bluuebunny/crossref_metadata_2025 huggingface dataset:
Pain assessment by patients and nurses in the early phase of acute myocardial infarction
Authors: Bondestam E. , Hovgren K. , Johansson F. Gaston , Jern S. , Herlitz J. , Holmberg S.
Published: December 2006

In 47 patients admitted to the coronary care unit (CCU) at Sahlgren's Hospital in Göteborg, Sweden, due to acute myocardial infarction (MI) the intensity of pain independently assessed by the patient and by the nurse on duty was evaluated during the first 24 hours in CCU. Pain was assessed according to a modified numerical rating scale graded from 0‐10, where 0 meant no pain and 10 meant the most severe pain. A positive correlation between the patients’ and nurses’ assessments was found (r = 0‐76; P < 0‐001). However, the nurses under‐estimated the patients’ pain in 23% of the situations and over‐estimated it in 20%. Over‐estimation was particularly found when heart rate and blood pressure increased. Many patients scoring their pain to fairly high degrees were not given pain‐relieving treatment. Treatment with morphine did not cause substantial pain relief in a substantial number of patients. A significantly positive correlation was found between the patients’ and nurses’ assessments of pain, although underestimation as well as over‐estimation occurred. A few patients with severe pain were not treated and when treatment was given it was often ineffective.
Nursing and medical student attitudes towards nursing disclosure of information to patients: a pilot study
Authors: Davi Anne J. , Jameton Andrew
Published: December 2006

The American Hospital Association‘Patient's Bill of Rights’ encourages greater disclosure of medical information to patients. However, the‘Bill of Rights’ and conventional hospital practice centre responsibility for disclosure on physicians. The standing of nurses with regard to disclosure of information remains unclear. Many features ofthe nursing role indicate nurses could participate more fully in disclosure. A questionnaire exploring issues of disclosure by nurses was circulated to senior nursing students and fourth‐year medical students. The 28 nursing respondents and 28 medical respondents differed significantly on 20 of the 87 items. In 15 of these, nursing students clearly showed more support than medical students for an active nursing role in disclosure, informed consent, expressing professional opinions, and patients’ decision‐making. A more active role by nurses in disclosing information may support increased patient participation in decision‐making.
The role of the community psychiatric nurse in improving treatment compliance in alcoholics
Authors: Wetherill Julie , Kelly Tim , Hore Brian
Published: December 2006

Patient compliance in alcoholism treatment remains an under‐researched topic. Some factors as to why patients comply to treatment have been studied but the intervention of nursing staff who work in the community has not been extensively researched. This study looks at the effect, if any, of having community psychiatric nurses following up a randomly‐selected group of new patients referred to the Withington Hospital Alcoholism Treatment Unit. This study looks at the involvement of community psychiatric nurses in their initial treatment.
Quality assurance: is it professional insurance?
Authors: Lees Geoffrey D. , Richman Joel , Salauroo Mohamed Aniff , Warden Sharon
Published: December 2006

Quality assurance (QA) is being hailed as a ‘new frontier’ of nursing. Its diffusion into nursing theory and practice in the United Kingdom is outlined. QA is not an alien import; favourable preconditions already existed. The systems‐reasoning of the nursing process, which sprawned a plethora of models, each geared to the ‘orderly’ progression of stages, objectives and process, is resonant with the values and measurement techniques of QA. A major limitation of QA is that it downplays the organizational complexity of hospitals. Although QA is projected as being in the service of clients, its major impetus is concerned with professional self‐defence, as regards other professions, the state and litigious clients. Further, QA enlisted by nursing strongly reproduces the ethos and logic of the dominant medical model; patients are ‘objectified’ as the technical products of production. The ‘medical gaze’ is now being joined with the ‘nursing gaze’.
Records as a data source: the case for health visitor records
Authors: While Alison E.
Published: December 2006

Health records as a source of research data are examined. A case study approach is adopted to evaluate the reliability of health visitor records as a data source. It is argued that such records may be a rich source of epidemiological data although their deficiencies should be acknowledged.
The interaction between the Parkinsonian patient and his caregiver during feeding: a theoretical model
Authors: PhD Astrid Norberg RN , RNT Elsy Athlin
Published: December 2006

A theoretical model for the assessment of the interaction between the patient with Parkinson's disease and his caregiver during assisted feeding is suggested. It is based on literature about impairments in Parkinson's disease and about interaction. The main concepts of the model are clarity of cues, sensitivity, interpretation, responsiveness and synchrony. It is suggested that the patient should be allowed to focus on the socio‐emotional content versus the task content of communication during different phases of interaction during the meal.
Feeding of severely demented patients in institutions: interviews with caregivers in Israel
Authors: PhD Astrid Norberg RN , DNSc Miriam Hirschfeld RN
Published: December 2006

