer Professor and Director Cleveland Clinic

Society—Eastern University of Pennsylvania Foundation

Division School of Nursing Department of NursingNorth Brunswick, NJ Philadelphia, PA Education and Research

Clinical Preventive Online Journal of Cleveland, OH

Services Delivery Knowledge Synthesis for Osteoarthritis

Nursing

APRN, BC Mara M Baun, DNSc, New York University

Division of Nursing

New York, NYUniversity of Arizona Lee & Joseph D Jamail

College of Nursing Distinguished Professor Urinary IncontinenceTucson, AZ University of Texas Health

Rebecca J Bonugli, MSN,

Depression in Families Sciences Center at RN

Houston Clinical Instructor

Judith A Baigis, PhD, RN, School of Nursing

University of Texas Health

Science CenterAssociate Dean for

Pet Therapy School of NursingResearch and Scholarship

San Antonio, TXGeorgetown University Cheryl Tatano Beck,

Serious Mental Illness

School of Nursing and DNSc, CNM, FAAN

Health Studies Professor Joan L Bottorff, PhD, RNWashington, DC University of Connecticut Professor and UBC

Distinguished University

Health Conceptualization School of Nursing

ScholarStorrs, CT

Tamilyn Bakas, DNS, RN University of British

Nurse-Patient Relationship

Contributors xiii

Meg Bourbonniere, PhD, Helen Kogan Budzynski, Jeeyae Choi, RN, MS

Assistant Professor Faculty Emeritus Columbia UniversityYale University University of Washington School of Nursing

School of Nursing School of Nursing New York, NY

New Haven, CT Seattle, WA Formal Nursing

Physical Restraints Biofeedback Languages

Diane K Boyle, PhD, RN Vern L Bullough, PhD, Norma J Christman, PhD,

Associate Professor RN, FAAN RN, FAAN

University of Kansas Distinguished Professor Associate Professor

School of Nursing Emeritus Emeritus

Kansas City, KS State University of New University of Kentucky

Lexington, KYStony Brook, NY

Barbara Braden, PhD, RN,

Preoperative Gender Research; Sex

FAAN

Psychological and Gender

Professor and Dean,

Preparation for Surgery

Associate ProfessorAdult Pulmonary Medicine

Omaha, NE

Yale UniversityMilford, CT

FAAN

Illinois State UniversityDecker School of Nursing

Associate ProfessorMennonite College of

Binghamton University

University of WisconsinNursing

Binghamton, NY

College of NursingBloomington, IL

Osteoporosis

Milwaukee, WI

Feminist Research

Dorothy Brooten, PhD, Methodology International

Professor Suzanne Hetzel Campbell, Nursing Practice

Florida International PhD, APRN, IBCLC (ICNP ®)

University Assistant Professor

Marlene Zichi Cohen, PhD,

School of Nursing Fairfield University

RN, FAAN

Miami, FL School of Nursing

John S Dunn, Sr.,Fairfield, CT

Clinical Trials;

Distinguished Professor

Transitional Care Breast-feeding

in Oncology Nursing

Emma J Brown, PhD, RN Victoria Champion, DNS, University of Texas Health

Associate Professor and RN, FAAN Science Center at

Chatlos Endowed Chair Associate Dean of Research Houston

University of Central Indiana University School of Nursing

Florida School of Nursing Houston, TX

School of Nursing Indianapolis, IN

Descriptive Research;

Orlando, FL Breast Cancer Screening Nursing Assessment

Urban Health Research:

Nursing Research in

Urban Neighborhoods

Kathleen Byrne Colling, Barbara J Daly, PhD, RN, Danielle Deveau, BS, MPS

Assistant Research Scientist Associate Professor California State University,University of Michigan Case Western Reserve Fresno

School of Nursing University Central California CenterAnn Arbor, MI Frances Payne Bolton for Health & Human

ServicesSchool of Nursing

Associate Professor Mary Jo Devereaux

Family Satisfaction With

University of North Hospital Librarian

End-of-Life Care

Carolina Chapel Hill Community Medical

Inge B Corless, PhD, RN, School of Nursing Center

Professor Bibliometrics Orem’s Self-Care Deficit

Hospital Sabina De Geest, PhD, RN

Institute of Health Director Elizabeth C Devine, PhD,Professions University of Basel RN, FAAN

Boston, MA Institute of Nursing Science Professor

Hospice; Terminal Illness Basel, Switzerland University of

Byrdine F Lewis School of Professor

Colleen Corte, PhD, RN Nursing University of

Wisconsin-Postdoctoral Research Atlanta, GA Madison

Delphi Technique; Grief;

Suicide

School of Medicine

Hermeneutics

Ann Arbor, MI Karen E Dennis, PhD, RN,

Disturbances and Eating Professor PhD, RN

Disorders University of Central Assistant Professor

West Virginia UniversityFlorida

Jessica Shank Coviello,

School of Nursing Robert C Byrd Health

MSN, RN

Orlando, FL Science CenterLecturer

School of NursingYale University Obesity as

Charleston, WVSchool of Nursing Cardiovascular Risk

New Haven, CT Factor Nutrition in the Elderly

Angina; Cardiovascular

Disease

Contributors xv

Fabienne Dobbels, MSc Jacqueline Dunbar-Jacob, Janet Enslein, MA, RN

Assistant Professor ofKatholieke Universiteit PhD, RN, FAAN

Dean and Professor

St Ambrose UniversityCenter for Health Services University of Pittsburgh

School of Nursingand Nursing Research School of Nursing

Davenport, IALeuven, Belgium Pittsburgh, PA

Adherence/Compliance;

