bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between burnout and job satisfaction in nurses
Authors: Dolan Sister Nuala
Published: December 2006

Nursing is a stressful occupation. This study, carried out on two groups of nurses, confirms the thesis that job satisfaction as measured by the Job Satisfaction Questionnaire designed for this study was a reliable indicator of burnout. It was expected that an inverse relationship between job satisfaction and burnout would be found. The hypothesis was that high job satisfaction would be associated with low burnout. It was found that a relationship exists between job satisfaction as measured by the Job Satisfaction Questionnaire and burnout as measured by the Maslach Burnout Inventory.
Student and qualified midwives’ attitudes to aspects of obstetric practice
Authors: Todman John B. , Jauncey Linda
Published: December 2006

Midwife groups qualified for less than 5 years, 5–10 years and more than 10 years, and a group of student midwives, expressed degrees of agreement/disagreement with statements relating to aspects of obstetric practice. Responses were factor analysed and six interpretable rotated factors were obtained. Factors 1 to 3 represented ‘patient‐centred’ attitudes to obstetric issues of increasing technicality. Factor 1 could be construed as a broad attitude to women's rights, factor 2 as an attitude to pregnant women's preferences being the main determinant of obstetric decisions of a relatively non‐technical nature and factor 3 as an attitude to pregnant women exercising control in relation to obstetric decisions where technical expertise may be a major consideration. Different patterns of factor score differences between the four length of qualification groups and between student nationality subgroups were found for these factors. Implications of these distinctive patterns for the training of midwives are discussed.
Multi‐dimensional approach: a task for curriculum development
Authors: Yuen Felix
Published: December 2006

Curriculum development is an issue of continuing concern to nurse educators. For the planning model to be effective, it must be compatible with, and actually facilitate, the implementation of the particular programme or practice that is to be used. In nursing, the process of curriculum construction is predominantly influenced by the linear approach. This planning model which has taken over nursing education at all levels and in all content areas seems neutral, but it is not. It carries with it a particular value position on human nature. This paper examines the value position of the linear model and its limitation, and proposes a multi‐dimensional model as a possible alternative.
The process of translating research findings into nursing practice
Authors: Hunt Maura
Published: December 2006

Action research studies are described which involved nurse teachers, ward sisters and nurse managers in the processes of: (a) nursing practice problem identification and the search for relevant research literature; (b) the evaluation and synthesis of the collected literature; (c) the identification of the need to change practice and the translation of the research synthesis into practice if warranted. The processes engaged in by the groups in each of the three phases in relation to the management of mouth care and preoperative fasting are analysed. The findings suggest that the demands of these processes are beyond the capacity of any one individual nurse and require systematic organizational approaches such as that proposed by quality assurance programmes. The need is emphasized for as much status and resources to be expended on the utilization of existing information as is given to the generation of new knowledge.
Smoking behaviour of student nurses enrolled in diploma, associate degree and undergraduate nursing programmes
Authors: Rausch Judith Cartledge , Zimmerman Grenith , Hopp Joyce , Lee Jerry
Published: December 2006

Because the literature shows that (1) cigarette smoking is a major causative factor in the occurrence of chronic illness, (2) lung cancer is becoming more common in women than breast cancer, (3) nurses smoke more than any other group of health care providers and (4) studies have not examined differences of smoking among the associate degree, undergraduate and diploma levels of nursing, this study was designed to examine selected health behaviours and their relationship to cigarette use among Alabama senior student nurses, and to determine smoking prevalence by level of educational preparation. A sample of senior associate degree, undergraduate and diploma student nurses in Alabama responded to an 87‐item questionnaire which was personally administered by the investigator in a classroom setting. Twenty‐two of the 87 items were used to compile the demographics, prevalences and health behaviours reported here. The remaining items were used to develop a sequence of information required to test Ajzen and Fishbein's Theory of Reasoned Action and are beyond the scope of this article. Though there was no significant difference of smoking prevalence among educational levels, there was a trend for increased smoking from undergraduate to diploma level with prevalences of: total sample, 26.2%; diploma, 30%; associate degree, 26%; and undergraduate, 24%. Health behaviours which were significantly different between smoking and non‐smoking student nurses were breakfast frequency and coffee consumption. Having a regular exercise routine was not significant. Males smoked significantly more than females. More older nurses (over 40 years) smoked than younger nurses. The findings reported here are useful to the development of health education strategies designed to reduce and prevent cigarette use among student nurses. Nursing education can play an important role in preventing smoking among nurses.
The journal publication process: the perspective of the nurse author
Authors: White Jane H.
Published: December 2006

