bluuebunny/crossref_metadata_2025 huggingface dataset:
The meal situation in geriatric care — intentions and experiences
Authors: Sidenvall Birgitta , Fjellstrom Christina , Anna‐Christina
Published: March 2003

Meals in geriatric institutions are often served in a dining room The elderly patients — endowed with theor socialized table manners and diet habits — who enter this milieu are affected by diseases and handicaps, reducing their ability to eat In the present study individual patients’ meals in geriatric care institutions were studied with respect both to nursing staffs’ intentions and assessments of patients, as well as to those patients’ expenences and the amount of influence they expected to have The research approach was ethnographic Eighteen newly admitted, mentally orientated patients and their primary enrolled nurses were allocated The results indicated that the idea of both the nurses and the elderly patients was to reach a meal situation that was as natural and independent as possible Compared with the elderly patients, the nursing staff had broader standards for acceptable table manners, and carried out collective dining of all 18 The elderly patients strove to behave in accordance with their standards and suffered because of their own limited eating competence and the experience of other patients’ problems The elderly patients avoided expressing their needs, and some enrolled nurses thought they were prying if they asked questions about such issues These different, culturally dependent, perceptions resulted in care that was not congruent with the needs of the elderly patients
An evaluation of the adequacy of health visitor education for neonatal hip screening
Authors: Haugh Pauline E , Mason Carolyn , Trainor Bernadette P , Kernohan W George , Thompson Kathryn , Mollan Raymond A B
Published: March 2003

Congenital dislocation of the hip (CDH) affects two children per 1000, with potentially serious consequences Student health visitors in Northern Ireland learn screening techniques for CDH at a half‐day workshop at a regional hospital In order to evaluate the adequacy of this preparation, 71 qualified health visitors were surveyed to assess their knowledge relating to CDH, their views on the adequacy of the training, and their opinions about referral of positive cases Knowledge in some areas was poor and preparation was considered too short Direct referrals of positive cases to orthopaedic clinics, without a general practitioner acting as an intermediary, was a frequently cited desire Recommendations include extending the training for those involved in CDH screening while ensuring that experienced health visitors, from whom novices learn, are themselves using correct procedures
Knowledge and level of consciousness: application to nursing practice
Authors: Ingram Nigel
Published: March 2003

Assessing a patient's level of consciousness is a skilled part of nursing practice The epistemology of this activity is discussed using the four patterns of knowing identified by Carper It is suggested that all four patterns and their interaction are necessary for a practitioner to be able to carry out this activity with the necessary reliability and accuracy that good safe practice dictates A possible enhancement to how a practitioner gains this knowledge can be through the work of joint appointments, between education and clinical areas
Evaluation of a breast examination facilitation device
Authors: Leslie Nan S , Roche Bonita G
Published: March 2003

Breast self‐examination (BSE) is recommended in order to help women detect possible breast cancer early in its development Correct BSE performance has been shown tobe positively associated with breast lump detection ability Few women, however, report practising BSE, citing reasons such as dislike of touching one's own breasts, fear of finding a lump, lack of confidence in their‐ability to perform BSE The purpose of this study was to test a breast examination facilitation device (BEFD) for women, which would provide a teaching/screening tool, as well as a shield between breast and fingers for women who are reluctant to touch their breasts A sample of 36 registered nurses in the United States was asked to perform BSE on three separate occasions using a BEFD made of latex, paper or cloth on which a wedge pattern for BSE had beenimprinted Subjects found the BEFD to be a useful tool for teaching/learning BSE, and expressed a clear preference for the latex material One size of BEFD is not adequate for all women A smaller size for women who wear A and B cup‐size bras, and a larger size for women who wear C cup size and above, would be more acceptable
The application of the ideas of Frantz Fanon to the practice of mental health nursing
Authors: Hopton John
Published: March 2003

This paper is based on an extensive review of the published literature which refers to the clinical and social psychology of Frantz Fanon, and seeks to establish the relevance of Fanon's psychological thought to the practice of mental health nursing in the 1990s The writer sets out the key principles of Fanon's clinical and social psychology, and engages with the theoretical problems which arise from the close relationship between Fanon's psychological theories and his involvement with violent revolutionary politics After discussing the links between Fanon's unique psychology and the work of the anti‐psychiatrists of the 1960s and later critiques of mental health care, the writer argues that the development and adoption of a neo‐Fanonist approach to the practice of mental health nursing would address many of the problems of current mental health care practice In particular, the principles of Fanon's psychology address many of the concerns about disempowerment of service users which have been highlighted in work by feminist and anti‐racist writers, and by members of the Mental Health Service Users' Movement
Nurse educators’ perceptions of reflection and reflective practice: a report of a descriptive study
Authors: Burnard Philip , P BURNARD
Published: March 2003