Persons Behavioral Research Carol Diane Epstein, PhD,

RN, FCCM Joanne McCloskey Patricia C Dykes, DNSc,

Fairfield, CTUniversity of Iowa Partners HealthCare

Critical Care Nursing

College of Nursing Wellesley, MA

Iowa City, IA Clinical Judgment W Scott Erdley, DNS, RN

Nursing Interventions Clinical Assistant Professor

Karen L Elberson, PhD,

Classification (NIC); University at Buffalo

RN

Associate Professor and Buffalo, NY

Moreen Donahue, DNP, Associate Dean

Electronic Network

University of the Health

Sr Vice President Patient Lois K Evans, DNSc, RN,

Greenwich Hospital Graduate School of Viola MacInnes/

Greenwich, CT Nursing Independence Professor

Dean and Professor Jennifer Harrison Elder, Physical Restraints

Johns Hopkins University PhD, RN, FAAN

Melissa Spezia Faulkner,

School of Nursing Associate Professor

DSN, RN

Baltimore, MD University of Florida

Associate ProfessorCollege of Nursing

Basic Research

Department of Gainesville, FL

Chicago, ILLouisiana State University RN, CGRN

Associate Professor

New Orleans, LA Indiana University

Annemarie Dowling- Enteral Tube Placement

Nursing & Health

Castronovo, MA, APRN,

Sciences

University ofAssistant Clinical Professor GNP, APRN, BC, FAAN

Massachusetts-BostonNew York University Professor

College of Nursing &Division of Nursing University of Tennessee

Health SciencesNew York, NY School of Nursing

Boston MAMemphis, TN

Gerontological Advanced

(Dorothy) Johnson’s Practice Nursing Newman’s Theory of

Behavioral System Model Health

Suzanne L Feetham, PhD, Ellen Flaherty, PhD, Emily Fox-Hill, PhD, RN

APRN, BC Associate Professor

Director of Division of Interdisciplinary Teams

MichiganServices Administration Medical Branch

Detroit, MIBethesda, MD School of Nursing Medical

(Imogene) King’s Family Care; Family Branch

Conceptual System and

Theory of Goal Evidence-Based Practice

Health and Human

Indiana University Henry R Luce Professor ofDevelopment

School of Nursing Nursing EthicsAssociate Professor of

Indianapolis, IN Boston CollegeMedicine, Department of

School of NursingPsychiatry Community Health

Chestnut Hill, MAThe Pennsylvania State

Chicago

Terry Fulmer, PhD, RN, Joseph M Filakovsky, College of Nursing

FAAN MSN, APRN, CCNS, Chicago, IL

The Erline Perkins McGriff

CS, FAHA

Delirium Professor and Division

Doctoral Student

HeadCase Western Reserve Frances Foster, MS, RN,

New York University

CS

University

Division of NursingAdult Health Nurse

Frances Payne Bolton

New York, NYPractitioner

School of Nursing

Massachusetts General

Hospital Elderly; Elder

Assistant ProfessorAssociate Professor Professor Emeritus

University of Texas AustinIndiana University School of Nursing

School of NursingSchool of Nursing University of Virginia

Austin, TXIndianapolis, IN School of Nursing

Quality of Life

Charlottesville, VA

Cost Analysis of Nursing

Care; Health Services Mental Health Services

Research Administration

Contributors xvii

Rauda Gelazis, PhD, RN, Patricia A Grady, PhD, Hurdis M Griffith, PhD,

Associate Professor Director Professor and Dean

Ursuline College National Institutes of Emeritus

Breen School of Nursing Health Rutgers University

Pepper Pike, OH National Institute of College of Nursing

Newark, NJNursing Research

Deborah L Gentile, MSN, Health; National Current Procedural

University of

Wisconsin-Milwaukee Judith R Graves, PhD, Deborah Gross, DNSc,College of Nursing RN, FAAN RN, FAAN

Milwaukee, WI Professor, College of Professor

Patient Education Nursing Rush University

College of NursingAdjunct Associate Professor

Phyllis B Giovannetti, ScD,

Department of Medical Chicago, IL

RN

Informatics Mother-Infant/ToddlerProfessor

School of Medicine RelationshipsUniversity of Alberta

University of UtahFaculty of Nursing

Salt Lake City, UT Sheila Grossman, PhD,Edmonton, Alberta

in Nursing: The Arcs©

Program; Secondary

Data Analysis; Sigma

Professor

Sarah Hall Gueldner, DSN,

Theta Tau International

Michigan State University

Decker School of Nursing

International Nursing

Barbara A Goldrick, Library Binghamton, NY

Nurse Consultant Bobbe Ann Gray, PhD,

Assistant Professor

Wright State University Clinical Specialist

Marion Good, PhD, RN, College of Nursing and Veterans Affairs

Childbirth Education

University

Family Theory and

Frances Payne Bolton

Barbara K Haight, DrPH, Emily J Hauenstein, PhD, Martha N Hill, PhD, RN,

FAAN LCP, APRN, BC

Charleston, SC Depression in Women; Hypertension

Mental Health in Public

Sector Primary Care

Associate Professor of

Laura Hayman, PhD, RN, Edward J Halloran, PhD,

Carolina Chapel Hill New York, NY

Boykin & Schoenhofer:

Statesboro, GA Wellness Cancer in Children

Advanced Practice

Eileen M Hermann, RN, Diane Holditch-Davis,

ProfessorCritical Care Nurse

Among Older Adults

RN, FAAN Patricia A Higgins, PhD,

Gretchen Harwood, MS, RN Professor Emeritus

RN Assistant Professor University of Texas Health

Doctoral Student Case Western Reserve Science Center

The Ohio State University University School of Nursing

Columbus, OH Frances Payne Bolton San Antonio, TX

School of Nursing

Cleveland, OH Shivering; Thermal

Balance Failure to Thrive (Adult)

Division of NursingDean Center for Excellence in

Nursing Practice

San Francisco Brigham and Women’s Neuroleptic Use inSchool of Nursing Hospital Nursing Homes

San Francisco, CA Brookline, MA

Sharol F Jacobson, PhD,

Nursing Education; Mental Status

RN, FAAN

Substruction Measurement: The

Mini-Associate Dean for

Mental State

June Andrews Horowitz, Examination Research and Practice

Professor Sally A Hutchinson, PhD, University of Alabama

Boston College RN, FAAN School of Nursing

William F Connell School Professor Tucsaloosa, AL

of Nursing University of Florida Cultural/TransculturalChestnut Hill, MA College of Nursing Focus

Jacksonville, FL

Postpartum Depression

Ada Jacox, PhD, RN,

Grounded Theory;

Carol Noll Hoskins, PhD, Research Interviews FAAN

RN, FAAN (Qualitative) Director, Clinical Practice

New York University Kathleen Huttlinger, PhD, University of VirginiaDivision of Nursing RN Charlottesville, VA

