bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating labour ward services: the art of the possible
Authors: Brown Carole , Dawson Jane
Published: December 2006

Midwives have contended that midwifery and obstetric workloads could not be measured and that only a 11 ratio of mother to midwife should occur, at least in the labour ward environment This would appear to be true if traditional hospital statisties are used However, this project set out to measure workload and staffing requirements Using clinically based process and outcome criteria, dependency classification enabled daily, weekly and monthly workload and patterns of workload to be studied Contrary to widely held beliefs it was demonstrated that mothers could be classified according to levels of need which form consistent patterns of distribution A mean average of the total time spent on the labour wards by mothers was calculated for each level of need using 11 months' data. This produced a positive correlation with the dependency classification Dependency classification and total time spent on the labour wards provides a mechanism for measuring workloads To enable economic use of resources, a level of dependency for which a 11 ratio of staff mother is considered essential has to be agreed To assist with this decision two surveys designed to collect information concerning the percentage of the mothers' time spent in contact with the nursing/midwifery staff was conducted. The results were remarkably similar and again demonstrated a positive correlation with dependency classification It was recognized that midwifery is a chronically understaffed service and that midwives working within the service felt unable to give the care they considered a woman in labour deserves In response to this a panel of midwives was asked to pass judgement on the criteria used in dependency scoring, with regard to the time needed to fulfil their function as a midwife, involving both the physical and psychological aspects of care. Substituting the actual contact time with the professionally judged time it was possible to calculate the optimum hours required for direct care of mothers Activity sampling provided information on how staff spent their time This allowed the study of working patterns for more effective and efficient use of the available staff time Though mechanical in its approach, redeployment of work can be achieved With the optimum reallocation of activities, staffing requirements to cover the labour wards and indicators of an appropriate staff mix were calculated
Nurses' perception of stress in preoperative surgical patients
Authors: Biley F C
Published: December 2006

It is generally recognized that the stress of hospitabzation and hospital treatment can impede the recovery of patients and in some cases cause potentially life‐threatening physiological changes Previous studies have indicated that nurses do not accurately perceive worry, anxiety and stress in patients In order to assess how accurately nurses perceive worry, anxiety and stress in their patients, questionnaires were designed and distributed to a group of preoperahve patients and nursing staff from general surgical wards, in order to discover how closely these two groups considered various situations and events as causing worry in preoperahve patients The results showed that whilst there was a considerable level of agreement between the two groups for the rank order of the 26 items in the questionnaire, nursing staff consistently assessed patients as worrying considerably more than the patients actually reported themselves The nurses in the study were therefore over‐estimating the degree of worry, anxiety and stress in their patients
The entrepreneurial nurse consultant: a Marxist analysis
Authors: Crowley Margaret A
Published: December 2006

Consultation based on an entrepreneurial model is becoming an increasingly popular career choice for nurses Marx's theoretical formulations were selected as a framework for examining various aspects of the entrepreneurial model of consultation in nursing Areas addressed include the growing alienation of nurses from their work in institutional settings, entrepreneurial practice as an escape from alienation, and the inherently conservative nature of entrepreneurial consultant practice
Graduate nurses' adjustment to initial employment: natural field work
Authors: Horsburgh Margaret
Published: December 2006

This study used natural field work methods in order to understand initial employment for new graduate nurses. The researcher participated in the first 3 to 4 months of the nurses' employment in general hospital settings. Background information related to the introduction of the comprehensive nursing courses in New Zealand is included, together with an overview of the research methodology. The five major themes which emerge from the study are presented and discussed, indicating that the rhetoric and practice of the school of nursing is different from the rhetoric and practice of nursing within general hospital settings. It is argued that management practices which support the ideals of the New Zealand comprehensive nursing courses and a total qualified nursing workforce have yet to occur. There are implications in this study for nursing education and nursing practice.
Integrative care planning in acute psychiatry
Authors: Meades Stephen
Published: December 2006

Psychiatric nurses in Britain are increasingly utilizing the problem‐solving techniques embodied in the nursing process in order to formulate programmes of care. The paper disputes the validity of an approach which suggests that one discipline (nursing) possesses the broad‐based assembly of skills necessary to promulgate coping strategies in the client and his family or sustainer‐group. The efficacy of such an approach is particularly questionable when we consider that much of our work as nurses is practised in a hospital environment, where the client is abstracted from his familiar surroundings and support networks. Suggestions are made for improving the appropriateness and quality of psychiatric nursing interventions within a multi‐disciplinary care framework, and the argument is put forward that dogmatic adherence to the nursing process, with the emphasis upon finding answers to problems, may dually impede interdisciplinary teamwork and also lead us away from analysis of the skills which are important in establishing an effective interaction with the client and his family.
The meaning of visual impairment to visually impaired adults
Authors: Allen Marion N.
Published: December 2006