The concepts of reflection and reflective practice have been widely discussed in the nursing literature Only a small amount of that literature reports research studies This paper offers the findings of a qualitative and descriptive study in which 12 nurse educators from various teaching institutions were interviewed about reflection and reflective practice The report identifies the findings of the study under the following headings reflection in nurse education, reflective practice in nurse education, nursing and the use of reflection, advantages and disadvantages of reflection and teaching reflective practice While many of the respondents reported positively and enthusiastically about reflection, a number also expressed views about its being a‘fashionable’ concept and one, as yet, of unproven value Various suggestions are made for further research in this field
Cambodian refugees' family planning knowledge and use
Authors: Kuhg Judith C
Published: March 2003

An ethnographic study was conducted within a Cambodian refugee community to discover information about Cambodian women's and men's knowledge and use of family planning methods This 18‐month study included participant observation at community and calendrical events, and within families' homes Open‐ended interviews were conducted with 53 informants from a variety of educational and socio‐economic backgrounds Both women and men were interviewed through a female bilingual interpreter when the informant lacked proficiency in speaking English Major findings include a lack of knowledge among the sample about how the family planning methods work in the woman's body, and concerns about side‐effects Implications include the need to include Cambodian women and men in the planning and implementation of family planning programmes
The nursing process re‐examined: enrolment and translation
Authors: Latimer Joanna
Published: March 2003

The current paper proposes a different way of considering the nursing process Extant theorizing of the nursing process as a framework to help teach or organize nursing is consistent with a‘diffusion model’of practice In line with this view, it is assumed that a set of best practices can be assimilated by theorists and then, through a process of‘diffusion’, implemented throughout hospitals and clinics (or wherever else nurses practise) Difficulties with implementing the nursing process are explained as due to inadequate resources, inadequate training or the‘context’of practice The nursing process is considered in the current paper in relation to processes of‘enrolment’and‘translation’As a model or framework the nursing process is both a technology and a set of arte facts through which nurses extend themselves in ways which help manage their interests and (re)constitute their identity Rather than researching practice as if there is a model of nursing to which nurses should conform, a different view of the nursing process emerges as one in which nurses enrol, and are enrolled by, managerialist and performative devices in their organizing and identity work
Transcultural nursing: a perspective derived from Jean‐Paul Sartre
Authors: Rajan Marie‐France Juneau
Published: March 2003

Transcultural nursing care is a well‐established theoretical framework. This theory, developed by Madeleine Leininger, can have an impact on clinical practice, academic preparation and nursing research. The heightened interest in applying transcultural care and the increased need to espouse this framework have been triggered by constant population changes. This paper defines transcultural nursing care and expands its definition further by comparing and contrasting it with Jean‐Paul Sartre's existentialist perspective. The two modes of existence as defined by Sartre are closely examined. Concrete examples are offered as cultural phenomena and the components of a cultural assessment are discussed and applied. The philosophical thesis is approached from a transcultural nursing perspective and existentialism is shown to serve as a foundation for transcultural nursing. The advantages and disadvantages of transcultural nursing practice and the preparation of transcultural nurses are finally addressed.
The moderating effect of demographic variables on coping effectiveness
Authors: Spitzer Ada , Bar‐Tal Yoram , Golander Hava
Published: March 2003

In spite of the theoretical recognition regarding the role of coping as a moderator, empirical findings indicate that it has only a modest effect as such This study was designed, therefore, to examine the moderating effect of demographic variables (DV) on coping effectiveness, i e active cognitive coping, avoidance coping and active behavioural coping The study sample was comprised of 12 male and 65 female patients with rheumatoid arthritis who were treated in three outpatient clinics of large hospitals in Israel Findings suggest that demographic variables do play an important, and somewhat surprising, role in the effectiveness of coping strategies to temper psychological distress Of the various demographic variables studied, marital status was found to have a significant effect on active cognitive coping and avoidance coping, and adherence to a religious belief system was found to have a significant effect on avoidance coping The implications of the results for coping effectiveness are discussed
The caring dimensions inventory (CDI): content validity, reliability and scaling
Authors: Watson Roger , Lea Amandah
Published: March 2003