This study's purpose was to describe the journal publication process from the perspective of the nurse author. A survey was mailed to 226 nurses who had published an article during the 1‐year period. A variety of clinical, research, educational and administrative nursing journals were used to select the sample. Results suggested that authors: find communicating with editors helpful; think time from acceptance to publishing is too lengthy; publish to share their information and contribute to the body of nursing knowledge rather than for career advancement; generally do not use enquiry letters; and many did not know if the journal to which they submitted was referred. Further research on the views of authors who have had manuscripts rejected would clarify whether this process is similar for all authors.
The World Health Organization's regions of the Eastern Mediterranean and Europe: ageing of the population and nursing care
Authors: Hirschfeld Miriam J.
Published: December 2006

This paper discuses the context and implications of nursing as a social force in regard to quality of care for the aged. The demographic transformations and its consequences in the WHO regions of the Eastern Mediterranean and Europe are discussed in their relation to socio‐political, economic and educational developments and epidemiological changes. It is postulated that nursing has the choice of becoming a social force through raising its awareness of the new reality of a sizeable dependent population with chronic diseases. Nursing knowledge and research, the sharpening of political skills and the refinement of caring skills have the potential for influencing health care policy and long‐term care services toward quality health care for the aged. Special attention is given to the use and misuse of concepts as self‐care and appropriate technology. The final proof of nursing's willingness and ability to act as a social force will be in the allocation of efforts and resources in different countries. The value of nursing's contribution to the actual care of the aged will depend upon careful ethical considerations, as much as upon knowledge and influence.
Planning and evaluation of cross‐cultural health education activities
Authors: Nolde Tania , BSN Carol Smillie
Published: December 2006

This paper was written to assist health professionals who are or who are planning to undertake health education activities with people of a different culture. The focus is on the educative function of health promotion. A short summary of relevant learning theory is presented. Some obstacles (pitfalls) encountered in cross‐cultural transfer of information, knowledge and skills are presented and the effects of this learning process on the learner and teacher are explored. Examples of possible conflict situations drawn from the author's experiences and research are presented. Variables which influence planning and implementation of health education in cross‐cultural settings are examined. A cyclical model which identifies critical questions to be asked and decisions to be made in a four‐phased process of assessment, planning, implementation and evaluation is described for the use of health educators in transcultural settings. The need for systematic cultural assessment prior to planning is stressed to ensure relevancy, acceptance and positive outcome of programmes. Cooperative efforts of health educators with existing systems and traditional teachers and involvement of clients during all phases of the decision making process are suggested.
Community psychiatric nursing intervention in an accident and emergency department: a clinical pilot study
Authors: Storer David , Whitworth Roger , Salkovskis Paul , Atha Chris
Published: December 2006

In a pilot study, 99 patients referred from a general hospital accident and emergency department were seen by a community psychiatric nurse (CPN) using a time series design. They were categorized into those patients having a previous psychiatric history and those with none. The level of service use for the 6 months immediately prior to CPN intervention, 6 months following referral, and 6 months of follow‐up indicated a very high level of psychiatric and general medical service use by this group. Referral to the CPN was associated with substantial reduction in the demands on other ser/ices made by the group with previous psychiatric history. The group with no previous history showed a decrease in total service usage at follow‐up.
Raising standards of clinical practice — the fundamental issue of effective nursing practice
Authors: Kitson Alison L.
Published: December 2006

The proposition put forward in this paper is that standards of nursing practice can only be assured if the profession is able to find ways of responding to the intuitions and gut reactions of its practitioners. Rather than deny them, nurses have to know how to test and thus legitimize them. Such a validation process demands more clinically based nursing research projects and the proliferation of arrangements such as clinical nursing practice units. It is further argued that by linking the intuitive and rational aspects of nursing in this way the profession is in a better position not only to fulfil its societal obligations but also to build up its own knowledge and skills.
Stigma and psychiatric day care
Authors: Teasdale Kevin
Published: December 2006

Comparatively little is known about the stigma which attaches to psychiatric day care, as opposed to in‐patient care. This study uses grounded theory to analyse the views of 21 clients of a psychiatric day unit. The results suggest that clients have difficulty in interpreting their reasons for continuing to attend the unit, and that these difficulties are connected with a fear of being labelled ‘mad’. The issue of stigma management was important to the clients, and some thought that the move to a locally‐based service would exacerbate problems by reducing the number of available stigma management strategies.
Persons and humans
Authors: Henry C. , Tuxill A. C.
Published: December 2006