Kent State University

University of Texas at Gail L Ingersoll, EdD, RN, for Health Disparities

School of Nursing Professor & Director of University of PennsylvaniaAustin, TX Clinical Nursing School of Nursing

Philadelphia, PA

Managed Care Research

University of Rochester Urban Health Research:

Heddy Bishop Hubbard,

School of Nursing Nursing Research in

Health Services Research Pamela Magnussen

Center for Health Policy,

Health Policy Hermeneutics

Rockville, MD

Patient Safety

Jean E Johnson, PhD, RN, Maureen Keckeisen, RN, Mary E Kerr, PhD, RN,

Professor Emeritus Clinical Nurse Specialist Professor and

University of Rochester Transplant/Surgical UPMC Health SystemSchool of Nursing Specialties ICU Chair of Nursing ScienceRochester, NY UCLA Medical Center University of Pittsburgh

School of NursingDepartment of Nursing

College of Nursing Gwen Brumbaugh Keeney,

Shake´ Ketefian, EdD, RN

Iowa City, IA PhD, RN, CNM

ProfessorClinical Assistant Professor

Benchmarking in Health University of MichiganCare; Nursing Outcomes University of Illinois at School of Nursing

Practice Models Susan J Kelley, PhD, RN,

Grandparents Raising Buskerud UniversityIndianapolis, IN

Grandchildren College

Telehealth

Kongsberg, Norway

Alice R Kempe, PhD, CS Evanne Juratovac, RN,

Narrative Analysis

Breen School of NursingCoordinator

Pepper Pike, OHPrentiss Care Networks

University of UtahUniversity Related Mood Disorders

College of NursingFrances Payne Bolton

Salt Lake City, UTSchool of Nursing

Clinical Setting Disparities in Minority

Mental Health

Contributors xxi

Kenn M Kirksey, PhD, Marjorie Thomas Lawson, Wendy Lewandowski, PhD,

RN, CS

RN, APRN, BC PhD, APRN, BC, FNP

Associate Professor of Associate Professor Assistant Professor

Nursing University of Southern Kent State UniversityCalifornia State University, Maine College of Nursing

Fresno College of Nursing and Kent, OH

Department of Nursing Health Professions Community Mental

HIV Symptom Interpersonal Irene Daniels Lewis, DNS,Management and Communication: Nurse- APN, FAAN

Quality of Life Patient College of Applied Sciences

Judith A Lewis, PhD,

School of Nursing

Galveston, TX

Maternal Anxiety and

Adaptation During University

Katharine Kolcaba, PhD,

Pregnancy School of Nursing

RN, C

Richmond VAAssociate Professor Yi-Hui Lee, MSN, RN

Genetics

University of Akron PhD Candidate

College of Nursing Patricia Liehr, PhD, RN

Case Western Reserve

University

Comfort Frances Payne Bolton Doctoral Program

Florida Atlantic UniversitySchool of Nursing

Heidi V Krowchuk, PhD,

College of NursingCleveland, OH

Carolina at Greensboro Elizabeth R Lenz, PhD, Deborah F Lindell, ND,

Greensboro, NC Dean and Professor Assistant Professor of

Ohio State University

Case Western Reserve

Effects; Failure to Thrive College of Nursing

Frances Payne Bolton

Doctoral Education

Eugene Levine, PhD

St Louis University

Grounded Theory

Professor EmeritusSchool of Nursing

Uniformed Services

University of the Health FAAN

Dizziness in the Elderly

Sciences Dean and Professor

Cheryl A Larson, MS, RN Graduate School of Emeritus

Doctoral Candidate Nursing University of NebraskaUniversity of Arizona Bethesda, MD Medical Center

College of Nursing Quantitative Research College of Nursing

Adrianne D Linton, PhD, Marilyn J Lotas, PhD, RN Kiran Mangrola, MSN,

Associate Dean for Student

Services and Director

BSN ProgramUniversity of Texas Health Division of Nursing

Associate Professor

Case Western Reserve

University

Frances Payne BoltonSan Antonio, TX

School of Nursing Anne Manton, PhD,

Wandering

Cleveland, OH APRN, FAAN

Psychiatric Mental Health

Terri H Lipman, PhD, Prevention of Preterm

and Low-Birthweight

Births

University of Pennsylvania Courtney H Lyder, ND Emergency NursingSchool of Nursing University of Virginia

Pediatric Nurse Practitioner Medical Center Lucy N Marion, PhD, RN,

Division of Endocrinology Professor of Nursing FAAN

Children’s Hospital of Professor of Internal Professor and Dean

Philadelphia Medicine and Geriatrics Medical College of GeorgiaPhiladelphia, PA University of Virginia School of Nursing

Augusta, GA

Clinical Decision Making School of Nursing

Charlottesville, VA Primary Care

Doris Troth Lippman, Pressure Ulcers

Brenda L Lyon, DNS, RN

ProfessorFairfield University Dean and Professor

Indiana UniversitySchool of Nursing Wright State University

Management Nurse Researcher in the

Jane Lipscomb, PhD, RN, Meridean Maas, PhD, RN, Clinical Setting;

Associate Professor Emeritus Professor and Research DisseminationUniversity of Maryland Director of the John A.

School of Nursing Hartford Center of Linda J Mayberry, PhD,

Baltimore, MD Geriatric Nursing RN, FAAN

Associate ProfessorExcellence

New York UniversityProfessor Nursing Outcomes

University of California Classification Division of Nursing

Immigrant Women Nursing

Nicholls State UniversityDepartment of NursingThibodaux, LA

Violence

Development andIndiana University Robert C Byrd Health

Extended StudiesSchool of Nursing Science Center

University of ColoradoIndianapolis, IN School of Nursing

Health Sciences CenterMorgantown, WV

Stanford Geriatric University of Connecticut

Associate Professor andEducation Center School of Nursing

DirectorSchool of Medicine Storrs, CT

Office of Student EquityPalo Alto, CA Health Care

and Multicultural Affairs

Ethnogeriatrics Communication University of Nebraska

Madison Hospital and Austin, TX Helen M Shearer ProfessorClinic Cognitive Interventions; in Nutrition

Madison, WI Self-Efficacy University of Pennsylvania

School of Nursing

Primary Nursing

Beverly J McElmurry, Philadelphia, PASandee Graham McClowry, EdD, RN, FAAN Neurobehavioral

