bluuebunny/crossref_metadata_2025 huggingface dataset:
Decision making: the context of nurse prescribing
Authors: Luker Karen A. , Hogg  , Austin  , Ferguson  , Smith
Published: March 2003

From October 1994 qualified district nurses and health visitors from eight demonstration sites in England have been able to prescribe from a limited list of formulary items. Data collected from nurses formed only one part of the evaluation of nurse prescribing. These data highlighted a number of areas where prescribing nurses were faced with difficult decisions. A number of authors have considered how both doctors and nurses make decisions, and the factors which may influence the decision making process. With reference to the literature this paper focuses on the findings related to decision making in the context of nurse prescribing.
The case for case studies in nursing research: the problem of generalization
Authors: Sharp Keith
Published: March 2003

This paper examines the logic of generalizing from case studies and other non‐representative samples. It is argued that the generalizability of such research is often underestimated, because of a fundamental confusion about two quite distinct logical bases upon which generalizations can be made: empirical and theoretical. It is suggested that once it is accepted that theoretical generalizations do not depend upon representativeness for their validity, the full value of case study, and other small‐scale qualitative research to nursing and other health care disciplines, can be appreciated.
Consumerism and health care: the example of fertility treatment
Authors: Meerabeau Liz
Published: March 2003

This paper discusses the concepts of consumerism and the consumer of health care, and applies them to the example of fertility treatment, drawing on the health policy literature and data from a study of couples undergoing fertility treatment. It is argued that the concept of the consumer is a slippery one, that it provides only a partial view of being a patient, and that in particular it neglects emotional issues.
Parents with learning disabilities: a review of the literature
Authors: Sheerin Fintan
Published: March 2003

Parenting by learning disabled persons is a highly emotive issue, eliciting arguments from both extremes. Many of the arguments against such parenting have their basis in eugenic theory, whereas those in favour, often cite human rights declarations, and philosophies such as ‘normalization’. This review of the literature describes the chronological development of theory on the subject, spanning 1900 to the present day. It has become clear that, whereas parents with learning difficulties may be more predisposed to having problems, they can indeed perform as adequate parents, given appropriate training and support. This paper traces the development of current theory, through an in‐depth discussion of the available literature.
Promoting breast feeding: the perceptions of Vietnamese mothers in Sydney, Australia
Authors: Rossiter Joh Chin
Published: March 2003

A review of the literature indicated that the majority of Vietnamese mothers bottle fed their infants after migration to western countries. Those who breast fed weaned their infants very early. This study aimed to explore, from the Vietnamese mothers’ perspective, their experiences of infant feeding and the attributes of nurses, midwives, other health professionals and the health care system that were considered to be important in encouraging the immigrant Vietnamese women to breast feed in Sydney, Australia. A convenience sample of 124 postnatal Vietnamese women were recruited from the western and south‐western suburbs of Sydney of New South Wales, Australia. In‐depth interviews were conducted in the privacy of the respondents’ homes. An ethnographic approach guided the concurrent data collection and content analysis. Through constant comparison of categories, nine concepts emerged from the findings to describe the women’s process of decision making, experiences and perceptions of breast feeding: believing, complying, rewarding, facing the unexpected, experiencing pleasure and pain, fulfilling, communicating, counselling and supporting. These findings highlighted the significance of social, cultural and economic factors which influenced the women’s decisions and maintenance of breast feeding. Implications for nursing practice and further research are discussed.
How not to do clinical supervision in nursing
Authors: Yegdich Tania
Published: March 2003

The widespread nursing interpretation of clinical supervision following the accepted definitions of Butterworth and Faugier, elides refinement of boundaries between personal and professional development and growth. In so doing, nursing interpretation confuses the differences between two similar processes and ultimately distorts the purpose of clinical supervision. In nursing supervision, the patient can become lost, thus perpetuating the avoidance of anxiety in intimate therapeutic work, originally described by Menzies in 1959. While a tension naturally exists between the two processes, this paper demonstrates the utter importance of working within the tension of boundaries that define the triadic situation of supervisor, supervisee and patient. When supervision is accepted as personal development, the triadic situation may deteriorate into a dyadic one between supervisor and supervisee only, significantly altering the relationship to the point where the supervisee becomes a patient. Parallel process, ordinarily reflecting the therapeutic nurse‐patient relationship in the supervisory one, may then become merely a process running parallel to the supervisee, while utilizing the patient as a source of material for personal growth. This paper demonstrates through Faugier's casework material the necessity of defining boundaries and the difficulties associated in maintaining them, rather than prosaically declaring that ‘supervision is not therapy’.
People with HIV/AIDS: who cares?
Authors: Robinson Nicola
Published: March 2003