This paper examines the concept of a person, in particular in terms of its relationship with the concept of human. It discusses the function of person as a concept and the purpose of making a distinction between human and person and allocating all the value connotations of the two terms to person. An examination of possible definitions of person follows, divided into those dealing mainly in intrinsic features, centrally rationality and self consciousness, and those dealing with the concept as it functions as a relation in terms of role or status. Finally, possible accounts of the relation between human and person are considered and ‘potential’ is identified as a way of linking the two.
The relationship between quality of nursing care and the ward as a learning environment: developing a methodology
Authors: Smith Pam
Published: December 2006

This paper describes the development of a methodology to study the relationship between quality of care received by patients and the quality of the ward as a learning environment for nurses in training. Firstly, the literature review and background literature to the research question are described. Secondly, the methodology or rationale for the choice of methods is discussed. Key research perspectives include (a) the role of the participant observer in generating low level grounded theory or working hypotheses and (b) triangulation of the data using a multi‐method approach. The organization of the project is outlined schematically and the research setting and data collection described. The final section of the paper discusses preliminary findings as illustrative of the grounded theory approach, i.e. the analysis of the data as they are collected and the formulation of working hypotheses to be tested and developed as the research progresses.
Towards effective clinical teaching in nursing
Authors: Won Julia , Wong Shirley
Published: December 2006

During the last two decades, the structure and function of clinical learning and teaching have undergone significant changes. Nursing students demand quality teaching rather than supervision in the clinical area alone. At the same time, expectations and demands of university nursing faculty also change. Nurse educators are under increasing pressure to engage in scholarly activities. Clinical instruction in baccalaureate nursing programmes becomes the primary responsibility of either the inexperienced or part‐time, sessional instructors. This pattern of faculty teaching assignment is not without problems. This paper critically examines these problems and proposes strategies for dealing with them.
A model to guide development and application of multiple nursing theories
Authors: Kristjanson Linda J. , Tamblyn Robyn , Kuypers Joseph A.
Published: December 2006

Over the past decade there has been an explosion of interest and activity in the nursing profession directed toward the development of a theory base for nursing education and practice. Although we support the overall thrust of nursing theory development, we have concerns about its utility, scope and stated purposes. We are especially sensitive to the plight of the practising nurse who might attempt to use the current nursing theories to guide and explain choices made in daily practice. In this paper we examine current use of the word ‘theory’ and describe problems inherent in nursing's efforts to apply educationally derived conceptual frameworks to nursing practice. We identify a need for the development and use of many theories for nursing and argue that there is a logical need for a ‘meta‐model’ which will guide the use of multiple theories in practice. A model is presented which allows the practising nurse to examine the various theories in terms of their applicability to a given client situation. We believe the model is also useful to nurse educators and researchers who may be attempting to use nursing theories for educational purposes or develop nursing's knowledge base through empirical work.
Higher education: the coping stone of nursing education?
Authors: Gibbs Ian , Rush Brenda
Published: December 2006

For many years the nursing profession in the United Kingdom has sought ways of improving the education of nurses. The present article explores some of the issues surrounding the recent proposals for an alternative to the long‐standing apprenticeship system, namely that of moving basic nurse education into institutions of higher education. In particular, it focuses upon and explores the views of clinical nurse teachers and nurse tutors. In order to provide an historical context, the article begins by outlining the history of nurse education over the last century with reference to the various reports that have been published throughout the period. Before discussing the results of a questionnaire completed by those currently involved in the training and education of nurses, the article also considers the experience of other countries where collegiate education for nurses has been introduced.
Chronic illness and compliance
Authors: Cameron Keltie , Gregor Fran
Published: December 2006

For a person with a chronic illness, life is altered in some way. Whether simple or complex, changes are nevertheless permanent. A patient with a chronic disease assesses recommended treatments on how well they can be integrated into his life. Evidence suggests that an individual's perception of his situation will determine whether or not he will comply with a medical regimen. Health professionals neglect the patient's point of view if they believe that patients regard the health professional as an absolute authority, thereby contributing to non‐ compliance. The contingency contract provides a model of patient‐provider transaction, which requires input from both parties. The health professional can work with the person to make the medical regimen compatible with the individual's lifestyle.
First impressions: paradigms for patient assessment*
Authors: Price Bob
Published: December 2006

