Date of Award

2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

Abstract

Mary Tiberg

Loyola University Chicago

IT IS ALWAYS THE MONKEY ON MY BACK: THE DIAGNOSIS OF CIRRHOSIS

A significant current challenge in health care today is meeting the needs of a population that has chronic disease, especially for those that have a health condition with a life threatening long -term outcome (Falkenstern, et al., 2005). In these health illness transitions, when there are no secure expectations, there are the additional burdens of enduring emotional unease, facing the closing stages of physical stamina, and confronting an indeterminate future. The objective of this study was to explore and describe the experience of those individuals who have been diagnosed with cirrhosis, which marks the beginning of end stage liver disease (Ebell, 2006). The goal of this research was to develop a more complete description of the phenomenon and process that an individual undergoes during this specific transition point in chronic liver disease and illness. This area of research has not yet been investigated. The research proposal for this dissertation, is presented, followed by a comprehensive literature review and the research question that is proposed for this study. These chapters are followed by the study methodology, which utilized grounded theory to discover the basic social process that an individual undergoes after being diagnosed with cirrhosis and living life with a threatening chronic disease and illness trajectory. The result of this study is a linear process that included twelve conceptual categories and a core category, that had a central relation to all other categories. This substantive theory is compared to other theoretical and conceptual work, along with the identification of the unique findings from this research. This dissertation is concluded with a discussion of the strengths and limitations of this work along, with recommendations for future application in nursing research, practice, administration, and education. These implications include testing of the theory, tailoring care to meet the needs of this patient population, teaching the assessment and critical thinking skills that are needed to target nursing care, and the nursing resources that are necessary to care for this patient population.

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