In an exploratory, open‐ended, and non‐random study, 60 health care workers in nine long‐term care institutions in Israel were questioned regarding their experiences, thoughts and feelings related to force feeding senile demented patients. The main findings were analysed according to an ethical decision‐making model. Israeli care workers tended to ground their explanations in traditional Jewish sanctity of life ethics. Their actions as well as their emotional reactions seemed the logical outcome of this world view: patients were force fed and caregivers did not feel guilt for using force or accepting suffering, since they felt obliged to preserve life and thus their actions were right. They did feel ugly and upset about the situation. While most caregivers felt that force feeding was the only acceptable route in an institution, some suggested family home care where discretionary case by case ethics was seen as a viable alternative. This paper compares the Israeli interview results with those of the Swedish studies.
An examination of preconception health teaching by nurse practitioners
Authors: MSN Mary Lee Barron RN , MSN Maureen Brown RN‐C , PhD Lawrence H. Ganong
Published: December 2006

Fifteen nurse practitioners in a Midwestern urban area in the United States of America volunteered to participate in a study which sought to determine what preconception self‐care practices are taught to female clients at risk for pregnancy as a part of routine health maintenance. Subjects' teaching responses were compared to an investigator‐developed model for preconception counselling. The subjects listened to an audiotape of a stimulus client‐nurse practitioner interview. Their responses were audiotaped and categorized into the following categories: nutrition, vitamins, preconception weight, menstrual cycle review, alcohol, smoking, drug use, exercise, environment hazards, dental care, immunizations, and ‘other’. Frequency counts of the teaching responses and a x2 analysis comparing teaching responses to expected teaching based on the PREPARED model (x2= 78‐01, P = 0–001) demonstrated a lack of teaching overall. The conclusion was reached that obstetrical care has not expanded into preconception counselling.
Clinical construct validity
Authors: RN Stephanie J. Nagley PhD , RN Patricia H. Byers PhD
Published: December 2006

When concepts and the ‘paper and pencil’ tests used to measure these concepts are developed in fields other than nursing and subsequently are used for nursing purposes, the perspective mismatch heralds a validity issue. This paper presents a case for clinical construct validity as one method of evaluating whether the substantive meaning of a test captures the nursing meaning.
Teaching ethics using games
Authors: PhD Gladys B. White RN , PhD Anne J. Davis RN
Published: December 2006

Many students find analysis of ethical dilemmas difficult due to the ambiguity and uncertainty they see in these situations. Games have been developed and are used in a wide variety of educational experiences. An ethics game entitled ‘Rights: Helter Skelter’ has been used with nursing students in their first course focused on ethics and nursing. This game enhances their ability to tolerate high levels of uncertainty while they analyse ethical dilemmas.
Managing alcohol and drug abuse in the nursing profession
Authors: ABPsS Peter G. Booth BSc MPsychol
Published: December 2006

Annual increases in indices which reflect the extent of alcohol and drug abuse in society result in a considerable cost to industry. Nurses as a professional group have not generally been identified as having a significantly high incidence of staff with problems of alcohol or drug abuse, although there is some evidence that they are more likely than other workers to attend treatment agencies. The role of nurse management in the early recognition and handling of problems can be vital and training material has been developed to encourage appropriate involvement. A brief description and preliminary evaluation of management training is given. Guidelines and policies which clarify the roles of management, trade unions, occupational health and specialist treatment agencies should facilitate the rehabilitation of the nurse with a drink or drug problem and, in doing so, have potential economic as well as personal benefit to the parties involved.
Being old does not always mean being sick: perspectives on conditions of health as perceived by British and American elderly
Authors: van Maanen Hanneke M. Th.
Published: December 2006

The process of ageing is frequently described in terms of decline and deterioration. Limited attention is paid to the gains in later life. Studies among self‐defined healthy American‐born elderly and ill‐healthy British‐born older persons, indicated that the perception of health was determined by many dimensions other than the absence of disease and illness. The older the person, the more emphasis was placed on health as a state of mind, even in situations of a gradually failing body. It was evident that these respondents, among them the ill‐healthy elderly challenged the current beliefs of health and illness as perceived by health providers.
Nursing staff's perceptions of work in acute and long‐term care hospitals
Authors: Heiskanen Tuula Aulikki
Published: December 2006