The interview that the nurse completes with a patient on his admission to hospital may be seen as one more negotiated step within a patient career that may span many years. Nevertheless, the nurse's assessment of the patient marks a key point in this career, his entry into a formal institution. It also marks the starting point of a planned intervention on the part ofthe nurses involved. Whilst such interviews have traditionally not been seen as important as that with the consultant, they are likely to have a significant effect upon how patient and nurse subsequently interact. This paper describes a research project which sought to identify the ways in which student nurses formulate an assessment of a patient on admission. A qualitative research methodology was used and a symbolic interactionist perspective employed.
Study of patients with indwelling catheters
Authors: Roe Brenda H. , Brocklehurst J. C.
Published: December 2006

Indwelling urethral catheters are used for the long‐term management of intractable urinary incontinence or bladder outlet obstruction with resultant retention of urine. There are welldescribed problems associated with their use including urinary tract infections and mechanical problems. Urinary tract infections have been well researched, however mechanical problems associated with blockage of the catheter lumen due to encrustation, leakage of urine and general discomfort, have been the least investigated. To date, there has been no research of patients’ views, understanding or feelings in relation to their catheters. This paper comprises a preliminary investigation of patients’ understanding and knowledge of their catheter's location and function, its acceptance, problems associated with its use, social implications and its subsequent management. Thirty‐six patients from the community of one health district were surveyed. It was concluded that an indwelling catheter is a prosthesis which, to be successful, requires adequate patient education and management. Education of the patient and carers is particularly important since an understanding of the catheter and its function will lead to better acceptance of the device and will enable better management of the urine drainage system.
The Delphi technique: a critique
Authors: Goodman Claire M.
Published: December 2006

The development of the Delphi technique, as a survey method of research, and examples of its use are described. The technique's key characteristics, anonymity, use of experts and controlled feedback, are examined. The method's usefulness in structuring group communication for the discussion of specific issues and as an aid to policy making is discussed in the light of the technique's perceived drawbacks and limitations.
Partnership in care
Authors: Armstrong C. A. , Lacey B. , Sandilands M. , Browne K. D.
Published: December 2006

The Alberta Child Health Passport was developed to provide parents and health professionals with a shared record of the child's health, growth, development, immunization and contacts with health services. A structured evaluation ofthe passport, and survey ofthe views of mothers and community nurses using it was carried out. The need for such a record was confirmed by those questioned. Responses also helped to identify sections ofthe booklet that are particularly useful and those which might be modified or removed. The passport is seen as having considerable advantages in improving the relationship between health professionals and clients.
Factors related to progress towards completion of correspondence courses in a baccalaureate nursing programme
Authors: Billings Diane M.
Published: December 2006

This study focuses on the instructional technique of correspondence instruction—the learner, the setting, and the problem of course non‐completion. The purpose of this study was to develop a model of completion of correspondence courses which identifies factors related to progress towards course completion. The objectives were to estimate the model and identify factors associated with course completion. The causal model for this study was adapted from Bean's synthetic model of student attrition from institutions of higher education. Data to test the model were obtained from a questionnaire, transcripts, and progress records of students enrolled in independent study programme courses and declaring a nursing major. Eleven variables in the model estimated in this study accounted for 44% of variance in course progress. Students making progress intended completing the course in 3 months, submitted the first lesson within 40 days, had high SAT scores and GPAs, completed (and did not drop) other correspondence courses, perceived family support but not employer support, had high goals for completing the programme and obtaining the BSN, lived closer to the instructor, and entered the nursing programme with college preparation (as a registered nurse). The model can be used for understanding and explaining progress toward course completion as well as the distance education setting of correspondence instruction. The intent variable explains most variance and can be measured while students are enrolled in the course. The lesson submission variable is theoretically justified.
Factors associated with student and pupil nurse wastage
Authors: Lindop Edward
Published: December 2006

The records of student and pupil nurses who discontinued nurse training within the North Staffordshire Health Authority between the beginning of 1981 and the end of November 1986 were examined. The reasons for leaving were classified according to comments made by the learners themselves as well as impressions of tutorial staff. Nine categories for leaving were formed for students and pupils. Stress and unsuitability for nursing were significant factors in student wastage while stress was of high significance in relation to pupil wastage.
The nursing process: the effect on patients' satisfaction with nursing care
Authors: RMN David A. Richards , RMN Pat Lambert SRN
Published: December 2006