The purpose of this study was to explore the subjective meaning of visual impairment in the context of day to day life to adults whose visual impairment began in their adult years. Information was elicited through interviews from 25 people whose visual impairment ranged from an inability to see ordinary print to no light perception. Hermeneutics, as elaborated by Ricoeur, was used in the interpretation of the texts (transcribed interviews). A core variable, adjusting to a visual impairment, and five distinct categories, each with subcategories, emerged from the data. The meaning of visual impairment was derived from the manner in which the categories interrelated with the process of adjusting.
Learning clinical teaching skills at the baccalaureate level
Authors: Byrne Carolyn , McKnight Janet , Roberts Jacqueline , Rankin Jean
Published: December 2006

Nurses returning to work after obtaining their baccalaureate degree in nursing find increased expectations to participate in student and staff clinical education. Often these nurses are not prepared for this role. This paper describes a project that involved final year post‐diploma registered nurse students in the clinical teaching of second year basic degree students in a baccalaureate nursing programme. Results of a pilot study to determine if the perceptions of the students involved in the teaching project changed following the experience, show a more positive change in teacher behaviours in these student tutors compared to students doing a traditional clinical experience. Course evaluations indicate the experience increased knowledge and comfort in clinical teaching, and point to positive changes in the perceptions of behaviours conducive to clinical teaching.
Variables related to research utilization in nursing: an empirical investigation
Authors: Champion Victoria L. , Leach Anna
Published: December 2006

The purpose of the correlational study was to identify variables which were related to utilization of research in the clinical area. A convenience sample of 59 nurses from a community hospital in the southwest part of the United States was utilized for the sample. The concepts of attitude, support and availability were identified through the literature and used as independent variables for this study. Scales were developed from past research and tested for validity and reliability. Results indicated that attitude and availability were related to research utilization (R= 0.65, P 0.00). In addition, the support of administrators was also important in determining research use. Results from this study can be used to develop strategies to increase research utilization.
Managing chronic illness in the family: women as caretakers
Authors: Anderson Joan M. , Eifert Helen
Published: December 2006

This paper is based on an ethnographic study examining how families caring for a chronically ill child in the home construct their experiences of illness. The role of women caretakers is examined, and it is argued that the term family glosses over the work that women do in caretaking. The ‘ideology of competence’ which determines women's subjective experiences is discussed, and the notion is forwarded that health professionals rely upon this ideology to get the job of caretaking done in the home. Some implications of this discussion for health care delivery are presented.
Modelling and role‐modelling: integrating nursing theory into practice
Authors: Walsh Kathleen Kelley , VandenBosch Terry M. , Boehm Susan
Published: December 2006

This article contrasts two clinical cases using a relatively new paradigm and theory, modelling and role‐modelling. The concepts and linkages from modelling and role‐modelling are presented and are the basis for analysing the outcomes of two patients. The case study approach communicates an understanding of the theory modelling and role‐modelling and assists nurses to develop expertise in its use.
Psychomotor skills laboratories as self‐directed learning: a study of nursing students' perceptions
Authors: McAdams Constance , Rankin E. Jean , Love Barbara , Patton Diane
Published: December 2006

Fifty‐nine baccalaureate nursing students were surveyed regarding their preferred method of learning psychomotor skills necessary for clinical practice. In addition, 12 faculty members were also asked to express their opinions of the best way for students to learn psychomotor skills. The use of a self‐directed clinical laboratory was supported by both students and faculty in this study. Hands on and visual pre‐clinical experiences with adequate equipment were the major factors influencing the students' requests for clinical laboratories. Faculty expressed the same concerns about equipment and human resources, but their support of the laboratory was tempered and based on the presence or absence of adequate human resources and equipment available to students in the clinical setting.
The significance of primary nursing
Authors: Bowers Len
Published: December 2006