The survey study compared perceptions of work in the nursing staff of acute and long‐term care hospitals. The focus was on professional challenges, career prospects, independence, responsibility, the social requirements of work, time pressure and workload. Consistent differences were found in the extent to which the two groups experienced their work as challenging: the scores were lower in the long‐term care hospital than in the general hospital. For example, 40% of the respondents in the long‐term hospital felt their work was too easy compared with their knowledge and skills, while the figure was only 9% in the general hospital. Among these workers, a simultaneous decline was found in personal resources, as measured by psychosomatic symptoms, and in the individual's commitment to the organization. In the theoretical discussion the experience of lacking challenges is related to the concepts of work orientation, coping strategies and work culture.
A comparison of sources of nursing stress and job satisfaction among mental handicap and hospice nursing staff
Authors: Power K. G. , Sharp G. R.
Published: December 2006

This study compares sources of nursing stress and job satisfaction among 181 mental handicap and 24 hospice nurses. It was hypothesized that nursing stress varies as a consequence of nursing speciality. Analysis of variance revealed differing features of nursing stress between the two specialities. Hospice nurses reported stress as primarily associated with death and dying and inadequate preparation to meet the emotional needs of patients and their families, while mental handicap nurses reported stress related to workload, conflict with other nurses and nursing environment. The results suggest that two additional factors that did not differ between specialities require further examination, namely patient behaviour and purposelessness of nursing care. Job satisfaction also differed between specialities with hospice nurses reporting higher satisfaction with supervision, co‐workers, and pay, and lower satisfaction with promotion in comparison to mental handicap nurses. Within the mental handicap groups nursing stress correlated with job satisfaction, state‐trait anxiety and non‐psychotic psychiatric disturbance in predicted directions. Analysis of the above variables with respect to mental handicap nursing grade was also undertaken. Overall results indicate the importance of nursing speciality as a major factor influencing nursing stress.
Do nurses smoke because of stress?
Authors: Elkind Andrea Knopf
Published: December 2006

A comparison of learner nurses and student teachers indicated that occupational differences in smoking prevalence were established prior to entry. However, learner nurses experienced higher stress for the greater part of their first year of training and this was one factor contributing to the consolidation of smoking among them. In general, smoking was seen as a way of dealing with negative feelings and although smokers did not experience greater stress than non‐smokers, the former were more likely to feel anger. Lower levels of perceived stress were associated with moves to lesser smoking, suggesting that stress prevents smoking being given up. Some non‐smokers were vulnerable in that they both experienced higher stress and saw smoking as a solution. The use of maladaptive intrapsychic coping techniques and the absence of social support outside nursing were both associated with movements to greater smoking.
Violent incidents on a regional secure unit
Authors: Rix Gary , Seymour Daniel
Published: December 2006

This 1‐year retrospective study was conducted on a regional secure unit at the Bethlem Royal Hospital, London, using the hospital's data collection sheet for violent incidents. The majority of incidents were minor in nature but there were a few assaults that involved pain, lacerations or bruising. Although violence was common to the majority of patients, two contributed a large number. Those staff at the bottom of the nursing hierachy who spent most time with patients were most at risk. Likewise fellow patients were also often involved in incidents. Violence did not tail off after the breakfast period, as reported in previous studies, but continued to rise until bedtime.
Merging nursing research and practice: a case of multiple identities*
Authors: Jennings Bonnie Mowinski , Rogers Sandra
Published: December 2006

Although using research to guide nursing practice has been a long‐standing goal for the nursing discipline, the actual merger of research and practice is not yet widespread. There are many possible explanations for the limited progress that has been made in this arena. In this paper, it is suggested that the multiple identities taken on by nurses may stifle actualizing a merger between research and practice. Diverging responsibilities and orientations among identities are depicted by considering the nurse as researcher, clinician, educator and administrator. In addition to elucidating differences among these various nurse identities, the paper addresses their commonalities, the most obvious and important of which is that of nurse. If individuals retain the identity of nurse as the generic and salient characteristic, the multiple nurse identities have the potential to become a complementary array of diverse resources that can empower rather than thwart merging research and practice.
The use of profile similarity indices and the Bem sex role inventory in determining the sex role characterization of a group of male and female nurses
Authors: Pontin David J. T.
Published: December 2006

A group of male and female general nurses was tested using the Bem Sex Role Inventory (BSRI), with statistical modifications, to determine the degree of psychologically ‘androgynous’ sex role characterization, so that comparisons might be drawn between the sexes regarding attributes commonly held to be desirable for nurses. Some indicators for future trends in nurse recruitment are given.
Reciprocal trust in health care relationships
Authors: Thorne Sally E. , Robinson Carole A.
Published: December 2006

This paper examines the phenomenon of trust in health care relationships from a new perspective, that of the recipients of care for chronic illness. The authors argue that reciprocal trust is a necessary component of satisfying, effective health care relationships when the illness is of an ongoing nature. From the patient's perspective, reciprocal trust has a significant impact on the experience of being a receiver of health care and on the development of competency with illness management. Because of this, the authors claim that it is imperative for health care professionals to alter their traditional beliefs with regard to sick role and trust. With a new perspective, they may then develop the specific skills necessary to enact the caring aspect of the service they offer. The authors offer a number of suggestions for actualizing this reciprocal trust in clinical practice.
Nursing values: exploring the clichés*
Authors: Wilson‐Barnett Jenifer
Published: December 2006