This study compares the effects of the nursing process and traditional care in a patient population where the environment, nurses, other multidisciplinary team members and the nursing model were the same for two patient groups. Both groups were nursed using traditional therapeutic community techniques. One group also received care using a nursing process approach. Patients in the nursing process group did not feel nurses were significantly more therapeutic nor were they more satisfied with their care.
The impact of nursing theory on the clinical decision making process
Authors: PDh Peggy Anne Field RN
Published: December 2006

The concepts of the nursing process and nursing diagnosis are related to models of nursing. The use of nursing diagnosis in relation to Orem, Neuman and Roy's models is presented. Benner's work, describing the development of the nurse from novice to expert, is used to demonstrate strategies that can be used to enhance the decision making process, and the role of the nursing process and models in decision making is explicated.
Relaxation training as a technique for helping patients cope with the experience of cancer: a selective review of the literature
Authors: HVCert Sally E.R. Sims BNurs MSc SRN NDNCert
Published: December 2006

The experience of cancer places considerable physiological and psychological demands upon the patient. In recent years the potential benefits of relaxation training have generated widespread interest in both the lay and professional literature, particularly in the area of stress management. This paper examines the use of relaxation training as a method for helping patients cope with the experience of cancer and reviews a number of studies which have used progressive muscle relaxation and guided imagery in the oncology setting. Although these studies have produced some encouraging results, there are a number of issues which need to be addressed if future relaxation studies are to be useful for nursing practice, and these are discussed.
A clinical study of Sudocrem in the management of dermatitis due to the physical stress of incontinence in a geriatric population
Authors: SRN Denis Anthony BA RMN , SRN Elizabeth Barnes BSc , MRCP James Malone‐Lee MB BS , Pluck Ron
Published: December 2006

A double blind controlled trial was carried out to measure the efficacy of Sudocrem, compared with zinc cream BP, in the treatment and prevention of incontinence‐associated dermatitis in an elderly inpatient population. Three objective measures of skin condition were used to assess efficacy. Sudocrem was shown to be superior to zinc cream BP in the treatment of dermatitis, with no significant difference shown in terms of prophylaxis. The objective measures of skin health seemed to be a promising advance on earlier, subjective methods, and their further development is recommended. There was some indication that the normal skin of an incontinent patient does not deteriorate when managed with Sudocrem or zinc cream.
Discharge planning for psychiatric patients: the effects of a family‐patient teaching programme
Authors: DNSc Fatma A. Youssef RN MPH
Published: December 2006

The aims of this study were (1) to develop and implement a family‐patient teaching programme for psychiatric inpatients prior to their discharge, and (2) to assess the effect of the teaching programme on patients' functional level and readmission rate. The population of this study consisted of 30 hospitalized psychiatric patients, with schizo‐affective disorders. Subjects were randomly assigned to two groups – a control group and an experimental group. Families of the experimental group subjects were involved in the patient‐family education sessions twice a week. The subjects were followed‐up after discharge for a 12‐month period. In analysing the data, results indicated that improvement in functional level based on the Global Assessment Scale (GAS) was clearly noticed among subjects of the experimental group. In addition, the findings of this study lend support to other studies which showed that patient‐family education is an effective means of reducing the readmission rate among psychiatric patients.
Perceptions and attitudes of academic nursing students to research
Authors: Eckerling Shoshana , Bergman Rebecca , Bar‐Tal Yoram
Published: December 2006

Tel Aviv University students' perceptions of nursing research activities were examined. Specifically, the research concentrated on attitudes, role perception, ability and behaviour al intention to perform research in the future. It was found that nurses in all stages of their academic studies, viewed research activities favourably on all four measures. Differences, however, were shown on the subjects' rating of their ability to perform research, their attitudes and their intentions to engage in research activity, according to their job level and academic level. No differences were found on the four measures when examined by work domain or clinical area. The multiple regression analysis showed that the best predictor of the intent to do research was the perception of ability, followed by the perception of research as part of the nursing role and the subjects' attitudes towards research.
Mentoring in doctoral education
Authors: Davidhizar Ruth E.
Published: December 2006

Mentoring has historically been common among men. Recently, however, mentoring has emerged as a popular concept in nursing and more and more references in the nursing literature describe the importance of a mentor to the nurse. Mentoring is also an important concept in doctoral education in nursing. This paper discusses both the development of mentoring and its use in nursing today. Furthermore, six important characteristics of the mentoring relationship which can vitally contribute to the development of the nurse leader are discussed. A mentoring relationship between a doctoral student and a more experienced professional can enable the development of leadership potential and significantly contribute to the development of competent professionals in nursing.
Tedium among patients with insulin‐dependent diabetes mellitus
Authors: Lundman Berit , Asplund Kjell , Norberg Astrid
Published: December 2006

