bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of mercury and digital clinical thermometers
Authors: Davies Sian Pugh , BSC John Y. Kassab , Thrush Abigail J. , BA Peter H. S. Smith
Published: December 2006

A primarily clinical trial has been undertaken to investigate and compare the use of mercury and digital thermometers in a ward situation. Both laboratory and clinical studies show that there is no significant difference in the average accuracy of the two types of thermometers, however there is a greater fluctuation of readings of temperature when using electronic thermometers. In clinical studies between 9 and 23% of repeated measurements using an electronic thermometer differ by 0.5°C or more whilst the corresponding range for mercury thermometers is 0‐6%. It is also shown that when making clinical measurements with mercury thermometers there is no clinical advantage in using a measurement time longer than 3 minutes.
Relearning to eat late after a stroke by systematic nursing intervention: a case report
Authors: Axelsson Karin , Asplund Kjell
Published: December 2006

Using a training programme developed by Heimlich. we have aitempled to train swallowing in a 78‐year‐old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and. during a follow‐up of I year, the patient was eating normal food. The training process is analysed as a two‐level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of ‘eight stages of man’.
Nurses’ attitudes to care of the elderly
Authors: Snape J.
Published: December 2006

There are problems recruiting nurses to the geriatric wards in Leicester. Using a Likert attitude scale, attitudes of training and trained nurses to the care of the elderly were assessed. Although the trained staff had a significantly more positive attitude than the nurse learners, the latter felt that the attitudes of the trained staff were poor. Possible explanations for this contraindication are discussed.
Elucidation and measurement of clinical learning opportunity
Authors: Jacka K. , Lewin D.
Published: December 2006

Competence in nursing derives from the actual practice of the craft. The authors describe ways of assessing the variety and extent of opportunities for clinical learning available to student nurses. Cohorts of students from each of three different types of hospital (72 students in all) were followed from the beginning to the end of training. From interviews with ward sisters, observation on the wards, and examination of nursing notes the pattern of clinical conditions characteristic of each training ward is established and hence, by aggregation, the pattern for each of the three training schemes. However, it is argued that only by investigating the learning careers of individuals can one gain knowledge and insight in sufficient detail to act as a guide to reform. Information on allocation to training wards is used to construct individual profiles of clinical opportunity, one for each student. Clinical conditions are grouped into 13 categories and it is shown how, for some categories, there are large differences between the experiences of individuals within a cohort, especially in one hospital. Finally the authors explain how, with a minimum of effort, these methods and findings could be adapted to improve and facilitate training; the procedures could be used to monitor each developing profile and, by judiciously modifying the continuing process of allocation, tutors would be able to achieve equality of clinical opportunity for their students.
Paradigms and practices: the organization of the delivery of nursing care
Authors: Berry A. J. , Metcalf C. L.
Published: December 2006

The patient allocation paradigm of nursing care is slowly superseding the task allocation paradigm. A research study reported here upon the introduction of patient allocation in a maternity hospital found that patients experienced few significant changes in their satisfaction; similar to previous studies this research found that the nurses reported significant gains in satisfaction. Following analysis of the ‘medical model’ assumptions inherent in the two paradigms and the methods used in the studies, it is suggested that a third paradigm of nursing care is emerging, ‘patient centred’— a paradigm within which the patient is a participating individual.
The Human Needs Model of Nursing
Authors: Minshull Jean , ROSS Kathryn , Turner Janet
Published: December 2006

Nurses in the United Kingdom spend much time attempting to fit British nursing practice into the theoretical framework of American nursing models. This is often a manipulative process in that it seeks to establish positive links with a care delivery system totally unlike our own. In the present paper the authors detail the process of establishing a new nursing model which integrates nursing curricula, education and practice to meet the needs of patients, staff and students within their own health district. An over‐emphasis on lower levels of human need is common within nursing practice, which, although often blamed upon lack of human and financial resources, is also due to practitioners’ misconceptions. The latter are invariably the result of a lack of an adequate or overt, practice orientated, conceptual framework. The Human Needs Model of Nursing adapts Maslow's concept of human needs to create such a conceptual framework for practice. It places equal emphasis on those patient problems which arise as the result of unmet needs at higher levels as well as those at lower levels, thereby acknowledging the holistic and dynamic nature of man.
Is a science of caring possible?
Authors: Dunlop Margaret J.
Published: December 2006