Many fundamental values underpin the practice of nursing and, in an inaugural address to nurses and those in other disciplines, it seemed appropriate to explore values which have special relevance to nursing. If future research and practice are to exploit these values, they must be explained and understood. To that end the concept of holistic care, individualized care and practical care are discussed. Nursing research, which demonstrates their relevance to patients' needs during recovery, is then briefly reviewed. Throughout this paper differences in focus between nursing and medicine are highlighted in order to promote complementarity between the professions.
For better, for worse: nursing in higher education
Authors: Owen Grace M.
Published: December 2006

In this paper the recently proposed developments in nursing edueation within the United Kingdom are discussed within a historical context. Since a number of nursing departments already exist within the higher education sector (comprising universities, polytechnics and colleges of technology), it is suggested that use should be made of the experience already gained by nurses working within higher education. The pros and cons of nurse education being provided in or associated with higher education are discussed. Theoretical perspectives from change theory are applied. The importance of educating the practitioner for a holistic and community‐based role is stressed.
Patterns of evaluations of accents amongst health visitor students
Authors: Brettell Katherine M.
Published: December 2006

The rationale for a research‐orientated approach to health visiting is discussed and the application of research material adapted from the behavioural sciences to the study of health visiting practice is considered. A study using the ‘matched guise’ technique was conducted to determine health visitor student attitudes to accent. The sample consisted of 72 female students from three colleges in the south east of England. Each set of students was randomly divided into a control and variable group. An actor read the stimulus material in four different guises: south east educated accent, Birmingham, Yorkshire and Asian accented English. The control group heard the prestige south east educated accent and the second group heard one of three other accents which acted as the variable. The subjects were then asked to rate the speaker's personality on 17 bipolar scales of personality traits. Significant results were obtained on the personality ratings, but this pattern did not reflect previous research findings. Overall subject scores showed that the speaker was rated as favourably when using the Birmingham, Yorkshire and south east accented English, but significantly less favourably when using the Asian accented English. The possible reasons for these results and the implications for health visiting are discussed.
Using the OSCE to measure clinical skills performance in nursing
Authors: Ross Margaret , Carroll Giséle , Knight Janet , Chamberlain Marie , Fothergill‐Bourbonnais Francis , Linton Jeanette
Published: December 2006

The measurement of clinical skills performance continues to pose a challenge for nurse educators. This paper will report on the use of the objective structured clinical examination (OSCE) to measure the psychomotor learning outcomes of a programme designed to assist students to learn to conduct a nursing neurological examination. The OSCE has a tradition in medicine, having been developed by Ronald Harden in Scotland and first reported in the British Medical Journal in 1975, The University of Ottawa has the longest North American experience with this type of evaluation procedure and there is an increasingly rich medical literature referring to the OSCE, Although the OSCE appears to be a promising method for evaluating competence in the performance of clinical skills, there are no studies in the nursing literature examining the use ofthe OSCE as a method for evaluating the performance of clinical skills by nurses. Our experience suggests that the OSCE may be a powerful tool in the evaluation of clinical competence in nursing and that it may also be an effective facilitator for learning to perform clinical skills in nursing.
A study to evaluate the intervention of a nurse visiting patients with disabling chest disease in the community
Authors: Heslop A. P. , Bagnall P.
Published: December 2006

This paper describes the work of two nurses visiting patients with chronic respiratory disease at home. The outcome measures suggested that there were fewer deaths in the nurses' group but failed to show any changes in quality of life.

The nurses chose the nursing mode) devised by Roper et al. as a framework for their intervention. Initial assessment by the nurses showed the patients had a number of problems which could be grouped into physical health, knowledge, psychosocial and social. The nurses' monthly visits were used to assist the patients to plan strategies for resolving their problems. Advice was directed at helping patients promote and control their own health and measurable goals were set. Most of the patients achieved the goals set, valued the visits and said they wished them to continue. Psychosocial problems proved most difficult to solve. Patients' knowledge was demonstrated to have increased. A nursing audit found the patients had received ‘excellent’ quality of care. The nursing method used in this study would be appropriate for such work as it focuses attention on the indiviudal patient and his problems. Application of this approach will require education and support for nurses.
New measures for the formative and summative evaluation of a post‐basic psychiatric nursing education course
Authors: Milne Derek , Whyke Terry
Published: December 2006

