Increasing use of research in clinical practice is inevitable, and therefore, integrative reviews can play a greater role in developing evidence-based nursing practices. Because of this, nurse researchers should pay more attention to sound integrative nursing research to systematise the review process and make it more rigorous.
This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients.
The qualitative study reported in this paper aims to describe the planning and assessment of psychiatric nursing in a hospital environment. The theoretical framework consists of the three types of psychiatric nursing outlined in a developmental model of nursing: confirmatory, educational and catalytic. Confirmatory psychiatric nursing is based on a hierarchical and authoritarian model. Educational psychiatric nursing is based on a professionally driven and behavioural model. Catalytic psychiatric nursing is systematic, theoretical, and research-based. Catalytic psychiatric nursing may vary, depending on the patient's needs, from confirmatory and educational to situationally determined nursing. However, it always enables patient initiatives. The purpose of this paper is to describe patient initiatives during the assessment and planning of patient care by an interdisciplinary mental health team in a psychiatric hospital environment, and the assessment and planning as described by nurses working in a hospital environment. The data, which were collected in two psychiatric hospitals by videotaping interdisciplinary teamwork situations and recording interviews of nurses afterwards, consisted of 384 pages of written text. A total of 640 sentences were identified in the text as reflecting the assessment of care by the interdisciplinary team and by the nurses working in the hospital environment. Deductive content analysis techniques were used to analyse the written data. The results showed that nursing was described by the nurses to be catalytic in 13% of the cases, while the same nurses assessed psychiatric nursing to be most commonly educational (40%) or confirmatory (47%).
This article describes how ethical guidelines have been applied while interviewing psychiatric patients who were recovering from mental illness, especially from psychosis, to allow nurses to understand these patients' experiences. Because psychiatric patients are vulnerable, their participation in research involves ethical dilemmas, such as voluntary consent, legal capacity to consent, freedom of choice, and sufficient knowledge and comprehension. The first part of this article describes the most important ethical guidelines concerning human research. These have been published by different organizations, departments, committees and commissions for the purpose of protecting human rights and dignity whenever research participants are vulnerable persons or their capacity to consent is limited. At present, however, no special regulations govern research involving adults who have been diagnosed with a condition characterized by mental impairment. Furthermore, a relatively small body of research has documented the effects of various disorders (e.g. psychiatric conditions) on decision-making capacity per se. One basic moral and policy question is whether these individuals should ever be involved in research. The second part of this article concentrates on how the investigator made sure that participating patients had understood their role in this particular piece of nursing research. During the interviews the investigator noticed that some ethical dilemmas required further study and debate because of the lack of consensus on the proposed regulatory provisions on research involving institutionalized persons and their ability to make an informed and voluntary decision.
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