bluuebunny/crossref_metadata_2025 huggingface dataset:
Need and provision of health visiting in the London district health authorities
Authors: Powell Martin
Published: December 2006

This paper considers the degree of equity associated with the delivery of health visiting in London, England As is common in the National Health Service, it is argued that an area with a greater need for a service should get greater provision of that service Different indices for measuring needs and resources are discussed In particular, the vital distinction between measures of resource input and output is examined The relationships between provision indices are discussed and then the associations between need and provision are examined It is concluded that the implications for equity are unclear, as the magnitude of the correlations change depending on the choice of indices
The perception of psychiatric‐hospital ward sisters/charge nurses towards nursing models
Authors: McKenna Hugh P
Published: December 2006

A search of the literature revealed a dearth of research on hospital ward‐based practitioners’ opinions/perceptions towards nursing models This is surprising considering that such frameworks are being introduced into patient care settings on an international basis As part of a larger investigation pertaining to model selection, the researcher interviewed a population of 95 ward managers, giving each of them the opportunity to put forward their views concerning models of nursing The research area was psychiatric continuing‐care/rehabilitation facilities in Northern Ireland The majority of opinions (611%) were positive in nature while 23 2% of respondents voiced negative perceptions Implications for nursing practice, education and administration are raised from the study's findings
Nursing education leadership. Effect of situational and constraint variables on leadership style
Authors: Goldenberg Dolly
Published: December 2006

A descriptive study investigating the effect of situational and constraint variables on leadership style is reported A sample of 35 administrators of college (diploma) nursing programmes and 106 of their senior faculty participated in the study The Leadership Style Analysis Instrument was used to determine the administrators’ leadership styles, as perceived by the administrators themselves and by their senior faculty Demographic characteristics of the administrators and constraint variables were examined by chi‐square analysis (0 05) regarding their relationship to leadership styles It was found that despite variations in administrator characteristics and extent of constraints, the perceived leadership style was consistently relationship‐oriented The results have implications for educators and administrators in nursing
Natural sociology and moral questions in nursing: can there be a relationship?
Authors: Johnson Martin
Published: December 2006

This paper argues that the current sources of material for the debate of moral questions in health care in general and nursing in particular, are inadequate The current bases of nursing's knowledge and values are explored, and the conclusion drawn that reliance upon theory developed by other disciplines has led to theories which are wholly inappropriate to explain either how nursing is practised or even how it ought to be A case is made that naturalistic sociological methods such as participant observation have the greatest possibilities to describe and explain moral conduct in nursing Further, these methods can produce a view of reality more consistent with the experiences and feelings of the patients or clients and other health workers It would seem that data and theory generated using this perspective could better inform the debates of moral philosophers than the currently dominant sources of their case material, the views of the medical and legal professions
Status passage into nursing: undertaking nursing care
Authors: Bradby Mary B
Published: December 2006

A status passage is the process of change from one social status to another In this report, the process of transition from lay person to nurse in respect of undertaking essential elements of patient care is described The aspects of care included in the study are attending to hygiene needs, incontinence, altered body image, the very ill and dying person, and behavioural problems associated with attention‐seeking, confusion, suicidal attempts and aggression Student nurses mainly were expected to cope with these situations alone The emotional effects on these students and implications of undertaking care in this manner are noted
Nursing ethics and Project 2000
Authors: Hussey Trevor
Published: December 2006

Project 2000 gives us an opportunity to reconsider the need for nursing ethics in initial nurse education in the United Kingdom Three arguments are presented to justify its inclusion The overall aim of an ethics course should be to help the student become an autonomous moral agent, capable of functioning in the complex and difficult nursing environment Hence, to design such a course we need an analysis of the skills, knowledge and motivation required by such an agent This will help us choose our objectives and course content A tentative analysis is offered Suggestions are made about the teaching of the course and the integration with other subject areas Some practical, moral and philosophical objections to this approach are considered and replies are offered
Jokes and reassurance are not enough: ways in which nurses relate through conversation with elderly clients
Authors: Gibb Heather , O'Brien Bart
Published: December 2006

An ethnographic study was conducted into the style of conversation registered nurses used with elderly residents during activities of morning care Speech was analysed into basic components of speech act categories (e g explanation, instruction, reassurance) Patterns of speech style were seen to vary in relation to the physical procedure being earried out, and to function as an adjunct to the smooth execution of this physical activity However, they were also seen to have an important psychological function reflecting a particular way of relating Some morning‐care activities — the journey — were associated with a more personally engaging social interaction which appeared to be mutually beneficial to nurse and resident Other approaches to morning care — the dissection —appeared to constrain the way the nurse interacted, producing a more formal style of relating Findings were discussed in terms of optimal use of physical activities of nursing care to achieve greatest benefit in relation to the psychological needs of the resident, as addressed through verbal interaction
Crisis theory: a paradigm of effective intervention with families of critically ill people
Authors: Woolley Norman
Published: December 2006