Primary nursing is a relatively new phenomenon in the organization of ward‐based nursing. This paper seeks to answer the question of what lies behind primary nursing's sudden and startling rise in popularity. Factors within nursing which are implicated include most importantly the adoption of the nursing process, and the attempt to provide truly individualized patient care. Nursing's search for professional status has played its part, primary nursing frequently being seen as a key strategy in its achievement. Other areas of wider social change have also had an impact, from the nascent dominance of new right political/social values, to the micropolitical scene within the British National Health Service. While appearing to be the ideal answer to some of nursing's current problems, primary nursing contains some inherent contradictions, most evident being those surrounding the concept of accountability. It may also threaten the cohesiveness of the nursing team on the ward, and may lead to the uncovering of conflicts between doctors and nurses. Finally, perhaps one of the major reasons for its continuing success is the way it brings together the various nursing interest groups and current managerialism in the NHS.
Bulimic and non‐bulimic college females’ perceptions of family adaptability and family cohesion
Authors: Coburn Joyce , PhD Lawrence Ganong
Published: December 2006

Bulimia appears to be increasing among young women of middle to upper socioeconomic status. Although the aetiology of bulimia syndrome is not fully understood, family functioning patterns are thought to contribute to development of the disorder. The purpose of this study was to investigate the relationship between self‐reported bulimic behaviour in female college students and their perceptions of family adaptation and family cohesion levels. A sample of 308 subjects from three social sororities at the University of Missouri‐Columbia completed a demographic questionnaire, the Bulimic Test (BULIT) and the Family Cohesion and Adaptability Evaluation Scale (FACES III). Twenty subjects were found to be bulimic, 21 incipient, and 267 non‐bulimic. Analysis of data using the chi‐square test resulted in a statistically significant relationship between self‐reported bulimia and perceptions of family cohesion. No significant relationship was found between self‐reported bulimia and family adaptation. Implications for nursing practice are discussed.
Community psychiatric nurses: their self‐perceived roles
Authors: Barratt Elaine
Published: December 2006

The self‐perceived role of 16 community psychiatric nurses (CPNs) were analysed with reference to four conceptual models of psychiatric illness. The roles discussed by the CPNs echoed many of those found in previous research. Overall the CPNs used different models of illness when discussing various aspects of their roles. It is believed that the models of illness preferred by CPNs may be a useful reflection of the role they may have in caring for different client groups.
A survey of the attitudes of senior nurses towards graduate nurses
Authors: Bircumshaw Denise
Published: December 2006

This small scale survey is one aspect of a larger study of the progress and function of graduates of a nursing degree course. There is very little current literature regarding the views of senior nurses on the role and function of graduate nurses. The aim of this study was not to survey all senior nurses, but to obtain the views of senior nurses in the areas where graduates included in the main study were working. A descriptive survey approach was taken using postal questionnaires to ascertain views on the role and function of graduate nurses. Six chief nurses and 11 directors of nursing and midwifery services returned the questionnaires. The results showed varied views on whether graduates should and do function differently to traditionally trained nurses and interesting comments were made in relation to this. The implications of the study are important, since the views of senior nurses are likely to influence the posts held by graduates and the way they function within those posts, and there is a need for a more in‐depth study of this area.
Determining quality in a unit where nursing is the primary intervention
Authors: Pearson Alan , Durant Ismene , Punton Susan
Published: December 2006

This paper discusses the use of a variety of quantitative and qualitative methods of measuring quality in a nursing unit. It reports the results of comparing the quality of nursing care between patients admitted to the nursing unit concerned (in Oxford, England) following admission to an acute ward, with patients who spent the whole of their hospitalization in an acute ward. The findings suggest that quality can be best assessed by using a number of methods, and the quality of nursing care delivered in a unit which focuses on therapeutic nursing is significantly and consistently higher than that delivered in acute hospital wards.
Community psychiatric nursing a research‐based profession?
Authors: Simpson Kevin
Published: December 2006

This paper examines the relationship between research and professionalism, and considers the question of why research is necessary for the development of nursing. Suggestions which have been made for areas suitable for community psychiatric nursing research are looked at, and comments from various authors regarding the lack of evaluative (as opposed to descriptive or prescriptive) studies are noted. The paper goes on to look at recent CPN research, and finds mainly small‐scale and locally‐oriented studies. Three studies which look at the work of community psychiatric nurses (CPNs) in detail are examined; two of these found CPN practice to be lacking in any research or theory base, and in effect suggested therapeutic incompetence in dealing with neurotic clients. The third concluded the opposite, but suggested a need for more specialized training. The paper, which includes as an appendix an overview of 36 recent (1983‐1988) research studies of interest to CPNs, concludes that, if research is a necessary precursor to autonomous professional development, such research into CPN practice has yet to be done.
Stressor frequency, tension, tiredness and coping: some measurement issues and a comparison across nursing groups
Authors: Dewe Philip J.
Published: December 2006

