bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ attitudes and concerns pertaining to HIV and AIDS
Authors: van Wissen Kim A , Siebers Robert W L
Published: July 2003

A pilot study was conducted to identify nurses’ attitudes and concerns pertaining to the care of people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) Data were collected using an anonymous, voluntary questionnaire, which was made available to all nurses at a Wellington Area Health Board (New Zealand) hospital Of 562 nursing staff, 286 (51%) responded, of which 74 (25 9%) had previously attended an HIV/AIDS workshop for Area Health Board staff Of those staff handling blood, 132 (49 4%) always wore gloves, and only half of the respondents (n = 148, 51%) treated all body fluids as potentially HIV positive The possible attrition rate from nursing positions in the canvassed hospital was 2 8%, with a further 43 (15 0%) undecided about resigning from their post Only 56 nurses (12 5%) believed the employer did not provide adequate safety measures The provision of education regarding HIV/AIDS, by the employer, was considered inadequate by 61 (213%) respondents This study demonstrates that further safety and education needs should be attended to or reinforced
Effective multidisciplinary teamwork in primary health care
Authors: Poulton Brenda C , West Michael A
Published: July 2003

The nature and development of teamwork in primary health care is discussed and some barriers to effective teamwork identified Theories of team effectiveness are outlined and methods of applying these to primary health care teams are explored The ‘constituency approach’ and the theory of team innovation are examined in more detail Team‐building interventions are described as one way of improving team effectiveness but their limitations are also acknowledged The Health Education Authority primary health care team workshops are used as an example of a team‐building intervention Research at the MRC/ESRC Social and Applied Psychology Unit, Sheffield University, is described This is evaluating the outcomes of the primary health care team workshops in terms of team effectiveness The research will measure viability (the extent to which the team sufficiently sustains good relationships to continue working together) and team performance (achievement of desired outcomes) pre and post workshop Team effectiveness will be measured through team self‐assessment, patient satisfaction and family health service authority designated targets for health promotion The overall aim is to develop a model of team effectiveness for primary health care teams, which can then be used to diagnose and guide teams in their work
Advanced rehabilitation nursing care of coronary angioplasty patients using self‐efficacy theory
Authors: Jensen K , Banwart L , Venhaus R , Popkess‐Vawter S , Perkins S B
Published: July 2003

The rapidly increasing numbers of patients who experience coronary angioplasty have not been widely studied concerning their rehabilitation, risk factor modification, health maintenance and role resumption Bandura's self‐efficacy theory serves as the framework of a study designed to explore the efficacy expectations for and behavioural performance of walking, following a diet, health maintenance, resumption of role and return to work in angioplasty patients Based in this study, assessment and intervention strategies used by cardiovascular clinical nurse specialist authors are described with a clinical example
Nurses' perception of the first hour of the morning shift (6.00–7.00 a.m.) in a German hospital
Authors: Bauer Irmgard
Published: July 2003

Morning shifts in Germany usually start at 6 00 a in Apart from the well‐known effects of shiftwork on health and family/social life, the early rising tune poses additional problems Part of a study on the first hour of the morning shift is described in this paper Thirteen nurses on a female surgical and on a male medical ward were interviewed using a serru‐structured interview guide The findings were obtained through phenomenological analysis Seven themes emerged from the results (a) the impact of rising early on the individual, (b) the detrimental effect of alternating shifts on well‐being, (c) disturbances to personal life, (d) the rationale for early start, (e) consequences for patients, (f) suggestions for change, and (g) increased risk of leaving the job The findings suggest that the early start puts nurses under considerable stress Tradition rules the time‐oriented and ritualized way of organizing work Further extensive research is recommended
The role of denial in clinical practice
Authors: Russell Graham C
Published: July 2003

Denial is typically viewed as maladaptive in clinical practice, despite ample evidence of its adaptive role in personal and health cases The failure of health professionals to embrace the positive aspects of denial lies deeply rooted in cultural beliefs, which have been reinforced in more recent times by misapplication of clinical theory Denial is a form of self‐deception that protects the individual from threats to the self and involves exaggerated perceptions of control and self‐efficacy Social‐psychological research suggests that such biases in cognitive appraisal are the norm and not exclusive reactions to cases It is proposed that denial has the following functions during cases denial protects the integrity of the self‐concept by distorting reality in a self‐enhancing way, promoting a sense of mastery and control, this in turn leads to lower levels of anxiety, which may enhance decision‐making under conditions of stress Psychological health appears to be contingent, at least in part, on an ability to see the world through ‘rose‐tinted glasses’ Health professionals should be aware, therefore, that whilst trying to promote psychological well‐being we do not ask patients to be unrealistically realistic
Effect of attitudes, subjective norms and perceived control on nurses’ intention to assess patients’ pain
Authors: Nash Robyn , Edwards Helen , Nebauer Monica
Published: July 2003