Admission to a critical care unit often causes a great deal of distress and anguish, not only for the patient but also his or her family If one believes in the holistic approach to care, then it is essenhal that the critical care nurse is able to identify the specific needs of family members, and demonstrate appropriate intervention techniques with those in need of support It is suggested that crisis theory can provide an effective tripartite framework on which to base such nursing care Following a brief description of its development and basic principles, application of its approach will be demonstrated in relation to the specific needs and concerns which have been identified from responses of family members themselves Suggestions are offered which may assist the nurse in further developing basic communication skills which can assist the intervention process at this difficult time Awareness of such principles is of value to all workers in critical care areas
Management strategies and patient needs: the provision of nursing care in the community
Authors: Jacoby Ann
Published: December 2006

Community nurse managers in 17 health districts in England were interviewed about their strategies for identifying and coping with unmet need for nursing care in the community, and their efforts to plan community nursing services and to meet changing levels of demand for care The managers were found to have access to a wide range of information for planning services, but this information did not always seem to be used most effectively The managers’ efforts to identify unmet need were often piecemeal and unco‐ordinated, and this may have been, in part, because managers were facing difficulties in meeting existing demands for services As a result, several were beginning to set priorities for care Faced by increasing demand and limited finance, it seems likely that managers will continue to do so, and will develop more stringent criteria for nursing care
Health within the experience of breast cancer
Authors: Moch Susan Diemert
Published: December 2006

The purpose of this descriptive research was to explicate the concept of health within illness by describing women's experiences with breast cancer The study is based on Newman's view of illness as expanding consciousness Twenty women, ages 38–60, with previously diagnosed (within 4–18 months) breast cancer, were asked to describe their expenence with breast cancer through two open‐ended interviews Data collection and analyses were based on a qualitative research methodology which incorporates aspects of existential phenomenology and phenomenological nursology with a focus on person—environment interaction patterning Through thematic analyses and patterning of the person‐environment analyses based on the North American Nursing Diagnosis Association Taxonomy I dimensions, themes consistent with health as expanding consciousness emerged
An evaluation of two systems of in‐patient care in a general hospital psychiatric unit II: measures of staff and patient performance
Authors: Long Clive G , Blackwell Claire C , Midgley Marie
Published: December 2006

This study reports on a comparison between a single ward and a two‐ward system of acute in‐patient care in a general hospital psychiatric unit It looked at job satisfaction, levels of stress, absenteeism/sickness and work proficiency amongst the staff and also at patients’ level of disturbed behaviour, length of stay and re‐admission rates It was found that a continuous‐care ward was associated with a lower level of behavioural disturbance and was preferred by the majority of staff, with some increase in job satisfaction and a decrease in stress The continuous‐care ward was also associated with shorter admissions However, those who progressed through a two‐ward system were less likely to be re‐admitted within 3 months The implications of these results are discussed
Reflex sympathetic dystrophy syndrome: a retrospective pain study
Authors: Greipp Mary E
Published: December 2006

While reflex sympathetic dystrophy syndrome (RSDS) research is lacking and the pathophysiology remains obscure, it is known that it affects all age groups with the common overriding complaint of severe, unrelenting, burning pain It seems to be triggered by trauma (major or minor), including more central events such as myocardial infarction, cerebrovascular accident and tumours Diagnostic characteristics of RSDS are spontaneous burning pain, hyperalgesia, vasomotor disturbances, exacerbations by emotional upset, occurrence either spontaneously or after minor injury, occasional spontaneous resolution, extension to other body parts, and relief by sympathetic denervation The problem may recur after earlier resolution The problem for this author, and others, is the discrepancy between what appears in the literature and what is evidenced in clinical practice What is being observed is a large number of individuals with RSDS who are not easily treated or cured The problem for some clients becomes one of total body involvement, with severe incapacitahon related to the constant and intense nature of the pain and the accompanying alterations in mobility This author and two colleagues designed and conducted a study of clients registered with the RSDS Association to delineate the magnitude and long‐term effects of RSDS in this sample
Trends in nursing of families
Authors: Wright Lorraine M , Leahey Maureen
Published: December 2006