After some exploration of caring as a socio‐historical construct, the author examines the changing conception of caring in nursing between Florence Nightingale's day and our own. The place of the older and emergent meanings in the work of some of the recognized nursing theorists is critically examined. A distinction is drawn between a science for caring and a science of caring and some of the problems of conceptualizing and developing a science of caring are explored. It is argued that a science of caring may need to take a hermeneutical form, as, for example, in the work of Patricia Benner. The recognition of nursing skills, knowledge and values as exemplified in nursing caring is linked to the broader struggle for recognition of the ways in which women function intelligently in the world, as thinking, as well as feeling, beings. A link is thus made between nursing's attempts to establish itself as an academic discipline and the academic arm of the feminist movement, particularly where it insists that women's traditional knowledge and concerns be taken as seriously as those of men.
Curriculum models: product versus process
Authors: Sheehan John
Published: December 2006

At the beginning of this article there is a brief outline of the nature of the curriculum and models. This leads into a discussion of curriculum models in which ‘product’ and ‘process’ models are set out and discussed. The strengths and weaknesses of both approaches to the curriculum are outlined and issues relating to the choice of model are advanced.
Numerical measures of integration
Authors: Jacka K. , Lewin David
Published: December 2006

In a previous article the authors showed how, by following the clinical careers of individual student nurses, one could paint a coherent and illuminating picture of opportunities for clinical learning on the wards. By observing and counting, and using only the simplest methods of calculation, numerical measures of comparison were constructed. Here the authors turn to the question of the integration of classroom and ward. Indices of integration between theory and practice were devised and computed for three sets of students in three different training schools (72 students in all). The results were used to answer the following questions, (a) Within each training school what was the degree of equality of educational opportunity? (b) For each hospital what is the maximum level of integration which the organization of training makes possible, and what was the actual level achieved? (c) What is the connection between the achieved levels of integration and the type of training scheme (modular, block, etc)?
Implementing faculty practice: a question of human and financial resources
Authors: Rodgers Marianne W.
Published: December 2006

Two issues confronting nursing education are: improving the relationship between nursing service and nursing education, and achieving status as an academic discipline. The concept of faculty practice addresses both of these problems. By definition faculty practice requires demonstration of clinical competence through practice, and scholarly outcomes of practice which satisfy the research requirement of the nursing faculty role. While scholarly practice by nursing faculty members may benefit the nursing service‐education relationship, it is a myth that nursing faculty members were more effective teachers prior to nursing education's move into institutions of higher education. While few argue against the need for clinical competence of nursing faculty members for effective teaching, the need to attain educational preparation for effective teaching must not be overlooked. The vast majority of nursing faculty members hold, master's degree as their highest earned credential. To establish itself as an equal in academe and to increase teaching effectiveness, nursing education needs faculty prepared at the doctoral level. If nursing faculty members add faculty practice and doctoral study to the standard faculty role requirements of teaching, research and service, chronic overload will result. Nursing faculty members cannot solve all the problems confronting nursing education by continuously increasing their workload. Nursing programmes need to assess their resources and priorities. For all of its merits, faculty practice should not be implemented until a programme has adequate resources to support it.
Hospital admission for depression
Authors: Coupar Alan , Conway Carol
Published: December 2006

Fifty depressed patients in a psychiatric unit were asked in an open‐ended and a forced‐choice question: ‘When you're feeling depressed what sorts of things can make you feel worse in hospital and at home?’. The responses were analysed and compared with a study where non‐depressed subjects were asked the same question. Implications of the results of this study for the admission of clinically depressed people to hospital are discussed.
Research on the informal carer: a selected literature review
Authors: Goodman Claire
Published: December 2006

This paper gives a selected review of the available research on the role of the family in caring for elderly or handicapped relatives in the community. In particular, studies which describe who the carers are, the nature of their responsibilities and the physical and emotional costs of caring are examined. The implications of the findings from these studies and the recommendations made for improved care are discussed. A need for further research in this area is identified, particularly from a nursing perspective.
Preparing for change: an investigation into the attitudes of assessors to ward‐based assessments as a preliminary to continuing clinical assessments
Authors: Everden J. J.
Published: December 2006

A sample of ward‐based assessors from the Gwynedd School of Nursing demonstrated unfavourable attitudes to the current system of practical examinations as measured by a scale produced by the author. He suggests that this information could be a desirable adjunct to the unhindered introduction of continuing clinical assessment.
The changing nature of fatherhood: the nurse and social policy
Authors: Hanson Shirley M. H. , Bozett Frederick W.
Published: December 2006

