... This article reports an example of quantitative-qualitative triangulation, illustrating the .... more ... This article reports an example of quantitative-qualitative triangulation, illustrating the ... First, using both quantitative and qualitative methods can be resource intensive ... power, influence, andleadership style); organizational characteristics (distributive justice, promotional ...
To describe the experiences of families with a relative in the intensive care unit (ICU). Retrosp... more To describe the experiences of families with a relative in the intensive care unit (ICU). Retrospective, descriptive, and qualitative. The surgical-trauma ICU in a midwestern university-affiliated tertiary medical center. Eighteen women and 2 men with relatives in a surgical trauma ICU. Focus group and individual unstructured interviews. A group interpretive process was used to code, categorize, and identify themes found in the transcribed interviews. Four categories of experiences were identified: hovering, information seeking, tracking, and the garnering of resources. Hovering is an initial sense of confusion, stress, and uncertainty. Information seeking is a tactic used both to move out of the hovering state and to identify the patient's progress. Tracking is the process of observing, analyzing, and evaluating patient care and status and the family's own satisfaction with the environment and with care givers. The garnering of resources is the act of acquiring what family members perceive as needed for themselves or their relative. Families experience a sense of uncertainty that is eventually resolved by seeking information and resources. Health care professionals can minimize the stress associated with hospitalization of relatives in the ICU by anticipating and addressing the family's needs for information and resources.
The study describes the design and implementation of an Internet-based, computed-assisted telepho... more The study describes the design and implementation of an Internet-based, computed-assisted telephone survey about the care-planning process in 107 long-term care facilities in the Midwest. Two structured telephone surveys were developed to interview the care planning coordinators and their team members. Questionmark Perception Software Version 3 was used to develop the surveys in a wide range of formats. The responses were drawn into a database that was exported to a spreadsheet format and converted to a statistical format by the Information Technology team. Security of the database was protected. Training sessions were provided to project staff. The interviews were tape-recorded for the quality checks. The inter-rater reliabilities were above 95% to 100% agreement. Investigators should consider using Internet-based survey tools, especially for multisite studies that allow access to larger samples at less cost. Exploring multiple software systems for the best fit to the study requirements is essential.
Maternal/infant characteristics and birth location impact on breastfeeding initiation and duratio... more Maternal/infant characteristics and birth location impact on breastfeeding initiation and duration (Börk, L.; Bott, M. J.), p2-31. Rhetorical strategies implemented by the American Medical Association to identify roles within the interprofessional healthcare team (Ekholm, E. M.; Ford, D. J.), p32-72. Nurse-reported vs. patient-reported symptom occurrence, severity, and agreement using the Therapy-Related Symptoms Checklist (TRSC) in cancer patients (Heiman, A.; Williams, P. D.), p73-96. The effect of nurse characteristics on satisfaction with professionalism in the work environment (Wright, Z.; Cramer, E.), p.97-12
The practice environment is important to nurse satisfaction and patient outcomes. Laschinger and ... more The practice environment is important to nurse satisfaction and patient outcomes. Laschinger and Leiter posited causal relationships by development and testing of the Nursing Worklife Model (NWLM). Using a secondary analysis of unit-level data (N = 3,203; medical, surgical, medical-surgical, critical-care, and step-down units) from the 2011 National Database for Nursing Quality Indicators®, hypothesized pathways of the NWLM were tested using structural equation modeling. Practice Environment subscales developed by Lake were used to operationalize model variables with job enjoyment being the outcome variable. Positive pathways identified in the original causal model were supported. However, using an iterative process, additional pathways were identified that improved model fit (comparative fit index = 0.99; root mean square error of approximation = 0.06; standardized root mean square residual = 0.002). Nurse manager ability, leadership, and support had direct links to job enjoyment as well as other elements of the model. Development of nurse managers is important to the retention of clinical nurses in the hospital setting.
