Abstract
Constraints and barriers to advanced practice psychiatric nursing were reported by respondents of the Primary Mental Health and Advanced Practice Psychiatric Nursing survey of certified psychiatric clinical nurse specialists. Primary data (N = 507) were the qualitative responses to a survey item about constraints and secondary data were the literature and theoretical memos. Methodology was based on principles of qualitative data analysis and procedures for manifest and latent content analysis. Findings resulted in eight themes that explained both constraints and barriers to advanced practice: (1) reimbursement, (2) prescriptive authority, (3) admitting privileges, (4) bureaucracy, (5) practice environment, (6) colleagues, (7) image, and (8) personal. Themes were interpreted within the context of regulatory, market-based, and inter/intraprofessional constraints and barriers that led to suggestions for organizational and individual strategies for action. The survey was funded by the Society for Education and Research in Psychiatric-Mental Health Nursing with technical support from the Center for Mental Health Services.
| Original language | English |
|---|---|
| Pages (from-to) | 198-209 |
| Number of pages | 12 |
| Journal | Archives of Psychiatric Nursing |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| State | Published - 1997 |
Bibliographical note
Funding Information:Constraints and barriers to advanced practice psychiatric nursing were reported by respondents of the Primary Mental Health and Advanced Practice Psychiatric Nursing survey of certified psychiatric clinical nurse specialists. Primary data (N = 507) were the qualitative responses to a survey item about constraints and secondary data were the literature and theoretical memos. Methodology was based on principles of qualitative data analysis and procedures for manifest and latent content analysis. Findings resulted in eight themes that explained both constraints and barriers to advanced practice: (1) reimbursement, (2) prescriptive authority, (3) admitting privileges, (4) bureaucracy, (5) practice environment, (6) colleagues, (7) image, and (8) personal. Themes were interpreted within the context of regulatory, market-based, and inter/intraprofessional constraints and barriers that led to suggestions for organizational and individual strategies for action. The survey was funded by the Society for Education and Research in Psychiatric-Mental Health Nursing with technical support from the Center for Mental Health Services.
Funding Information:
This study was part of the Primary Mental Health and Advanced Practice Psychiatric Nursing Survey funded by SERPN from 1994 to 1997. The research project featured triangulation of methods (SERPN, 1997). Methodology for this study about constraints to practice was based on principles of qualitative data analysis (Lincoln & Guba, 1989; Patton, 1990), a study design that involved procedures recommended for manifest and latent content analysis (Catanzm'o, 1988) and the constant comparative method (Glaser & Strauss 1967). To ensure compatibility and consistency with the principles of naturalistic inquiry, criteria for trustworthiness much like those described by Lincoln and Guba (1989) were established. For example, the importance of flexibility was taken into account, yet rules were delineated for coding, classifying, and quantifying the textual data that included some data management with the computer software program Martin (University of Wisconsin, Madison WI). Simultaneously, investigator roles and boundaries for steps of the research process that emphasized adequate time for examining and synthesizing the data were agreed on. To enhance synthesis, protocols were established for a minimum of three levels of analysis for development of meaningful concepts that accurately depicted the reported constraints. Procedures for both independent and joint data analysis were developed because the investigators' differing practice and research expertise in psychiatric nursing fit the criteria for investigator triangulation (Kimchi, Po-livka, & Stevenson, 1991; Patton, 1991). Peer debriefing strategies included research team involvement and feedback. Finally, theoretical and methodological memos for audit purposes were developed. In essence, the plan for trustworthiness was used as a guide for promoting credibility of the larger study (SERPN, 1997) as well as this one.
ASJC Scopus subject areas
- Psychiatric Mental Health