Fathers, fathering and fatherhood are topics which receive little attention throughout the world's professional literature. Only recently has there been increased interest and research on the changing roles of men with particular emphasis on nurturing and parenting. A body of knowledge has started to accumulate which investigates the role of fathers with their families. The purpose of this article is to summarize the research literature about fatherhood in the United States of America today and to discuss the implications of this research for the practice of nursing. This analysis synthesizes the literature using two different perspectives. The developmental perspective traces the role of fathers from family planning through the family life cycle to grandfatherhood. The social contextual perspective summarizes the literature related to fathers for three common variations in society today: single custodial fathers, fathers in dual earner families, and adolescent fathers. Lastly, implications for nursing practice and social policy are discussed.
Testicular self‐examination: teaching, learning and practice by nurses
Authors: Stanford James
Published: December 2006

Testicular cancer is increasing in incidence, is now the commonest solid tumour in men aged 20 34 years and has a better prognosis when detected and treated early. Testicular self‐examination is an effective self‐screening procedure that is easily taught, learnt and practised. The aim of this study was to discover the extent of the teaching, learning and practice of this procedure by nurses. The data were collected by means of a questionnaire which was sent out to 60 nurses of various grades in one Sussex hospital. Nurses’ knowledge of lesticular self‐examination was found to be better amongst men than women, although over a half of female nurses did know of it. Their knowledge of groups at high risk of testicular cancer was incomplete. Whilst two‐thirds of nurses saw the teaching of testicular self‐examination as part of their role as health educators, very few had in fact taught it. It appeared that most male nurses do self‐examine on a regular basis. The results indicate that nurses need to accept their responsibilities as health educators. Testicular self‐examination should become an integral part of nurse training. Facilities and materials should be made available to assist nurses in disseminating such information.
Attitudes and perceptions of nursing students toward preparation for interdisciplinary health care teams
Authors: Beatty Patricia Robbins
Published: December 2006

Using a modification of the Snyder's Health Care Team Questionnaire, the author conducted a study pertaining to attitudes of undergraduate nursing students toward health care teams, and perception of curriculum content on health care teams. The study design involved a random sample of 126 associate degree programmes and 122 baccalaureate degree programmes representing 14 southern states; 588 senior nursing students responded to the questionnaire. Analysis of the data collected suggested differences in attitudes of students. In addition, the data indicated that differences did exist between programmes on specific health care team concepts taught and settings chosen for clinical experiences. Differences were also detected between programmes in perception of readiness of the students to participate as health care team members, and the number of courses taught on health care teams. Data from an Interdisciplinary Health Care Team Questionnaire were analysed using univariate analysis of variance (ANOVA) with the total scale representing attitude as the dependent variable. The statistical design was a mixed model ANOVA with the type of nursing programme as the fixed factor with two levels: ‘Associate Degree’ and ‘Baccalaureate Degree’. The School of Nursing was the random factor nested within programme type.
Identification of older adults’ perceptions of their health, feelings toward their future and factors affecting these feelings
Authors: Melanson Patricia M. , RN Barbara Downe‐Wamboldt
Published: December 2006

Controversy exists as to whether older adults living in the community perceive their health status positively or negatively. It is also not known how the elderly perceive their future. In 1982, the Halifax Social Planning Department conducted a survey to assess the health needs of 889 adults ranging in age between 50 and over 85 years and living in eight separate urban public housing accommodations. This descriptive study uses the responses to selected questions from this data bank to describe the subject's perceived health status, feelings about their future and factors affecting these feelings. Perceived health status was found to be the principal contributor to variance in scores of feelings about the future. The majority of respondents perceived their health to be good or excellent and 58% reported positive feelings about their future.
Developing self‐care skills and reducing institutionalized behaviour in a long‐stay psychiatric population: the role of the nurse in behaviour modification
Authors: Stokes Graham , Keen Irene
Published: December 2006

This paper examines the potential for behaviour modification in the rehabilitation of chronic, long‐stay psychiatric patients and the impact such procedures may have on the work role of ward‐based nursing staff. Through the use of five case histories the effectiveness of behavioural analysis and modification in encouraging self‐help skills and constructive activity is identified, In addition to a critical examination of the clinical and organizational factors involved in palienl improvement, it is argued that behaviour modification develops the therapeutic potential of nurses. The development of the patient‐teaching dimension of the nursing role not only fosters greater clinical responsibility, but also promotes both professional independence and institutional power. This is not to imply that the use of behavioural methods cannot be combined with customary nursing practices, for in many ways they provide nurses with an appropriate technology to achieve established therapeutic goals. In conclusion, it is noted that clinical success is not sufficient to ensure the acceptance of ward‐based behavioural programmes. The critical issues concern conventional hospital and staff practices and institutional rigidity, not the commitment of nursing staff or patient improvement.
Nursing theory development: successes and challenges
Authors: Jennings Bonnie Mowinski
Published: December 2006