Caring is an elusive phenomenon but this should not prevent the development and validation of reliable quantitative tools for studying this concept in large samples of nurses. The present paper reports on the content analysis of a questionnaire called the Caring Dimensions Inventory (CDI). The CDI was content validated in terms of existing conceptualization of caring and research in this area and also in terms of a nursing taxonomy and its representation in popular United Kingdom nursing publications. The CDI was administered to a large sample of nurses working in Scotland and data were obtained from 1430 qualified and student nurses. The internal consistency of the CDI items related to perceptions of caring was established and the scalability of a sub‐set of CDI items was demonstrated. The CDI scale was related to the constructs of age and sex of respondents. Possibilities for further analysis and development of the CDI are discussed.
Development and testing of the ethical reasoning tool (ERT): an instrument to measure the ethical reasoning of nurses
Authors: McAlpine Heather , Kristjanson Linda , Poroch Davina
Published: March 2003

Ascertaining the thinking of professionals as they are confronted with ethical practice issues is a prerequisite to understanding ethical decision making. Before researchers or educators can examine the effectiveness of various approaches to ethics teaching and learning, there is a need for reliable and valid tools to assess practitioners' cognition. A potential problem with the few measuring instruments currently available is the fact that they ask subjects to rank order existing lists of issues. This says little about an individuals' own thinking about ethical issues and may prompt thinking or responses which would not otherwise have occurred. This paper reports the results of a study to test the psychometric properties of a new instrument, the Ethical Reasoning Tool (ERT) that measures ethical reasoning of nurses. The ERT demonstrates a promising way to reveal unprompted ethical thinking about a practice dilemma, thereby clarifying ‘real’ versus ‘assumed’ professional reasoning. The tool allows nurse educators to identify areas of student learning/reasoning deficiency that can be addressed by educational interventions. The ERT also allows nurse educators to evaluate the effectiveness of nursing ethics study units in a trustworthy way.
A Critical review of the literature on sharps injuries: epidemiology, management of exposures and prevention
Authors: Hanrahan Anita , Reutter Linda
Published: March 2003

This article reviews the literature related to the epidemiology, prevention and management of sharps injuries in health care workers, particularly nurses, and the subsequent risk of harm. The studies are reviewed chronologically, beginning with the efforts to reduce sharps injuries by changing behaviours, followed by the introduction of barriers to protect the caregiver, and finally, the engineering of safer products. Initial efforts to prevent sharps injuries focused on placing rigid, disposal containers at the site where sharps were used and instructing health care workers to refrain from the practice of recapping. When these interventions were shown to alter the type, but not the overall number, of sharps injuries, alternative measures were sought. This search intensified with the increasing evidence of the small, but measurable, risk of the transmission of human immunodeficiency virus from sharps injuries. The current knowledge of the factors related to sharps injuries has been collected primarily through retrospective surveillance. This surveillance has been conducted primarily in hospital settings and has focused on the type of sharp and the purpose for which it was used rather than prospective research. Research is now needed to elucidate the organizational and behavioural factors leading to sharps injury both within the hospital as well as other health care settings. The implications for nursing practice are discussed.
The practice of health education in acute care setting in Hong Kong: an exploratory study of the contribution of registered nurses.
Authors: Twinn Sheila F. , Lee Diana T.F.
Published: March 2003

A multiple case study design was used to explore the practice of health education in acute care settings in Hong Kong. Two case studies, a medical ward and a surgical ward, were selected to reflected to reflect the real setting in which nurses carry out health education in acute care. Data collection methods involved the use of non‐participant observation and semi‐structured interviews. Seven nurses and eight patients were interviewed to explore their understanding of health education concepts, the use made in the wards of health education and the factors influencing such practice in the acute settings. Individual and cross‐case analysis showed that respondents' understanding of the concept of health education was limited to patient information‐giving. Although the importance of health education in acute patient care was acknowledged, the degree to which health education featured in nurses' practice was minimal. Many available opportunities for health education were missed and factors such as nurses' busy‐ness and the associated lack of time and staff were identified as influencing health education practice in these acute care settings. Implications for practice and future studies were discussed in the light of these findings.
Studying the future: a Delphi survey of how multi‐disciplinary clinical staff view the likely development of two community mental health centres over the course of the next two years
Authors: Beech Bernard
Published: March 2003

