Descriptive study of shared decision making about lifestyle modifications with individuals who have psychiatric disabilities.

BACKGROUND: Shared decision making (SDM) is a process of active participation by clients with practitioners in weighing the risks and benefits of treatments. It has not been extended to decisions about making lifestyle modifications. OBJECTIVE: Describe how frequently health lifestyle behaviors are addressed in 15- to 20-minute medicine clinic visits with individuals who have psychiatric disabilities and how often SDM is used in reaching decisions. DESIGN: Content analysis of 98 audiotaped transcripts from practitioner and client medicine clinic visits. RESULTS: The most frequently discussed lifestyle behaviors discussed were sleep (89%) and diet (61%). SDM, defined as sharing information and options about behavior by either or both practitioner and client and affirmation of a decision by both, occurred 48 times (44%) when a problem existed. CONCLUSION: Discussion of lifestyle behaviors along with use of SDM in negotiating changes in behavior is feasible in a 15- to 20-minute visit.

Using a modified electronic health record to develop nursing process skills.

In our study, we described the experiences and behaviors of beginning nursing students learning the nursing process using a modified electronic health record. Eight students led by an experienced nursing instructor from a midwestern university comprised the criterion purposive sample. Data were obtained from observations of the group, interviews with students and the teacher, and evaluation of care plans that were generated using the technology. Two foundational themes were identified through qualitative content analysis: Techno-Savvy Students and Teacher, Simulated Technology, and Data-Rich Case Studies--a valuable hybrid "SEED" for learning. Seeing, Hearing, and Doing--a catalyst for application and spontaneous interaction. The concluding theme emerged: Honing the Data Gatherer and Data User Roles with a Modified Electronic Health Record--an authentic, learner-centered experience. Further study is needed to measure learning outcomes with similar technology-based, learner-centered activities.

Psychological acculturation: a concept analysis with implications for nursing practice.

Psychological acculturation is a complex process that has been widely discussed in the literature of anthropology, psychology, and sociology. The purpose of this article is to analyze the concept of psychological acculturation using Walker and Avant's strategy for concept analysis. The authors bring greater clarity to this process of acculturation to help nurses understand individuals'health behaviors. Definitions of acculturation are examined using different resources including dictionaries and scholarly literature. Antecedents, defining attributes, and consequences are identified, discussed, and summarized. A model case and contrary case are presented. Measurement of psychological acculturation is discussed in the context of defining attributes. Direction for future research and implications for nursing practice are presented.

The experience of living with chronic mental illness: a photovoice study.

PURPOSE: This study aims to explore if photovoice methodology can be used to enhance the level of empathy professionals feel when meeting a patient who carries a psychiatric diagnosis in any setting. DESIGN AND METHODS: This study used a qualitative descriptive design. Seven adult patients were interviewed for 1 hr regarding photos that were taken to represent what it has been like to live with their chronic illness. FINDINGS: Four major themes emerged: (a) feeling misunderstood and invisible in the world; (b) attempting to gain control and be safe through various actions and activities; (c) making an ongoing effort to repair injured self-esteem; and (d) using various coping skills. PRACTICE IMPLICATIONS: Patients in this study enjoyed the process of taking photos to help tell their story, and they were able to capture meaningful images that communicated their lived experience of dealing with a mental illness.

A qualitative investigation of fatigue among healthy working adults.

Despite considerable attention to fatigue in acute and chronic illnesses, little is known about fatigue in a healthy population. A detailed exploration of fatigue, therefore, was conducted to answer the broad question of what fatigue is to a basically healthy population and to lay the groundwork for establishing an empirically based definition of fatigue. Qualitative and quantitative methods were used. Results of the qualitative phase of the study, in which 40 persons were interviewed, are presented here. Categories and themes of the experience of fatigue were identified. Based on the qualitative findings, we propose that fatigue in generally healthy adults is an acute, subjective, sometimes overwhelming, but temporary state (with physical, emotional, and behavioral manifestations) caused by stress and overwork in one's life roles, which disrupts activity and alerts the person to take restorative measures.