This study examines the underlying determinants of nurses’ behaviour regarding the conduct of pain assessments One hundred nurses in a variety of health care facilities were invited to complete an Attitude Intention Questionnaire based upon the theory of planned action which is an extension of the theory of reasoned action Results provide some support for the theory of planned action, as nurses’ intention to conduct pain assessment was shown to be predicted by attitude, subjective norms and perceived control, although the latter was the only variable to make an independent contribution to intention Additional support for the importance of perceived control was provided by the analysis of ‘intenders’ and ‘non‐intenders’(to conduct pain assessments), as perceived control was the only variable which differed significantly between the groups The findings are consistent with earlier studies which showed that the variables in the theory of planned behaviour provided reasonably accurate predictions of behavioural intention
Qualified nurses’ perceptions of the needs of suddenly bereaved family members in the accident and emergency department
Authors: Tye Christopher
Published: July 2003

This study aimed to identify qualified nurses’ perceptions of the helpfulness of selected nursing actions, derived from the literature, in meeting the needs of suddenly bereaved family members in the accident and emergency (A&E) department The effect of age, length of professional experience and death education received on the respondents’ perceptions was examined The nurse subjects’ feelings of preparation for this stressful role were also identified A self‐administered, structured questionnaire using a five‐point, Likert‐type rating scale and two open‐ended questions was developed A non‐randomized, convenience sample of 52 qualified nurses working in three A&E departments in the Greater London Area was used Analysis of the sample's responses to the 35 nursing actions included revealed that certain activities were ranked lower in terms of their perceived helpfulness, compared to the survivors’ perceptions in other studies All three variables considered had a statistically significant correlation with the perceptions of the sample as measured by the instrument (P<0 05, using Mann–Whitney U‐test) Only 42% of the sample had received any form of death education and 56% felt unprepared for this specialist role
Accident and emergency work: a review of some of the literature
Authors: Sbaih Lynn
Published: July 2003

Accident and emergency (A and E) work is undergoing many changes including a revision of trauma patient management, examination of medical and nursing skill mix and the introduction of health care support workers Such changes affect all members of the A and E health care team, including nurses whose role has traditionally been in the provision of continuing care of the patient and family A and E nurses’ response to change and subsequent professionalization is poorly documented within current health literature, much of which reflects medicine's response to change within A and E departments The following literature review illustrates that the examination of A and E related issues involves some exploration of the ‘open access’ policy and its perceived effects upon the A and E department
The care and handling of peripheral intravenous cannulae on 60 surgery and internal medicine patients: an observation study
Authors: Lundgren Anna , Jorfeldt Lennart , Ek Anna‐Christina
Published: July 2003

The purpose of this study was to analyse the actual routines surrounding the use of peripheral cannulae and the occurrence of complications Thirty surgery patients and 30 internal medicine patients were observed daily at a medium‐sized hospital The patients were followed from the time the cannula was inserted until after withdrawal and until both the insertion site and the vein were free from pain The results showed that most of the cannulae were placed on the upper side of the hand and sizes most frequently used were 1‐0 and 1‐2 mm The fixation was unsatisfactory in 23 cases already after the second day Twenty‐three cannulae were removed after 24 hours Thirty‐seven (62%) patients were stated to have thrombophlebitis phlebitis in different degrees Only seven cannulae fulfilled the criteria for good cannula care and handling The frequency of complication was especially high when fructose‐glucose, antibiotics or anticoagulants were given There was no documentation in the patient record, according to current laws in Sweden The complications observed were redness, swelling, haematoma, subcutaneous swelling and suppurating infection The study showed that the longer the cannula had been in situ, the greater were the complications (very distinct after 24 hours) The care and handling was unsatisfactory to very unsatisfactory in 52% of the cases Complications can last for a very long time In this research, pain was noted up to 5 months after the cannulae were removed
Women's views of the cervical smear test: implications for nursing practice — women who have not had a smear test
Authors: McKie Linda
Published: July 2003