Two community mental health centres (CMHCs) in North Staffordshire, England were the sites for a recent Delphi survey of multi‐desciplinary clinical staff. The views of staff were sought on the likely developments over the next 2 years, at the CMHC where they worked. Each group of staff independently produced healthy numbers of suggestions, with few contradictions, and displayed predominantly positive attitudes, both towards particular suggestions and the future in general. Summarized results were classified within seven themes, producing similar distribution patterns for both CMHCs. The most frequently occurring themes were changing staff roles and CMHC functions and developments in therapies and skills. Mid‐placed themes concerned community development and communication/continuity. The least frequently reported themes covered general management, user involvement and quality assurance. Issues raised by the study are discussed and related to other published works, followed by consideration of how the findings might be utilized. Clinical staff have generated a large number of suggestions and, importantly, via rounds of confidential voting, indicated the group consensus on each item. Consequently, management of change should stand a high chance of success. Finally, one means of taking the findings forward is described.
Aggression in clinical settings: nurses’views
Authors: Farrell Gerald A.
Published: March 2003

Although much has been written about‘agression’from a variety of viewpoints, little systematic information has been gathered about what nurses see as‘aggression’. Also, it is not clear from previous reports just how important horizontal violence is for nurses compared with the other‘aggressions’encountered at work. A qualitative approach was adopted as this was an initial exploratory study to describe nurses’views regarding the nature and extent of aggression in the clinical setting. A total of 29 nurses were interviewed. Findings indicate that nurses are most concerned about their colleagues’aggression towards them. Colleague abuse ranged from non‐verbal innuendo to physical assault. Nurse managers were criticized for failing to implement supportive structures when aggression did arise (from colleagues or others) or to take appropriate action to prevent its recurrence. On a practical level much of the aggression reported can be seen as a breakdown in‘relationship rules’, i.e. staff failed to respect each other's privacy, were unwilling to help out, keep confidences and so on.
Using multi‐sensory environments with older people with dementia
Authors: Hope Kevin
Published: March 2003

This paper examines the utilization of multi‐sensory rooms as an adjunct to the care of older people with dementia. Their evolution into the field of dementia care is explored and analysed. The degree to which the aims of therapy can be realized is addressed in terms of process issues experienced whilst utilizing the therapy in practice. These are initiation of therapy, transfer of patients, selection of patients and resources. On the basis of these findings recommendations are offered, the focus of which is the active promotion of such therapy within the remit of trained nursing staff.
Breast self‐examination: an analysis of self‐reported practice
Authors: Persson Kerstin , Svensson Per‐Gunner , Ek Anna‐Christina
Published: March 2003

The aim of this study was to investigate the relationship between the performance of breast self‐examiniation (BSE) and age, place of residence, ethnic background and religion, as well as whether a group willing to take part in an interview regarding BSE mirrored the whole population. Six hundred and ninety‐four (69.4%) women, aged 25–80, responded to the questionnaire. Of gthese, 69.6% examined their breasts. Whether the subjects lived in urban or rural areas was of no importance for practising BSE, nor was country of birth or number of years in Sweden. A larger proportion of women aged 45–80 practised BSE compared with women aged 25–44 (P < 0.001), the former practising BSE once a month or more. Step‐wise logistic regression analysis showed that, for the whole sample as well as for the interview group, age was the only significant predictor of breast self‐examination (P < 0.001). There were no significant differences between the whole sample and the interview group. The importance of younger women performing the examiniation is stressed. Dur to nurses being strategically located in a wide range of geographical locations, allowing them to meet women in different settings, they are a good choice for motivating women to prctise BSE.
Childbirth confidence: validating the childbirth self‐efficacy inventory (CBSEI) in an Australian sample
Authors: Drummond Jane , Rickwood Debra
Published: March 2003

This study examined the reliability and validity of the Childbirth Self‐Efficacy Inventory (CBSEI) (Lowe 1993) in a sample of 100 Australian women. Consistent with US data, the measure was shown to have high internal consistency. Validity of the instrument was determined by applying self‐efficacy theory (Bandura 1982), which predicts that parity should have the largest effect on childbirth self‐efficacy, followed by knowledge, then support and finally anxiety. Results revealed that having a prior good birth experience and knowledge about childbirth had significant effects on childbirth self‐efficacy. A factor analysis was performed to determine whether the original factor structure of this instrument held for Australian women. While outcome expectancies and self‐efficacy expectancies emerged as distinct factors, the results showed that Australian women did not differentiate between active and second‐stage labour. Rather than the two stages of labour emerging as dimensions of the CBSEI, two externally focused coping strategies were revealed.
Backs to the future? Reflections on women, ageing and nursing
Authors: Bernard Miriam
Published: March 2003