Tedium assessment and factor analysis of psychosocial variables were performed in 158 insulin‐dependent diabetic patients. High tedium scores correlated significantly (P < 0.05) with high education, lack of self‐monitoring, many reported problems concerning insulin injections, diet, strict planning of the activities of everyday life and anxiety concerning complications. There was also a significant relationship between low tedium scores and reported positive effects of the diabetes. There was a higher proportion (ns) of high tedium scores among patients in poor or good metabolic control than in those with intermediate metabolic control.
The effect of training on knowledge and opinion about smoking amongst nurses and student teachers
Authors: Elkind Andrea Knopf
Published: December 2006

At their entry to training, student teachers and nurses (pupils, general students and paediatric students) completed a questionnaire and were interviewed about their knowledge and opinion of smoking as a health hazard. This was repeated a year later. The nurses and student teachers did not differ in their knowledge of eight smoking‐related diseases at their entry to training, but the nurses were less willing to acknowledge the importance of smoking as a health problem. This was in part related to differences in their smoking behaviour, smokers being less likely to perceive smoking as a hazard than non‐smokers. Smokers were also more likely to express doubts about the role of smoking in illness. In general at entry the pupil nurses were the least likely to accept that smoking is harmful to health. After a year of training little change was evident among the student teachers. Among the nurses knowledge had improved for some conditions and decreased for others. Improved knowledge was most evident among the general students but scores declined consistently among the pupils. The uptake of knowledge was also related to the nurses' smoking behaviour, non‐smokers tending to become better informed and smokers less certain. In general, the nurses had also become less likely to acknowledge the importance of smoking as a health issue, and again, this was most marked among the pupils. Smoking behaviour did not account for these changes. The nurses applied their training experience to their views, the effect usually being to confirm existing ideas. Not all experience had a positive impact and training had not enhanced understanding of the causal relationship between smoking and illness. One explanation could lie in the way the subject of smoking is dealt with during teaching.
Health promotion in the family: current findings and directives for nursing research*
Authors: Duffy Mary E.
Published: December 2006

This paper reviews the current nursing research findings on health promotion within the family and provides directives for future research. The concept of health promotion—the overall enhancement of well being—is contrasted with primary or disease prevention, the specific protection from a health threat. The conceptual parameters of health promotion were used to search the nursing research journals for studies of health promotion in the family. The four major nursing research journals were reviewed and yielded five articles in 105 issues which addressed this phenomenon. The findings from these studies as well as other research literature are used to develop future directives. The directives are presented for both the internal environment of the family and its external environment. Areas for study related to the internal environment include definitions of health and health promotion, descriptions of current health promotion behaviours and those practised over time, decision making, fathering, and methods of intervention. Research ofthe external environment includes the societal norms, societal interventions, and the effects of societal institutions. This discussion of health promotion in the family describes an agenda for nursing research which is necessary to support nursing practice with families if ‘health for all’ is to be reached by the year 2000.
Ward sisters' management styles and their effects on nurses' perceptions of quality of care
Authors: Whelan Janet
Published: December 2006

The aim of this study was to determine if a ward sister's management style influenced the quality of care received by patients on the ward. The management styles of sisters on 16 oncology wards at the Royal Marsden Hospital were assessed by structured interviews with staff members from each ward. Management styles were classified as high, medium or low on three dimensions, namely socio‐emotional orientation, task orientation and pattern of decisionmaking. The quality of patient care was determined by asking all grades of clinical nursing staff to complete a questionnaire. A score for each nurse's perception ofthe quality of care given on her ward was thus obtained. Correlation of management style and nurse's perception of quality of care indicated that the management style prevalent on a ward influenced the quality of care carried out there. Other factors that influence both management style and quality of care were identified. Suggestions for improving the quality of care given on a ward are thus identified.
Clinical reasoning in nursing*
Authors: Jones Jennifer A.
Published: December 2006

This paper traces the development ofthe concept of nursing diagnosis and the various approaches being used to explain the cognitive processes used by practitioners in diagnosing patient problems. Three main types of explanation are compared; hypothesis generation/testing, decision analysis, and the information processing model. The recent development ofthe latter approach within the field of artificial intelligence is described and expert system research introduced. Finally, the potential benefits ofthe advent of expert systems into nursing are discussed.
Support of wives of myocardial infarction patients
Authors: Thompson David R. , Cordle Christine J.
Published: December 2006