The case for the formative and summative evaluation of training courses is presented prior to focusing upon the development of two new measures designed to gauge the efifectiveness of a short course of training. Results derived from these two measures are presented from two successive English National Board 953 courses (‘Developments in Psychiatric Nursing’). The findings indicated that our measures were reliable and valid indices of learning and so could facilitate formative evaluation. However, in terms of summative evaluation the post‐course scores were low and so the case for a revised course was presented. Implications were drawn for the routine evaluation of post‐qualification courses.
Use of implicit criteria in evaluation of mental nurses
Authors: Shanley Eamon
Published: December 2006

This paper describes the development of an instrument based on implicit criteria currently used by mental nurses in deciding whether a nurse is a good or a poor mental nurse. Existing implicit means of assessing mental nurses in the form of ward reports have been found to be inadequate. The study consisted of two stages: firstly, the production of a preliminary questionnaire using statements describing good and poor mental nurses obtained by interviewing mental nurses; secondly, the production of an assessment instrument, the Mental Illness Nurses' Evaluation Test, derived from the results of factor analysing responses of mental nurses to the preliminary questionnaire. The criteria used to evaluate mental nurses that emerged in order of importance were benevolence‐malevolence to other nurses, amiable‐irascible, regard‐disregard for patients, confident‐uncertain, directive‐non‐directive and professional‐unprofessional. The study exposes current values used in judging mental nurses and constitutes a first important step in developing a valid and reliable instrument in assessing mental nurses in terms of their prescribed role.
Action process of nurse administrators to problematic situations based on Orlando's theory
Authors: Schmieding Norma Jean
Published: December 2006

This study used Orlando's theory to investigate the action process of nurse administrators to realistic hypothetical situations presented to them by their staff. Ninety subjects recorded their thoughts, feelings and actions in response to six problematic situations. Findings indicated the administrators' first thought was seldom about their staffs reaction to the situation. Most experienced negative feelings about the staff member or about other people associated with the situation which were not expressed. The majority of administrators would handle the situation alone or tell the nurse what to do; less than half would ask their staff a question. The conclusion was that subjects did not consider situations as problematic.
Towards a personal control/uncontrol balance
Authors: Moch Susan Diemert
Published: December 2006

Patterns of personal control are predominant in Western culture, including the health care arena. A personal control theme is evident in the language of health care, the prevalent diseases, and the intervention strategies. However, facilitating a balanced pattern of personal control and personal uncontrol in interaction with the environment is most consistent with nursing theory and practice. In this paper, personal control and personal uncontrol nursing interventions are identified and analysed. Either set of interventions may enhance the health of the person, depending upon the control/uncontrol needs of the person.
An inquiry into the attitudes of qualified nursing staff towards the use of individualized nursing care plans as a teaching tool
Authors: Daws Janet
Published: December 2006

This paper summarizes a research study inquiring into the attitudes of qualified nursing staff towards the use of individualized nursing care plans as a teaching tool. The survey was conducted in medical and surgical wards used for nurse training, in two hospitals. In common with many hospitals, the introduction ofthe nursing process into the surgical wards is of more recent origin than the medical areas, so would this be reflected in the attitudes of staff? Results indicated an overall positive attitude of all staff, although significant differences were identified between the grades of staff participating in the study and between the two hospitals. There was no significant difference shown in the comparison of all surgical staff with all medical staff, but the ward sister demonstrated a more positive attitude than staff nurses or enrolled nurses. The length of time care plans had been in use and whether the Open University Programme P553 had been completed, were taken into consideration. Analysis ofthe individual statements which clustered around the same theme is discussed. Possible factors affecting the attitudes identified are suggested and recommendations which include ongoing educational support, in particular for the enrolled nurse, and exploration ofthe ‘role model’ function ofthe ward sister made. Finally, the method of study is critically examined.
Easing the transition to the maternal role
Authors: Jenise A.
Published: December 2006

This study was conducted to determine if a nursing intervention designed to teach primiparas about their infants' behaviours and abilities would ease their transition to the maternal role. Data were collected at 3 days and 3 weeks postpartum from a relatively homogeneous sample of 16 control mothers and 15 experimental mothers. The intervention was presented to each experimental participant on the third postpartum day. Effectiveness ofthe intervention was determined by measuring maternal anxiety, using the State‐Trait Anxiety Inventory, and concern about infant care and adjustment to the maternal life style, using the Postnatal Research Inventory revised by Ellis and Hewat. Additional data were also collected from hospital records, a demographic questionnaire, and an informal interview conducted at 3 weeks postpartum. Although the outcome measures demonstrated no statistically significant differences, the conclusions support the need for a predictive framework which would help nurses identify mothers who may have difficulty during the transition to the maternal role.
Assessing community health needs of elderly populations: comparison of three strategies
Authors: Schultz Phyllis R. , Magilvy Joan K.
Published: December 2006

