Date of Award

2020

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Graduate Group

Nursing

First Advisor

Sarah H. Kagan

Abstract

Adolescents and emerging adults with life-limiting illnesses and injuries have social relationships with family members, peers, healthcare providers, and other adults. Nurses caring intimately for young people at end-of-life are both witnesses to and participants in social relationships. Within the context of nurses’ caring, the nature of social relationships at end-of-life lacks description and interpretation. This inquiry uses dimensional analysis method in discovery mode to uncover dimensions of social relationships in nurses’ end-of-life caring of adolescents and emerging adults. Theoretical sampling drove selection of a heterogeneous group of nurses who work across settings, roles, and patient populations. Semi-structured interviews with twenty-one nurses explored experiences caring for young people at end-of-life. Concurrent with data collection, data analysis included iterative phases of dimensionalizing, coding, writing analytic memos, and frequent dialogic engagement with fellow scholars. The findings of this dimensional analysis offer an explanation of social relationships in nurses’ caring for adolescents and emerging adults at end-of-life. From the perspective of Caring for You Around You, a young person exists as the center of a circle of social actors. Nurses either traverse the circle to care for a young person at end of life directly, or they care indirectly by way of the social actors in the circle. Within a context of Where I Care, Accept and Except, and Handling Time nurses’ approaches to social relationships unfold in alignment with the nursing process (assess, diagnose, plan, intervene, and evaluate). Assessing Right for You, Diagnosing the Circle, and Planning Right for Me establish the conditions under which nurses shift between being witnesses to social relationships and being direct actors in relationships as they engage in the process I Draw and Redraw the Circle. The consequence Evaluating the Connection is a nurse’s re-assessment of the outcomes of the process. The findings provide a theoretical foundation for understanding the nature of social relationships in nurses’ caring with implications for future research and relational practice. Greater empirical and theoretical attention to social relationships is imperative to improve end-of-life care experiences of adolescents and emerging adults.

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Available to all on Monday, August 05, 2024

Included in

Nursing Commons

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