The authors describe their observations of three trends in the nursing of families namely, increased diversity in nursing practice, increased research, and increased family content in academic settings These trends have major implications for nursing practice, research and education The authors speculate on the implications and their effect on the families for whom nurses care
Use of community support services by elderly patients discharged from general medical and geriatric medical wards
Authors: Jackson Marilyn F
Published: December 2006

This descriptive study examines the use of community support services by elderly persons discharged from general and genatric medical wards of a large acute care British teaching hospital A convenience sample of 40 patients were interviewed at 6‐week intervals over a 3‐month period about their need for and use of community support services The type of ward from which patients were discharged did not influence the use of nursing, homemaker, physician, or warden/community visitor services, hospital day care, or meals‐on‐wheels Patients who used the largest number of community services, and were the most frequent users of all available services, were those who, because of their fragility, died or were readmitted to hospital within 6 weeks of discharge All families interviewed identified a need for more information about their elderly members’ illnesses and prescribed medical regimes
Role‐playing as a method in nursing research
Authors: Maerker Margot , Lisper Hans‐Olof , Rickberg Sven‐Enk
Published: December 2006

This report describes a way in which role‐playing can be applied in nursing research The questions investigated were how much the memory capacity is influenced by different methods of providing information, and in what manner objective and comprehensive information about a disease with all its possible consequences is experienced by the recipient To elucidate these questions, 48 healthy persons imagined that they had a chronic disease The study was arranged as a 2 × 2 factorial design, the factors being group information versus individual information about the disease, and provision of the whole information at once versus division of the information into three parts separated by 15 minutes. The information was given orally and a structured interview was consequently conducted After 1 week the subjects were telephoned and were asked to tell the investigator what they remembered about the disease The results showed that the amount and type of information recalled was not affected by the way in which it was given The information in itself, however, had the effect of making the subjects calmer Several parallels between the results of the role‐playing study and observations in patients demonstrate that role‐playing provides useful knowledge and should be applied to a greater extent in nursing research
Professional nurses’ attitudes towards humour
Authors: Sumners Ann D
Published: December 2006

A study of the attitudes of 204 registered professional nurses’ towards humour showed differences in the attitudes in two settings Fishbein & Ajzen's theoretical framework of attitude development and measurement was used to guide the study The positive functions of humour indicate that it is a useful strategy for nurses to employ in their professional work setting Although the nurses held positive attitudes towards humour in both the professional and personal settings, they were lesspositive in the professional work setting The findings indicate that a potentially useful nursing strategy is not being fully utilized by nurses
Persistence in breastfeeding: a phenomenological investigation
Authors: Bottorf Joan L
Published: December 2006

Persistence in breastfeeding: a phenomenological investigation The expenence of mothers who continue to breastfeed when other alternatives are available has received little attention To examine the underlying meamng of the reality of persisting with breastfeeding, a phenomenological approach is used Based on interviews with breastfeeding mothers, the author explores the meanmg of continuing to breastfeed m relation to a mother's decision to breastfeed, the problems encountered, the relationship between mother and baby, being committed and choosmg a time to stop The aim of the author is to stimulate thinkmg beyond taken for granted attitudes towards breastfeeding and to enhance understanding of what breastfeeding and continuing to breastfeed is like for mothers in a deeper more meaningful way
Moral education for nursing decisions*
Authors: van Hooft Stan
Published: December 2006

This paper attacks the Kantian conception of morality that predominates in our society and the rationalist educational strategies that flow from it In its place it offers an Aristotelian conception of ethics in which sensitivity and feeling are important components of practical reason It argues that a nurse's ethical concerns extend further than the several moral dilemmas discussed in the daily press and that those concerns should be responded to in moral education by a process called ‘empowerment’ Empowerment seeks to develop confidence and sensitivity in the making of difficult decisions and does so by training habits, developing attitudes, and encouraging reflection on actions performed
Health visiting: a withering profession?
Authors: Fatchett Anita B
Published: December 2006

Over the past 2 years, community nursing appears to have been quietly marginalized within successive government health documents The health visiting profession in particular looks to be under the greatest threat, and it is to that issue that the discussion will be addressed The argument will be made that changing the content of health visiting practice in an attempt to solve the apparent problems, is not sufficient in itself to both protect and allow development of the profession for the 21st century It is of more relevance to determine the direction for health visitors within the rapidly changing context of primary health care provision The potentially worrying changes in the community health agenda for health visitors will be demonstrated by some analysis of the Cumberlege Report 1986, the 1987 White Paper Promoting Better Health, the Griffiths Report on Community Care 1988, and the NHS Review 1989 Working for Patients Potential avenues for action are explored, including neighbourhood nursing, and a serious attempt at membership of primary health care teams within general practice The conclusion is that health visitors need to indulge in some painful decision‐making, in order to prevent the withering away of their profession within the newly emerging context for primary health care delivery
Power and collegial relations among nurses on wards adopting primary nursing and hierarchical ward management structures
Authors: McMahon Richard
Published: December 2006

