|English title dissertation||Patient preferences in nursing decision-making. A theory about fine-tuning knowledge in acute care.|
|Name PhD (surname first)||Den Hertog, Ria|
|Doctor is (has been) nurse|
|Date of promotion||08/12/2015|
|University||Vrije Universiteit Amsterdam|
|Promotores||Prof.dr. Hans Reinders, dr. Theo Niessen|
The general objective of this grounded theory study was to develop a substantive theory of how good nurses in acute care tune in to patient preferences in nursing decision making, and what knowledge they deploy in doing so. In Evidence-Based Practice (EBP) literature, the focus is mostly on the evidence from scientific research to the detriment of patient preferences. The operationalization of patient preferences in EBP is dependent on the espoused scientific tradition of the researcher. Because the answer is not found in the literature, an empirical study was conducted to describe how good nurses address norms, values and patients’ preferences in the daily nursing decision-making. The respondents (n=27) emphasized in the interviews the importance of a good nurse-patient relationship as a prerequisite to discover the patient preferences and taking account into them in the nursing decision making. They establish instant connection in creating a ‘click’, use ‘antennae’ or probes and communicate openly by asking ‘empathic’ questions. Based on the acquired knowledge they form, often unconsciously, a broad frame of reference and use it in nursing decision-making. Additionally, seven 'good' nurses have been observed during their shifts in a nursing ward to discover what can be seen regarding attuning to patient preferences and the use of tools in daily nursing practice. One of the respondents summarized their working attitude as ‘Teach me the best way to take care for you in this situation’.
|Download dissertation (Dutch)||complete_dissertation.pdf|