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CHAPTER 8 Marilyn Anne Ray 111

TABLE 8-1 Research Publications Related to the Theory of Bureaucratic Caring—cont’d
Year Citation Research Focus and Findings

2001 Ray, M., & Turkel, M. Impact of TRICARE/ A phenomenological study was conducted to illuminate the life
managed care on total force readiness. world descriptions of experiences of USAF active duty and
Military Medicine, 166(4), 281-289. reserve personnel with managed care in the military and civilian
health care systems. The research illuminated the need for policy
change to better meet the health care needs of these personnel
and their families.
2001 Turkel, M., & Ray, M. Relational complex- The article describes a series of studies that examined the relation-
ity: From grounded theory to instrument ships among caring, economics, cost, quality, and the nurse-
theoretical testing. Nursing Science patient relationship. The results of theory testing revealed
Quarterly, 14(4), 281-287. relational caring as a process and the strongest predictor of the
outcome—relational self-organization that is aimed at well-being.
2002 Ray, M., Turkel, M., & Marino, F. The Relational self-organization is a shared, creative response to a
transformative process for nursing in continuously changing and interconnected work environment.
workforce redevelopment. Nursing Strategies of respecting, communicating, maintaining visibility,
Administration Quarterly, 26(2), 1-14. and engaging in participative decision making are the transfor-
mative processes leading to growth and transformation.
2003 Turkel, M. A journey into caring as expe- The purpose of this phenomenological study was to capture the
rienced by nurse managers. Interna- meaning of caring as experienced by nurse managers. Essential
tional Journal for Human Caring, 7(1), themes that emerged were growth, listening, support, intuition,
20-26. receiving gifts, and frustration.
2003 Turkel, M., & Ray, M. A process model This phenomenological study illuminated the experiences of USAF
for policy analysis within the context of personnel with managed care in the military and civilian health
political caring. International Journal care systems. A model outlining the process of policy analysis
for Human Caring, 7(3), 17-25. was generated.
USAF, U.S. Air Force.

Her work is a synthesis of nursing science, ethics, administrative system resources (including eco-
philosophy, complexity science, economics, and orga- nomic/budgetary procedures). The tools are being
nizational management. Ray described her most translated into Swedish and are being tested. This
recent program of research as sponsored by the interdisciplinary research is at the cutting edge and
TriService Nursing Research program (Turkel & Ray, will lead to enhanced understanding of the concepts
2001). It included instrument development and psy- and relationships outlined in the Theory of Bureau-
chometric testing of the original Nurse-Patient Rela- cratic Caring.
tionship Resource Analysis Tool, now referred to as
the Relational Caring Questionnaire (Professional Critique
Form) and the Relational Caring Questionnaire
(Patient Form) (Watson, 2009; Watson Caring Sci- Clarity
ence Institute, www.wcsi.org). These tools are Likert- The major structures—spiritual-religious, ethical, tech-
type questionnaires for health care professionals nological-physiological, social, legal, economic, political,
(nurses and non-nurses and nurse-administrators) and educational—are defined clearly in Ray’s 1989 pub-
and patients that measure the nurse-patient relation- lication. These definitions are consistent with definitions
ship as an administrative and interpersonal resource. commonly used by practicing nurses. They have seman-
These tools will help researchers link the non- tic consistency in that concepts are used in ways consis-
economic (interpersonal) resources of caring with the tent with their definitions (Chinn & Kramer, 2011).