In nursing research a number of approaches have been adopted when measuring the relationship between stressor and stress. However, despite thorough questionnaire development, excess demand, that is the extent to which the situation actually taxes the resources of the nurse, is measured more by implications than by presence. By combining different facets of demand and by measuring them in conjunction with one another this research revealed the extent to which the demands of frequently occurring situations actually taxed the resources of the nurse; provided a procedure for more specifically investigating the relationship between stressor frequency and response and considered these findings in terms of different types of nurses (enrolled, staff, charge) and the coping strategies used. The results were discussed in terms of measurement, training, available resources, coping and interventions
Evaluating Antonovsky's Salutogenic Model for its adaptability to nursing
Authors: Sullivan Grace C.
Published: December 2006

Despite dissatisfaction with disease‐oriented models, nursing has not yet adopted a truly health‐oriented paradigm. It is important that nurse theorists remain open to health‐oriented conceptual models which, although developed in other disciplines, offer adaptability for nursing. In the accompanying article, Antonovsky's Salutogenic Model is analysed and evaluated for adaptability to nursing from its parent discipline, medical sociology. The central concern of this model, as its name suggests, is explaining how people manage to stay well despite omnipresent stressors. The difference between health breakdown and wellness may depend more upon one's outlook on life than upon the avoidance of stress. An orientation which views life activities as meaningful and perceives life events as comprehensible and manageable is called a sense of coherence. People who have a strong sense of coherence manage tension effectively and resist health breakdown. Nursing which strengthens the client's sense of coherence promotes wellness and fosters the client's ability to stay well or get well. Evaluation of the Salutogenic Model relative to its potential usefulness as a nursing paradigm is accomplished by applying the framework for analysis and evaluation of a model developed by Fawcett. The Salutogenic Model is determined to be explicit, comprehensible, logically congruent, and to have social significance, congruence and utility. We conclude that it is suitable for adaptation to the nursing milieu.
Evaluating the effects of a nurse preceptorship programme
Authors: Allanach Bruce C , Jennings Bonnie Mowinski
Published: December 2006

Nurse preceptorship programmes have evolved as a means to ease the turmoil of transition from student nurse to staff nurse In this era of economic retrenchment, it is possible that such programmes might be elimmated Conversely, it is also possible that preceptorship programmes represent an important mechanism for recruitment and retention, issues that also pervade the contemporary health care arena This study was conducted, therefore, to evaluate the transition process of new graduates who participated m a preceptorship programme While the objechve measures used in this investigation did not support the common belief that the transition from student nurse to staff nurse is an emotion‐laden experience, the preceptees did verbalize feelings of psychosocial discomfort Several explanations are proposed to account for these findings, including that the effectiveness of the programme may have sustained the more positive affective states The authors conclude that preceptorship programmes remain important and necessary interventions to facilitate integrating and enacting the professional nurse role
Health promotion self‐care within Orem's general theory of nursing
Authors: Hartweg Donna L
Published: December 2006

The growing emphasis on health promotion by society and the increasing utilization of Orem's general theory of nursing to guide practice, education and research create a need to clanfy health promotion activity withm the model The concept of health promotion self‐care is developed after an analysis of statements by Pender and Orem for their logical congruence Further m‐depth analysis of Orem's model facibtates the placement of the new concept within its current structure The potential strength of the model for guiding health promotion practice is discussed, as well as areas for needed development
An exploratory analysis of nurses’ provision of postoperative analgesic drugs
Authors: Closs S José
Published: December 2006

Adequate pain relief during the postoperative period has long been recognized as difficult to accomplish The reasons for this are mentioned in a bnef review of methods of pain control, and an overview of the detrimental effects of acute pain is given This retrospective analysis of data from 36 patients set out to examine whether those whose night‐time sleep was found to be disturbed by pain were subject to different patterns of analgesic provision from those whose sleep was not Although no such differences emerged, it was found that analgesics were given approximately half as frequently during the night when compared with during the day It was also noted that only 30–35% of the maximum doses of analgesics prescribed were actually given within the immediate postoperative period The possible reasons for these findings are discussed
From organizational to interorganizational development in nursing practice: improving the effectiveness of interdisciplinary teamwork and interagency collaboration
Authors: Iles Paul A , Auluck Randhir
Published: December 2006

Organization development approaches to improving nursing practice, especially survey feedback and team development approaches, are described, and differences from organization development in industry explored Problems encountered in developing effective interdisciplinary teams with nurse participation are examined in the context of studies of intergroup relationships, especially studies of interprofessional relationships in the health and social services fields Reference is made to a specific intervention with a community drug team in order to highlight issues of goals, roles, procedures, skills and accountabilities in such teams Some problems encountered in developing interagency collaboration between nursing and social work staff are illustrated with reference to a specific intervention made in a West Yorkshire maternity unit antenatal clinic, and some recommendations for increasing the success of such projects are made
Gaining access to clients: the case of health visiting
Authors: Luker Karen A , Chalmers Karen I
Published: December 2006