Power and collegial relations among nurses on a number of hospital wards were analysed using a mixed methodology Half the wards had adopted primary nursing whilst the rest continued with hierarchical management structures Nurses’ interactions were recorded as they worked, as were those that occurred during the shift handover period The nurses’ own perceptions of their collegial relations were measured using a ‘Likert scale’ type of questionnaire Qualitative analysis of the observational data suggested that genuine differences in the nature of the power relations existed between the laterally and hierarchically managed wards Some of the nurses on the primary nursing wards were observed to identify and discuss solutions to their patients’ nursing problems, whereas these were either not followed‐up or referred to other health care workers on the traditionally managed wards Statistical analysis of the questionnaires suggested that nurses on the primary nursing wards found their collegial communication to be significantly more collaborative than that of the nurses on the hierarchical wards Comparison between specialities did not reveal a statistical difference
How postpartum women explain their lack of obtaining adequate prenatal care
Authors: Leatherman Julia , Blackburn Della , Davidhizar Ruth
Published: December 2006

The quality of life for infants and children is often dependent on the adequacy of the prenatal care pregnant women receive From July through to December 1985, 15% of pregnant women in one Midwestern county were identified as having inadequate prenatal care The purposes of the study were to identify and analyse the reasons women in that county gave for not obtaining adequate prenatal care In addition, chi‐square was used to determine the relationship between the reasons given and the three variables, age, time between knowledge of pregnancy and making an appointment for care, and source of payment A convenience sample (n = 44) was used in a study over a 5‐month penod at three locations The Health Belief Model was the conceptual framework for this study Insufficient money to pay for care was the primary reason given for not obtaining adequate prenatal care (81%) Other reasons included motivational issues (45%) and access or lack of transportation (19%) There was a significant relationship (P= 0 05) with four reasons to the variable of age and with three reasons to both the variables of time and source of payment The following recommendations were identified as a result of this research the need for subsidized prenatal care and the need for a community‐wide education campaign regarding the need for adequate prenatal care and the consequences of inadequate care Prenatal care is sometimes not available to all in the United States in spite of the relationship of infant mortality and the quality of life for infants and children to adequate prenatal care
Predictors of parental attachment during early parenthood
Authors: Mercer Ramona T , Ferkehch Sandra L
Published: December 2006

Parental attachment of 121 high‐risk women, 61 partners of high‐risk women, 182 low‐risk women, and 117 partners of low‐risk women, was studied at the first week postpartum and 8 months following birth The tests of theoretical models showed low predictive ability explaining from zero to 21% of the variance in parental attachment in the four groups over the two test periods Empirical respecified models predicting parent‐infant attachment at the first week postpartum and 8 months explained 31% and 29% of the variance among high‐nsk women, 69% and 45% among high‐nsk partners, 41% and 53% among low‐nsk women, and 35% and 38% among low‐risk partners Parental competence was a major predictor of parental attachment over all test periods for all four groups Early parent‐infant contact following birth was never a predictor except at 8 months when, among low‐nsk women, the opposite effect than that expected was observed; the later women held their infants the higher was their attachment High‐nsk women scored significantly higher than low‐risk women during the first week postpartum only
Health visitors as educators
Authors: Foster Mane‐Claude , Mayall Berry
Published: December 2006

This paper describes some models of health education as a context for considenng data from a recent study of mothers’ and health visitors’ perspectives on good child health care Most health visitors favoured an individualistic top‐down approach aimed at changing mothers’ behaviour Mothers preferred a dialogue which started from their own priorities
Timing of preoperative patient teaching
Authors: Lepczyk Marybeth , Raleigh Edith Hunt , Rowley Constance
Published: December 2006