People with HIV/AIDS: who cares? Studies have shown that some nurses, doctors and other carers have negative attitudes towards people with human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Some cope by avoiding working with such patients, while others just do the best they can. But does it matter? This paper describes a review of the literature on the impact of attitudes to care and the barriers affecting the quality of care for people with HIV/AIDS by professional health care workers and other carers. Most of the reports identified were based on attitude scales, mostly unique and often unvalidated. Attitudes of health care workers based in the community, and ‘house keeping’ staff such as porters, receptionists, etc., have been neglected areas of research. There is also little information about the culture of organizations and the attitudes of individuals with HIV/AIDS to care. Only three references were found in which both patients’ and carers’ attitudes to each other were considered and none of these looked at negative feelings and their impact. There is scope therefore to investigate the attitudes of patients and carers towards each other and how this can effect the quality of care. It is anticipated that the benefits of such investigations could lead to the development of educational strategies designed to improve the quality of patient care.
The role of computer software in the analysis of qualitative data: efficient clerk, research assistant or Trojan horse?
Authors: Morison Moya , Moir Jim
Published: March 2003

In the last 15 years there has been a proliferation of computer software packages designed to facilitate qualitative data analysis. The programs can be classified, according to function, into a number of broad categories such as: text retrieval; text base management; coding and retrieval; code‐based theory building; and conceptual‐network building. The programs vary enormously in the extent to which they can facilitate the diverse analytical processes involved. The decision to use computer software to aid analysis in a particular project may be influenced by a number of factors, such as the nature of the data and the researcher's preferred approach to data analysis which will have as its basis certain epistemological and ontological assumptions. This paper illustrates the way in which a package called NUD.IST facilitated analysis where grounded theory methods of data analysis were also extensively used. While highlighting the many benefits that ensued, the paper illustrates the limitations of such programs. The purpose of this paper is to encourage researchers contemplating the use of computer software to consider carefully the possible consequences of their decision and to be aware that the use of such programs can alter the nature of the analytical process in unexpected and perhaps unwanted ways. The role of the Computer Assisted Qualitative Data Analysis (CAQDAS) Networking Project, in providing up‐to‐date information and support for researchers contemplating the use of software, is discussed.
The effect of therapeutic touch on pain and anxiety in burn patients
Authors: Turner Joan G. , Clark Ann J. , Gauthier Dorothy K. , Williams Monica
Published: March 2003

The purpose of this single‐blinded randomized clinical trial was to determine whether therapeutic touch (TT) versus sham TT could produce greater pain relief as an adjunct to narcotic analgesia, a greater reduction in anxiety, and alterations in plasma T‐lymphocyte concentrations among burn patients. Therapeutic touch is an intervention in which human energies are therapeutically manipulated, a practice conceptually supported by Rogers’ (1970) theory of unitary human beings. Data were collected at a university burn centre in the south‐eastern United States. The subjects were 99 men and women between the ages of 15 and 68 hospitalized for severe burns, and they received either TT or sham TT once a day for 5 days. Baseline data were collected on day 1, data were collected before and after treatment on day 3, and post‐intervention data were collected on day 6. Instruments included the McGill Pain Questionnaire, Visual Analogue Scales for Pain, Anxiety and Satisfaction with Therapy, and an Effectiveness of Therapy Form. Blood was drawn on days 1 and 6 for lymphocyte subset analysis. Medication usage for pain in mean morphine equivalents, and mean doses per day of sleep, anxiety and antidepressant medications were recorded. Subjects who received TT reported significantly greater reduction in pain on the McGill Pain Questionnaire Pain Rating Index and Number of Words Chosen and greater reduction in anxiety on the Visual Analogue Scale for Anxiety than did those who received sham TT. Lymphocyte subset analyses on blood from 11 subjects showed a decreasing total CD8+lymphocyte concentration for the TT group. There was no statistically significant difference between groups on medication usage.
Nursing in the health care system of the postmodern world: crossroads, paradoxes and complexity
Authors: Spitzer Ada
Published: March 2003

Entering the postmodern world in which society is confronting crossroads, paradoxes, and complexity, the health care system is encountering a transformation more comprehensive and revolutionary than has ever been seen before. Analysis of the state of nursing vis a vis these transformations indicates that the current paradigm does not ensure the existence of the profession in the postmodern health care system. That is because of increased difficulties in consolidating the economic and quality issues into the core of nursing, and in understanding the complexity inherent in health related situations.
The fatigue experience: persons with HIV infection
Authors: Rose Linda , Pugh Linda C. , Lears Kate , Gordon Dorothy L.
Published: March 2003