The aim of this paper is to explore the concept of gaining access to clients as it emerged from an in‐depth qualitative study of health visiting practice The study was conducted using a grounded theory approach to data collection and analysis Forty‐five experienced health visitors were interviewed using a semi‐structured interview guide The interviews were tape recorded and later transcribed A detailed analysis of the processes involved in‘entering’ into client situations to begin health visiting work is presented Entry into the client/family situation is a process which involves both obtaining access to the client in the environment where health visitor and client meet and‘entering’ into the client situation more fully to continue the health visiting work The data from this study would suggest that the work involved in entering client situations involves many strategies to ensure entry and re‐entry This process is influenced by many factors within the client, the health visitor, and the health visitor‐client encounter This paper makes a contribution to our understanding of the processes involved in everyday health visiting practice
Postoperative pain: patients’ expectations and experiences
Authors: Carr Eloise CJ
Published: December 2006

Recent evidence suggests that postoperative pain is poorly controlled and it is reported that nearly 75% of hospitalized patients failed to receive adequate pain relief It was hypothesized that there was no difference between expected and experienced pain and that pain scores on the first postoperative day would be‘low’ Factors affecting the management of pain were identified using a patient questionnaire A Visual Analogue Scale was used to measure patients’ pain, pre‐ and post‐operatively A patient questionnaire explored pain experience and identified contributing factors A review of all analgesia prescribed and given to the patients was undertaken Twenty‐one surgical patients participated in the study There was a significant difference between preoperative expectations and postoperative experience of pain No relationship was found between the doses of analgesia and pain scores on the first day postoperatively and pain scores on the first day postoperahvely were not ‘low’ The nurse did not play a key role in the preoperahve information given to the patient Patients experienced ‘worsened’ pain in the morning and evening Nurses questioning patients about their pain often failed to identify those in pain
Contract learning reconsidered: a critical examination of implications for application in nurse education
Authors: Mazhindu Godfrey N
Published: December 2006

This paper defines and explores the nature of learning contracts It also discusses the origins of learning contracts, presents a critical evaluation covering the implications of their use in nurse education and makes recommendations
Nursing diagnosis: exploring the factors which may influence the reasoning process
Authors: Woolley Norman
Published: December 2006

Nursing diagnosis is defined and discussed in relation to nursing's metaparadigm, the cognitive processes involved in problem‐solving, and nursing's theoretical knowledge base It is argued that each of these distinct yet related domains must be addressed by the clinician when applying the reasoning process Factors are identified which can hinder and dramatically influence this diagnostic process, even to the detriment of the patient's welfare Suggestions are offered throughout the discussion which may assist the nurse in developing more effective and accurate clinical decision‐making strategies
The use of the Ethnograph program to identify the perceptions of nursing staff following the introduction of primary nursing in an acute medical ward for elderly people
Authors: MacGuire Jillian M , Botting Deborah A
Published: December 2006

Interviews with a small group of nurses working in a primary nursing ward were content analysed using the Ethnograph computer program In response to some very general questions about their views of primary nursing, the respondents talked at some length about their improved knowledge of patients, about better communication, about their relationships with pahents and relatives and about personal responsibility They did not talk spontaneously about controlling their own practice, decision‐making, autonomy or accountability Such terms did not form part of their vocabulary in describing their work though these issues were raised obliquely in the conversations The value of the change in the way of organizing the delivery of nursing care was seen more in terms of its potential for developing therapeutic relationships rather than in terms of personal professional development Increased knowledge of and responsibility for specific patients coupled with the greater continuity of care they were able to provide, gave them greater job satisfaction than they had previously experienced
Self‐efficacy and activity level following cardiac surgery
Authors: Gortner Susan R , Jenkins Louise S
Published: December 2006