With the increasing cost of health care and the growing constraints made by third party payers, in‐hospital time for preoperative teaching is quickly being reduced Seventy‐two patients attended preoperative instruction either as an inpatient the day before surgery or as an outpatient 4–8 days before surgery Anxiety and knowledge levels were measured before and after class and the evening before surgery No differences were found between the groups on a measure of anxiety levels Both groups demonstrated a moderate anxiety level with no significant change over the testing period Using the knowledge pretest as a covariate, repeated measures analysis of variance suggested the knowledge gained with the class was significantly greater for the outpatient group than the inpatient group (P= 0 018) There was also a significant positive relationship between the knowledge score and knowing someone who had cardiac surgery (t = 2 34, d f = 66, P=0 022) The results suggest that it makes little difference whether patients receive information up to a week before surgery or just the day before, therefore, the more economical preadmission teaching may be the path of choice
Research on nurse‐patient relationships: problems of theory, problems of practice
Authors: BScEcon Carl May
Published: December 2006

Research, theoretical and educational literature on interpersonal relations between nurses and patients has proliferated since the 1960s This has generated a range of divergent accounts of what the nurse‐patient relationship (NPR) ought to be, how this should be achieved, and how the NPR is constituted in practice In this paper — through a selective review of the literature — the development of two contending perspectives on NPR and on nurse ‐ patient interaction (NPI) characterized as technocratic and contextual, is discussed, and related to the increasingly problematic status of the relationship between nurses and patients in nursing theory and research
Moral learning in nursing education: a discussion of the usefulness of cognitive‐developmental and social learning theories
Authors: Callery Peter
Published: December 2006

The preparation of students for ethically sound practice is an essential concern for nurse educators The theories of cognitive development and social learning theory are discussed as explanations of moral learning The implications of the application of each of these theories to nursing education are discussed and the usefulness of each theory to nurse educators is reviewed It is argued that neither theory is entirely satisfactory for application to nursing education and it is concluded that a pragmatic eclecticism is desirable in the approach to moral education in nursing
Effecting personal effectiveness: assertiveness training for nurses
Authors: Slater Jo
Published: December 2006

This paper describes a client‐centred approach to assertiveness training with nurses The approach recognizes and utilizes the skills and resources within a group, through a process of enabling rather than teaching The group's own knowledge and expenences are shown to be at least as valid as other academic and research texts which are referred to In personal development terms they are more valid Technique‐based courses are thought to have less impact than this approach, clearly rooted in self‐awareness and development After looking at the history of assertiveness training, and ways of defining it, the paper goes on to describe the process and content of a programme which is group led Space is also given to considering why it may be particularly difficult for nurses to act assertively, due to tradition and stereotypes
Helping people to stop smoking: a study of the nurse's role
Authors: Clark Jill Macleod , Haverty Sheila , Kendall Sally
Published: December 2006

Sixteen trained nurses from various clinical backgrounds participated in a project designed to describe the process and assess the outcome of their attempts to help a range of patients and clients to stop smoking A case‐study approach was employed and the nurses initiated 68 health education interventions related to smoking cessation All interventions were tape‐recorded and data on patients’ and clients’ characteristics, smoking history, health beliefs and motivation to give up smoking were also collected Forty‐two patients were followed up 1 year post‐intervention Data collected at this time revealed that 17% had successfully given up smoking, while a further 12% had substantially reduced their cigarette consumption These findings compare very favourably with those of previous studies in which general practitioners have attempted to help patients stop smoking The results of the research reported here therefore suggest that nurses have enormous potential for fulfilling a highly effective health education function
Lifestyle modification as an intervention for inner city women at high risk for preterm birth
Authors: Freda Margaret Comerford , Andersen H Frank , Damus Karla , Poust Dorothy , Brustman Lois , Merkatz Irwin R
Published: December 2006

This study details a programme which emphasized nursing interventions for women at high risk for preterm birth Preterm birth continues to be a major health problem, with ongoing research being conducted both in the United States and internationally in an effort to find causative factors Programmes designed to prevent preterm birth have been described often in the literature, with lifestyle factors being implicated in the incidence of preterm birth by many researchers The purpose of this study was to determine the lifestyle factors most often associated with preterm birth in a high risk population of inner city women, and to examine the effect of change in lifestyle when change was possible Women at high risk for preterm birth were interviewed extensively for prevalence of 12 lifestyle factors most often cited in the literature as being high risk client The assessment, intervention and evaluation of lifestyle changes in the high risk perinatal client are an integral part of perinatal nursing practice, and could provide important areas for future nursing research.
Predictors of nursing staff turnover
Authors: Cavanagh Stephen J
Published: December 2006