Seventy‐six wives ofpatients suffering a first myocardial infarction were studied by questionnaire 6 weeks after their husbands went home. Despite the routine provision of support and information to spouses during their husband's stay in hospital, a high proportion reported physical and emotional symptoms of stress. The majority of wives felt they were poorly informed about myocardial infarction, had not had enough opportunity to ask the experts questions, and had received most support from relatives. The reasons for thesefindings are discussed and suggestions for early and systematic nursing intervention are made in an attempt to reduce stress and prevent the development of unhealthy patterns of behaviour.
The what, why and how of hyperkinesis: implications for nursing
Authors: Porter Luz S.
Published: December 2006

Hyperkinesis refers to a combination of traits that typically include: overactivity; restlessness; short attention span; distractability; low frustration tolerance; impulsiveness. Its aetiology and prevalence have not been established but associating problems underscore the importance of early identification and treatment. Theories about aetiology relate to minimal brain damage, heredity, temperament variations, maturational lag, dysfunction of the reticular activating system, food sensitivity, and learned response to unorganized environment. Hyperkinesis may be distinguished only by its behavioural manifestations. Insightful analyses of behavioural problems require viewing the child from a development perspective, such as those advanced by Freud, Erikson, Berne and others. Sensitivity to the ramifications of labelling the child as deviant is critical. Multidimensional assessment is needed upon which management decisions are made. An eclectic approach merits consideration: medication, if it works; therapeutic counselling; parental counselling; intervention with school personnel; and above all, support for the child. The nurse plays a crucial role in providing the health team with key information basic to establishing accurate diagnosis and evaluating interventions. The problem of hyperkinesis bears many implications for nursing practice and research.
Reporting therapeutic discourse in a therapeutic community
Authors: Chapman G. E.
Published: December 2006

Research in nurses' communications has concentrated on nurse to patient interactions. Those few studies which focus on nurse to nurse communications seem to be generated by a pragmatic and normative concern with effective information sharing. In this paper, which describes one aspect of a larger case study of a hospital‐based therapeutic community, the description and analysis of nurses' reports flows not from a normative model of professional practice, but rather an exploration of how professional practice is articulated as discourse in nurses' written accounts. Foucault's ideas about therapeutic discourse inform the theoretical framework of the research. Ethnomethodological concerns with the importance of documentary analysis provide the methodological rationale for examining nurses' 24‐hour report documents, as official discourse, reflecting therapeutic practice in this setting. A content analysis of nurses' reports, collected over a period of 4 months, demonstrated the importance of domesticity and ordinary everyday activities in nurses' accounts of hospital life. Disruption to the ‘life as usual’ domesticity in the community seemed to be associated with admission to and discharge from the hospital when interpersonal and interactional changes between patients occur. It is suggested that nurses in general hospital wards and more orthodox psychiatric settings might usefully consider the impact of admissions and discharges on the group of patients they manage, and make this a discursive focus of their work.
Spiritual care: an element in nursing care planning
Authors: Labun Evelyn
Published: December 2006

Nursing has recognized spirituality as an aspect of holistic patient care but little has been written on the understanding of this concept within the holistic approach. In a discussion of this issue, three basic questions are addressed. Thesequestions include‘What is spirituality?’,‘How do patients express their spirituality?’, and‘How can spiritual care be incorporated into a plan of care?’Drawing upon nursing and health‐related literature, an outline of the concept of spirituality is drawn and five broad areas of expression are described. The nursing process is used to demonstrate how spirituality can be incorporated into the patient's plan of care.
Curriculum evaluation: an approach towards appraising a post‐basic psychiatric nursing course
Authors: Chambers M.
Published: December 2006

Recently, considerable interest has been generated in the area of curriculum evaluation, most of which has concentrated on basic nurse education. This paper describes how an illuminative evaluation approach was used to examine the curriculum for a post‐basic psychiatric nursing course. Following a brief introduction to curriculum evaluation it outlines the various methods of data collection and analysis, adds a word of caution and concludes by saying: the study revealed that psychiatric nurses were being trained to a high standard in a pleasant, relaxed environment where the standard of nursing care and the commitment of all involved was excellent.
Teaching nurses therapeutic conversation: a pilot study
Authors: Paxton Roger , Rhodes David , Crooks Ian
Published: December 2006

