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Complexity in Nursing Homes. Neo-configurational approaches and Qualitative Comparative Analysis as method in nursing science to determine the influence of organizational factors in the complex adaptive system "nursing home"

  • Nursing homes are places of high complexity where staff, residents and the institution itself are in an interdependent, non-linear relationship. Therefore phenomena cannot be explained mono-causally and additively. The thesis focuses on the infuence of organizational characteristics on resident outcomes. These characteristics are limited by a number of internal and external infuences, such as legislation, economics, etc. This form of complex causality with its factors of equifnality, assymetry and conjunctural causation is the main reason why nursing homes are considered complex adaptive systems. Organizational research has been aware of these methodological difficulties for many decades. However, the lack of a method capable of taking them into account has long led to a gap between theory and methods. With the emergence and development of Qualitative Comparative Analysis by Charles Ragin in 1987, a way of closing this gap was found. The method is based on the principles of set theory and Mill's methods. With a synthesis of qualitative and quantitative elements, necessary and sufficent conditions for the emergence of an outcome are revealed through the analysis of a truth table. It is shown that although the method is already used in nursing science in several instances, it is still incomplete, erroneous, or not yet used in accordance with newest methodological developments in many places. The own practical application shows that fundamental influences of organizational characteristics on the residents outcome "fall" can be demonstrated. The comprehensive organizational data from the research project "PiBaWü" were used for this purpose. However, the results also show that without the inclusion of person-intrinsic conditions no exhaustive solution can be found. In view of the high complexity of the phenomenon, this was to be expected. Nevertheless, the method offers decisive advantages for nursing science due to its possibilities to act with low data levels and smaller case numbers. At the same time, the need for theoretically sound assumptions also presents the discipline with obstacles. As a catalyst for the lack of theory-building in recent decades, it can still have a stimulating effect and be seen as a real progress.

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Metadaten
Verfasserangaben:Philipp Bentz
URN:urn:nbn:de:0295-opus4-22228
Gutachter*in:Albert Brühl, Adrian Dusa
Betreuer:Albert Brühl, Adrian Dusa
Dokumentart:Dissertation
Sprache:Englisch
Datum der Veröffentlichung (online):27.07.2021
Datum der Erstveröffentlichung:27.07.2021
Titel verleihende Institution:Philosophisch-Theologische Hochschule Vallendar
Datum der Abschlussprüfung:28.06.2021
Datum der Freischaltung:27.07.2021
Freies Schlagwort / Tag:Complex adaptive system; Complexity science; Nursing; Nursing home; Qualitative Comparative Analysis
GND-Schlagwort:Pflege; Komplexität; Organisationsforschung
DDC-Sachgruppen:300 Sozialwissenschaften
Zugriffsrecht:Frei zugänglich
Hochschulen:Philosophisch-Theologische Hochschule Vallendar
Lizenz (Deutsch):License LogoCreative Commons - Namensnennung, Nicht kommerziell, Keine Bearbeitung 3.0