Nursing turnover is of great concern to patients, management and the profession, and numerous studies have been conducted to increase understanding about this phenomenon Most of these, however, have focused on staff nurses in the public sector, little is known about nurse manager turnover or the characteristics of nurses leaving the private hospital sector The purpose of this study was to examine turnover of staff nurses and nurse managers in both the public and private hospital sectors Variables which appeared to have a consistant relationship with nurse turnover were identified from the literature, and multiple regression methods were used to attempt to identify variables which could be used to predict turnover behaviour of staff nurses and nurse managers This study encountered methodological difficulties similar to those which have plagued previous studies, nevertheless, a clearer picture of nursing turnover is emerging
The influence of component parts on the performance of urinary sheath systems
Authors: Watson Roger , Kuhn Martin
Published: December 2006

A quasi‐experimental trial, yielding 30 data points per system, was earned out to investigate the influence of component parts on the overall performance of urinary sheath systems Information was obtained on the effect of changing both the sheath and leg‐bag Data from the trial was supported by accurate stocktaking analysis over two periods of 4 weeks’ duration when alternative systems were used in a clinical setting Results suggest that leg‐bag design profoundly influences the performance of urinary sheaths A significant difference in the performance of two urinary sheaths in the presence of the same leg‐bag was also observed The significance of the findings for nursing practice is discussed since the optimum performance, from the components tested, was a‘hybrid'system A continuing line of investigation is suggested whereby improvements in the composition of urinary sheath systems could be made from nursing research
Further assessment of a method to estimate reliability and validity of qualitative research findings
Authors: Hinds Pamela S , Scandrett‐Hibden Sharon , McAulay Leon S
Published: December 2006

The reliability and validity of qualitative research findings are viewed with scepticism by some scientists This scepticism is derived from the belief that qualitative researchers give insufficient attention to estimating reliability and validity of data, and the differences between quantitative and qualitative methods in assessing data The danger of this scepticism is that relevant and applicable research findings will not be used Our purpose is to describe an evaluative strategy for use with qualitative data, a strategy that is a synthesis of quantitative and qualitative assessment methods Results of the strategy and factors that influence its use are also described
Personal and contextual factors predicting patients’ reported quality of life: exploring congruency with Betty Neuman's assumptions
Authors: Hinds Cora
Published: December 2006

The search for factors which influence seriously ill people's quality of life continues to generate both interest and research A retrospective cross‐sectional study was conducted among 87 patients with lung cancer who ranged between the ages of 38 and 82 years The purposes of this investigation were to determine whether relationships existed between patients’ preferences for illness‐related information, their satisfaction with family functioning, their level of learned resourcefulness and their reported quality of life This paper focuses on the results of a stepwise multiple regression analysis which identified seven factors, namely, prognosis, surgery, current radiotherapy, performance status, self‐control skills (learned resourcefulness), preference for information and agegroup, which accounted for 30% of explained variance in patients’ reported quality of life No single factor contributed a substantial amount of the variance in this sample's reported quality of life This observation suggests differences in people's perceptions of these factors and their importance to them These results support a conclusion that people's evaluation of their quality of life is subjective, changeable and depends on the circumstances they face Congruence between the assumptions underlying Neuman's health care system model, and the personal and contextual nature of these seven factors in patients’ quality of life areexplored These findings are relevant for practice
An integrative nursing theoretical framework
Authors: Schmieding Norma Jean
Published: December 2006

The use of an mtegrative nursing theoretical framework for both clinical and administrative practice has recently been suggested The author developed a theoretical framework which incorporates key concepts from the writings of Ida J Orlando and Virginia Henderson and proposes it to be used as an integrative framework The rationale for using a framework is discussed along with clinical and administrative examples of how to integrate concepts from the proposed framework The reasons for using an integrative theoretical framework are that it serves as a guide for both clinical and administrative decisions, forms the basis of the nursing philosophy, facilitates communication with patients and colleagues, helps identify congruent supporting theories and concepts, provides a basis for educational programmes, helps to differentiate nursing from non‐nursing activities, and enhances nurse unity and self‐esteem The premise of the article is that benefits are derived from the use of a nursing theoretical framework because it provides a specific vision of nursing
The need for continuing professional education for nurses
Authors: Nugent Ansel B
Published: December 2006

This study was conducted among a total of 100 first level nurses, working within the St Helens & Knowsley Health Authority in the north of England The aim was to discover the extent to which nurses were aware of the need to continue their education beyond the basic level of nursing, and to ascertain what steps were taken to ensure competence in practice
Psychophysiological processes of stress in chronic physical illness: a theoretical perspective
Authors: Leidy Nancy Kline , Ozbolt Judy G , Swam Mary Ann P
Published: December 2006