Fatigue is a frequently reported symptom by persons with HIV infection and one that has an adverse impact on activities of daily living and overall quality of life. Although the concept of fatigue has been studied extensively and discussed in the literature, little is known about the experience of fatigue by persons with HIV infection. A hermeneutic phenomenological study was conducted to investigate the subjective experience of HIV‐associated fatigue and to describe the management of fatigue in the context of daily life. In‐depth interviews were done with 10 adult patients of an outpatient HIV/AIDS clinic. Thematic analysis identified three concerns that represented the meaning of fatigue for the participants. The first concern was ‘Fatigue as a signal of AIDS’. A second concern was ‘The mind, the body, the social experience of fatigue’. The third concern was ‘Choosing ways to live with fatigue and addiction’. The findings provide insights for nursing practice regarding the subjective meaning of fatigue for patients with HIV and the need for nurses to explore this topic with patients.
Validation of the quality of life scale: living with HIV
Authors: Holzemer William L. , Spicer Joan Gygax , Wilson Holly Skodol , Kemppainen Jeanne K. , Coleman Christopher
Published: March 2003

A grounded theory of Salvaging Quality of Life provided the conceptual framework for the development of the Living with HIV scale which was validated in this study. The HIV+ convenience sample (n=187) was 66% male, with a mean age of 40·6 years, 69% African‐American, and with an average CD4 count of 229 mm3. A principal components factor analysis with varimax rotation was conducted on the final 32‐item scale and nine factors with Eigenvalues >1 explained 60% of the variance. A second order factor analysis of these nine factors resulted in a two factor solution (HIV Struggles and HIV Reverence) which explained 49·4% of the variance. Cronbach alpha reliability coefficient for the total scale was 0·84. Differences between gender, ethnicity, education and presence of an AIDS diagnosis, and quality of life, were explored. Females had higher total scores which suggested they had a more positive quality of life than males. The Living with HIV scale can be used as a method of obtaining input from patients for care planning and for evaluating the effectiveness of nursing care intervention using quality of life as an outcome of care.
Guided participation and development of care‐giving competencies for families of low birth‐weight infants
Authors: Pridham Karen F. , Limbo Rana , Schroeder Michele , Thoyre Suzanne , Van Riper Marcia
Published: March 2003

Guided participation and development of care‐giving competencies for families of low birth‐weight babies¶The concept of guided participation is central to theory for supporting families in developing competencies for care of their low birth‐weight infants. Guided participation is a process through which an experienced person helps another person who has less experience to become competent in practices that are personally and socially meaningful practices of everyday life. A practice is made up of socially formed activities directed to accomplishing a recurring goal. For a parent, infant care‐giving encompasses protecting, comforting and nurturing activities, including feeding. For premature infants, a mother’s care‐giving begins during the neonatal intensive care unit stay and continues, after the infant’s discharge from hospital, in the home. Care‐giving competencies are addressed through guided participation of a mother in her care‐giving practice. In this process, her working model of herself as parent, her infant, and feeding is constructed and revised through the guided participation process. In this paper, a general theory of guided participation that could be used to promote care‐giving competencies is described. Two cases from a pilot study are presented to illustrate the application of the theory to a mother’s feeding practice with infants who were born prematurely and who developed problems with feeding during the first year of life. These cases indicate that guided participation offers a means of precisely tailoring support for care‐giving to the mother’s needs and goals for development of competencies. Further research on how guided participation is best introduced to families of varying resources and life circumstances, how it is best implemented across settings as the infant moves from hospital to home, and how nurses can apply its principles with available resources and opportunities is needed.
A concept analysis of parent–infant attachment
Authors: Bell Linda , St‐Cyr Tribble Denise , Paul Denise , Lang Ariella
Published: March 2003

A concept analysis of parent–infant attachment¶A concept analysis, the clarification of a concept, is the first step towards building the foundations of nursing theory, research and practice. As a relevant concept for nurses working with childbearing families, parent–infant attachment is an important part of the body of nursing knowledge. Wilson’s method of concept analysis was used to generate antecedents, critical attributes and consequences of parent–infant attachment, highlighting the need to refine measurements of this concept.
Hope: future imagined reality. The meaning of hope as described by a group of healthy Pentecostalists
Authors: Benzein Eva , Norberg Astrid , Saveman Britt‐Inger
Published: March 2003