PhD, RN, FAAN Professor and Associate Development and

New York University University of Illinois at

Paula M Meek, PhD, RN

Division of Nursing Chicago

Assistant ProfessorNew York, NY College of Nursing

University of ArizonaChicago, IL

Sue E Meiner, EdD,

of Nursing Quinnipiac University

APRN, BC, GNP

Yale University Department of Nursing

Assistant ProfessorSchool of Nursing School of Health Sciences

University of Nevada, LasNew Haven, CT Hamden, CT

Vegas

Chronic Illness Pulmonary Changes in School of Nursing

Gastroesophageal Reflux Disease

Janet C Meininger, PhD, Koen Milisen, PhD, RN Ethel L Mitty, EdD, RN

Adjunct Clinical Professor

RN, FAAN Center for Health Services

and Nursing Research

New York UniversityUniversity of Texas Health Katholieke Universiteit

LeuvenSciences Center at Division of Nursing

New York, NYHouston Leuven, Belgium

School of Nursing Medications in Older End-of-Life Planning and

Nancy Houston Miller,

Design

Wanda K Mohr, PhD, BSN, RN

RN, FAAN Afaf Ibrahim Meleis, PhD, Associate Director

Associate Professor

University of Medicine andDean of Nursing Rehabilitation Program

Dentistry of New JerseyUniversity of Pennsylvania Stanford University

School of NursingSchool of Nursing Medical Center

Newark, NJPhiladelphia, PA Palo Alto, CA

Children Exposed to Immigrant Women; Smoking/Tobacco as a

Intimate Partner International Nursing Cardiovascular Risk

Violence; Intimate Research; Transitions Factor

Partner Violence and Health

Peggy A Miller, MS, RN Mary Moller, MSN, RN Victoria Menzies, PhD, RN Research Coordinator

Doctoral StudentCenter for the Study of University of Kansas

Case Western ReserveComplementary and School of Nursing

UniversityAlternative Therapies Kansas City, KS

Frances Payne BoltonUniversity of Virginia

Job Satisfaction School of Nursing

School of Nursing

Cleveland, OHCharlottesville, VA Susan M Miovech, PhD,

Schizophrenia Complementary and RNC

Alternative Practices and Assistant Professor Rita Monsen, DSN, MPH,Products (CAPPs) Holy Family University RN

Interim Executive DirectorSchool of Nursing & Allied

Bonnie L Metzger, PhD, Health Professions Genetic Nursing

Margaret Shandor Miles, Assistant Professor

Carolina, Chapel Hill

Carolina at Chapel Hill Columbia, SC

Parental Response to the Watson’s Theory of

of a High-Risk Infant;

Parenting

West Virginia UniversityDean for Research Boston College

School of NursingCase Western Reserve School of Nursing

Morgantown, WVUniversity Chestnut Hill, MA

Frances Payne Bolton Data Management; Moral Distress; MoralSchool of Nursing Quantitative Research Reckoning

Cleveland, OH Methodology; Statistical

Mary Duffin Naylor, PhD,

Pain Management: A Techniques

University of Iowa University New York, NY

College of Nursing Frances Payne Bolton

HIV/AIDS Care and

Iowa City, IA School of Nursing

Dean and Professor

Elders; Pilot Study

Patricia Moritz, PhD, RN, Fairfield University

FAAN Madeline A Naegle, PhD, School of Nursing

Professor and Dean APRN-BC, FAAN Fairfield, CT

University of Colorado Professor Nursing EducationHealth Sciences Center New York University

Workplace Violence

Case Western Reserve RN, BSN

Graduate StudentUniversity

Hartford FoundationSan Antonio, TX

Nursing: Human Minority Women Radford University

Becoming Theory; Offenders School of Nursing

Ann L O’Sullivan, PhD, Linda R Phillips, PhD, Eileen J Porter, PhD, RN

Associate Professor

RN, FAAN CRNP, FAAN

Professor University of MissouriProfessor

University of Arizona School of NursingUniversity of Pennsylvania

College of Nursing Columbia, MOSchool of Nursing

Tucson, AZ

Clinical Nursing Adolescence; Adolescent Lorrie L Powel, PhD, RN

Research

Parenting; Infant Injury Sally Phillips, PhD, RN School of Nursing

College of Health andDirector of Bioterrorism

Joanne O’Sullivan, PhD, Preparedness Research Public Affairs

APRN, BC, FNP Program University of Central

Assistant Professor Agency for Health Care Florida

Graduate Program of Research and Quality Orlando, FL

Nursing Rockville, MD Cancer Survivorship;Massachusetts Institute of Caring; Nursing Process Prostate Cancer

Associate Professor,

Professional LiaisonAssociate Dean for

Mary H Palmer, PhD,

CINAHL InformationCommunity Partnerships

RNC, FAAN

SystemsUniversity of Michigan

Umphlet Distinguished

Glendale, CASchool of Nursing

Professor in Aging

Cumulative Index to

Ann Arbor, MIUniversity of North

Nursing and Allied Nursing Centers

Carolina at Chapel Hill

Health Literature

School of Nursing Denise F Polit, PhD

Jana L Pressler, PhD, RN

Chapel Hill, NC President

Assistant Dean for

Prostate Cancer Humanalysis, Inc.

Research, Professor,Saratoga Springs, NY

John R Phillips, PhD, RN Assistant Professor

Professor Emeritus Demetrius J Porche, DNS, Case Western Reserve

School of Education Associate Dean of Frances Payne BoltonNew York, NY Research & Evaluation School of Nursing

Cleveland, OH

(Martha E.) Rogers and Professor

Health Science of Unitary Louisiana State University

Conceptualization; Persons Health Sciences Center

Contributors xxvii

Joanne W Rains, DNS, Mary Anne Rizzolo, EdD, Norma Martinez Rogers,

PhD, RN

Dean and Associate Director for Professional Assistant Professor

Professor Development University of Texas HealthIndiana University East National League for Science Center

