The meaning, process, and consequences of nurse caring as perceived by spinal cord injured individuals during rehabilitation

Abstract

The purpose of this qualitative study was to describe the meaning, process, and consequences of nurse caring from the perspective of spinal cord injured (SCI) individuals while in rehabilitation. This study addressed the following research questions: (1) What is the meaning of nurse caring to SCI individuals in rehabilitation? (2) How is the process of developing a caring relationship perceived by SCI individuals during rehabilitation? (3) What are the consequences of nurse caring for SCI individuals in rehabilitation? The theoretical foundation of this study was synthesized from philosophical, ethical, feminist, and nursing literature. A purposive sample of adults with traumatic SCI were interviewed at least once during their initial rehabilitation admission. Only individuals who could speak and understand English were included in the study. Individuals with all levels of injury, both complete and incomplete lesions, were included; individuals with a documented head injury or cognitive deficits were excluded. In-depth, tape recorded interviews with participants were conducted after receiving informed consent. The constant comparative method of Glaser and Strauss was used for collection and analysis of data; appropriate strategies were used to insure scientific credibility. Twenty interviews were conducted with fifteen SCI individuals at various times during their rehabilitation stay. Interviews were conducted over a six month period at two free-standing rehabilitation centers in southwestern Pennsylvania. The core category of "getting back together" or reintegration of self, which was the major work of rehabilitation, was accomplished with nurses and therapists who were perceived as caring. Four dimensions of caring were important to SCI participants in rehabilitation: knowledge, technical skill, interpersonal skill, and competence. The process of a developing caring relationship was conceptualized, from participants' descriptions, in three phases: learning the other, learning what I need to know, and letting me find out. Consequences of nurse caring for SCI individuals were: well-being, self-care, autonomy, independence, and hope. Nurse caring is perceived by SCI individuals in rehabilitation as central to recovery and to a positive attitude toward disability. Concepts described in this study can be used to develop an instrument to measure nurse caring and to teach nurses and nursing students important aspects of caring in rehabilitation.