Central to this paper is the belief that developing nursing theory is fundamental to establishing nursing's scientific foundation. Therefore, the paper examines successes and challenges in nursing theory development. This is achieved by evaluating both the present status of nursing theory as well as ideas for future directions. Within present status, the author considers three areas — those in which there is agreement, those in which both opinions differ and the prescribed course of relationships has not yet been achieved, and those which may serve as catalysts for future progress. A tripartite framework is also used to contemplate future directions by evaluating how nursing's knowledge has developed, what improvements and refinements might take place, and how the domains of nursing might be expanded. The author concludes that satisfaction and pride in current successes are not only justified but may motivate future pursuits; pursuits that are necessary to advancing the discipline of nursing.
Recent advances in the care of children with acute diarrhoea: giving responsibility to the nurse and parents
Authors: Candy Christine E.
Published: December 2006

Five hundred million attacks of diarrhoea occur each year in children under 5 years of age, throughout the world, and acute gastroenteritis remains a frequent cause of admission to hospital in the United Kingdom. Current practice in the treatment of diarrhoeal dehydration in the UK is focused upon intravenous rehydration. Drugs (eg antibiotics, anti‐emetics, anti‐diarrhoeal agents and absorbents) are commonly prescribed, and ‘therapeutic’ starvation, followed by cautious reintroduction of diet, is recommended. Studies conducted by health workers in developing countries have challenged these dogma. Whilst intravenous rehydration is occasionally required (eg. in shock, ileus or coma) the majority of episodes of dehydration can be treated orally. Oral rehydration is less unpleasant than intravenous infusion, safer, quicker, cheaper and readily administered by parents with nursing supervision. Recovery may be hastened by continuing to breast feed and offer normal diet, and weight loss is minimized. These principles are being applied in pilot studies at The Children's Hospital, Birmingham. Outpatient treatment is largely supervized by trained paediatric nurses, after initial medical assessment of the child. Nurses are becoming more confident in the technique of oral rehydration, coupled with early reintroduction of food. This is reflected in less discomfort and weight loss for the child, less parental anxiety, decreased length of hospital stay, and financial savings.
Beliefs, feelings and insight of patients with schizophrenia about taking medication
Authors: Davidhizar Ruth Elaine
Published: December 2006

There has been little systematic study of the attitude of clients with schizophrenia toward treatment, specifically about taking medication. This study measured the attitude of 100 clients with schizophrenia toward taking their medication in the hospital. They include 47 males and 53 females ranging in age from 18 to 75 years (= 33). Interviews occurred on the 1st to 32nd hospital day (= 4). Fishbein's expectancy‐value model provided the theoretical base for this study. Both open‐ended and fixed‐response estimates of attitude were made. Insight was measured, and the relationship between insight and attitude and between hallucinations and insight were analysed. Age and sex were evaluated in order to determine their effects, if any, on attitude. Internal consistency of both the fixed‐response instruments and the insight instrument was evaluated. Clients were able to provide information about beliefs and feelings about taking medication and about insight into illness and treatment. Attitudes varied tremendously; clients frequently held both strongly positive and strongly negative beliefs at the same time. The range for the fixed‐response estimate of attitude was ‐ 52 to + 76; the range for the open‐ended estimate was ‐84 to +24. However, the instruments were significantly correlated (r= 0.5640, P= < 0.000). Clients also varied widely in their insights with some having good insight and some having poor insight. The insight instrument correlated with the fixed response instrument (r= 0.2585; P= 0.005) suggesting that insight may be related to positive attitude. Attitudes were not affected either by age or sex. Insight was negatively affected by hallucinations. The internal consistency of the fixed‐response attitude instrument with the Cronbach alpha test was r= 0.779, while the insight instrument was r= 0.909.
The prevalence of pressure sores within an area health authority
Authors: Nyquist R. , Hawthorn P. J.
Published: December 2006

A point prevalence survey carried out to determine the number of pressure sores within the Nottingham Health Authority revealed that 5.3% patients were affected (132 patients out of 2513). The majority of patients were elderly (80.3% aged over 65), female (76.5%), and either categorized as immobile or having very limited mobility (77.2%). There were 233 pressure sores, 54.9% of which were on the buttocks or sacrum, and 24.9% of which were on or near the heels and ankles. Nine different cleansing agents were in use, 31 different preparations were applied to the sores and nine types of dressings were employed, with little standardization of use. The most popular aids used for the relief of pressure areas included synthetic sheepskin pads (supplied to 46.2% of the affected patients) and ripple mattresses (supplied to 28.8% of the affected patients). The prevalence of pressure sores within the health authority is indicated. These findings are similar to those of a previous study and may be applicable to other health areas.
Towards an epistemological basis for experiential learning in nurse education
Authors: MSc Philip Barnard
Published: December 2006