Hope: future imagined reality. The meaning of hope as described by a group of healthy Pentecostalists¶ A holistic health care approach involves body, mind and spirit. Religiosity, spirituality and hope, as a part of the spiritual dimension, are often linked to various health‐related outcomes such as physical health, spiritual well‐being and experienced meaning in life. A person’s outlook on life and the experience of hope are essential issues in all health care. The purpose of this paper is to describe the meaning of hope as expressed by a group of healthy adult Pentecostalists (n = 15). Using narratives, the ultimate hope was described as life after death, the future imagined reality, promised by God. Hope was strengthened by reading the Bible and saying prayers, through experienced meetings with God and shared values. Hope was quite stable but sometimes God was experienced as being at a distance, which resulted in a sense of alienation. Hope unconnected to Christian belief was of no significant importance to the interviewees.
Patient initiatives during the assessment and planning of psychiatric nursing in a hospital environment
Authors: Latvala Eila , Janhonen Sirpa , Wahlberg Karl‐Erik
Published: March 2003

Patient initiatives during the assessment and planning of psychiatric nursing in a hospital environment¶ The qualitative study reported in this paper aims to describe the planning and assessment of psychiatric nursing in a hospital environment. The theoretical framework consists of the three types of psychiatric nursing outlined in a developmental model of nursing: confirmatory, educational and catalytic. Confirmatory psychiatric nursing is based on a hierarchical and authoritarian model. Educational psychiatric nursing is based on a professionally driven and behavioural model. Catalytic psychiatric nursing is systematic, theoretical, and research‐based. Catalytic psychiatric nursing may vary, depending on the patient’s needs, from confirmatory and educational to situationally determined nursing. However, it always enables patient initiatives. The purpose of this paper is to describe patient initiatives during the assessment and planning of patient care by an interdisciplinary mental health team in a psychiatric hospital environment, and the assessment and planning as described by nurses working in a hospital environment. The data, which were collected in two psychiatric hospitals by videotaping interdisciplinary teamwork situations and recording interviews of nurses afterwards, consisted of 384 pages of written text. A total of 640 sentences were identified in the text as reflecting the assessment of care by the interdisciplinary team and by the nurses working in the hospital environment. Deductive content analysis techniques were used to analyse the written data. The results showed that nursing was described by the nurses to be catalytic in 13% of the cases, while the same nurses assessed psychiatric nursing to be most commonly educational (40%) or confirmatory (47%).
Towards (re)conciliation: (re)constructing relationships between indigenous health workers and nurses
Authors: Jackson Debra , Brady Wendy , Stein Irene
Published: March 2003

Towards (re)conciliation: (re)constructing relationships between indigenous health workers and nurses¶ Currently in Australia, both Aboriginal and non‐Aboriginal Australians are attempting to reconcile themselves with a history of colonization/invasion, which resulted in human rights violations against Australia’s indigenous people. Australian nursing has to examine its past in relation to the treatment of Aboriginal Australians. Relationships between nurses and Aboriginal health workers are the most commonly occurring professional relationships between nurses and Aboriginal people and are of key importance to the successful delivery of health services to Aboriginal communities. This qualitative study, grounded in feminism, aimed to explore the professional relationships between Aboriginal health workers and nurses and to develop insights which could assist the Australian nursing profession through a process of reconciliation with Aboriginal Australians. Feminist analysis of narrative text revealed several key themes as being crucial to this process. These were: learning to know and understand; towards workplace equity; and skill sharing — learning from each other. Implications for nursing, in its journey toward reconciliation with Aboriginal Australians, are drawn from this study.
Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls
Authors: Udén Giggi , Ehnfors Margareta , Sjöström Kerstin
Published: March 2003

Use of initial risk assessment and recording as the main nursing interventions in identifying risk of falls¶ The consequences of falls among hospital patients are a great problem, for the patient, the family and society, and cost billions of dollars. In Sweden, almost one‐third of all hip fractures occur in the hospital population. Despite this, very few prevention strategies have been developed and tested. In this study, a risk assessment and recording programme in relation to the risk of falling among patients in a geriatric department at a Swedish hospital was implemented. The records of all patients admitted to a geriatric unit during one year, and a stratified random sample of patient records, constituting the control group from the year before, were reviewed. No recording of assessments regarding the patients’ risk of falling, and no preventive nursing interventions, were found in the records of the control group. The study group, however, increased the recording of risk assessment to 96%. Only implemented nursing interventions were found in the patients’ records, despite the fact that Swedish law makes it obligatory for the registered nurse to record both the planning and implementation of nursing care. In the study group there were explicit descriptions of problems of concern for nursing regarding the patients’ risk of falling in less than one‐third of the records, the nursing care plans were rare, and the evaluations were not satisfactory. Nursing interventions consisted mostly of information or education, promotion of patient participation, and structuring of the environment. There was no agreement on any standard‐care plan. Recording of falls was found more often in the study group than in the control group (probably due to more careful recording), but the proportion of injuries in relation to falls was higher in the control group. The results of this study may be used as a baseline for developing a nursing strategy and documentation relating to falls.
Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research
Authors: Anderson Kathryn L. , Burckhardt Carol S.
Published: March 2003

Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research¶ If health care providers are to be able to document effective outcomes resulting from their interventions, they must first develop clear conceptual definitions for the outcomes, and then select measures that represent these concepts. No consensus exists in the health care disciplines about what quality of life is or how it should be measured. This paper presents historical and conceptual arguments in favour of a particular definition of quality of life, and distinguishes between quality of life and concepts often confused with it in the literature: symptoms, mood, functional status, and general health status. Whether quality of life is actually amenable to change as a result of health care interventions, and whether we ought to be trying to influence clients' quality of life is also discussed. We conclude that quality of life is an important outcome of health care intervention. However, traditional approaches to influencing quality of life may be misdirected, and the relative importance of our interventions to clients — whose opinions matter the most — ought to be put into perspective.
How can we achieve evidence‐based practice if we have a theory–practice gap in nursing today?
Authors: Upton Deborah J.
Published: March 2003

How can we achieve evidence‐based practice if we have a theory–practice gap in nursing today?¶The purpose of this paper is to discuss how nursing can achieve evidence‐based practice when a theory–practice gap exists in nursing today. The paper commences with an introduction to the concept of evidence‐based practice and a discussion of the relationships between theory, practice and the theory–practice gap. An analysis of the two concepts will then be presented from within the four pillars of nursing, namely management, practice, research and education. The paper will conclude with a discussion of whether evidence‐based practice can be achieved in view of the theory–practice gap.
The relationship between infant feeding practices and diarrhoeal infections
Authors: Ziyane Isabella S.
Published: March 2003

The relationship between infant feeding practices and diarrhoeal infections¶ To determine the relationship between infant feeding practices and diarrhoeal infections, a descriptive survey was conducted on infants aged between 6 and 12 months of age. A guided interview was conducted with 105 mothers of infants who attended the health facilities of Mbabane, Swaziland. The results showed that breast feeding was routinely practised by the majority of mothers, although exclusive breast feeding was very low. Supplementary feeds in the form of formula or solids were introduced by the majority of respondents within the first 3 months of life. Infants who were given colostrum and breast milk had fewer diarrhoeal attacks. Other factors, for example education and cultural factors, influenced the feeding practices and number of diarrhoeal attacks. It is recommended that breast feeding should be promoted as an important intervention in the control of diarrhoea.
Changing roles and identities in primary health care: exploring a culture of uncertainty
Authors: Williams Anne , Sibbald Bonnie
Published: March 2003

Changing roles and identities in primary health care: exploring a culture of uncertainty¶This paper highlights a key area of analysis emerging from research undertaken in order to explore cultural differences between medicine and nursing, and implications for primary care. Concerns about the role of nursing in primary health care within the UK are of particular interest to the authors. A specific concern centres on the movement of health care work from one group of health workers to another, in particular from doctors to nurses. A number of studies show that work is moving from doctors to nurses and explore the policy drivers, notably the pressure to improve the cost‐effectiveness of care. However, few studies reflect on how ideas, values and beliefs are being challenged, confirmed and used to justify new roles and identities. We are interested in exploring this latter aspect of the movement of health care work, and argue that changing roles and identities create a culture of uncertainty which has important implications for the future of primary health care nursing.
Exploring variables underlying non‐response in a survey of nurses and nurses' aides in practice
Authors: Barriball K. Louise , While Alison E.
Published: March 2003

Exploring variables underlying non‐response in a survey of nurses and nurses' aides in practice¶This paper demonstrates that distinguishing between the different sources of unit response failure (i.e. refusals and non‐contact) in survey research is methodologically important since minimizing non‐contact and refusals requires different approaches. The findings of an interview survey show that unit response failure can be contained successfully through careful study design and management. The potential value of using resampling (i.e. obtaining some information from non‐respondents) for identifying: (i) which direction, if any, the data from respondents are biased and; (ii) influencing variables on the incidence of non‐response is also demonstrated.
Discharging older people from hospital to care homes: implications for nursing
Authors: Reed Jan , Morgan Debra
Published: March 2003

