AIM

This study explored the developmental process of self-advocacy among nurses and proposed a conceptual framework, The Nurse Becoming Model of Self-Advocacy, to contribute to middle-range theory development.

A constructivist grounded theory design guided this study. Data was gathered from 29 nurses through in-depth individual and group interviews across academe, hospitals, and professional organizations in Region I and the Cordillera Administrative Region. Theoretical and disconfirming sampling was used to refine categories. Data was analyzed using constant comparative methods.

Self-advocacy emerged as a developmental trajectory comprising four interrelated stages: self-preservation, selfdevelopment, self-actualization, and self-transcendence. Novice nurses often relied on protective strategies such as silence and conformity, while experienced nurses engaged in assertiveness, credibility-building, leadership, and collective advocacy. Nurses emphasized that self-advocacy extended beyond the individual to encompass patients, the profession, and society, while highlighting its relational and collective nature.

Self-advocacy is a dynamic process and core dimension of professional identity. It evolves through stages of growth, integrating self-care, competence, engagement, and transcendence. Supporting self-advocacy through education, mentoring, reflective practice, and enabling organizational structures enhance nurses' well-being and strengthens their capacity to advocate for patients, advance the profession, and contribute to societal transformation. The Nurse Becoming Model of Self-Advocacy offers a transferable framework to guide nursing research, education, and policy toward empowerment and resilience.

PURPOSE: This study was conducted to identify and analyze the trends of theory-based research published in Asian Oncology Nursing (AON) from 2011 to 2017. METHODS: We analyzed 22 theory-based studies taken from among the 232 studies published in AON for 7years. We analyzed the framework developed by researchers, descriptive summaries of theory, keyword classification of nursing meta-paradigms, the generic character of the studies, and the type of research designs. RESULTS: A total of 23 theories were applied in the 22 (9.5%) studies. ‘Nursing’ was the most prevalent field of study (34.8%). In the field of study of theory, nursing theory was the largest with eight (34.8%), and in the method of theory utilization, all 22 studies were theoretical applications 3 middle-range theories were most prevalent. In the keyword classification using meta-paradigm in nursing, we found 83 key words. Among them, ‘Health’ related key words were most frequent (53), followed by ‘Cancer’ keywords (13). CONCLUSION: AON has a high ratio of theoretical study compared to other journals, but the ratio is still less than 10%, which is still weak. Therefore, it is believed that the attention to, utilization of, application, and institutional establishment of nursing theory should be necessary.
Asian Continental Ancestry Group ; Classification ; Humans ; Methods ; Models, Theoretical ; Nursing ; Nursing Theory ; Oncology Nursing ; Research Design

PURPOSE: The purpose of the study is to understand the experiences of career exploration among nursing students during their clinical practice and to develop a theoretical framework for the career exploration process. METHODS: From February 2 to 28, 2015, data were collected through focus group interviews from 24 participating fourth-year nursing students. The data were analyzed using grounded theory. RESULTS: The central phenomenon of 'confusion between the ideal and the reality of nursing' occurred in contexts for various reasons of choosing one's major, nurses in the ideal, a vague fear of the field, arduous nursing assignments in the field, and severe adversity in the nursing field. Nursing students tried to deal with their confusion by using interaction strategies such as pursuing the intrinsic value of nursing, finding role models, trying to project oneself, and preparing for adapting to reality. The career exploration process in clinical practice was a voyage to discover the authentic nurse of the pre-registration nurse. CONCLUSION: This result shows that nursing students were to gain confidence in their career choices by finding the value of nursing and interacting with patients. Therefore, opportunities for learning experiences about interaction with patients and various positive experiences in clinical practice should be provided for nursing students.
Career Choice ; Focus Groups ; Grounded Theory ; Humans ; Learning ; Nursing ; Nursing, Practical ; Qualitative Research ; Students, Nursing

PURPOSE: This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients. METHODS: The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory. RESULTS: The core category was “the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity.” The core phenomenon was “shattered by suffering from cancer,” and the causal conditions were “physical change” and “limitations in daily life.” The contextual conditions were “decreased self-esteem,” “feelings of guilt toward the family,” and the sense of “economic burden.” The participants' action and interaction strategies were “maintaining or avoiding social relations,” “seeking meaning of the illness,” “falling into despair,” and “strengthening the willingness to battle the cancer.” The intervening conditions were “support from health care providers and family,” “dissatisfaction with health care providers,” “spiritual help from religion,” and “the improvement or worsening of health conditions.” The consequences were “having a new insight for life,” “living positively along with cancer illness,” and “the loss of willingness to live.” A summary of the series of processes includes the “crisis stage,” “reorganizing stage,” and the “ego integration stage.” CONCLUSION: This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.
Aged ; Delivery of Health Care ; Ego ; Grounded Theory ; Guilt ; Health Personnel ; Humans ; Nursing ; Qualitative Research

PURPOSE: This study aimed to introduce and elucidate changes in Strauss and Corbin's grounded theory and discuss its application to the field of nursing in South Korea. METHODS: The changes in grounded theory by Strauss and Corbin were examined through a literature review of grounded theory from its inception. RESULTS: Strauss and Corbin acknowledged their philosophical backgrounds of symbolic interactionism and pragmatism; however, their methodology based on positivism overwhelmed their epistemology and ontology. This inconsistency has been represented by the coding paradigm and the premise of “emergent from the data.” In the revised version of Basics, Strauss and Corbin modified their theory to weaken the coding paradigm and strengthen the strategies for the development of substantive theory. CONCLUSION: Strauss and Corbin's revised grounded theory did not fully address the inconsistency of their epistemology and ontology between their acknowledgement and methodology. However, these changes constitute a meaningful step toward resolving inconsistencies and highlight the development of substantive theory. This has implications for Korean nursing researchers who have utilized methodologies in grounded theory with dogmatic approaches; grounded theory, with its evolving nature, is not a finalized method and calls for open approaches for the development of a grounded theory that fits Korean nursing.
Clinical Coding ; Grounded Theory ; Korea ; Methods ; Nursing ; Nursing Research

