AimsTo explore the possible extension of the illness script theory used in medicine to the nursing context.DesignA qualitative interview study.MethodsThe 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.ResultsThrough 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.ConclusionThe 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.ImpactIllness 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.
Abstract Technology has a major impact on the way nurses work. Data-driven technologies, such as artificial intelligence (AI), have particularly strong potential to support nurses in their work. However, their use also introduces ambiguities. An example of such a technology is AI-driven lifestyle monitoring in long-term care for older adults, based on data collected from ambient sensors in an older adult’s home. Designing and implementing this technology in such an intimate setting requires collaboration with nurses experienced in long-term and older adult care. This viewpoint paper emphasizes the need to incorporate nurses and the nursing perspective into every stage of designing, using, and implementing AI-driven lifestyle monitoring in long-term care settings. It is argued that the technology will not replace nurses, but rather act as a new digital colleague, complementing the humane qualities of nurses and seamlessly integrating into nursing workflows. Several advantages of such a collaboration between nurses and technology are highlighted, as are potential risks such as decreased patient empowerment, depersonalization, lack of transparency, and loss of human contact. Finally, practical suggestions are offered to move forward with integrating the digital colleague
"A proportion of those with eating disorders have also experienced traumatic events and ongoing symptoms of PTSD such as re-experiencing of the trauma and nightmares. We implemented an innovative trauma intervention called Imagery Rescripting (ImRs) to explore whether for those undergoing inpatient treatment for an eating disorder (in an underweight phase), it would be possible to treat the various trauma-related symptoms as well as the eating problems. Since this has not been investigated before, we asked the participants in this study to recount their experiences. Twelve participants who were underweight, reported a past history of trauma and were in an inpatient eating disordertreatment program participated in ImRs therapy intervention. One of these participant did not engage in the ImRs therapy because she discontinued the inpatient ED treatment. Analysis of interviews with these participants found that -although they were reluctant before the start of the treatment- the ImRs treatment during their inpatient admission had given them hope again. They added that it was important to have support from group members, sociotherapists and therapists. They shared a number of ways that the ImRs treatment could be adapted to people with eating disorders. Their experiences indicated that given these factors it was possible to treat PTSD during an underweight phase. This is important: until now, treatment for eating disorders has not specifically been trauma-focused and these tips have scope to improve the ImRs intervention and eating disorder treatment more broadly in the future."
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