There is now a certain amount of evidence to support the contention that ageism is not only rife amongst the population at large, but also amongst many of those who care for older people in a professional capacity. Given that many of these professionals are women caring for other women — and nursing is a prime example — this should at the very least give us serious cause for concern. This paper explores the relationship between ‘ageing women’ and ‘old women’ from the point of view of personal and professional attitudes and practices. It examines the proposition that until we, as women, fully explore and understand our own attitudes towards ageing and old age, we cannot work in ways which are truly beneficial and empowering for the older women in our care. The purpose of the paper is threefold. First, it reviews what is a relatively limited body of literature and research on this topic. Second, it reports on the preliminary findings from an exploratory study examining the attitudes of female nurses to their own ageing. Finally, it reflects further on the issues raised and considers some of the ways in which we can begin to address and confront the challenges which being ‘ageing women’ and ‘aged women’ in late 20th century Britain presents.
A survey of psychiatric nursing practice in two inner city acute admission wards
Authors: Ryrie Iain , Agunbiade Dayo , Brannock Lisa , Maris‐Shaw Andrew
Published: March 2003

In response to the British government’s Review of Mental Health Nursing this paper reports on a study which examined nursing practice in two inner city acute admission wards. Eight nursing staff maintained a record of their activities over a 7‐day period according to four operationalized variables. Qualitative detail was also collected to enable the specification of activities. The amount of time available for patient contact work is calculated and those activities which currently restrict opportunities for experienced nursing staff to have therapeutic interactions with their patients are identified. The findings do not differ markedly from earlier studies and some tentative conclusions are drawn concerning the therapeutic milieu within an inner city psychiatric in‐patient facility.
Mentally restorative experiences supporting rehabilitation of high functioning elders recovering from hip surgery
Authors: Travis Shirley S. , McAuley William J.
Published: March 2003

Because mentally restorative experiences are pivotal in the context of rehabilitation and recovery, a prospective descriptive study was designed to learn more about the opportunities for, locations, and actions taken by, a group of elderly people (n=8) over the age of 60 (average age=82·5) that resulted in agreeable or pleasurable states of mind and perceived improvement in their ability to pay attention. Both structured and unstructured interviews were used to describe elderly patients’ past and current patterns of and preferences for mentally restorative experiences. Data collection procedures were utilized during complete lengths of stay (range=14–62 days) in sub‐acute care. Results demonstrate that the actions elderly people take to create opportunities for mentally restorative experiences are related to past patterns of restorative activities, opportunities made available by the facility, special circumstances of their care, environmental limitations in the immediate care environment, and the degree to which external factors (such as family visits) are readily available. Implications for designing and managing the care environment are discussed.
Loss: an analysis of a concept of particular interest to nursing
Authors: Robinson David S. , McKenna Hugh P.
Published: March 2003

The term ‘loss’ is used frequently in the nursing literature and by nurses in the clinical setting. However, loss as a concept has not been defined comprehensively. In this paper, an attempt will be made to analyse the concept. The paper will begin with an overview of approaches to concept analysis. Subsequent sections include a literature review examining current and classic usage of the concept. General and specific definitions of loss provide a template for discussion. The paper will conclude with the identification of critical attributes for the concept which will form the basis for an exploration of explicit empirical referents.
Intellectual development and research: student nurses’ and student midwives’ accounts
Authors: MacVicar Margaret Hannah MacArthur
Published: March 2003

The way in which student nurses and midwives experience research in practice is described here through accounts from in‐depth interviews with 10 student midwives and nine student nurses while they were in the rostered service component of their pre‐registration diploma courses. Also reported here is an impressionistic model of their intellectual development in relation to research which has been created inductively from the same data and which offer a new line of inquiry on the research to practice problem. Although this research is primarily concerned with these particular students it is of general interest since there may be a level of intellectual development which is a necessary condition to being able to initiate and use research in practice.
Bridging the gap between theory and practice: a supervision programme for nursing students
Authors: Severinsson Elisabeth I.
Published: March 2003

This paper describes nursing students’ views of a supervision programme provided during the second semester of their education, which was their first period of nursing practice. A form with open questions and a 24‐item questionnaire were completed by the 28 nursing students. The analysis of their responses was a combination of factor analysis and grounded theory approach, based on comparative analysis. The results indicate two specific effects of the programme: personal growth and integration of knowledge. The process of creating knowledge includes four stages: awareness of concepts and phenomena, development of a ‘language of caring’, development of a ‘model’ of communication, and reflection gained as an effect of the intervention. The nursing students reported that reflection was a way to bridge the gap between theory and practice. Their views of the effect of the supervision showed high values for the following three factors: improved interpersonal skills, improved professional skills, and improved communication skills.
Nurses’ perceptions of their work environment in a Nursing Development Unit
Authors: Avallone Isabelle , Gibbon Bernard
Published: March 2003