Self‐efficacy expectations were measured in 149 recovering cardiac surgery patients to determine whether in‐patient education and telephone monitoring during convalescence enhanced perceptions of cardiac efficacy and reported activity Significant differences were found for experimental patients in self‐efficacy expectations for walking between 4 and 8 weeks (P=0 02) and between 8 and 24 weeks (P= 0 05) following surgery Experimental patients also reported higher levels of general activity at 4 weeks (P= 0.05) and 8 weeks (P=0.02) as well as more walking and lifting at 8 weeks (P= 0 01 and P= 0.0008, respechvely) By 12 weeks, treatment differences were no longer significant except for continued higher general activity levels (P=0.03) for experimental patients Self‐efficacy expectations, summed for all physical activities, at 8 weeks were found to be a significant predictor of self‐reported activity at 12 weeks, contributing 14 8% of the 34 8% explained variance (R2 change = 0 1479, F= 26 58, P < 0 0001) Self‐efficacy expectations summed for all physical activity at 8 weeks were also significant predictors of self‐reported activities at 24 weeks, contributing 8 5% of the variance (R2 change = 0 0847, F= 14 48, P=0 0002) A New York Heart Association functional class at 4 and 8 weeks was an independent predictor of self‐reported activity at 12 weeks, as was 8 week functional class for self‐reported activity at 24 weeks Mood state did not contribute to explained variance in the regression models These findings suggest that efficacy expectahons in the recovering cardiac surgery patient (a) can be influenced by in‐pahent education and further enhanced by out‐patient coaching by telephone during home recovery, (b) are correlated with activity and mood state and are predictive of subsequent activity, (c) change rapidly in the first weeks after discharge, and (d) may be influenced by cardiac functional class following surgery, in that cardiac class is also predictive of activity
Content areas for cardiac teaching: patients' perceptions of the importance of teaching content after myocardial infarction
Authors: Chan Vivian
Published: December 2006

This descriptive study was undertaken to investigate patients’ perceptions of the seven content areas commonly included in cardiac teaching in terms of how important and how realistic they were for being learned following the experience of an acute myocardial infarction (MI) Lazarus's stress‐coping theory was used as a framework for the study A sample of 30 MI subjects were interviewed before discharge and during early convalescence Before discharge, subjects rated six out of the seven content areas as ‘important’ for learning Although the information was considered important, it was not rated as equally realistic to learn During early convalescence, mean scores under ‘important to learn’ were slightly lower, but all seven content areas were rated as significantly more realistic to be learned (P < 0 05) Little variation in patients’ perceptions of the importance of teaching content was noted over time However, there was major variation between their perceptions of how important and how realistic it was to learn the material before discharge Both dimensions, how important and how realistic, are therefore crucial to consider in cardiac teaching
The effect of systematic care planning after acute stroke in general hospital medical wards
Authors: Hamrin Elisabeth KF , Landmark Birgitta
Published: December 2006

In a mutidisciplinary study comprising 280 patients with acute cerebrovascular disease, the functional capacity was followed from the acute stage onwards with a test battery mainly measuring activities of daily living and motor capacity Systematized care procedures with written care plans in accordance with the nursing process model, together with a booklet of guidelines in stroke care, were introduced during an experimental period in the care of 173 of the stroke victims The remaining 107 patients received conventional care The functional improvements were equal from a statistical standpoint in these two groups However, in the group, which received special activities, there was a significant decrease in bed days, and a slightly larger number were able to return to their own homes Compared with another stroke population from the same hospital, measured with the same functional instrument 7 years ago, the patients in this study seemed better off from a functional standpoint For the individual severely‐disabled patient, the care planning procedures seemed to be valuable and an effective way of promoting communication between different units The difficulties in introducing new routines for documentation are discussed
Empathy: a review of the literature with suggestions for an alternative research strategy
Authors: Gould Dinah
Published: December 2006

Although empathy is regarded as a necessary component of good quality nursing care, defining and measuring empathy have both been fraught with problems A historical overview helps to explain these difficulties, as nurses have tended to accept the views of psychotherapists uncritically, and have used scales developed for clients in counselling with people who are physically ill Methodological difficulties combined with the results of studies demonstrating low levels of empathie ability in nurses have culminated in disenchantment with this topic A framework is used to show why nurses cannot always demonstrate empathic awareness of every patient's need and an alternative approach for exploring the nature of empathy is suggested
A survey of opinion amongst trained nurses and junior medical staff on current practices in resuscitation
Authors: O'Donnell Claire
Published: December 2006

