The doctoral dissertation in the field of Nursing Science will be examined at the Faculty of Health Sciences at Kuopio campus. The public examination will be streamed online.
What is the topic of your doctoral research? Why is it important to study the topic?
My doctoral research investigated compliance with family nursing and impact of nurse-led interventions during acute care from the perspective of nurses and patients’ family members. Family interactions and ties to the patient experiencing illness shape crucial psycho-social dimensions that influence health outcomes of individuals and populations within any cultures. The primary goal of supporting the patients’ family during the care trajectory is to promote coping and prevent development of new illnesses or persistence of existing health problems for both the patient and their family. In addition, engaging the family in care aligns with the nursing metaparadigm which supports inquiry into interventions designed to support families as an external factor that impacts a person’s health and well-being.
While there is emphasis and acknowledgement of the role of the family in health, the absence of family perspectives is most perplexing in the realm of family nursing. This prompted me to examine the following questions in this doctoral research: What are the family members’ perceptions of the extent of family support (i.e., cognitive, and emotional support)? What are the nurses’ perceived extent of nursing practice with families? While answering these questions, the extent of nurses and family members´ perspectives on family nursing framed opportunities for exploration of nurse-led interventions for supporting families in the trajectory of acute care.
What are the key findings or observations of your doctoral research?
Among the main findings of my doctoral research, I illustrated the application of polychoric correlations and polychoric confirmatory factor analysis as a valid alternative statistical approach using data on family members’ perceived support from nurses as an exemplar. We showed that polychoric correlation gives stronger associations, and consequently, the approach can be more credible for ordinal Likert scales commonly used in nursing research. We identified that there was controversial evidence on the impact of diaries in improving family outcomes in critical care settings. Due to the few studies identified, there was very little ability to make strong recommendations on the effectiveness of nurse-led FN interventions to support families in critical care settings. A single-group before-and-after quasi-experimental design of a family strength-based nursing intervention showed positive differences in family outcomes (cognitive and emotional support) and nurses’ skills in working with families in critical care settings but not nurse–family relationships.
How can the results of your doctoral research be utilised in practice?
This study provided insights into the specific perspectives of healthcare service users, that is, family members and healthcare service providers (nurses), on the family. Together, these perspectives enrich three central concepts of the nursing metaparadigm: the person/family receiving nursing care, health, and nursing, particularly in the field of family nursing. The results also highlight and emphasize the potential of considering polychoric CFA as an alternative statistical approach that can be used to examine Likert measurement tools in nursing science. In addition, a new perspective on family support interventions was explored – the family strengths-based nursing intervention was examined. The intervention leverages structural and functional family-system components, specifically family strengths, to promote nursing actions for supporting families in acute care settings. This intervention can be developed further as a guiding framework that nurses can utilize to support family members in acute care settings.
What are the key research methods and materials used in your doctoral research?
The study was conducted in two phases each with distinct research methods. In the first phase, a cross-sectional design was used. This was conducted among a sample of family members (n=800) and nurses (n=460) from two Uganda tertiary hospitals. The Icelandic Family Perceived Support Questionnaire (ICE-FPSQ) was utilised for collecting data from patients’ family members while the Family Nursing Practice Scale was used to collect data from the nurses. The two questionnaires were being used in the setting for the first time thus, before their use, assessment of their validity for use in the setting was conducted. The data from the cross-sectional was mainly quantitative given the nature of the instruments.
In the second phase of the study, initially, a mixed-method systematic review was conducted to examine the evidence of nurse-led family interventions and their family outcomes during the trajectory of care in adult critical care settings. Following the review, a nurse-led family support intervention was developed and examined using a single group before and after quasi-experimental design. The theoretical foundation of the intervention was Strength-Based Nursing – a philosophy that considers collaborative, empowering partnerships between the patient, their family, and healthcare providers.
The doctoral dissertation of Frank Kiwanuka, MSc, entitled Compliance with family nursing and the impact of nurse-led interventions during acute care: family members’ and nurses’ perspectives will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Karin Brochstedt Dieperink of the University of Southern Denmark, and the Custos will be Professor Tarja Kvist of the University of Eastern Finland.
For further information, please contact:
Frank Kiwanuka, MSc, franki(a)uef.fi, 0465868026, https://uefconnect.uef.fi/henkilo/frank.kiwanuka/