Research has indicated that using coping strategies is significantly related to resisting smoking... more Research has indicated that using coping strategies is significantly related to resisting smoking during highly tempting situations. However, little is known about the nature of coping during smoking cessation. The purpose of this study was to identify coping strategies used within the first 10 days of smoking cessation by having participants describe these strategies into a handheld tape recorder at the actual time of occurrence. The aim of a qualitative analysis of the narrative accounts was to create a descriptive taxonomy of smoking cessation strategies grounded in the participants'own terms. Over3 consecutive days, 36participants recruitedfrom smoking cessation programs provided 477 narrative accounts of coping episodes. Seven major taxons-context, anticipatory efforts, awareness, urges, strategies, effects, and metaphors-reflected the entire process participants described when dealing with the urge to smoke. This taxonomy, inductively derivedfrom real time rather than retrospective data, provides a holistic picture of strategies used in the early stages of the quit experience.
Methodology: European Journal of Research Methods for The Behavioral and Social Sciences, Aug 1, 2012
Content validity elicits expert opinion regarding items of a psychometric instrument. Expert opin... more Content validity elicits expert opinion regarding items of a psychometric instrument. Expert opinion can be elicited in many forms: for example, how essential an item is or its relevancy to a domain. This study developed an alternative tool that elicits expert opinion regarding correlations between each item and its respective domain. With 109 Registered Nurse (RN) site coordinators from National
The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led... more The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed. Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged. The journey to ...
Nursing home staff turnover results in high cost--both economic and personal--and has a negative ... more Nursing home staff turnover results in high cost--both economic and personal--and has a negative impact on the quality of care provided to residents at the end of life. Reducing staff turnover in nursing homes would benefit both the cost to the U.S. health care system, and, most importantly, the care residents receive in the vulnerable period leading to death. There is rising pressure on nursing homes to improve their palliative and end-of-life care practices and reduce transfers to hospital for situations and conditions that can be safely managed on site. Nursing care staff deserve an investment in the specific training necessary for them to give the highest quality care to dying residents. This training should be multifaceted and include the physiological, psychological, spiritual, interpersonal, and cultural (including ethnic) aspects of dying. Empowerment with these necessary knowledge, skills, and attitudes will not only result in better care for residents but likely also will ...
... This article reports an example of quantitative-qualitative triangulation, illustrating the .... more ... This article reports an example of quantitative-qualitative triangulation, illustrating the ... First, using both quantitative and qualitative methods can be resource intensive ... power, influence, andleadership style); organizational characteristics (distributive justice, promotional ...
To describe the experiences of families with a relative in the intensive care unit (ICU). Retrosp... more To describe the experiences of families with a relative in the intensive care unit (ICU). Retrospective, descriptive, and qualitative. The surgical-trauma ICU in a midwestern university-affiliated tertiary medical center. Eighteen women and 2 men with relatives in a surgical trauma ICU. Focus group and individual unstructured interviews. A group interpretive process was used to code, categorize, and identify themes found in the transcribed interviews. Four categories of experiences were identified: hovering, information seeking, tracking, and the garnering of resources. Hovering is an initial sense of confusion, stress, and uncertainty. Information seeking is a tactic used both to move out of the hovering state and to identify the patient's progress. Tracking is the process of observing, analyzing, and evaluating patient care and status and the family's own satisfaction with the environment and with care givers. The garnering of resources is the act of acquiring what family members perceive as needed for themselves or their relative. Families experience a sense of uncertainty that is eventually resolved by seeking information and resources. Health care professionals can minimize the stress associated with hospitalization of relatives in the ICU by anticipating and addressing the family's needs for information and resources.
The study describes the design and implementation of an Internet-based, computed-assisted telepho... more The study describes the design and implementation of an Internet-based, computed-assisted telephone survey about the care-planning process in 107 long-term care facilities in the Midwest. Two structured telephone surveys were developed to interview the care planning coordinators and their team members. Questionmark Perception Software Version 3 was used to develop the surveys in a wide range of formats. The responses were drawn into a database that was exported to a spreadsheet format and converted to a statistical format by the Information Technology team. Security of the database was protected. Training sessions were provided to project staff. The interviews were tape-recorded for the quality checks. The inter-rater reliabilities were above 95% to 100% agreement. Investigators should consider using Internet-based survey tools, especially for multisite studies that allow access to larger samples at less cost. Exploring multiple software systems for the best fit to the study requirements is essential.