This descriptive study examined nurses’ perceptions of their work environment in a Nursing Development Unit (NDU). A postal survey of 70 nurses working in three NDUs was conducted using the Work Environment Scale (WES) for data collection. The response rate was 76%. The aggregate scores from the WES indicate that the nurses surveyed were satisfied with their work environment. The ratings for the 10 subscales of the WES were higher than the norms given by the authors of the scale. However, the findings do not fully support the literature and previous research into nurses’ satisfaction in NDUs. A significant finding of the study was the marked difference, in satisfaction with the work environment, between the three units surveyed. It is suggested that a larger scale study should be carried out to explore whether the findings of this study are reflected in other NDUs. Research into the management of change in NDUs is also suggested.
Are practice nurses an unexplored resource in the indentification and management of alcohol misuse? Results from a study of practice nurses in England and Wales in 1995
Authors: Deehan Ann , Templeton Lorna , Taylor Colin , Drummond Colin , Strang John
Published: March 2003

Changes in the health promotional work undertaken in primary care, including the work needed to meet the ‘Health of the Nation’ alcohol targets, have led to a rapid expansion of the number of practice nurses in England and Wales. However, there has been little evaluation of this role. This study provides data, for the first time at a national level, about practice nurses’ work in identifying and managing patients drinking above recommended sensible guidelines. Data were collected by postal questionnaire from all nurses in a 50% random sample of 1852 practices (drawn from a general practitioner (GP) national study, undertaken at the same time). 43% of nurses responded from 62% of the targeted practices. Respondents reported identifying a mean of 3·1 patients per month who were drinking above recommended sensible guidelines. These patients tended to be male, above 40 years of age and in contact with the nurse for the first time about this problem. Most patients were categorized as having a potential alcohol problem; few were classified as currently dependent. Very little intervention work was undertaken by nurses except for referral to the GP. If real progress is to be made in meeting the ‘Health of the Nation’ targets on population alcohol consumption, then primary care work in identifying alcohol misusing patients needs to be developed as a matter of urgency. The patients identified by practice nurses are those patients relevant to the ‘Health of the Nation’ alcohol targets. More emphasis needs to be placed on the valuable contribution practice nurses can make, particularly through the use of screening instruments and brief interventions.
An exploratory study of demand for the health visiting service within a marketing framework
Authors: Collinson Suzan , Cowley Sarah
Published: March 2003

A small exploratory study was carried out to consider the concept of demand for the health visiting service from the clients’ perspective. Because of the internal market introduced to the British health system under the National Health Service and Community Care Act, the idea of ‘marketing’ was used as a conceptual framework to underpin the study. Guided interviews were carried out with a sample of nine mothers of pre‐school children to elicit the reasons why clients access the service, what they value about it and how they think it could be improved. A detailed qualitative analysis of these data indicates that demand for health visiting relates, in the first instance, to clients’ knowledge of the service. This knowledge, and the extent to which the service meets their expectations, appear to influence the value the women place on health visiting and their subsequent use of it. A cycle is described, which illustrates critical points at which health visiting responses affect demand and use of service. The implications of the study for health visiting and for marketing the service are discussed.
Socialization and personal change: a personal construct psychology approach
Authors: Buckenham Michael A.
Published: March 2003

Socialization and personal change: a personal construct psychology approach As we enter the world of work we are socialized into the role we are to perform, and also into the ethos of the organization where we are to work. This socialization is argued to be both a normative and individualistic process. Studies on socialization which concentrate on the social elements tend to identify the commonalities or normative aspects of this change. Studies which have analysed the cognitive elements tend to identify the idiosyncratic aspects of the change. This paper presents Kelly's theory of Personal Construct Psychology (PCP) as a technique for analysing this change which can identify both the normative and ideographic changes if these are present. This paper gives a brief account of the theory prior to concentrating on the specific treatment of self and change in self (the experience cycle). It is argued that use of PCP theory can assist in understanding not only the changes that occur during socialization, but also other changes, and training needs, that individuals may experience within their working life.
Trends in community care and patient participation: implications for the roles of informal carers and community nurses in the United Kingdom
Authors: Kirk Susan , Glendinning Caroline
Published: March 2003

