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Title: The hermeneutic nature of process in nursing : a grounded theory approach.
Author: Lewis, Tom.
Awarding Body: South Bank University
Current Institution: London South Bank University
Date of Award: 1998
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This thesis is an enquiry into the nature of process in nursing. The study was initiated by the experience of the researcher as a nurse attempting to utilise the Nursing Process in clinical practice. From the outset however, the focus of the study shifted from the utility of the Nursing Process to the nature of process in nursing. The data were collected by in depth, unstructured interviews with twenty staff nurses from general medical and surgical wards in five district general hospitals in the South of England. The interviews were transcribed, and analysed following grounded theory methods. The analysis produced a number of categories related to nursing practice and the context in which it occurs. The major finding of the study is represented as the core category and is labelled Nursing carea s clinicalh ermeneuticIsn. identifying this category the researcher considers nursing to be essentially a process of interpretation of clinical situations, that is to say that process in nursing is essentially hermeneutic in nature. Other categories were identified relating to the strategies used by nurses and the context of nursing practice. These were labelled as; latching over,T hinking about,B eingt here,D oing to,f orand with, Letting go, Climate of Constantc hangeL, andscapeo f predictabilitya nd Landscapeo f perfect expectation. These categories were linked to each other and to the core category forming an illumination of the core category. The categories of SufferingC' omfortinga nd Healing were identified as providing the impetus for nursing care. The categories have been linked together in a statement of substantive theory which describes nursing care as clinical hermeneutics in the following way: A process, which is the resultant of a complex, dynamic interplay between knowing, thinking, feeling, doing and context, in which the nurse seeks to prevent and relieve suffering, to promote comfort and facilitate healing. This interpretative process is achieved by helping the patient to understand the illness process, by reducing the alienating effects of illness and by facilitating a return to a taken-for-granted state of wholeness of mind and body. It is achieved through the nursing strategies of watching over, thinking about, being there, doing to, for and with and lettinggo and shaped by the context in which it occurs. In using grounded theory to achieve this theoretical stance, the thesis makes and seeks to justify four important claims about nursing. These are firstly, that nursing is more than simply a collection of tasks, but rather is a process of interpretation involving certain kinds of tasks. Secondly that apparently simple (or indeed complex) tasks involved in nursing are themselves an integral part of the process of interpretation. Thirdly that as a hermeneutic process, nursing may claim to have a philosophical basis. And finally that as a hermeneutic process, nursing is supported by and requires many forms of knowing, none of which are privileged but all of which are legitimate.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Nurses; Decision making; Clinical practice Medical care