An anonymously‐completed questionnaire was used to examine the opinions of trained nurses and their junior medical colleagues regarding the resuscitation of a patient following cardiac arrest Nurses were less satisfied with their pre‐qualification training and recorded lower scores on a subjective assessment of performance than did the doctors Those nurses who had attended some post‐qualification training in resuscitation were significantly more confident of their resuscitation skills Both doctors and nurses agreed on some frequently‐encountered problems such as the presence of too many people and the uncertainty of those present of the role they should assume Doctors recorded poor initial resuscitation and the absence of equipment as common problems significantly more often than did the nurses Nurses showed a lack of knowledge of the drugs used during a resuscitation 30% were unsure of the function of more than half of the drugs Nearly 20% of nurses showed a similar lack of knowledge with regard to the equipment used Those having post‐qualification training in resuscitation recorded significantly greater knowledge in these areas Widespread support was shown for the proposed initiation of compulsory resuscitation lectures, the presence on each ward of resuscitation equipment and more clearly defined roles for those taking part in the proceedure A requirement for a full‐time resuscitahon officer is clearly indicated
The Patient Learning Needs Scale: reliability and validity
Authors: Bubela Natalie , Galloway Susan , McCay Elizabeth , McKibbon Ann , Nagle Lynn , Pringle Dorothy , Ross Eleanor , Shamian Judith
Published: December 2006

The article describes the development and initial psychometric evaluation of an instrument to measure patients’ perceptions of learning needs at time of discharge from hospital to home Evaluation of the Patient Learning Needs Scale was based on responses of 301 adults hospitalized with a medical or surgical illness Factor analysis isolated seven subscales medications, activities of living, feelings related to condition, community and follow‐up, treatment and complications, enhancing quality of life and skin care These seven factors accounted for 56 1% of the variance Cronbach's alpha for the 50‐item scale was 0 95
An investigation of recognized incontinence within a health authority
Authors: McKeever Margaret P
Published: December 2006

Incontinence affects a very large proportion of the population bringing with it considerable physical, social, psychological and often financial implications for the sufferer Hence, it poses a considerable challenge to the providers of health care in relation to service provision and appropriate treatment of the problem This descriptive study focused on the service provided by one health authority to sufferers of incontinence The service in operation prior to the study had mushroomed with little thought being given to its organization or management, with the result that little was known about the people receiving the service The study was commissioned to establish the number of people receiving assistance and the nature of the assistance given Data were collected using pre‐existing records, by questionnaire and by interview A total of 847 people were found to receive assistance from the health authority, the majority of these being female and over the age of 65 Less than half of the study population were in regular contact with the community nursing service with regard to their incontinence Of the remainder, inadequate incontinence products were found to be supplied without prior assessment of the problem to a proportion of the study population Some strategies used by this group to manage their incontinence, disclosed during interview, were considered to be detrimental to the general health and well‐being of the individuals practising them These include non‐compliance with prescribed diuretics and self‐restriction of fluids The service provided was considered to be a basic one providing assistance to 0 47% of the population of the study area The implications of the service provided, highlighted by the findings, are wide‐reaching in terms of the resultant underprovision which led to increased misery for some sufferers and the employment of inappropriate coping strategies
Status passage into nursing: another view of the process of socialization into nursing
Authors: Bradby Mary
Published: December 2006

A status passage is the process of change from one social status to another and, in this report, transition into the occupational role of nurse is described The status passage includes the anticipations, entry, reporting of contrasts and changes which are often accompanied by surprise, and reality shock before making sense of the passage some months later Subpassages are noted, and in particular the subtle process of divestiture which results in loss of personal identity Personal identity is sought through patients and those outside the institution Occupational role identity occurs between 6 and 10 months after entry into nurse training The status transition is easier for those with higher self‐esteem and lower anxiety scores The study involved four cohorts of trainee nurses during their first year of training in two schools of nursing, and the study was undertaken using multiple research methods Present and future policy implications are noted
Theory Z as a framework for the application of a professional practice model in increasing nursing staff retention on oncology units
Authors: Boyd Maria , Collins Lynn , Pipitone Janet , Balk Ellen , Kapustay Pam
Published: December 2006

Recruitment and retention of nurses is the most significant issue facing nursing administrators, educators, researchers and clinicians in the ongoing nursing shortage in the United States today It has been cited in the literature that American nurses feel that job satisfaction is a major issue in retaining qualified nurses in hospitals Satisfaction occurs when nurse expectations are matched with the hospital's vision and values It is for this purpose that the authors have chosen theory Z as a hospital management model to coincide with the inshtutioin of the Marker Professional Practice Model to increase job satisfaction (autonomy) in hospital‐based nurses There are four ‘hidden’ challenges in health care today They are (a) fundamental changes occurring within the profession and practice of nursing, (b) the expanded role of women in management, (c) ethical dilemmas related to advances in medical technologies, and (d) the difficulty for health care managers in the United States to make changes related to the above three challenges The authors feel that it is inherent to the nursing profession to combine existing theories and models to enhance the retention of nurses to the profession
Empathy, experience of burnout and attitudes towards demented patients among nursing staff in geriatric care
Authors: Àstrom Shire , Nilsson Mats , Norberg Astrid , Winblad Bengt
Published: December 2006