Division of Nursing Nursing School of Nursing

Richmond, IN New York, NY San Antonio, TX

Collaborative Research Research on Interactive Minority Women

Offenders Video

Barbara Rakel, MA, RN

Information Systems andHospitals and Clinics

Garvin Professor of Quality AssuranceIowa City, IA

Nursing Warren Grant Magnuson

Ethnography Frances Payne Bolton

Clinical CenterSchool of Nursing

Pamela G Reed, PhD, RN, National Institutes of

Case Western Reserve

University

Cleveland, OH

College of Nursing Falls; Functional Health

Eileen Virginia Romeo,

Tucson, AZ

MSN, RN Karen R Robinson, PhD

Peplau’s Theoretical

Doctoral StudentNon Clinical Lecturer in

Model; Spirituality

Case Western ReserveGastroenterology

University

Barbara Resnick, PhD, Institute of Infection,

Frances Payne Bolton

CRNP, FAAN, FAANP Immunity and

School of NursingAssociate Professor Inflammation

Cleveland, OHUniversity of Maryland University Hospital

School of Nursing Queens Medical Center Orem’s Self-Care DeficitBaltimore, MD Nottingham, United Nursing Theory

Continuing Care Kingdom Marlene M Rosenkoetter,Retirement Communities Current Procedural PhD, RN, FAAN

Coronary Heart Disease

Assistant Dean for Student

Atlanta, GAAffairs

Bonnie Rogers, PhD,

COHN-S, LNCC, FAAN

Indiana University Virginia K Saba, EdD,

Associate Professor and

Director, Occupational

Safety and Health

Education and Research

Georgetown University

Susan K Riesch, DNSc, Center

School of Nursing and

RN, FAAN University of North

Health StudiesProfessor, School of Carolina at Chapel Hill

Washington, DCNursing School of Public Health

Home Health Care

University of Wisconsin- Chapel Hill, NC

Classification System;

Madison Nursing Occupational

Home Health Systems;

School of Nursing Injury and Stress

Nursing Informatics;

Madison, WI

Nursing Information Nursing Centers

Systems

Ali Salman, MD, RN Judith Kennedy Schwarz, Shyang-Yun Pamela K.

PhD Candidate PhD, RN Shiao, PhD, RN, FAAN

Case Western Reserve Consultant, Ethics and Associate Professor

University End-of-Life Care University of TexasFrances Payne Bolton New York, NY Health Sciences CenterSchool of Nursing Advance Directives School of Nursing

Joan L Shaver, PhD, RN,

FAAN

Professor and Dean

University of Illinois atChicago

Project Director, CPAP Chicago, IL Clinical Director

Research Study Sleep Psychiatry Care CenterUniversity of Kansas Mount Sinai Medical

Mary Cipriano Silva, PhD,

Assistant Professor Model

Pittsburgh, PA Mary Shelkey, PhD, RN, Massachussetts

Patient Contracting

Assistant Professor Ethics of Research;

Donald F Schwarz, MD, Seattle University Philosophy of NursingMPH, MBA College of Nursing

Deputy Physician-in-Chief Seattle, WA Carol E Smith, PhD, RNChief, Craig-Dalsimer Alzheimer’s Disease Professor

Division of Adolescent University of KansasMedicine Deborah Shelton, PhD, School of Nursing

University of Pennsylvania RN, CNA, BC Kansas City, KS

Schools of Medicine and Associate Professor of

Caregiver; Home Care

Case Western Reserve

University

Frances Payne Bolton

School of NursingHealth Sciences Center Patient Safety

Cleveland, OHSchool of Nursing

Denver, CO Triangulation Ora L Strickland, PhD,

Els Steeman, MSN

ProfessorCenter for Health Services

and Nursing ResearchProfessor and Associate Nell Hodgson School of

Measurement and Scales Medications in Older

Robert C Byrd Health

Edith Clemmer Steinbright

Drinking and Driving Associate Professor of Professor in GerontologyAmong Adolescents; Nursing Director of the Center forMiddle-Range Theories University of Michigan Gerontologic Nursing

School of Nursing Science

Bernard Sorofman, PhD Ann Arbor, MI

University of PennsylvaniaProfessor Self-Concept

School of NursingUniversity of Iowa Disturbances and Eating

Philadelphia, PACollege of Pharmacy Disorders

Kresge Center ResearchProfessor Emeritus

Susan M Sparks, PhD,

AssistantOhio State University

Ohio State University

Vulnerable Populations College of Nursing Hospital

New York, NYColumbus, OH

Endotracheal Suctioning Case Management

Hsin-Yi (Jean) Tang, PhD, Diana L Taylor, PhD, RN, Barbara S Turner, DNSc,

RN, FAAN

Professor Emeritus,Teaching Associate Professor and Associate

DeanUniversity of Washington Department of Family

Health Care Nursing

School of NursingSeattle, WA Adjunct Professor, Center

for Reproductive Health Durham, NC

Biofeedback

Policy & Research Informed Consent

Siew Tzuh Tang, DNSc University of California,

Assistant Professor San Francisco Doris C Vahey, PhD

College of Nursing San Francisco, CA Special Projects ConsultantNational Yang-Ming Menstrual Cycle; Mount Sinai HospitalUniversity Premenstrual Syndrome New York, NY

Debera Jane Thomas,

Chronic Illness

Barbara Valanis, PhD, DNS, RN, CS

Susan Dale Tannenbaum, Associate Professor FAAN

RN, BSN Florida Atlantic University Director of Nursing

Staff Nurse—Cardiac Unit Boca Raton, FL Research

Johns Hopkins University Kaiser-Permanente Center

Case Study as a Method

of Research

Hypertension Mary E Tiedeman, PhD, Consortial Research

RN Anita J Tarzian, MS, RN

Connie Vance, RN, EdD,

Associate Professor,Research Associate

FAAN

College of NursingUniversity of Maryland

Professor, School ofBrigham Young University

School of Nursing

NursingCollege of Nursing

Baltimore, MD

The College of NewProvo, UT

Roy Adaptation Model

School of Nursing

Roma Lee Taunton, PhD,

Sara Torres, PhD, RN, New Rochelle, NY

RN, FAAN

FAAN

Dean and ProfessorUniversity of Kansas

Health

Intimate Partner

Ann Gill Taylor, EdD, RN, Violence; Intimate Dayton, OH

Betty Norman Norris

Professor of Nursing and Toni Tripp-Reimer, PhD, Joyce A Verran, PhD, RN,

Director, Center for the RN, FAAN FAAN

Study of Complementary Professor and Associate Professor

and Alternative Dean University of ArizonaTherapies University of Iowa College of Nursing