Experiential learning methods have been recommended for teaching psychiatric nursing students. What has been lacking to date, however, is a sound theory of knowledge to underpin the concepts involved in this relatively new approach to learning. This paper offers an epistemological theory divided into three domains: prepositional knowledge, practical knowledge and experiential knowledge, as a basis for a theory of experiential learning. After a description of the theory, experiential learning is redefined and the practical issues relating to the theory are discussed. The paper closes with some thoughts on the problems of research in the field of experiential knowledge.
An individualized teaching programme following primary uncomplicated myocardial infarction
Authors: Fletcher Valerie
Published: December 2006

This paper describes the planning and implementation of an individualized teaching programme for patients and their families following primary uncomplicated myocardial infarction. This preliminary study was designed and implemented by a senior nurse while working in the clinical area. Patients were randomly allocated to a control or study group. Both groups of patients were interviewed on the fourth day following admission to hospital and again at 2 and 6 months after discharge. Nurse intervention in the form of individually planned consecutive teaching sessions achieved a reduction in anxiety and modification of identifiable risk factors (smoking, obesity, diet, exercise) in the patients included in the teaching programme.
Implementing contract learning in a senior nursing practicum
Authors: Richardson Sharon
Published: December 2006

The use of learning contracts With undergraduates and graduate nursing students, as well as in staff inservice and continuing nursing education, has been promoted in North America as a teaching/learning strategy to individualize learning, promote independence, promote habits of lifelong learning and teach nurses how to cope with change. The purpose of this article is to describe the implementation of contract learning in a required clinical nursing course at the undergraduate level in a Canadian university and to describe retrospectively perceived benefits and difficulties. The process of peer consultation and student evaluation used in modifying contract learning is described. Recommendations for nurse educators considering implementing contract learning are presented.
Respiratory teaching of patients: how effective is it?
Authors: Howard Janice E. , Davies Janet L. , Roghmann Klaus J.
Published: December 2006

In order to evaluate the effectiveness of a structured respiratory teaching programme, clients with chronic obstructive pulmonary disease who were hospitalized in a 13‐month period both prior to and following the implementation of the programme were compared on several parameters to assess changes in their ability to manage their disabilities. The study demonstrated that clients who participated in the teaching sessions had fewer hospital admissions, shorter lengths of hospital stay, and longer stays in the community. A sub‐group of clients who were or had been in at‐risk occupations was identified as representing the‘revolving door’client with shorter hospital and community stays. The teaching programme is described as well as specific elements that can be used for a shorter teaching experience to respond to time constraints when necessary.
Staff sickness and its relationships to violent incidents on a regional secure psychiatric unit
Authors: Rix Gary
Published: December 2006

This study aimed to examine the relationship between absenteeism in nurses and disturbed and/or violent incidents in patients. It was conducted in the Interim Secure Psychiatric Unit at the Bethlem Royal Hospital, London (which later transferred to the Denis Hill Unit) during 1985. Data was gathered from sickness figures recorded on the ward and in the nursing administration office. Violence records were collected from incident reports made by all grades of nursing staff. The hypothesis to be tested was that as violence increased then staff sickness would decrease. Results indicate that such a correlation is not present. However, staff sickness was significantly concentrated around days off. Some considerations for future research are given.
Justification of closed intermittent urinary catheter irrigation/instillation: a review of current research and practice
Authors: Burgener Sandy
Published: December 2006

Urinary tract infections secondary to urinary instrumentation continue to affect over 400 000 patients per year in the USA. While the debate continues over the effectiveness of catheter/bladder irrigation or instillation, these procedures continue to be indicated for certain conditions. Inconsistencies in how these procedures are carried out often depend on the type of catheter used, frequency of the procedure, and equipment available. This review article looks at the available literature on pathogenesis of urinary tract infections and specific literature on irrigation techniques and outcomes. This information is summarized and recommendations are made for adoption of a well‐supported procedure, which also provides more cost‐effective care. Proposals are made for further research involving use of this procedure.
Instilling eyedrops: difficulties experienced by patients following cataract surgery
Authors: Donnelly Deirdre
Published: December 2006