A 2‐day video‐based workshop developed for teaching psychiatrists was used to instruct learner psychiatric nurses in the conversational model of psychotherapy. A small evaluation was carried out to assess the effects of the teaching on the performance of these nurses in interviewing other learner nurses who role‐played people with common emotional difficulties. A randomized groups design was used comparing the interview behaviour of experimental and control groups before and after the workshops, and at 3 months follow‐up. Considered as a pilot the study was instructive, although only one significant result emerged. The conversational model of psychotherapy and the teaching workshops devised and used previously with psychiatrists can be used by nurses, including those still in training.
A study of nurses' attitudes towards associate degree nursing students
Authors: Jackson Janet , Neighbors Marianne
Published: December 2006

The purpose of this study was to examine the attitudes of staff nurses towards associate degree (AD) nursing students. The null hypothesis stated there will be no significant difference in the attitudes of staff nurses towards AD nursing students and associated concepts (nursing education, patient, physician, work, nurse.) The staff nurse's value as a role model is held in high regard yet little regard is given to her attitudes towards students. Through better understanding of staff nurses' attitudes, nurse educators can better plan, develop and coordinate clinical activities to provide an optimum learning environment. The findings showed the concept AD nursing student was significantly different from the rest, indicating a less positive attitude towards the AD nursing student than the related concepts. Implications for nursing practice are threefold. Nurse administrators must create an atmosphere and a philosophy which support the educational process within their institution, and recognize nurses' attitudes towards students. Practising nurses should examine their attitudes and willingness to work with students if their hospital offers their agency as a clinical facility. Educators must look closely at the units they assign students to, continually maintaining the lines of communication between staff nurses and clinical instructors. As service and education work together a quality environment can be provided in which there is optimum learning for the student. Both groups then contribute to the future of professional nursing.
Faculty practice: dilemmas and solutions
Authors: Joachim Gloria
Published: December 2006

While nursing educators in university settings teach, carry out research and provide some form of community service, they often do not practise. The reasons for not practising are varied and the consequences vast. Although there are dilemmas which perpetuate the situation of nursing professors not participating in practice, there are solutions. This paper places the issue in an historical perspective, notes its consequences, discusses the dilemmas which are involved and offers solutions to this complex problem.
The Marie Curie/St Luke's Relative Support Scheme: a home care service for relatives of the terminally ill
Authors: Johnson I.S. , Cockburn M. , Pegler Janet
Published: December 2006

A hospice‐based scheme for the support of relatives of dying patients is described. The majority of carers were females and almost a third of them elderly. Most patients were suffering from malignancy. Relatives reported a high level of satisfaction with the help they received from the scheme, but late referral was a common source of dissatisfaction. A large proportion of patients subsequently died at home but it is suggested that the intervention of the relative support scheme was not the only contributory factor. The perceptions of nurses working for the scheme and the susceptibility of volunteers to stress are highlighted.
Hospital and community liaison links in nursing: the role of the liaison nurse
Authors: Jowett Sarah , Armitage Sue
Published: December 2006

Since the 1960s there has been an awareness ofa ‘care‐gap’ when patients are transferred between hospital and home. In the United Kingdom, attempts to improve continuity of eare have included the development of the role of the hospital/community liaison nurse. The liaison role has evolved in different ways and no systematic evaluation has occurred. This paper reports the findings of an exploratory study into the structure and process of the liaison role. It is suggested that the role is effective in enhancing continuity of care, but that modifications accompanied by educational and organizational changes would improve current practice.
Marginality and the role of the clinical teacher
Authors: Smyth Terry
Published: December 2006

This paper discusses the concept of marginality and its relevance to an understanding of the role of the clinical teacher. Despite having a rather chequered history, the notion of marginality has proved, nonetheless, to be a powerful and resilient stimulus for many writers from a variety of backgrounds. After a brief overview of the historical development of the concept, this paper focuses on the theoretical framework proposed by Dickie‐Clark which is found to have value as both an accessible and flexible means of analysing a wide range of social and individual phenomena. It is this framework that is used to examine the position of the clinical teacher. The essence of the argument is that the clinical teacher is at a pivotal level at the intersection of two relatively distinct hierarchies (the formal educational and the informal clinical) which need to be reconciled if the clinical teacher is to be effective. Brief references are made also to Third World studies as an illustration of how seemingly remote concepts can be employed creatively to highlight some hitherto unconsidered aspects of the clinical teacher's role.