This paper argues that the interfaces between formal and informal care‐giving are changing as a result of two current trends; the increased scope of home‐based nursing care and the emphasis on participation both within nursing and in the wider health and social care arenas. These various changes are explored in relation to the provision of intensive and complex nursing care in the home. It will be argued that the changing interfaces between formal and informal care have important implications for the respective roles of nurses and informal carers which hitherto have been relatively overlooked. These implications urgently need addressing in research, policy and public debate if professional nurses are to provide appropriate help and support to informal carers.
The practice and perception of intensive care staff using the closed suctioning system
Authors: Blackwood Bronagh
Published: March 2003

The practice and perception of intensive care staff using the closed suctioning system¶Tracheobronchial suctioning using the closed suctioning system (CSS) has physiological benefits for critically ill patients. Despite these benefits, nurses have raised concerns about the CSS. The aims of this study were to identify concerns, count how frequently they occurred and examine the relationship between the concerns and the experience of the operators. Experience was defined as length of time working in an intensive care unit (ICU) and length of time using the CSS. Using a field research approach, six major concerns were identified: showering of condensate from the flush port over the hands of staff; difficulty cleansing the inner tube after use; ineffective secretion removal; disconnecting the CSS to use conventional catheters; ‘sticking’ of the CSS in the endotracheal tube; and possible tracheal trauma as observed by blood stained secretions. Based on these findings, a data collection form was developed and over an 8‐week period, 75 staff completed 923 forms. The findings indicated that although these concerns occurred frequently (up to 66% of the time), there was no relationship between their frequency and the experience of the operator. The study concludes that, if used appropriately, the advantages of CSS outweigh the disadvantages. Policies and guidelines should be developed to redress issues of secretion removal and infection risks to maximize effectiveness of the CSS for critically ill patients.
Health promotion and health education: what role should the nurse adopt in practice?
Authors: Norton Lavinia
Published: March 2003

Health promotion and health education: what role should the nurse adopt in practice?¶ Health promotion is widely accepted as part of the role of the nurse, midwife and health visitor. Theoretical definitions of health promotion and health education are presented. The author suggests that a variety of different approaches to health promotion can be adopted by nurses in practice, including education, persuasion, manipulation and attempts to promote an environment where healthy decisions about lifestyle can be made. Each strategy is examined and the advantages and the ethical limitations are explored. It is suggested that nurses may theoretically accept the notion of being a health promoter, but that in the reality of practice, their role may be primarily that of the health educator. The importance of recognizing that there are a variety of determinants of health, including social and environmental factors, as well as individual lifestyle, is emphasized throughout the paper.
Named nursing: in whose best interest?
Authors: Steven Alison
Published: March 2003

Named nursing: in whose best interest?¶ This paper explores certain influences and issues surrounding the implementation and application of the named nurse concept. The author critically examines the proposals that primary nursing increases job satisfaction, cost effectiveness and quality of care, and suggests that as primary nursing appears to be the template for named nursing, these are factors which may have influenced the former British government's decision to implement the concept of named nursing. Owing to problems regarding the reliability and validity of much of the research, the author draws the conclusion that the direct extrapolation from one concept (such as primary nursing) to another (such as named nursing) is perhaps open to question. The author also analyses other issues related to the implementation and use of the named nurse concept including advocacy and accountability, and proposes that the introduction of individualized care, and in particular named nursing, perhaps serves the drive towards the professionalization of nursing first, and the patient second, and if so questions whether there is a need to reconsider the aim of nursing.
Nurse prescribing: radicalism or tokenism?
Authors: McCartney William , Tyrer Stanley , Brazier Margaret , Prayle David
Published: March 2003

Nurse prescribing: radicalism or tokenism?¶The creation of
The Medical Products (Prescription by Nurses, etc.) Act 1992 has been generally welcomed by the nursing profession. This article seeks to introduce a note of scepticism about the assumed motivations for its introduction through an analysis of various legal, ethical, economic and political dimensions. In reviewing the position of nursing vis‐à‐vis medicine it is argued that one of the ways that nursing has sought to improve its professional position is to take on work previously done by doctors, and nurse prescribing can be seen in the context of the concurrent de‐regulation of medicines, allowing greater access to medicines and therefore greater consumer choice. This de‐regulation stems from the liberation ideology of the previous Conservative government. Viewed in this way nurse prescribing, particularly with reference to the limited nature of the nursing formulary, can be seen to be anomalous. In the light of this analysis, the reasons generally put forward (notably in the Crown Report 1989) for the introduction of nurse prescribing could be seen to be peripheral to its real purpose. It is argued that the most convincing reasons for its introduction relate to the medical profession as a social institution. It is proposed that the three primary aims behind the introduction of nurse prescribing are: the saving of money; the transfer of routine medical work to nursing; and a challenge to the professional monolith of medicine.
When I grow up I want to be a…? Where undergraduate student nurses want to work after graduation
Authors: Happell Brenda
Published: March 2003