University of Virginia College of Nursing Tucson, AZ

School of Nursing Iowa City, IA Instrumentation;

Charlottesville, VA Ethnography; Qualitative Reliability; Validity

Complementary and Research

Alternative Practices and

Products (CAPPs)

College of Nursing

Akron, OHUniversity of Michigan Frances Payne Bolton

School of NursingAnn Arbor, MI Experimental Research;

Cleveland, OH

Quasi-Experimental Health Disparities

Research Disparities in Minority

Clarann Weinert, SC, PhD,

Boston University

RN, FAAN

School of Medicine Sharon A Wilkerson, PhD,

Professor & Director

Center for Research onGeriatric Research Chronic Health Associate Professor ofEducation and Clinical Conditions in Rural Nursing

Edith Nourse Rogers College of Nursing School of Nursing

Memorial Veterans Montana State University- West Lafayette, IN

Bedford, MA Bozeman, MT Behavioral System Model

Mental Status Longitudinal Survey;

Carolyn A Williams, PhD,

Measurement: The Mini- Rural Health

RN, FAAN

Mental State

Dean and Professor

Joan Stehle Werner, DNSc,

Examination

RN University of KentuckyProfessor

University of

Eau Claire

College of Nursing and

Health SciencesMarquette University

Eau Claire, WI

Coping Doctoral Candidate

International

Louisiana State University

Classification for Mary Ellen Wewers, PhD,

Ohio State University

Patricia Hinton Walker,

College of Nursing

PhD, RN, FAAN Columbus, OH Celia E Wills, PhD, RN

Smoking Cessation

Uniformed Services Michigan State UniversityUniversity of the Health Ann Whall, PhD, RN, College of Nursing

Graduate School of Professor and Mental Health in PublicNursing Associate Director, Sector Primary Care;Bethesda, MD University of Michigan Mental Health Services

Holly Skodol Wilson, PhD, JoAnne M Youngblut, Cora D Zembrzuski, PhD,

APRN

ProfessorProfessor Emeritus Lecturer and Clinical

CoordinatorUniversity of California Florida International

University

NursingSchool of Nursing School of Nursing

Among Older Adults; (Qualitative) Modeling

Hydration and

Sarah A Wilson, PhD, RN Renzo Zanotti, PhD Dehydration in Older

Associate Professor Professor Adults

Marquette University University of Padova

University Case Western Reserve

UniversityFrances Payne Bolton

School of Nursing Frances Payne Bolton

School of NursingCleveland, OH

Cleveland, OH

Physiological Monitoring

Depression in Older

May L Wykle, PhD, RN, Adults; Factor Analysis;

FAAN, FGSA Resourcefulness

Dean and Florence Cellar

Professor of

Gerontological Nursing

Director, University Center

on Aging & Health

Case Western Reserve

L IST OF E NTRIES

Complementary andAction Science Cancer in Children Alternative Practices andActivities of Daily Living Cancer Survivorship Products (CAPPs)

Acute Care of the Elderly Capitation Computer-Aided

Adherence/Compliance Cardiovascular Disease Instruction

Adolescence Cardiovascular Risk Computerized DecisionAdolescent Pregnancy and Factors: Cholesterol Support Systems

Adult Health Caring Consortial Research

Advance Directives Case Management Content Analysis

Advanced Practice Nurses Case Study as a Method of Continuing Care

Alcohol Dependence Causal Modeling

CopingAlzheimer’s Disease Cerebral Ischemia

Coronary Artery BypassAngina Child Abuse and Neglect

Graft (CABG) SurgeryApplied Research Child Delinquents

Cost Analysis of NursingArtificial Intelligence Child Lead Exposure Care

Childbirth Education Cultural/Transcultural

FocusIntimate Partner Violence Cumulative Index toBasic Research

Chronic Conditions in Nursing and AlliedBehavioral Research

Childhood Health LiteratureBenchmarking in Health

Chronic Gastrointestinal Current ProceduralCare

Symptoms Terminology-CodedBibliographic Retrieval

Chronic Illness ServicesSystems

Clinical Decision MakingBibliometrics

D

Clinical JudgmentBiofeedback

Clinical Nursing ResearchBowel Elimination Among Data Analysis

Clinical Preventive Services

DeliveryBoykin and Schoenhofer: Data Management

Clinical TrialsThe Theory of Nursing Data Stewardship

Cognitive Interventions

Cohort DesignBreast Cancer: Psychosocial Delirium

Collaborative ResearchAdjustment to Illness Delphi Technique

ComfortBreast Cancer Screening Denial in Coronary Heart

DiseaseBreast-Feeding Community Health

xxxiii

Depression and Family Health HIV Risk Behavior

Cardiovascular Diseases Family Satisfaction With HIV Symptom

Depression in Families End-of-Life Care Management and

Depression in Older Adults Family Theory and Quality of Life

Depression in Women Research HIV/AIDS Care andDescriptive Research Fatigue Treatment

Diabetes Feminist Research Home Care TechnologiesDisaster Nursing Methodology Home Health Care

Discourse Analysis Fetal Monitoring Classification (HHCC)Disparities in Minority Fever/Febrile Response System

Mental Health Fitzpatrick’s Rhythm Home Health SystemsDizziness in the Elderly Model Homeless Health

Doctoral Education Formal Nursing Languages Homelessness

Drinking and Driving Functional Health Homelessness and RelatedAmong Adolescents Functional Health Patterns Mood Disorders

Gastroesophageal Reflux

HypertensionElder Mistreatment Disease

Gender ResearchElectronic Network

I

Emergency Nursing Genetics

Geriatric Interdisciplinary

End-of-Life Planning and Teams Individual Nursing Therapy

Endotracheal Suctioning Gerontological Advanced Infection Control

Endotracheal Suctioning in Practice Nursing Informed Consent

Newborns: NICU Grandparents Raising Instrumentation

Preterm Infant Care Grandchildren International ClassificationEnteral Tube Placement Grantsmanship for Nursing Practice