This paper proposes a theoretical framework and conceptual model for clinicians and investigators working with people who have a chronic physical illness The framework is based upon nursing theory and classical propositions from psychology and physiology The major premise of the model is that individuals with limited psychosocial attributes and a preponderance of unmet basic needs are more likely to perceive events as threatening and experience a maladaptive stress response, such as heightened symptoms and acute exacerbations of their illness Conversely, those with strong attributes and a perception of need satisfaction are more likely to view events as challenging, thus avoiding symptomatic discomfort and enhancing personal growth Implications for nursing practice and research are addressed
Study of the effects of education on the management of urine drainage systems by patients and carers
Authors: Roe Brenda H
Published: December 2006

A randomized controlled trial was undertaken to test the effects of an education programme, which included an information booklet and demonstration, on the management of unne drainage systems by patients and carers A total of 45 patients, new and established users, were included Data were collected at pretest, test and follow‐up visits The education programme was found to improve significantly the performance of handwashing after bag emptying and before and after bag changing, although this effect did not persist over time The findings are discussed with a number of conclusions drawn and recommendations for nursing practice
Occupational stress and coping strategies among female baccalaureate nursing faculty
Authors: Goldenberg Dolly , Waddell Janice
Published: December 2006

Considerable stress is involved in nursing education However, the sources and extent have not been fully investigated, nor have ways of coping The main purpose of the study was to explore the sources and levels of perceived stress, coping strategies and effectiveness among female baccalaureate nursing faculty The second purpose was to examine the relationship between stress, coping and academic responsibilities of the faculty member such as teaching, research and community service A sample of 70 subjects from eight Ontario universities completed the demographic questionnaire, the researcher‐developed ‘Stress‐Coping Anxiety Inventory’, and the ‘State‐Trait Anxiety Inventory’ Form Y (STAI) (Spielberger et al 1983) Analysis of data using frequencies, cross tabulations, ANOVA and Pearson product‐moment correlation were computed Perceived Stressors chosen most frequently as high in stress (≥ 4) (range = 1–5), in rank order, were ‘heavy workload (combined clinical and classroom teaching)’, ‘retaining failing students’, ‘failing clinically unsatisfactory students’, ‘meeting research requirements’ and ‘providing individual clinical supervision’ Active coping strategies were selected more frequently as being effective (≥ 4) than passive coping strategies Age of the respondent, number of years of full‐time teaching and tenure status were most often significant factors (< 0 05) relating to the level of stress Implications for nursing education administrators and their faculty are discussed
Stress is in the eye of the beholder:reconceptualizing the measurement of carer burden
Authors: Nolan M R , Grant G , Ellis N C
Published: December 2006

The development of community care policy and the inadequacies of professional responses to the needs of informal carers were described in an earlier paper A qualitative analysis of carers’ replies to a questionnaire survey demonstrated that the most potent Stressors, contrary to what has previously been assumed, were linked more to subjective perceptions of events or circumstances than to the objective features of the events and circumstances themselves This paper presents a quantitative analysis of data from the same survey which confirm the impressions gained from the analysis of the qualitative data These findings prompt a reconceptualization of carer burden within a transactional model of stress, which is then considered as a basis for understanding how carers adapt to stress in their lives Practice implications are assessed
The impact of fluctuating relationships with the Canadian health care system on family management of otitis media with effusion
Authors: Wuest Judith , Noerager Stem Phyllis
Published: December 2006

The analysis of data from a grounded theory study of family interaction when a child has otitis media with effusion (OME) shows that these families are engaged in the process of learning to manage Their relationship with the health care system, coupled with the effects of the disease on the child and the family lifestyle, has a powerful influence on how this process proceeds In this paper, the authors discuss the impact of the family's relationship with the Canadian health care system on the development of management skills Relationships with the health care system fluctuate forward and backward through entrusting, becoming disillusioned, learning the rules and negotiating, as families leam to manage the effects of the disease process on the child and the family The family perspective of the quality and availability of health care at a time when health care systems throughout the world are under close scrutiny, adds to our understanding of consumer expectations Some recommendations for improving current relationships between families and the health care system are made
The assessment of therapeutic attitudes in the psychiatric setting
Authors: Rolfe Gary
Published: December 2006

Although ‘attitude change’ is included as one of the aims of the 1982 training syllabus for psychiatric nurses, curriculum designers are given little guidance as to what constitute desirable attitudes in the psychiatric nurse, and how those attitudes are to be assessed and evaluated This study has three aims to attempt to outline what might count as desirable attitudes, to propose a theoretical framework for the measurement of those attitudes, and to devise a test instrument and pilot it on three groups with differing amounts of counselling skills and experience The outcome of the pilot study produced surprising results, leading to the tentative hypothesis that counselling training and/or experience may have a detrimental effect on so‐called ‘therapeutic attitudes’ in the nurse
A comparison of frequency and sources of nursing job stress perceived by intensive care, hospice and medical‐surgical nurses
Authors: Foxall Martha J , Zimmerman Lani , Standley Roberta , Bene Captain Barbara
Published: December 2006