It was hypothesized that patients instilling their own drops following cataract extraction would experience difficulties with this, due to age‐related factors, the nature of the operation itself and the fact that studies in other areas have shown compliance to be less than predicted. Ten patients who intended to instil their own drops were each interviewed on the ward before discharge and again 2 weeks later at home. They were asked about previous experience of using drops, general health, knowledge of their treatment regime, practice received on the ward and their feelings about how they were coping. The majority had inappropriate expectations of what compliance with treatment would involve. Six had used drops before and this was the major factor influencing their decision on this occasion. Supervised practice emerged as the recommended method for teaching drop instillation but this was not carried out often enough on the wards. It was concluded that if more time was devoted to developing and improving the teaching of drop instillation this would result in increased compliance with treatment. However, it may not be possible to achieve all the goals of a teaching programme on the wards and the teaching role may need to be extended into the community.
Concept of the person: introduction to the health professionals’ curriculum
Authors: Henry Christine , Tuxill A. C.
Published: December 2006

This paper deals with the concept of the person and its necessity in health care and health curricula. Specifically it looks at aspects of both the biological and social sciences. Further, there is some suggestion that for caring professionals in particular the concept of the person requires more analysis than purely a‘common sense’ everyday meaning and use, and that there is some requirement for sorting out and understanding the difference and the interconnections of the two terms ‘human’ and ‘person’. This first proposal will be followed by a further paper that discusses in more detail the distinction between the two terms and the moral issues that derive from the centrality of use of the concept of the person by the health professions.
The life sciences in nursing: development of a theoretical model*
Authors: Akinsanya Justus A.
Published: December 2006

This paper explores the relationship between the life sciences of anatomy, physiology, microbiology and pharmacology and the teaching/learning problems of their application in nursing. A theoretical model is proposed derived from a conceptual consideration of nursing tasks and of nursing actions developed to account for a direct link between these sciences and nursing. It is argued that a ‘bio‐nursing'approach to the use of the life sciences in nursing is comparable to that of a ‘bio‐medical’ approach in medical education and practice. The paper suggests lhat an appropriate examination of the contributions of the life sciences to nursing education will provide a more concentrated and illuminating exercise with regard to making possible the identification of a body of knowledge of direct relevance to nursing practice. The teaching/learning implications for nurse education and the development of a distinctive knowledge base derived from these sciences are discussed.
Foundational studies in nursing
Authors: Uys Leana R.
Published: December 2006

The essential nature of foundational studies in nursing, which are usually called meta‐theories or conceptual frameworks, is explored. There are three approaches to this type of study, namely foundationalism, language critique and philosophical analysis. The work of Orem, King and Rogers is briefly analysed as an example of each of these approaches.
Communication training in nursing may damage your health and enthusiasm: some warnings
Authors: Fielding R. G. , Llewelyn S. P.
Published: December 2006

The purpose of this paper is to outline and discuss some of the fundamental theoretical and practical considerations bearing on the teaching of communications skills to nurses. Although evidence exists that communications training is needed, and welcomed by both nurses and nurse managers, implementation of training schemes without consideration of a number of critical issues is likely to result in only partial success, or even complete failure. The issues identified and discussed in this paper are the need for accurate assessment and evaluation, the need to understand and take into accountresistance to change at the level of both the individual and the organization, and most pervasively, the need for a clear relationship between theory and practice.
The nurse's role in patient education: incongruent perceptions among nurses and patients
Authors: Tilley Janice D. , Gregor Frances M. , Thiessen Victor
Published: December 2006

The purpose of this study was to describe the amount of congruence in the perceptions of 38 matched nurse‐patient dyads concerning the nurse's role in patient education. The perceptions of nurses and patients from two hospital settings were measured with two complementary sets of questions, developed for this study; t‐tests were used to compare the mean responses of nurses and patients within and between the two settings to each set of complementary questions. The results indicated that incongruencies existed between nurses’ and patients’ perceptions of the nurse's role in patient education. Patients identified a general teaching function for nurses. When asked who they preferred to have teach them the specific information related to their condition, patients most frequently chose a physician. Nurses most frequently chose a nurse as the current and most desired patient teacher. Nurses incorrectly assumed that the desires of their patients for patient education were similar to their own. The results suggest that nurses need to develop a clear definition of their role in patient education, to validate patients’ desires for teaching, and to examine organizational factors influencing their performance of the patient teaching role.
Preventing chemotherapy‐induced alopecia in cancer patients: is scalp cooling worthwhile?
Authors: Tierney Alison J.
Published: December 2006

Alopecia (hair loss) is often singled out as the most distressing side‐effect of cancer chemotherapy treatment. This paper provides a comprehensive and critical review of the research literature on scalp cooling, a procedure introduced to prevent chemotherapy‐induced alopecia. In spite of a considerable amount of research (both nursing and medical) over a 15‐year period, the evidence on scalp cooling is inconclusive. Although concerned with a specialist issue, this paper may interest the general reader as it illustrates the value of a literature review in raising questions about current practice and in identifying issues for future research.
Characteristics of ‘best’ and ‘worst’ clinical teachers as perceived by university nursing faculty and students
Authors: Mogan Judith , Knox Janet E.
Published: December 2006