Three research strategies for assessing the community health needs ofthe elderly population of an urban neighbourhood are described. Two primary research strategies, survey and ethnography, are contrasted with the types of health‐related information available from the Census of Population and Housing. Different types of data emerged from each research strategy with census and survey data providing a global portrait ofthe community, and ethnographic data yielding more detail about the place of health in the lived experience of older residents.
Patient education: a literature review
Authors: Close Ann
Published: December 2006

The literature review has been carried out to examine the role of nurses as patient teachers. It attempts to determine why patient education is necessary and why it should be part ofthe nurse's role. Included is an account ofthe abilities required by the nurse in order to function in that role. It is generally agreed that it is part ofthe nurse's role to educate patients but this is often not carried out in reality. Where it is done it is mostly unplanned and haphazard in manner and the effectiveness uncertain. There are many reasons cited why this is the case and many of these reasons relate to the inadequate education and training of nurses for this role. Registered nurses are responsible for the nursing care of patients which should include their education. In order to be able to provide the necessary education nurses must have the opportunity to be taught to develop the appropriate skills during basic training. As a result, a study is now underway to attempt to determine the extent to which student nurses are being prepared for their role as patient educators during basic training.
Patient teaching or patient counselling?
Authors: Wilson‐Barnett Jenifer
Published: December 2006

Careless or eonfused use of terms sueh as information giving, teaehing and eounselling may lead to inadequate understanding and practice. In view ofthe progress made in this area, designed to help patients eope with illness and treatment, this paper aims to elarify and identify similarities and differenees between these aetivities and discuss their relevance for those in most need of these types of eare. Having recognised the complexity and persistence of sueh needs, patients,* their relatives and nurses should perhaps decide their respective roles and work towards improving the quality of and opportunities for sueh interventions.
Developing a sensation information message for femoral arteriography
Authors: Clark C. Roberta , Gregor Frances M.
Published: December 2006

Sensation information is proposed as a way of decreasing the patient's distress during a threatening health care event. A first step in developing a sensation information message is to determine the content of the message. This study, using a systematic theory‐based methodology, was conducted to describe and validate the common physical sensations experienced by patients undergoing the diagnostic procedure of femoral arteriography. (A conceptual framework based on how an individual perceives or senses a situation was used.) A three‐stage survey design was used including: (1) tool development following observation of the procedure and pilot‐testing of the interview schedule, (2) interview of patients who had undergone femoral arteriography about the sensations experienced during the procedure, and (3) validation of the responses. Twenty‐one steps in the femoral arteriography procedure of which patients were aware were identified. Nine ‘feeling’ sensations commonly experienced during the procedure and the sights and sounds associated with the procedure were determined. The sequencing and duration of procedure steps were observed and the environment in which the procedure was performed was described.
The clinical nurse specialist: from the outside looking in
Authors: Storr Gail
Published: December 2006

This paper considers the role ofthe clinical nurse pecialist (CNS) as portrayed in the literature. The historical development ofthe role is highlighted, rationale for preparation at an advanced level presented and controversy regarding placement ofthe CNS in a line or staff position outlined. Also discussed are the five commonly accepted sub‐roles ofthe CNS (practitioner, educator, consultant, researcher and change agent) as well as a new role (staff advocate) which can be seen to be emerging in the literature. The author presents some of her observations of the role ofthe CNS at a large urban teaching hospital and concludes that congruence between the ideal role portrayed in the literature and the actual practice ofthe role is possible.
A follow‐up of the graduates of the Cardiff Bachelor of Nursing Degree Course
Authors: Bircumshaw Denise , Chapman Christine M.
Published: December 2006

This paper considers the career patterns ofthe graduates of the University of Wales College of Medicine Bachelor of Nursing course. The 4‐year course commenced in 1972 and has now seen 11 years of graduates. A longitudinal questionnaire survey has been administered annually to graduates ofthe course to ascertain information relating to the posts held and qualifications gained by graduates, which is the focus ofthis paper. The questionnaire also elicits graduates' perceptions ofthe value of aspects ofthe degree course to posts held, and the reaction of colleagues to the fact that they are nurse graduates. The results of the follow‐up are presented to show the posts held by graduates at four time intervals; 6 months, 2 years and 5 years following graduation, and all graduates at the 1986 follow‐up. The numbers ofthose who have obtained various post‐registration qualifications are also presented. Thefindings support those of other follow‐up studies of nurse graduates and diplomates. The graduates largely entered nursing or related posts, with the majority remaining in clinical‐based posts as opposed to teaching and administration. Thefindings lead to further questions regarding the role and function ofthe nursing graduate. Further study is currently in progress to compare various elements ofthe practice style of Bachelor of Nursing graduates with non‐graduate nurses.
What can midwives learn from the babes? Implications for midwives of a maternity care programme for nursing students
Authors: Mander Rosemary
Published: December 2006

