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Theory-driven guidelines for practical care of older people, based on the theory of gerotranscendence
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
2003 In: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 41, no 5, 462-470 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2003. Vol. 41, no 5, 462-470 p.
Identifiers
URN: urn:nbn:se:uu:diva-90751OAI: oai:DiVA.org:uu-90751DiVA: diva2:163212
Available from: 2003-09-12 Created: 2003-09-12Bibliographically approved
In thesis
1. Gerotranscendence from a Nursing Perspective – from Theory to Implementation
Open this publication in new window or tab >>Gerotranscendence from a Nursing Perspective – from Theory to Implementation
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was to gain further knowledge about the nursing theoretical basis of care of older people, to translate the theory of gerotranscendence into practical guidelines, and to implement the theory and guidelines in practical settings.

Study I comprised a literature search and a review with qualitative analysis of nursing theories. The conclusion drawn was that nursing theories do not provide guidance on how to care for older people or on how to support them in the developmental process of ageing. Thus, there is a need to develop a nursing care model that, more than contemporary theories, takes human ageing into consideration.

Study II was a qualitative interview study involving staff working in care of older people. The interviews were qualitatively analysed. The conclusion was that staff members need an interpretative framework that allows them to understand the signs they sometimes observe in older people. Such a framework would enable staff to develop a broader approach to their care for older people. Parts of this framework can be found in the theory of gerotranscendence.

In Study III, guidelines for practical care of older people were derived from the theory of gerotranscendence. Focus group interviews were used and other sources supporting the guidelines were given. A qualitative analysis of the interviews was carried out, and the theory of gerotranscendence was used as the theoretical framework. The guidelines could be used to promote a development toward gerotranscendence and could also be of value for people who have already attained a state of gerotranscendence. The guidelines focus on the individual, activities and the organisation.

In Study IV, the theory of gerotranscendence and practical guidelines were introduced in a nursing home. Data were collected via qualitative interviews with staff and residents, and observations were made. Qualitative analysis and triangulation were performed. As theoretical frameworks, both the theory of gerotranscendence and innovation theory were used. The result showed that the most used guidelines were those focusing on the individual; these concern what each staff member could do in his/her relation to the resident and care. The findings showed further that those staff members who interpreted signs in line with the theory of gerotranscendence also used the guidelines. The staff who were early to adopt and promote the guidelines were those individuals who described a feeling of harmony with essential parts of the gerotranscendence theory.

The most important finding of this thesis was that it was possible to translate a theory such that it could generate practical guidelines that could be used by the staff. There are probably many theories that could be translated in order to be implemented in practical care, e.g. to build a bridge between theory and practice, thereby helping staff. Innovation theory could be of general interest in all contexts in which work towards change is being conducted.

Abstract [sv]

Det övergripande syftet med denna avhandling var att få kunskap om den omvårdnads teoretiska basen för vård av äldre, och att översätta teorin om gerotransendens till praktiska guidelines, och att införa teorin om gerotranscendens och guidelines i praktiken

Studie I, var en litteratursökning med en kvalitativ analys av omvårdnadsteorier. Den visade att dessa teorier inte ger någon vägledning om hur omvårdnad av äldre ska ske eller hur man kan stödja äldre i deras utvecklingsprocess. Därför finns det ett behov att utveckla en omvårdnadsmodell som mer än nuvarande teorier beaktar människans åldrande.

Studie II, var en kvalitativ intervjustudie med personal i äldrevård. Intervjuerna analyserades kvalitativt. Studien påvisade att personal behöver mer kunskaper om åldrandeprocessen så att de kan förstå tecken och beteenden de ibland observerar hos de äldre. Detta skulle göra det möjligt för personal att utveckla ett vidare perspektiv för hur de kan stödja äldre personer.

I studie III, utarbetades guidelines från teorin om gerotranscendens. Fokus grupps intervjuer användes. Intervjuerna analyserades kvalitativt och teorin om gerotranscendens användes som teoretisk grund. Dessutom ges i studien hänvisning till andra källor som stödjer guidelines. Guidelines kan användas för att stödja en utveckling mot gerotranscendens och kan också vara av värde för personer som redan uppnått gerotranscendens. Guidelines innehåller åtgärder som vårdare kan göra enskild, ger förslag till aktiviteter och organisatoriska åtgärder.

I studie IV, introducerades teorin om gerotranscendens och de utarbetade guidelines på ett äldreboende. Kvalitativa intervjuer gjordes med personal och boende och observationer genomfördes. Detta analyserades kvalitativt och triangulering användes, både teorin om gerotranscendens och innovations teori användes som teoretisk grund. Resultatet visade att de mest använda guidelines var de som enskilda vårdare kunde utföra självständigt. Vidare att den personal som förklarade tecken de såg hos äldre i linje med teorin om gerotranscendens, använde också guidelines. Den personal som tidigt tog till sig och stödde användandet av guidelines var de som själva beskrev att de kände igen sig själva i delar av teorin,

Det viktigaste resultatet in denna avhandling är att det var möjligt att översätta en teori till praktiskt användbara guidelines. Förmodligen finns det fler teorier som skulle kunna översättas och implementeras i praktisk verksamhet, vilket skulle vara att bygga en bro mellan teori och praktik, och hjälpa personal att kunna omsätta teorier praktiskt. Innovationsteori kan vara av generellt intresse i alla sammanhang när förändringsarbete bedrivs.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 86 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 130
Keyword
Caring sciences, Gerontology nursing, Gerontological care, Gerotranscendence, Nursing theory, Nursing models, Gerontological theory, Ageing, Care of older people, Nursing, Guidelines, Innovation, Vårdvetenskap
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-3544 (URN)91-554-5712-6 (ISBN)
Public defence
2003-10-10, Minus, Gustavianum, Uppsala, 10:15
Opponent
Supervisors
Available from: 2003-09-12 Created: 2003-09-12 Last updated: 2012-09-19Bibliographically approved

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