When I grow up I want to be a...? Where undergraduate student nurses want to work after graduation¶It is assumed that the majority of students undertaking undergraduate nursing education want to become nurses. Little research, however, has examined the specific areas in which students intend to pursue their careers after graduation. This paper reviews the results of the author's research, which clearly indicates that students have firm preconceived ideas as to the areas in which they wish to practise in the future. Midwifery, paediatrics, operating theatre and critical/intensive care are highly favoured, while working with the elderly, psychiatric nursing and community health nursing are significantly less popular. The implications of this situation for the nursing profession are considered.
The management of post‐operative nausea and vomiting
Authors: Thompson Hilaire J.
Published: March 2003

The management of post‐operative nausea and vomiting

Despite the advent of new technology and pharmacological agents, post‐operative nausea and vomiting (PONV) continues to have an incidence of 20–30% today. Development of PONV can lead to serious complications such as aspiration, dehydration, electrolyte disturbances and disruption of the surgical site. PONV leads to increased cost of treatment, and may be associated with increased anxiety, dissatisfaction with the surgical experience and anticipatory nausea in the future. The mechanisms of PONV are examined with associated risk factors. A review of the literature of PONV management is included covering pharmacological, dietary and behavioural interventions; culminating in the development of assessment and management guidelines and identification of areas for further study.
Sleep and quality of life assessment in patients undergoing coronary artery bypass grafting
Authors: Edéll‐Gustafsson Ulla M. , Hetta Jerker E. , Arén Claes B.
Published: March 2003

Sleep and quality of life assessment in patients undergoing coronary artery bypass grafting

Objective: To examine sleep before and after coronary artery bypass grafting (CABG) as well as measuring of quality of life (QoL), and to see if changes in subjectively rated sleep can be shown objectively by polysomnographic recordings. Sample: A consecutive sample of 38 male patients, aged 45–68, underwent CABG, Twenty‐two patients were graded in New York Heart Association (NYHA) classes III or IV, and 16 in class I–II before surgery. Methods: 24‐hour polysomnographic recordings, using the Oxford Medilog 9000 recorder, were performed 2 days prior to surgery, on the first 2 post‐operative days and 1 month after surgery. The Nottingham Health Profile instrument (NHP) was used to measure QoL before and after surgery. Results: Following surgery there was a profound decrease in sleep at night, and an increase in daytime sleep. During the second post‐operative recording period nocturnal sleep duration was reduced to 253·6 ± 94·1 minutes, with suppressed stages 3 and 4 sleep and lack, or slight recovery, of REM sleep. Even though there were evident changes in both the distribution and nature of sleep at night, daytime sleep increased and the total duration of sleep during the 24‐hour period was not significantly changed. The total sleep time was 421·1 ± 76·8 minutes before surgery, 483·2 ± 201·2 in the first period, 433·2 ±201·4 minutes in the second 24‐hour period post‐operatively and 443·2 ± 44·0 minutes at the 1‐month follow‐up. The NHP instrument demonstrated that 6 months after surgery the quality of life was significantly improved. Polysomnographically measured slow wave sleep was compared with the sleep section in the NHP instrument both before surgery and at 1 month post‐operatively. Conclusions: In the immediate period following CABG, there is a change in distribution of sleep, with reduction in nocturnal sleep duration and an increase in daytime sleep, which had almost returned to pre‐operative values 1 month after surgery. QoL scores were improved 6 months after surgery. This study demonstrates the importance of careful assessment of sleep and sleep disturbances for more individualized nursing care in order to promote sleep in the immediate post‐operative period.
Using a women’s health perspective to guide decisions made in quantitative research
Authors: Timmerman Gayle M.
Published: March 2003

Using a women’s health perspective to guide decisions made in quantitative research

Women’s health, as an emerging area of nursing scholarship, is based on a set of philosophical assumptions. These assumptions are: (i) women’s health can best be understood by examining women’s lived experiences within a specific context; (ii) gender bias must be avoided; (iii) the focus should be on health rather than illness; and (iv) non‐exploitative relationships should be established between the researcher and research participants. Assumptions from a women’s health perspective can be used by researchers to guide decisions made in conducting research with women. In order to strengthen the correspondent validity (i.e. the fit between theory and methods), research decisions need to be consistent with the philosophical assumptions of the inquiry. Examples of quantitative research decisions influenced by a women’s health perspective are illustrated using a study of binge eating in women.