This study identified and compared characteristics of ‘best’ and ‘worst’ clinical teachers as perceived by university nursing faculty and students. The Nursing Clinical Teacher Effectiveness Inventory (NCTEI) was distributed to 201 volunteer subjects. This survey instrument, developed by the authors, contains 48 clinical teacher characteristics grouped into five categories. Each participant was asked to rate, using the NCTEI, the ‘best’ and then the ‘worst’ clinical teacher from past observations. Results showed both groups perceived that being a good role model was the highest rated characteristic for ‘best’ teachers and the ‘lowest’ rated characteristic for ‘worst’ teachers. Faculty and students’ perceptions were fairly similar as to highest rated characteristics of ‘best’ clinical teachers. Less agreement was noted about the characteristics of ‘worst’ clinical teachers. When categories of clinical teacher characteristics were compared, there were significant differences between the ratings of faculty and students for ‘best’ clinical teachers, but none for ‘worst’ clinical teachers.
Outcomes of discharge from hospital for elderly people
Authors: Waters Karen R.
Published: December 2006

The numbers of elderly people going home from hospital in the United Kingdom are likely to increase over the next decade. Previous research suggests that this group of people are liable to experience some difficulties on returning home. This paper reports the findings of a study of the outcomes of discharge for 32 elderly people admitted to geriatric wards. A lower level of independence in daily living activities, and an increase in the amount of help needed after hospitalization were found. An increase in the rate of discharge of elderly people will have implications for both formal and informal carers.
Spiritual distress and the nursing response: theoretical considerations and counselling skills
Authors: Burnard Philip
Published: December 2006

Spiritual distress may be described as the failure to invest life with meaning. It is a condition that may be met by nurses in a variety of settings. This paper examines some of the issues and some of the practical skills involved in counselling those who experience such distress. Considerable reference is made to the literature on this vast topic in order that the issues under discussion may be followed up.
Nursing in the 21st century: alternate paths*
Authors: Orlando Ida J.
Published: December 2006

The nursing profession has the opportunity to choose one of two alternate paths as it enters the 21st century. One is a dependent path the other is independent. By virtue of a licence nurses have authority to practice their profession independently. Yet some nurses, health care policy makers, and administrators of institutions and agencies, formulate and implement roles and activities for nurses in order to fulfil the aims of medicine and institutional bureaucracy. This problem ‘forces’ nursing to travel a dependent path. A view is set forth that the problem stems from the collective failure of nursing to articulate and implement a function and product distinct from that of medicine and of other professions. Making this distinction is critical to the charting of an independent path. Nursing's past and present are examined in terms of the service nursing does in fact provide for society. This operationally defined role of nursing is presented in marked contrast to the definition of nursing currently being promulgated by the American Nurses’ Association. Collective articulation of a distinct function and product are set forth as a prerequisite for nurses to assume professional authority as they practise. This will safeguard consumers of professional nursing as well as the work and future of nursing as an independent profession.
The relevance of research to the ward sister
Authors: Robinso Janen
Published: December 2006

This paper addresses the relevance of research to practice under two headings using a policy analysis perspective. Firstly, the relationship of knowledge to action is considered within the context of a piece of longitudinal research into the welfare of children in hospital. The general difficulties of research application are discussed in terms of the different problem perceptions and time scales held by the policy makers who commission research, and the researchers themselves. The example cited demonstrates a useful compromise. The practical consequences arising from the distinct epistemological premises which underpin research into the natural and social worlds of nursing are considered. Secondly, the constraints on achieving research‐based action are described briefly in terms of the resources of time, manpower and funding. It is concluded that an awareness of both conceptual and practical issues is essential in order to comprehend fully the complexity of, and the necessity for, a range of research approaches to nursing issues.
Problematic situations in nursing: analysis of Orlando's theory based on Dewey's theory of inquiry
Authors: Schmieding Norma Jean
Published: December 2006

Orlando's theory, proposed as a framework to use in problematic situations, was analysed using Dewey's theory of inquiry. This analysis revealed that Orlando's concepts are remarkably similar to those of Dewey. Each used an organizing principle that was derived from the meaning of experience and both view investigation as a serial process using facts and ideas to determine the problem and its solution. Several areas in Orlando's work could be enhanced and extended through the formulations of Dewey. The analysis supports the use of Orlando's theory in problematic situations.
Nursing management of postoperative pain: use of relaxation techniques with female cholecystectomy patients
Authors: Levin Rona F. , Malloy Gail B. , Hyman Ruth B.
Published: December 2006