Discharging older people from hospital to care homes: implications for nursing¶This paper summarizes a research study which explored the experiences of older people being discharged from hospital to nursing and residential homes in the North East of England. While there has been considerable research which has looked at the discharge of patients from hospital to their own homes, little literature could be found which addressed discharge to care homes. While this may reflect an assumption that this form of discharge is less problematic, it is arguable that this is only the case for staff — there is a body of literature on re‐location which suggests that the move to a care home is a major life event for older people. Taking a qualitative approach, this study interviewed 20 older people and 17 of their family members after discharge from hospital to a care home. We found that few people had been offered opportunities to discuss their move with nurses, and that older people tended to adopt a stoical attitude. In focus groups, interviews and written responses from 23 members of staff in the hospital and in care homes, we found that there was a lack of clarity over whose role it was to initiate such discussions. The paper concludes with some discussion of the implications for nursing practice of changing care interfaces.
The use of focus group methodology — with selected examples from sexual health research
Authors: Robinson Nicola
Published: March 2003

The use of focus group methodology — with selected examples from sexual health research¶ This paper describes in detail the use of the focus group approach in research. The following issues are discussed: when, why and how focus group methods are used, their advantages and disadvantages and how data are analysed. Selected examples from four research studies on sexual health using this methodology are reported together with some of the problems experienced with␣their use. The importance of using focus groups in qualitative research is␣addressed and an argument is suggested for their more general use.
An analysis of the concept of pain
Authors: Montes‐Sandoval Lucy
Published: March 2003

An analysis of the concept of pain¶ This paper presents a conceptual analysis of the phenomenon of pain. The strategic process of developing a conceptual analysis is a cognitive exercise of critical thinking applied to a very common, but complex and poorly understood, experience. Within the classic framework developed by Walker & Avant (1995), pain is analysed and critical attributes are distilled. A model case, a related case and a contrary case are constructed in the course of creating conceptual clarity. Empirical referents that exemplify the concept of pain are identified. The concept analysis provides a forum for dialectics, offering one defensible interpretation of a complex human occurrence. Nursing implications are discussed in the conclusion.
Family‐centred care: a concept analysis
Authors: Hutchfield Kay
Published: March 2003

Family‐centred care: a concept analysis

Family‐centred care would seem to be a central element of children's nursing, but there is no consensus about its meaning. This paper uses a combination of Rodgers' evolutionary model of concept analysis and Schwartz‐Barcott and Kim's hybrid model of concept development to facilitate a dispositional approach to analysing this concept. Data from a qualitative survey undertaken during 1994/1995 was used in conjunction with data obtained through a questionnaire, to provide the field‐work element for the process of analysis. The process resulted in the identification of the antecedents and attributes of family‐centred care, and the identification of a lack of clarity related to the consequences of family‐centred care. Two alternative models of family‐centred care emerged, both of which demonstrate strong associations with the concepts of partnership with parents, parental participation and care by parents. The paper does not conclude with any definition of family‐centred care, but rather explores its usefulness in practice and considers how the concept might be operationalized. The tentative proposals for a hierarchy of family‐centred care will require exploration, testing and evaluation by practitioners in the real world of children's nursing.
Critical reflective inquiry for knowledge development in nursing practice
Authors: Kim Hesook Suzie
Published: March 2003

Critical reflective inquiry for knowledge development in nursing practice

This paper presents a method of inquiry which uses nurses' situated, individual instances of nursing practice as the basis for developing knowledge for nursing and improving practice. This method of inquiry is founded upon the ideas in action science and reflective practice, and critical philosophy. Nursing practice is viewed as a rich source of new knowledge as practitioners are engaged in creating as well as modifying knowledge to respond to specific clinical situations. At the same time, practitioners may be in practice without recognizing deficiencies or ineffectiveness. As a method to tap these two aspects of practice, the inquiry is designed to encompass three phases, i.e. descriptive, reflective and critical/emancipatory, and is oriented to provide understanding to practitioners of the nature and meaning of their own practice, to correct and improve practice through self‐reflection and critique, and to generate models of `good' practice and theories of application as well as to discover processes of practice as played out in clinical situations. This method of inquiry can be used by nurses and nursing students in collaboration with researches or mentors to develop nursing knowledge about practice, improve individual practice, and engage in shared learning.
A longitudinal study into the perceptions of caring and nursing among student nurses
Authors: Watson Roger , Deary Ian J. , Lea Amandah
Published: March 2003

A longitudinal study into the perceptions of caring and nursing among student nurses