In view of certain problems inherent in the maternity care experience for nursing students, the department of nursing studies in the University of Edinburgh has introduced a novel form of this experience. This programme reflects the philosophy ofthe department. The evaluation of this programme has revealed that the women who participated perceive that this scheme is of value in a range of respects. Some of these perceived benefits may provide useful insights for midwives regarding how the consumers view their care.
Sources of maternal confidence and uncertainty and perceptions of problem‐solving competence
Authors: Bullock Cindy Blenke , Pridham Karen F.
Published: December 2006

Although a mother's perception of her competence in problem‐solving issues of infant care may affect her sensitivity toher infant's cues, little is known about factors that contribute to this perception. This study explored the type of information on which maternal confidence is based and examined its relationship to perceived competence in problem‐solving issuesof infant care. The 49 mothers of healthy newborns who participated in this study were interviewed 30 and 90 days after theinfant's birth to learn about sources of confidence or uncertainty. The interview protocol also included scaled items to assess perceived problem‐solving competence. The infant's mood was most frequently reported as either a source of confidence or uncertainty at both 30 and 90 days. The infant's response to care as a source of confidence or uncertainty waspositivelyrelated to perceived competence, suggesting that strengthening mothers' attention to this source of information about theirperformance may be clinically useful. Direct study ofthe type of information used to evaluate competence in problem‐solvingis recommended, since it may differ from the type of information on which mothers base their confidence in caring for their infants.
Leaping the chasm between nursing theory and practice
Authors: Lewis Tom
Published: December 2006

The author considers that whilst nurse tutors teach theory, nurse practitioners go on nursing in the same way that they always have done. There appears to be a chasm dividing theory and practice. This paper describes an attempt to leap that chasm. The paper identifies the problem, inherent in the nursing process that creates such difficulties in its implementation. The nursing process alone does not provide an adequate framework for nursing practice. The paper then describes how the translation of theory into practice took place on a ward in Brighton General Hospital, Brighton, England. The barrier between theory and practice is highlighted, along with a description of how the problems this presents to ward staff were overcome. The author considers that the attribution of cause is a key concept in the problem‐solving approach, since it generates the question — Why?— and therefore that attribution of cause must be a concept in any model of nursing that is being used to implement the nursing process. The paper provides an example of how nursing models may be adapted, at ward level, to guide everyday practice, whilst retaining the conceptual framework ofthe model. The inference of the paper is that such a process could be applied to other models resulting in a greater use of theory in everyday nursing practice.
Experimental study to evaluate nursing staff morale in a high stimulation geriatric psychiatry setting
Authors: Jones R. G.
Published: December 2006

This work is part of a larger study carried out at Murray Royal Hospital, Perth, Scotland. The study was concerned with staff morale under two distinct management approaches towards the care ofthe elderly patient with dementia. In one ward a dynamic, high stimulation approach was adopted including reality orientation, reminiscence therapy and socialization therapy. This was run in a well‐structured manner by the ward staff and other agents. The other ward had no such structure imposed and was left to carry out ‘traditional’ nursing care to a high standard. The tool used to collect the data was a precoded questionnaire developed by Jones & Galliard. The hypothesis on which the study was based was as follows, ‘that morale is increased in nursing staff involved in a high stimulation ward environment for the hospitalized elderly patient with dementia’. The findings ofthe study appear to indicate that the hypothesis is supported. It appears that the imposition ofthe structured high stimulation management approach was responsible for such an outcome and that nursing staff respond well to such an approach.
The nursing prevention of pressure sores in hospital and community patients
Authors: Clarke Margaret , Kadhom Hana M.
Published: December 2006

The main purpose ofthe study was to evaluate the amount of time which was spent in giving preventive pressure area care in both a sample of hospital patients (n = 88) and a sample of community patients (n = 30). Bedfast or chairfast patients were studied from admission to the selected hospital wards or community nursing areas for a period of a maximum of 6 weeks or until they were discharged from care, developed pressure sores, died or became mobile. Data were collected by means of a diary sheet which was designed for use by nurses in the hospital and by nurses and relatives in the community. They were asked to record pressure area care as it was given on the diary sheets. The researcher also collected data about the patients' appetite, Norton score, age, sex and diagnosis. The outcome measure used was whether or not the patient developed a pressure sore, which was defined for this study as a break in the skin due to pressure. Some descriptive analysis ofthe data has been carried out. Results available so far show that a higher percentage of the hospital patients developed pressure sores (29%) than among the community patients studied (20%). The study appears to show that nursing care devoted to the prevention of pressure sores in terms of time and frequency is significantly related to outcome and thus to effectiveness.
Consumer satisfaction on a psychiatric ward
Authors: Shields P. J. , Morrison P. , Hart D.
Published: December 2006

