Illness scripts in nursing: Directed content analysis. / Vreugdenhil, Jettie; Döpp, Donna; Custers, Eugène J. F. M. et al.
In: Journal of advanced nursing, Vol. 78, No. 1, 01.2022, p. 201-210.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Illness scripts in nursing: Directed content analysis
AU - Vreugdenhil, Jettie
AU - Döpp, Donna
AU - Custers, Eugène J. F. M.
AU - Reinders, Marcel E.
AU - Dobber, Jos
AU - Kusukar, Rashmi A.
N1 - Funding Information: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. No conflict of interest has been declared by the authors Publisher Copyright: © 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
PY - 2022/1
Y1 - 2022/1
N2 - Aims: To explore the possible extension of the illness script theory used in medicine to the nursing context. Design: A qualitative interview study. Methods: The study was conducted between September 2019 and March 2020. Expert nurses were asked to think aloud about 20 patient problems in nursing. A directed content analysis approach including quantitative data processing was used to analyse the transcribed data. Results: Through the analysis of 3912 statements, scripts were identified and a nursing script model is proposed; the medical illness script, including enabling conditions, fault and consequences, is extended with management, boundary, impact, occurrence and explicative statements. Nurses often used explicative statements when pathophysiological causes are absent or unknown. To explore the applicability of Illness script theory we analysed scripts’ richness and maturity with descriptive statistics. Expert nurses, like medical experts, had rich knowledge of consequences, explicative statements and management of familiar patient problems. Conclusion: The knowledge of expert nurses about patient problems can be described in scripts; the components of medical illness scripts are also relevant in nursing. We propose to extend the original illness script concept with management, explicative statements, boundary, impact and occurrence, to enlarge the applicability of illness scripts in the nursing domain. Impact: Illness scripts guide clinical reasoning in patient care. Insights into illness scripts of nursing experts is a necessary first step to develop goals or guidelines for student nurses’ development of clinical reasoning. It might lay the groundwork for future educational strategies.
AB - Aims: To explore the possible extension of the illness script theory used in medicine to the nursing context. Design: A qualitative interview study. Methods: The study was conducted between September 2019 and March 2020. Expert nurses were asked to think aloud about 20 patient problems in nursing. A directed content analysis approach including quantitative data processing was used to analyse the transcribed data. Results: Through the analysis of 3912 statements, scripts were identified and a nursing script model is proposed; the medical illness script, including enabling conditions, fault and consequences, is extended with management, boundary, impact, occurrence and explicative statements. Nurses often used explicative statements when pathophysiological causes are absent or unknown. To explore the applicability of Illness script theory we analysed scripts’ richness and maturity with descriptive statistics. Expert nurses, like medical experts, had rich knowledge of consequences, explicative statements and management of familiar patient problems. Conclusion: The knowledge of expert nurses about patient problems can be described in scripts; the components of medical illness scripts are also relevant in nursing. We propose to extend the original illness script concept with management, explicative statements, boundary, impact and occurrence, to enlarge the applicability of illness scripts in the nursing domain. Impact: Illness scripts guide clinical reasoning in patient care. Insights into illness scripts of nursing experts is a necessary first step to develop goals or guidelines for student nurses’ development of clinical reasoning. It might lay the groundwork for future educational strategies.
KW - advanced practice
KW - clinical judgement
KW - clinical reasoning
KW - directed content analysis
KW - education
KW - illness scripts
KW - nurses
KW - nursing
UR - http://www.scopus.com/inward/record.url?scp=85112162998&partnerID=8YFLogxK
U2 - 10.1111/jan.15011
DO - 10.1111/jan.15011
M3 - Article
C2 - 34378221
VL - 78
SP - 201
EP - 210
JO - Journal of advanced nursing
JF - Journal of advanced nursing
SN - 0309-2402
IS - 1
ER -
ID: 19632404