A longitudinal study of a cohort of student nurses was undertaken in order to investigate whether changes in perceptions of nursing and caring take place and how perceptions of nursing and caring are related. The Caring Dimensions Inventory (CDI) and the Nursing Dimensions Inventory (NDI) were employed for data collection at entry to nurse education and after 12 months. There were significant changes in the scores of a range of items in both inventories which suggested that student nurses lose some of their idealism about nursing and caring after 12 months in nurse education. While the overall ranking of items in the inventories was very similar, it was possible to distinguish between the inventories at entry to training and to observe a change, particularly in the CDI, over time by means of Mokken scaling. Nursing and caring would appear to become more synonymous to the student nurses after 12 months in nurse education. Factors scores, for factors identified in the CDI in a previous study, were used to investigate whether these scores changed at 12 months into nurse education compared with entry. No significant changes were detected.
A content analysis of staff nurse descriptions of job satisfaction and dissatisfaction
Authors: McNeese‐Smith Donna K.
Published: March 2003

A content analysis of staff nurse descriptions of job satisfaction and dissatisfaction

Job satisfaction of nurses has been studied, using quantitative methodology, but hospital staff nurse descriptions of the source of their job satisfaction and job dissatisfaction have rarely been examined. This study collected information from 30 staff nurses through semistructured, taped interviews. Using content analysis, interviews were coded and categories and themes were identified. Findings indicate that job satisfaction was derived from the following categories: patient care, environment, balanced workload, relations with coworkers, personal factors, salary and benefits, professionalism, cultural background of the nurse and career stage of the nurse. Themes related to patient care, the pace and variety in an acute care environment, relationships with coworkers and meeting personal and family needs were cited as particularly relevant to job satisfaction. Job dissatisfaction was primarily influenced by patient care, factors that interfere with the job and patient care, feeling overloaded, relations with coworkers, personal factors, organizational factors and the career stage of the nurse. Themes related to the following categories have the greatest influence on job dissatisfaction: feeling overloaded, factors that interfere with patient care, coworkers who do not provide good care and situations that feel unfair. The actual words of nurses were included to provide depth and substance to the categories and themes. A discussion was presented of the relationship of these findings to theory and to outcomes of quantitative research. These findings have implications for nursing practice, administration and education as the profession considers organizational and individual factors influencing nurses’ feelings about their job and prepares for future nursing shortages.
The impact of ‘Project 2000’ educational reforms on the occupational socialization of nurses: an exploratory study
Authors: Philpin Susan M.
Published: March 2003

The impact of ‘Project 2000’ educational reforms on the occupational socialization of nurses: an exploratory study

There is much in both nursing and sociological literature concerning the socialization of students into health care professions. In the case of nursing, concern has been expressed at the disparity between the values espoused by the educational establishment and those in the clinical areas. This study aimed to explore the changes in nursing occupational socialization since the implementation of recent educational reforms. Ethical approval was obtained from the local Research and Ethics Committee. The sample (n = 18) was drawn from qualified nurses working in a range of departments within three Welsh hospitals, half had undergone traditional training and half had received Project 2000 education. Data collection and analysis techniques were based on a grounded theory approach; this approach was deemed appropriate in that it allows the possibility of developing fresh perspectives on the subject without being too constrained by earlier studies. A strongly emerging theme from the data was that the nature of nursing socialization was related to the work contexts in which it was experienced; in particular respondents offered sharply contrasting accounts of nursing culture in ‘acute’ and ‘chronic’ areas of health work. The process of socialization was found to be harsher in acute areas with numerous instances of negative sanctions used to ensure compliance to ward culture, whilst in chronic areas occupational socialization was a more satisfactory process and nurses experienced less dissonance between ward and educational establishments. The size of this study mitigates against any firm conclusions; however, the early indications suggest that it would be a fruitful area for further research with a wider sample group drawn from diverse areas. This exploratory study suggests that the location of nursing work, in terms of whether it is in acute or chronic areas, is a determining factor in the experience of contemporary occupational socialization of nurses.
A systematic review of the relationships between written manual nursing care planning, record keeping and patient outcomes
Authors: Moloney Rhona , Maggs Christopher
Published: March 2003

A systematic review of the relationships between written manual nursing care planning, record keeping and patient outcomes

A systematic review of research literature published in English between 1987 and 1997 was carried out to test the hypothesis that care planning and/or record keeping in nursing practice has no measurable effect on patient outcomes. The study was limited to research applicable to acute in‐patient care and to non‐information technology based recording. A search strategy was agreed with the steering group and search terms refined as the study progressed. Using the guidelines from the University of York National Health Service Centre for Reviews and Dissemination ( NHS Centre for Reviews 1995), a data extraction proforma was constructed. An initial search revealed ≈300 possible abstracts for discussion. Further analysis limited this to 43 studies, of which 30 were rejected as having too little information. Of the remaining 13 studies, none was sufficiently robust to be included in the review. The hypothesis can be neither accepted nor rejected. This has important consequences for nursing practice and management and for research. A multi‐centre rigorous study is recommended.
Early parental interactions with and perceptions of multiple birth infants
Authors: Holditch‐Davis Diane , Roberts Dia , Sandelowski Margarete
Published: March 2003