A survey of consumer satisfaction was carried out on one ward of the psychiatric unit of a district general hospital. Data were collected by questionnaire, the content of the questionnaire being guided by a number of semi‐structured interviews. The information collected suggested many ways in which the patients' time in hospital could be made more comfortable and relaxed. Areas attracting particular concern were the food, noise, the provision of information and boredom. The various methods which can be used to elicit consumer views are described, and we have discussed the value and possible obstacles to users having more influence in the planning and running of mental health services.
Narcolepsy: a review of a common, life‐long sleep disorder
Authors: Cohen Felissa L.
Published: December 2006

Narcolepsy is a severe debilitating chronic life‐lotig sleep disorder that can be ameliorated but not cured. In the United States, its prevalence is at least 1 in 1000 making it more common than multiple sclerosis or Parkinson's disease. Its symptoms lead to severe lifestyle consequences, with profound impact on the affected persons, their interpersonal relationships, job, school experiences, and family life. Despite this, little has appeared in the nursing literature about the disorder. The most characteristic symptoms include uncontrollable excess daytime sleepiness, cataplexy (bilateral voluntary muscle weakness), sleep paralysis, hypnagogic hallucinations and disturbed night‐time sleep. Characteristics of normal sleep are reviewed and compared with disturbances seen in narcolepsy. The aetiology, assessment, diagnosis, pharmacologic therapy, non‐pharmacologic therapy and psychosocial issues are discussed along with needed research directions.
Verbal communication and behaviour during meals in five institutionalized patients with Alzheimer‐type dementia
Authors: Sandman P.O. , Norberg A. , Adolfsson R.
Published: December 2006

Five institutionalized patients with Alzheimer‐type dementia were observed (video‐recorded) during meals. The aim was to assess their meal behaviour and social interaction. The results showed that when the patients ate without the participation of staff, the two least demented patients became ‘caregivers’ in the group and helped the three most demented patients to eat. When two mental nurses joined the group, the patients dropped their roles as helpers. The conversation in the group could be characterized as incomplete, with short sentences and a lot of breaks. Sixty‐three per cent of all comprehensible utterances concerned food and eating and almost all conversation concerned the present.
Preceptorship: a viable alternative clinical teaching strategy?
Authors: Myrick Florence
Published: December 2006

The difficulty experienced by many baccalaureate student nurses in making the role transition from student to graduate nurse continues to pose problems for nursing education and nursing service personnel alike. A variety of instructional strategies described in the literature which claim to enhance the effectiveness of student learning in the clinical setting and promote role adjustment immediately upon graduation have been used by nursing faculty and nursing service personnel. Preceptorship is one such strategy. The author reviews the evolution of preceptorship within the nursing profession and explores factors which are provoking current interest in this concept. Available empirical data regarding the effect of preceptorship on student and graduate nurse performance in the clinical setting are presented and implications for nursing education discussed.
Strategies and conditions for teaching theoretical nursing: an international perspective
Authors: Meleis Afaf Ibrahim , Price Martha J.
Published: December 2006

How, when, and why to teach nursing theory are still central questions for nurse educators. The questions are restated and generalized to the whys, and hows, and the whens to incorporate theoretical nursing rather than nursing theory in nursing education. Process and strategies for teaching theoretical nursing are compared and contrasted with those related to research. We propose the use of similar strategies and add several essential conditions related to theoretical nursing. In teaching theoretical nursing, educators are expected to develop an environment that values theory and ways by which a theoretical identity is facilitated and fostered in students. Critical and reflective thinking as well as the role modelling of local models of excellence are central ingredients in the development of nurses who are committed to using and developing theories. One approach in incorporating theory in curricula is to identify central components and goals such as historical analyses, domain boundaries, theory utilization, process and strategies for theory development and testing. Once components are identified, faculty can make a decision about where to incorporate them. We have proposed several approaches that incorporate theoretical nursing in undergraduate and graduate programmes.
Determinants of patient care: nursing process or nursing attitudes?
Authors: Moss A. R.
Published: December 2006

Nurses are increasingly striving to be recognized as independant professionals and often use the nursing process as evidence that they have their own area of expert knowledge. The nursing process is, in theory at least, an effective framework on which to base nursing care. However, there are a number of studies which indicate that nursing care is influenced to a significant degree by the attitudes of nursing staff. If nursing is to attain the status of an independant profession it must identify, and if possible, rectify the factors that influence nursing attitudes.