PURPOSE: It is extremely difficult to apply the model learned in basic education for public health nurses (PHNs) to conduct community health assessments. The purpose of this study was to clarify the process by which community health needs can be structured through PHNs' daily practice.METHODS: Semistructured interviews were conducted in 29 PHNs, and continuous comparative analysis using a qualitative study was performed with a modified grounded theory approach.RESULTS: The participants “used their five senses to understand the relationship between the health and life of people” and “considered those who do not attend” by “learning from stakeholders.” To verify such subjective feelings sourced from vague phenomena within the communities, subjective phenomena were converted into qualitative data.CONCLUSION: The application of the findings to organizational continuous education systems may not only help appropriately improve community health assessment methods but can also help improve the evaluation of daily practice and contribute to professional human-resource development.
Community Health Nursing ; Education ; Grounded Theory ; Nurses, Public Health ; Public Health Nursing ; Public Health

PURPOSE: This study develops a substantive theory on the recipients' experience of adapting to a permanent pacemaker.METHOD: The study used the grounded theory method developed by Strauss and Corbin (1998). The participants of the study were 13 adults who had received a permanent pacemaker during the previous year. The study addressed the research question “what is the experience of adaptation in people who had received permanent pacemakers?” From October 2016 to March 2017, data were collected from the participants through in-depth interviews.RESULTS: The core category indicating the essence of the adaptation experience was shown to be “accepting the pacemaker as part of my body and living in line with it.”CONCLUSION: In nursing practice, the results of this study will assist nurses in improving their communications with and developing guidelines or interventions for their clients who have received permanent pacemakers. In the field of nursing education, this study is expected to provide a framework to understand the experiences of future nurses and other healthcare workers working with permanent pacemaker recipients.
Adult ; Delivery of Health Care ; Education, Nursing ; Grounded Theory ; Humans ; Methods ; Nursing ; Sick Sinus Syndrome

PURPOSE: The purpose of this study was to explore preceptees' experience among nursing students in the Clinical Nursing Practice program as integral practice. Specific aims were to identify problems students face as preceptees at a clinical practice and how they interact with preceptors and others. METHODS: Grounded theory methodology was utilized. Data were collected from interactive field notes and transcribed notes with individual in-depth interview from 12 senior nursing students who had experiences as a preceptee in the Clinical Nursing Practice. RESULTS: Through constant comparative analysis, a core category emerged as “Being refined while taking a firm stand with lack.” The process of “Being refined while taking a firm stand with lack” consisted of four phases: sailing phase, adaptation phase, achievement phase and wistful returning phase. CONCLUSION: The findings of the study indicate that there is a need for nursing students to understand the limitations and strengths to learning experiences in preceptorship. In addition, the Clinical Nursing Practice as an integral practice program is needed to improve nursing capacity and for proper adaptation to real clinical environment among graduating students.
Grounded Theory ; Humans ; Learning ; Nursing* ; Preceptorship* ; Qualitative Research ; Students, Nursing*

PURPOSE: The aim of this study was to develop a substantive theory on self-management conducted by the adolescents with chronic kidney disease from their lived experience. METHODS: Data was collected through in-depth interviews from May to December in 2015 with thirteen adolescents with chronic kidney disease. The data collected were analyzed on the basis of Strauss and Corbin's grounded theory. RESULTS: The core of the category found in this study was “overcoming the unstable sense of self-control and integrating disease experience into their life”. The causal conditions triggering the central phenomenon were “restriction in daily life” and “manifestation and aggravation of symptom”. The central phenomenon in the experience of self-management within the adolescents with chronic kidney disease was “unstable sense of self control”. The intervening condition for unstable self control were “micro system support” and “motivational resources”. This study found that the adolescents with chronic kidney disease followed a series of strategies when they faced the central phenomenon, including; passive coping, reappraisal of illness, active coping, compliance with treatment, controlling physical activity, and adjusting school life. With these strategic approaches, the adolescents with chronic kidney disease could maintain their active lifestyles and achieve their health behaviors. The process of self-management by these adolescents passed through four phases; limited experience caused by diseases, effort for normalization, reorganizing their daily lives, and integration with daily lives and self-management. CONCLUSION: This Study explored the process and experience of self-management of adolescents with chronic kidney disease. These findings can be used for basis for developing substantive theory and nursing intervention strategy for adolescents with chronic kidney diseases.
Adolescent* ; Compliance ; Grounded Theory ; Health Behavior ; Humans ; Life Style ; Motor Activity ; Nursing ; Renal Insufficiency, Chronic* ; Self Care* ; Self-Control

PURPOSE: This qualitative study aimed to explore the experience of incivility among nursing students. METHODS: Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. RESULTS: Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as “being mistreated as a marginal person,” and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. CONCLUSION: The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments.
Bullying ; Counseling ; Education ; Grounded Theory ; Humans ; Learning ; Nursing ; Organizational Culture ; Qualitative Research ; Self Concept ; Shock ; Students, Nursing