Early parental interactions with and perceptions of multiple birth infants

The perceptions and interactions of mothers and fathers of seven sets of twins and one set of triplets were compared to those of parents of 49 singleton infants. Couples were typically interviewed together three times during the pregnancy and at 1 week and 3 months post‐partum. Two‐weekly observations of mother–father–infant interactions were conducted after the first postnatal interview. Three major themes were apparent in the interviews — the positive and negative specialness for multiple births, difficulties involved in managing more than one infant, and attachment issues — that were also evident during the observations. Although there were few differences in care‐giving and interactive behaviours between the multiple birth and singleton parents, the logistics of caring for more than one infant dictated that multiple birth infants were left alone more and looked at, talked to and held less often. Couples used different strategies to care for their infants, varying in both the extent to which they interacted preferentially with the infants and in the relative involvement of the mother, father and others.
The integration of comprehensive psychiatric/mental health care into the primary health system: diagnosis and treatment
Authors: Sokhela Nobesuthu Effie
Published: March 2003

The integration of comprehensive psychiatric/mental health care into the primary health system: diagnosis and treatment

This research study was funded by the Health Systems Trust in Cape Town through the University of Natal in Durban. Objectives The objectives of this study were to teach primary health care nurses to diagnose and treat common psychiatric conditions, to refer those patients whom they cannot handle, and to evaluate the implementation of these functions in their primary health care practice. Methods Twenty nurses from six clinics in one province of South Africa were trained, and implementation was studied. History taking, diagnosis, pharmacological treatment and referral were studied through record reviews. Record reviews were done by two independent psychiatrists, who achieved an inter‐rater reliability of 0·68. Results Record reviews showed that at the end of the project nurses could take substantially complete psychiatric histories in 89% cases, five axis diagnoses were correct in 63% of cases, and when STAT medication was prescribed it was appropriate in 92% of cases. Appropriate long‐term medication was prescribed in 60% of cases. Ethical issues Permission was obtained from the provincial office, the Municipal Offices and participating clinics. Informed consent was obtained by the registered nurses from all participating clients. Limitations The sample for the clinics was not representative of all clinics in the Eastern Cape but a representation of rural‐urban settings sampled from 20 clinics in a region. The sample of consumers was convenient and may not represent the client population in each clinic. For this reason the findings may not be a true reflection of the entire region, and generalization of the findings should be made at the utmost discretion of the reader.
Validation of the structure of the perceived meanings of cancer pain inventory
Authors: Chen Mei‐Ling
Published: March 2003

Validation of the structure of the perceived meanings of cancer pain inventory

This study examined the structure of a newly developed instrument measuring the meaning of cancer pain for Taiwanese patients. The Perceived Meanings of Cancer Pain Inventory (PMCPI) was developed based on Lazarus’s cognitive theory of emotion and on findings from qualitative interviews. The 27‐item PMCPI contains six scales: loss, threat, challenge, blame‐others, blame‐self, and spiritual awareness. Two hundred cancer patients from three hospitals in northern Taiwan who were experiencing pain were included in the study. A series of confirmatory factor analyses were conducted to test the fit of specified measurement models. The results indicated that only the loss, threat, challenge and spiritual awareness scales possessed good construct validity, while blame‐other and blame‐self failed to show a satisfactory fit with the data. Correlation coefficients among the scales were also estimated. Parallel‐item testing demonstrated that the items of each valid scale had the same factor loading and error variance.
Establishing the credibility of qualitative research findings: the plot thickens
Authors: Cutcliffe John R. , McKenna Hugh P.
Published: March 2003

Establishing the credibility of qualitative research findings: the plot thickens

Qualitative research is increasingly recognized and valued and its unique place in nursing research is highlighted by many. Despite this, some nurse researchers continue to raise epistemological issues about the problems of objectivity and the validity of qualitative research findings. This paper explores the issues relating to the representativeness or credibility of qualitative research findings. It therefore critiques the existing distinct philosophical and methodological positions concerning the trustworthiness of qualitative research findings, which are described as follows: quantitative studies should be judged using the same criteria and terminology as quanitative studies; it is impossible, in a meaningful way, for any criteria to be used to judge qualitative studies; qualitative studies should be judged using criteria that are developed for and fit the qualitative paradigm; and the credibility of qualitative research findings could be established by testing out the emerging theory by means of conducting a deductive quantitative study. The authors conclude by providing some guidelines for establishing the credibility of qualitative research findings.