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5.4 Resident Profile ......................................................................................... 168
5.5 Findings from Documentary Analysis ...................................................... 169
5.5.1 Analysis of Staff Rosters .................................................................. 169
5.5.2 Shift Patterns ................................................................................... 170
5.5.3 Daily Complement of Staff .............................................................. 170
5.5.4 Staffing Levels at Morning Report ................................................... 172
5.5.5 Staffing Levels at Evening Report ................................................... 173
5.5.6 Sick Leave ........................................................................................ 173
5.5.7 Management of the Research Unit ................................................... 174
5.5.8 Staff Turnover .................................................................................. 174
5.6 Findings from the Analysis of the Philosophy of Care ............................. 175
5.7 Findings from Analysis of Nursing Notes ................................................. 177
5.7.1 Element 1: Self-Governing, Self-Ruling, Self-Determining ............ 178
5.7.2 Element 2: Care Plans are Negotiated and Family are Involved ...... 180
5.7.3 Element 3: Residents Delegate Care Needs ..................................... 181
5.7.4 Element 4: An Atmosphere of Openness, Motivation and Flexibility ...
................................................................................................... 182
5.7.5 Element 5: Values and Beliefs of Staff are Non-Paternalistic. Ethos of
Maintaining Dignity. ........................................................................ 183
5.7.6 Element 6: Open and Respectful Communication and Sharing
Information ....................................................................................... 185
5.7.8 Element 7: Recognition of Past and Present Life, Which May Shape
Residents’ Wishes. Life Histories. ................................................... 186
5.7.9 Summary........................................................................................... 187
5.8 Findings from Interviews and Observations ............................................. 187
5.9 Observations Day One ............................................................................... 187
5.10 Observations Day Two .............................................................................. 188
5.11 Data Analysis ............................................................................................ 189
5.12 Reporting the Findings .............................................................................. 190
5.13 Findings from the Staff Attitude Survey ................................................... 231
5.14 Summary of Chapter .................................................................................... 232
6. Phase Two ................................................................................................... 234
6.1 Phase Two: Enhancing Autonomy ............................................................ 234
6.1.2 Introduction ...................................................................................... 234
6.1.2 Study Sample .................................................................................... 236
6.1.3 Study Site.......................................................................................... 236
6.1.4 Research Ethics ................................................................................ 236
6.2 Step 1: Diagnosing: Identifying or defining a problem ............................. 237
6.2.1 Diagnosing ....................................................................................... 237
6.2.2 Identifying the problem .................................................................... 237
6.3 Step 2: Action planning: Considering alternative courses of action for
solving a problem ................................................................................................. 238
6.4 Step 3: Action taking: Selecting a course of action ................................... 245
6.5 Step 4: Evaluating: Studying the consequences of the action ................... 248
6.6 Step 5: Specifying the learning.................................................................. 250
6.10 Summary ................................................................................................... 252
7. Discussion, Recommendations and Conclusions ................................................. 253
7.1 Introduction ............................................................................................... 253
7.2 The Personal .............................................................................................. 253
7.2.1 The Personal: The Person ................................................................. 253
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