Maternal/infant characteristics and birth location impact on breastfeeding initiation and duratio... more Maternal/infant characteristics and birth location impact on breastfeeding initiation and duration (Börk, L.; Bott, M. J.), p2-31. Rhetorical strategies implemented by the American Medical Association to identify roles within the interprofessional healthcare team (Ekholm, E. M.; Ford, D. J.), p32-72. Nurse-reported vs. patient-reported symptom occurrence, severity, and agreement using the Therapy-Related Symptoms Checklist (TRSC) in cancer patients (Heiman, A.; Williams, P. D.), p73-96. The effect of nurse characteristics on satisfaction with professionalism in the work environment (Wright, Z.; Cramer, E.), p.97-12
The practice environment is important to nurse satisfaction and patient outcomes. Laschinger and ... more The practice environment is important to nurse satisfaction and patient outcomes. Laschinger and Leiter posited causal relationships by development and testing of the Nursing Worklife Model (NWLM). Using a secondary analysis of unit-level data (N = 3,203; medical, surgical, medical-surgical, critical-care, and step-down units) from the 2011 National Database for Nursing Quality Indicators®, hypothesized pathways of the NWLM were tested using structural equation modeling. Practice Environment subscales developed by Lake were used to operationalize model variables with job enjoyment being the outcome variable. Positive pathways identified in the original causal model were supported. However, using an iterative process, additional pathways were identified that improved model fit (comparative fit index = 0.99; root mean square error of approximation = 0.06; standardized root mean square residual = 0.002). Nurse manager ability, leadership, and support had direct links to job enjoyment as well as other elements of the model. Development of nurse managers is important to the retention of clinical nurses in the hospital setting.
Research has indicated that using coping strategies is significantly related to resisting smoking... more Research has indicated that using coping strategies is significantly related to resisting smoking during highly tempting situations. However, little is known about the nature of coping during smoking cessation. The purpose of this study was to identify coping strategies used within the first 10 days of smoking cessation by having participants describe these strategies into a handheld tape recorder at the actual time of occurrence. The aim of a qualitative analysis of the narrative accounts was to create a descriptive taxonomy of smoking cessation strategies grounded in the participants'own terms. Over3 consecutive days, 36participants recruitedfrom smoking cessation programs provided 477 narrative accounts of coping episodes. Seven major taxons-context, anticipatory efforts, awareness, urges, strategies, effects, and metaphors-reflected the entire process participants described when dealing with the urge to smoke. This taxonomy, inductively derivedfrom real time rather than retrospective data, provides a holistic picture of strategies used in the early stages of the quit experience.
Methodology: European Journal of Research Methods for The Behavioral and Social Sciences, Aug 1, 2012
Content validity elicits expert opinion regarding items of a psychometric instrument. Expert opin... more Content validity elicits expert opinion regarding items of a psychometric instrument. Expert opinion can be elicited in many forms: for example, how essential an item is or its relevancy to a domain. This study developed an alternative tool that elicits expert opinion regarding correlations between each item and its respective domain. With 109 Registered Nurse (RN) site coordinators from National
The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led... more The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed. Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged. The journey to ...
Nursing home staff turnover results in high cost--both economic and personal--and has a negative ... more Nursing home staff turnover results in high cost--both economic and personal--and has a negative impact on the quality of care provided to residents at the end of life. Reducing staff turnover in nursing homes would benefit both the cost to the U.S. health care system, and, most importantly, the care residents receive in the vulnerable period leading to death. There is rising pressure on nursing homes to improve their palliative and end-of-life care practices and reduce transfers to hospital for situations and conditions that can be safely managed on site. Nursing care staff deserve an investment in the specific training necessary for them to give the highest quality care to dying residents. This training should be multifaceted and include the physiological, psychological, spiritual, interpersonal, and cultural (including ethnic) aspects of dying. Empowerment with these necessary knowledge, skills, and attitudes will not only result in better care for residents but likely also will ...
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Papers by Marjorie Bott