Ethics of Research Grounded Theory International Nursing

Health ConceptualizationExploratory Studies

ResearchSeriously Mentally Ill Conceptual System and

List of Entries xxxvTheory of Goal Neurobehavioral Osteoarthritis

OsteoporosisAttainment Development and

Outcomes MeasuresNutritive Sucking

L Neuroleptic Use in Nursing

P

HomesLeininger’s Theory of

Newman’s Theory of PainCulture Care Diversity

Health Pain Management: A and Universality

Mid-Nightingale (Florence) Range TheoryLongitudinal Survey

Nosocomial Infections Parental Response to theNurse-Patient Interaction Birth and Hospitalization

M

Nurse-Patient Relationship of a High Risk InfantNurse Researcher in the

Clinical Setting Parkinson’s DiseaseMaternal Anxiety and

Nurse Staffing Parse’s Theory of Nursing:Adaptation During

Nursing Assessment Human BecomingPregnancy

Nursing Centers TheoryMeasurement and Scales

Nursing Diagnosis Participant ObservationMedications in Older

Patient ClassificationNursing Education

Persons

Patient ContractingNursing Informatics

Menstrual Cycle

Patient EducationNursing Information

Mental Disorders

Patient SafetySystems

Prevention

Patient SatisfactionNursing Intensity

Mental Health in Public

Pediatric Primary CareNursing Interventions

Sector Primary Care

Pender’s Health PromotionClassification (NIC)

Mental Health Services

ModelNursing Occupational

Measurement: The

Mini-PhenomenologyClassification

Mental State

Philosophy of NursingNursing Practice Models

Examination

Physical RestraintsNursing Process

Mentoring

Physiological MonitoringNursing Studies Index

Meta-Analysis

Pilot StudyNursing Workload

Middle-Range Theories

Population HealthMeasurement Systems

Minority Women

PregnancyNutrition in the Elderly

Offenders

Premenstrual SyndromeMoral Distress

Observational Research Low-Birthweight Births

N

Online Journal of Primary Health CareKnowledge Synthesis for

National Institute of Nursing Prostate Cancer

Nursing Research Orem’s Self-Care Deficit Psychosocial InterventionsNational Institutes of Nursing Theory (PSI)

Health Organizational Culture Pulmonary Changes in

EldersNeuman Systems Model Organizational Redesign

Q Scientific Development Thermal Balance

Time Series AnalysisSecondary Data Analysis

Serious Mental Illness

System Urban Health Research:

Reminiscence and Life Smoking Cessation

Urban NeighborhoodsReview Smoking/Tobacco as a

Urinary IncontinenceReplication Studies Cardiovascular Risk

Knowledge for SNOMED International

ValidityComputational Modeling Social Support

Violence

in Nursing: The Arcs© Spirituality

Virginia HendersonProgram Statistical Techniques

International NursingResearch Careers Stress

LibraryResearch Dissemination Stress Management

Vulnerable PopulationsResearch in Nursing Ethics Stroke

Research Interviews Structural Equation

W

(Qualitative) Modeling

Research on Interactive Substance Abuse and Wandering

Video Addiction Among Watson’s Theory ofResearch Utilization Registered Nurses Human Caring

Resourcefulness Substruction Weight Management

Rights of Human Subjects Surgery Widows and Widowers(Martha E.) Rogers Science Women’s Health

of Unitary Persons T Workplace Violence

Roy Adaptation Model

TaxonomyRural Health

TelehealthTerminal Illness

S

Theoretical FrameworkSampling

Schizophrenia

tice and generating knowledge Argyris

Action Science

(1987) suggests further that action science is

an interventionist approach in which threeAction science is an approach to generating

prerequisites must be established for the knowledge for practice by engaging prac-

re-search to ensue: (a) a creation of normativetitioners in that process through reflection

models of rare universes that are free of

defen-on their own behavioral worlds of practice

sive routines, (b) a theory of intervention that(Argyris, Putnam, & Smith, 1985; Scho¨n,

can move practitioners and organizations1983) Scho¨n contrasts action science as ad-

from the present to a new desirable universe,vanced by these authors with the traditional,

and (c) a theory of instruction that can bepositivistic science, which he calls technical

used to teach new skills and create new rationality Technical rationality for profes-

cul-ture

sional practice is concerned with “knowing

Action science holds that actions in that,” whereas action science is oriented to

profes-sional practice are based on practitioners’

“knowing how” in practice Although

know-theories of action Theories of action areing how in practice contributes to the creation

learned and organized as repertoires of

con-of knowledge that is not available from

tradi-cepts, schemata, and propositions and are thetional research, what practitioners actually

basis on which practitioners’ behavioraldesign in their practice may be limiting, rou-

worlds are created in specific situations oftinized, and self-sealing Hence, action sci-

practice Argyris, Putnam, and Smith (1985)ence addresses generation of knowledge

identified espoused theories and through reflection that fulfills the functions

theories-in-use as two types of theories of action

Es-of discovery and change Action science is

poused theories of action are the rationaleprimarily oriented to studying individual

expressed by practitioners as guiding theirpractitioners in their practice and generation

actions in a situation of practice, whereas

of knowledge from individuals’ practice;

theories-in-use refers to theories that are however, it can be applied to organizational

actu-ally used in practice Theories-in-use are onlybehaviors and organizational intervention

inferable from the actions themselves, and

R Putnam (1992) suggests that action

sci-practitioners usually are not aware of or notence is based on three philosophical premises:

able to articulate their theories-in-use except(a) human practice involves meaning making,

through careful reflection and self-dialogue.intentionality in action, and normativity from

Argyris and Scho¨n (1974) and Argyris,the perspective of human agency; (b) human

Putnam, and Smith (1985) identified Modelpractice goes on in an interdependent milieu

I theories-in-use as a type that seals

prac-of behavioral norms and institutional

poli-titioners from learning and produces tics; and (c) the epistemology of practice calls

routin-ization and ineffectiveness in practice Modelfor the engagement of practitioners in gener-

II theories-in-use are proposed within actionating knowledge Action science thus is a

method and philosophy for improving prac- science as an intervention for Model I

theo-1

ries-in-use Model II theories-in-use encom- also acts as an interventionist by engaging the

practitioner to move toward new learning.pass principles of valid information, free and

informed choice in action, and internal com- Nursing practice is a human-to-human

service that occurs in the context of healthmitment Reflection and learning are the two

key processes necessary for the transforma- care Nurses practice within on-line

condi-tions that are complex not only with respecttion from Model I theories-in-use to Model