This study compared the frequency and sources of nursing job stress perceived by 35 intensive care (ICU), 30 hospice and 73 medical‐surgical nurses Analysis of variance revealed no significant differences among the three groups of nurses on the overall frequency of job stress Post‐hoc Tukey tests demonstrated a significant difference in three stress subscales among the three groups ICU and hospice nurses perceived significantly more stress than medical‐surgical nurses related to death and dying, ICU and medical‐surgical nurses perceived significantly more stress than hospice nurses related to floating, and medical‐surgical nurses perceived significantly more stress than ICU and hospice nurses related to work‐overload/staffing Spearman‐Rank Correlation revealed no significant correlations among the three groups in their rank‐ordering of the eight stress subscales Death and dying situations were the most stressful to ICU and hospice nurses, while work‐overload/staffing situations were the most stressful to medical‐surgical nurses Results of the study, although not generalizable, have implications for nurse managers
Discharge criteria in day surgery
Authors: Stephenson Marion E
Published: December 2006

Criteria are necessary to guide the nurse's clinical decision in determining when a patient is ready for discharge following day surgery On the basis of a literature search and a descriptive research study of the recovery and welfare of patients following day surgery, seven categories are proposed for guiding the nurse's decision making The seven categories are mental state, mobility, pain, eating and drinking, elimination, information and social factors Mental state examines recovery from the effects of the premedication (if used) and anaesthetic on mental abilities, and the related problems of headache and muzzyheadedness Mobility examines mobilization and the related problems of dizzyness or faintness Pain considers postoperative pain Eating and drinking considers oral intake and the related problems of nausea and vomiting Elimination considers voiding and the related problem of urine retention Educational factors relate to the patient's need for predischarge information Lastly, social factors consider the need for transportation and support within the home Although there is not a proposed category for wound and cardiovascular complications, the literature review in this area is included in order to support this decision The seven categories are subdivided into those criteria which are essential and those which are desirable Meeting the essential criteria ensures patient safety The desirable factors provide guidance for the nurse on additional factors which should be considered in relation to the quality of the patient's recovery and welfare With these factors the nurse exercises his or her judgement in relation to the individual patient
The effect of Orem's self‐care model on nursing care in a nursing home setting
Authors: Faucett J , Ellis V , Underwood P , Naqvi A , Wilson D
Published: December 2006

The need of the functionally disabled for nursing care is a primary rationale for institutionalization in long‐term care settings However, maintenance of the self‐care abilities that nursing home residents retain is an important component of their quality of life Nurses are in an important position to encourage and sustain residents’ abilities to participate in their care Nevertheless, without specifying the role of the resident in care, nursing interventions may inadvertently reinforce dependency and apathy at the expense of autonomy, control and well‐being Data from nursing home care records and interviews suggest that nursing staff using Orem's Self‐Care Deficit Nursing Theory differ in their nursing assessments and goals of care from staff on a control unit Further study is recommended of the influence of the model on staff perspectives of care and on interventions which support nursing home residents’ self‐care ability and well‐being
Profile: frail elderly women, maintaining independence
Authors: Jane Schank Mary , Ann Lough Mary
Published: December 2006

While several published studies have examined the interactions of health status and social support in the general population or elderly segment of the population, there has been no reported study that specifically examines the health status and social support of frail elderly women, aged 85 years and older This study reports on the findings of a research study that examined a group of frail elderly women, residing in the community It focuses on why and how these women are able to bve independently The relationships between health status and social support and between health status and the process of ageing are explored The study reveals the importance of social support assessments of this group as a prerequisite to effective health care policy, professional health education programmes, and community resource development
Nurses' attitudes towards computerization in clinical practice
Authors: Sultana Nusrat
Published: December 2006

This descriptive research project was designed to replicate the study of Brodt & Stronge (1980) and to extend and investigate the attitudes of nurses towards computers in clinical practice Lack of an adequate study into nurses’ attitudes to computers was the motive behind this study The research project was earned out in a district general hospital in the United Kingdom Data was collected by means of a Likert's type closed‐structure attitude‐scale questionnaire The sample consisted of 58 nurses working in a clinical setting The overall conclusion was that nurses’ attitudes to computers were more unfavourable than favourable