The purpose of this study was to assess the effectiveness of two different relaxation techniques in the management of postoperative pain. The sample consisted of 40 women between the ages of 21 and 65 years who were undergoing elective cholecystectomy. Using an experimental design, participants were randomly assigned to four groups: an experimental group who received a taped recording of a rhythmic breathing exercise (RB); an experimental group who received a taped recording of Benson's Relaxation Technique (BRT); an attention‐distraction control group (CA) who received a taped recording of a history of the hospital; and a standard control (CB) group who had only the routine perioperative care which all groups received. Data were collected on postoperative sensation and distress at five time points during the first 72 postoperative hours, number of doses of analgesic medication during the same time period, and number of postoperative hospital days. Data were analysed using multivariate and univariate analyses of variance. The BRT group was significantly different from the CA group on a combined sensation and distress factor (P= 0.011). No significant differences were found among groups for doses of analgesics (P= 0.068) or postoperative hospital days (P= 0.56).
A model for the assessment of eating problems in patients with Parkinson's disease
Authors: Norberg Astrid , Athlin Elsy , Winblad Bengt
Published: December 2006

A model for the assessment of eating problems in patients with Parkinson's disease was constructed on the basis of literature about eating and Parkinson's disease. The model is based on the World Health Organization's classification of disabilities and handicaps and on the Erikson theory of ‘eight stages of man’.
Inflammatory bowel disease: effects on lifestyle
Authors: Joachi Gloria , Milne Barbara
Published: December 2006

While there has been speculation in the literature about what life with inflammatory bowel disease (IBD) is like, patients have not, prior to this study, been asked about their perceptions. This paper reports the results of a study which measured the impact of having IBD on eight lifestyle variables. Eighty IBD patients completed the Inflammatory Bowel Disease Stress Index. Results showed that although the impact of IBD on relationships, school and employment, recreational activities, sexuality, psychosomatic symptomatology, body image and worry was minimal, the patients’ satisfaction with life was impaired as a result of having IBD. Rationale for this discrepancy and the significance of the findings for nurses are presented.
Identifying strategies nurses use to cope with work stress
Authors: Dewe Philip J.
Published: December 2006

Although in occupational stress considerable attention has been given to identifying causes and consequences, relatively few attempts have been made to examine and identify the strategies nurses use to cope with stress. In a nationwide survey nurses were asked to complete a check list of coping behaviours developed from strategies nurses themselves said they used. The analysis identified six strategies. These included problem‐oriented behaviour, trying to unwind and put things into perspective, expressing feelings or frustrations, keeping the problem to yourself and accepting the job as it is and trying not to let it get to you. The importance of these findings is discussed in terms of how coping has been defined, the role of palliative techniques and strategies for intervention.
The changing composition of the British hospital nursing workforce 1962–1984
Authors: Moores Brian
Published: December 2006

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) recently undertook a major project aimed at identifying the most appropriate future nurse staffing patterns. The results presented here were produced at the request of the UKCC in order that the recommendations stemming from their deliberations could be set against a wider backcloth. It proved possible to secure nurse staffing data from three of the countries of the United Kingdom, namely, England, Wales and Scotland. Most were secured from government publications but the appropriate government agencies also provided valuable assistance. The main trends emerging from a processing of the data are a steadily falling ratio of student nurses and midwives to their qualified counterparts and a steadily increasing contribution by state enrolled nurses. A number of other ratios are presented pictorially accompanied, where appropriate, by a commentary. The actual growth in whole time equivalent nurses is seen to be somewhat less than many people imagine when account is taken of the reduction in both the number of weeks and the number of hours per week worked. Indeed, there has been a levelling off of this last figure over the past few years.
Towards a coexistence of paradigms in nursing knowledge development
Authors: Cull‐Wilby Barbara L. , Pepin Jacinthe I.
Published: December 2006

During the last 35 years, nursing knowledge has known a surge in its development. Following the evolution of the scientific world, nursing first embraced the logical empiricist perspective of discovering and knowing. Historicism and, more recently, critical social theory have been explored as alternative ways of making knowledge in nursing. This paper discusses the evolution of nursing knowledge, considering its past and present activities. The authors suggest that a cooperative attitude amongst nurses, and a coexistence of various paradigms of knowledge development characterize the future of nursing. Nursing knowledge should be understood as a stage in its evolution and growth. The result of this process will never be a final static body of knowledge. Knowledge expansion will be encouraged through a process of integrating components from different research traditions, such that a multidimensional understanding of phenomena will be realised.