A non‐anonymous questionnaire was distributed to all nursing staff (n = 557) including RNs, LPNs (psychiatric), LPNs (somatic) and nurses’ aides, in one nursing home, one somatic long‐term care clinic and one psychogeriatric clinic Scales measuring empathy, burnout experience and attitudes towards demented patients were included in the questionnaire The aim of the study was to compare levels of empathy, burnout experience and attitudes among different categories of nursing staff and to examine connections between empathy, burnout and attitudes The nursing staff showed an overall figure of moderately welldeveloped empathy and the RNs showed the highest empathy The RNs had a significantly lower degree of burnout compared to the nurses’ aides and the LPNs Of all respondents, 27 4% were assessed at risk from burnout Overall, the staff showed a moderately positive attitude towards demented patients and the RNs were most positive No linear correlation was found between empathy, burnout experience and attitudes However, a weak negative correlation between burnout and empathy is in accordance with other authors who are suggesting that burnout experience leads to lower empathy in the nursing staff The fact that the RNs showed the most positive attitudes towards demented patients and had the highest level of empathy compared to LPNs and nurses’ aides could be related to lower degree of burnout assessed in the RNs Qualitative and quantitative overload among the LPNs and nurses’ aides connected to the growing number of demented patients in the institutions examined are discussed
Aspects of communication with people who have attempted suicide
Authors: Gibbs Andy
Published: December 2006

This paper addresses some potential difficulties in communication which may occur between health‐care professionals and those who are being assessed following an unsuccessful suicide attempt Attitudes towards suicide and attempted suicide which may be held by the patient and carer are reviewed and the effects that these may have on communication, particularly at the assessment stage, are considered Some techniques to enhance communication andassessment are proposed
Fostering hope in terminally‐ill people
Authors: Herth Kaye
Published: December 2006

This study explored the meaning of hope and identified strategies that are used to foster hope in a convenience sample of 30 terminally‐ill adults using the technique of methodological triangulation (interview, Herth Hope Index and Background Data Form) Cross‐sectional data were collected on 20 of the subjects, and longitudinal data were collected on 10 of the subjects in order to provide a clearer understanding of the hoping process during the dying trajectory Hope was defined as an inner power directed toward enrichment of ‘being’ With the exception of those diagnosed with AIDS, overall hope levels among subjects were high and were found to remain stable over time and across the background variables Seven hope‐fostering categories and three hope‐hindering categories were identified based on the interview responses The findings could serve as a guide for the development of interventions to foster hope in terminally‐ill people
Focus group interview: a research technique for informed nursing practice
Authors: Nyamathi Adeline , Shuler Pam
Published: December 2006

AIDS has become a leading cause of death for women between the ages of 25 and 34 An overwhelming proportion of these women are Black (52%) or Hispanic (20%) Despite the disproportionate number of minority women who are HIV infected, the majority of AIDS educational programmes have been directed at the White gay male The purpose of this paper is to present a qualitative research technique which used focus group interviews to promote the development of a programme devised to reduce risk behaviours in minority populations A summary of the investigation and implications for nursing are also presented
Colostomy patients: psychological adjustment at 10 weeks and 1 year after surgery in districts which employed stoma‐care nurses and districts which did not
Authors: Wade Barbara E
Published: December 2006

Two hundred and fifteen colostomy patients were interviewed at 10 weeks after surgery from a stratified random sample of 12 health districts in which stoma‐care nurses were employed and eight other districts 85 survivors who did not have restorative surgery were reinterviewed 1 year later The Present State Examination (PSE) was used to assess the prevalence of affective disorder on both occasions Analysis of covanance of the 10‐week PSE scores revealed that age was unrelated to psychological adjustment after controlling for the extent and seventy of patients’ symptoms and that patients in districts which employed stoma‐care nurses had significantly lower PSE scores Single and widowed males appeared to enjoy better emotional health than married men and than women Analysis of covanance of PSE scores obtained 1 year later also revealed that age was unrelated to psychological adjustment after controlling for the patients’ physical state No difference was found between patients who had access to a National Health Service stoma‐care nurse and patients in other districts, many of whom had seen a representative from one of the appliance companies The finding that single and widowed males appeared to fare better than married men was repeated Ten per cent of patients who felt completely well were anxious or depressed Psychiatric referral may be inappropriate for the majority of depressed patients who may instead benefit from medical treatment or from nursing intervention to deal with physical symptoms such as pain or urinary incontinence