II theories-in-use Action science, then, aims to clients problems but also in terms of

orga-nizational elements of the health care

envi-to engage both practitioners and researchers

in this process of transformation through the ronment Nursing practice is not based

sim-ply on linear translations of relevant creation of a normative model of rare uni-

theoreti-verse and application of theories of interven- cal knowledge that governs the situation of

practice but has to be derived and designedtion and instruction

Knowledge of practitioners’ theories-in from the nurse’s knowledge of and responses

to the competing and complex demands ofuse and espoused theories provides a descrip-

tive understanding about the patterns of in- the situation (Kim, 1994) In addition, as the

action scientists suggest, nursing practice inconsistencies between theories-in-use and es-

poused theories recalled in actual practice general, as well as particular nursing actions,

may be entrenched with routinization or Through action science, practitioners en-

fro-gaged in Model II theories-in-use produce zen within Model I theories-in-use

On the other hand, a great deal of nursingpractice knowledge that informs their ap-

proach to practice without routinization or as practiced may be exemplary and creatively

designed and enacted The general aim of the self-sealing mode In addition, action sci-

ac-ence generates knowledge regarding the pro- tion science for nursing is then to improve

nursing practice by freeing nurses from cess involved in self-awareness and the learn-

self-ing of new theories-in-use through reflective sealing practices and engaging them in the

process of learning and participatory practice and practice design

re-Research process in action science calls for search

the cooperative participation of practitioner

HESOOKSUZIEKIM

and researcher through the phases of

descrip-tion, discovery of theories-in-use, and

inter-vention Transcriptions of actual practice by

the researcher or narratives of actual practice Activities of Daily Living

by the practitioner are analyzed together in

order to describe and inform reflectively the Ability to care for oneself and meet basic

needs is fundamental to maintaining healthnature of practice and theories-in-use R Put-

nam (1996) suggests the use of the ladder of and independence The term “activities of

daily living” (ADL) is used to refer to the setinference as a tool to discover practitioners’

modes of thinking and action as revealed in of skills that constitute these essential

abili-ties ADL are evaluated for many purposes,transcripts or narratives The research pro-

cess is not oriented to the analysis of action such as to assess current capabilities, to

deter-mine care requirements, to gauge progresstranscripts or narratives by a researcher inde-

pendent of the practitioner It involves a post- or response to intervention, and to evaluate

outcomes Thus, ADL are useful to manypractice face-to-face discussion (interview)

between the researcher and the practitioner health disciplines and professions across a

wide range of health care settings and Such session, are used to get at the recon-

popula-structed reasoning of practitioners regarding tions for addressing both clinical and

re-search goals

critical moments of the practice and to

pro-vide opportunities for reflection on the think- ADL are generally viewed hierarchically

from the most basic of human skills (e.g.,ing and doing that were involved in the prac-

tice Through such sessions, the researcher ability to feed oneself) to somewhat higher

Activities of Daily Living 3ones (e.g., ability to bathe and dress oneself) may color responses Further, it is also im-

portant to distinguish between what the Higher still are those more complex skills

in-necessary to maintain independence in the formant says the individual can do, what the

individual actually can do, and what the community, such as using the telephone, do-

indi-ing household chores, and managindi-ing one’s vidual is expected to do, all of which may or

may not actually correspond with one finances This higher level skill set is usually

an-distinguished from the more basic ones by other (Smith & Clark, 1995) Even when

ob-taining ratings of actual rather than reporteduse of the term “instrumental activities of

daily living” or IADL ADL and IADL are performance, accuracy can be a problem An

evaluator should take care to note, or controlalso part of the broader concept of functional

assessment, which generally encompasses when possible, both environmental factors

(e.g., familiarity, glare, and noise), and more domains, such as cognitive and social

per-functioning sonal factors (e.g., fatigue or depression),

when conducting and interpreting Many scales have been developed to mea-

assess-sure ADL and IADL Among the most widely ments of ADL performance

The application of ADL and IADL used are the Katz Index of Activities of Daily

mea-Living, the Barthel Index, and the Functional sures to particular clinical populations is a

new approach that is beginning to gain Independence Measure, each of which ad-

no-dresses basic ADL These and similar scales tice, much as quality of life measures have

been specified to various clinical populations.encompassing IADL can be used alone, to-

gether, or in combination with other mea- Such specific ADL measures may be applied

best when the most commonly affected ADLsures of function, depending upon the pur-

pose and breadth of the assessor’s goals and related performance limitations are

known for a given population In these ADL scales vary, not only in the range and

situa-complexity of skills they include, but also in tions, the assessment can be targeted toward

the most relevant ADL and scaled morethe way skills are rated Generally, each scale

measures along one dimension, such as diffi- meaningfully to the nature of the difficulty

encountered For example, knowing that aculty in performing a skill (e.g., performs with

ease) or type of support (e.g., physical, cogni- person with dementia is unable to dress

them-selves independently is useful; but knowingtive) or level of assistance (e.g., single person

assist) needed to perform a skill Dichoto- that the person needs help with sequencing

the steps involved in selecting and donningmous and ordinal scaling approaches are

most common The scaling model is espe- appropriate clothing is substantially more

useful in supporting a higher level of cially important in determining not only the

indepen-dimension of ADL to be assessed, but also in dence for the individual This approach to the

assessment of ADL may be most beneficial indetermining the scale’s sensitivity to change

Although ADL and IADL assessments have a clinical context where prescriptions for the

kinds and levels of ADL assistance are made.been used for many years, the prevalence of

dichotomous and broad ordinal scaling mod- One disadvantage of specifying ADL

assess-ments to particular populations is that theels has led to only a limited understanding of

the pattern of ADL and IADL change over narrowed view may result in a failure to

iden-tify uncommon areas of difficulty

time for various patient populations

ADL scales can be used to elicit informa- In sum, ADL and IADL are widely used

concepts in nursing and health care practicetion from various informants including the

individual being assessed, a family member and research because they are valuable in

un-derstanding the impact of illness or injury on

or informal caregiver, a health professional,

or research staff To obtain accurate ADL a person’s everyday life and in determining

their needs for assistance in support of ratings it is essential to consider the infor-

contin-mant’s knowledge of the individual’s abilities ued independence Particular approaches to

assessing ADL and IADL should be selectedand any motivations of the informant that