This is the first of two papers reporting the findings of a study on the views of women with regards to the cervical smear test In this first paper the views of those who have not had a smear test are analysed The implications of those views for nursing practice in primary health care are identified and explored Conducted in 1989–1990, the ESRC‐funded study was located in the north‐east of England and drew respondents from two age groups living in working‐class localities Focusing upon the views of women who have not had a smear test, a number of conclusions were evident (a) that the call, recall system did not invite all women in the screening target group for a smear test, (b) that beliefs and attitudes, rather than practical problems, were cited as major factors in non‐attendance, and (c) that women hold strong views on aspects of service delivery they would like to see in place Thus the organization and delivery of the service might be reviewed However, the barriers posed by beliefs and attitudes must be further explored through community‐based work encompassing all community‐based health professionals
Utilizing Rogers’ Theory of Self‐Concept in mental health nursing
Authors: Hosking Penny
Published: July 2003

The work of mental health nurse is interactive in nature, the priority of which is the effective development and maintenance of a therapeutic relationship with clients This field of nursing bases its practice on theories from many schools of thought in order to provide clients with the highest quality of care One such theory is that of Carl Rogers whose practice as a psychotherapist was based on his Theory of Self‐Concept This paper examines the development of the Theory of Self‐Concept from the works of Cooley, Mead, Allport and Rogers and relates to the therapeutic alliance between a primary nurse and a client who has been medically diagnosed as being ‘depressed’ The implications for practice are considered and some of the difficulties of utilizing Rogers’ theory on an in‐patient unit are explored The paper emphasizes the need for nurses to be aware of the use of such theories in order to enrich the care that clients receive It also highlights the need for nurses to be aware of their own ‘self when working with clients, a state that can only be achieved if the nurses themselves have adequate clinical supervision and an environment which is supportive of such work
Chaos theory suggests a new paradigm for nursing science
Authors: Coppa Denise F
Published: July 2003

The traditional approach to science is an empirical or cause‐and‐effect one, where answers to research questions come about deductively Nursing has followed this path in its attempt to establish a knowledge base Difficulty occurs when nurses attempt to develop strategies to solve nursing problems involving human systems using this reductionistic approach Human systems are complex, dynamic and individual Traditional scientific models often fall short of providing adequate frameworks for describing, explaining and predicting the behaviour of these complex systems Many scientific communities have been searching for a flexible more three‐dimensional model to describe non‐traditional system behaviours Chaos theory may provide science with the new paradigm for the study of these complex systems This paper suggests Thomas Kuhn's philosophy of science to use as a foundation for the application of chaos theory or the theory of non‐linear dynamics to the science of nursing
The job satisfaction of health visitors, district nurses and practice nurses working in areas served by four trusts: year 1
Authors: Wade Barbara E
Published: July 2003

This paper reports the results of the first of three annual surveys of the job satisfaction of health visitors, district nurses and practice nurses working in communities served by four trusts Analysis of variance illustrates differences in the level of Personal Satisfaction, Satisfaction with Workload, Satisfaction with Professional Support, Satisfaction with Training and Satisfaction with Pay and Prospects Practice nurses appear to be the most satisfied group, the level of satisfaction for health visitors is significantly lower Qualitative analysis of the additional comments made by approximately one‐third of respondents illustrates the gulf in perceived values between staff and management and the feelings of uncertainty experienced by community nurses in the wake of major legislative change Possible reasons for differences in level of staff satisfaction between the four trusts are discussed
Quality of life of adults with acute leukaemia
Authors: Bertero Carina , Ek Anna‐Christina
Published: July 2003

The cause of acute leukaemia is unknown Untreated, the disease is generally fatal after a few months The therapeutic regimen is chemotherapy, and sometimes also bone marrow transplantation, and the aim is to cure the patient Not only does the person live under pressure from a life‐threatening disease with all the physiological complications that therapy can result in, the therapeutic regimen also involves a great psychological effect The concept of quality of life (QOL) is individual for each person, as is his/her experience of the value of the contents of life The principal aim of the study was to describe what QOL means to adults with acute leukaemia, not to describe the degree of QOL The second aim was to give the concept of QOL a theoretical and empirical significance relevant to nursing care Eight adults with diagnosed acute leukaemia detected in adulthood have been interviewed about their quality of life The concept was given one superior dimension in all the interviews, positive attitude to life Below the superior dimension were two further dimensions, interpersonal relationships and autonomy Different qualities were given below these dimensions, viz security, support, respect, information and conversation
To understand and alleviate suffering in a caring culture
Authors: Lindholm Lisbet , Eriksson Katie
Published: July 2003

The purpose of this study is to help understand what suffering is, i e how patients and nurses describe suffering, and how suffering can be alleviated The study has a descriptive–explorative design and its approach is phenomenological–hermeneutical The informants (research group) are 11 nurses (nurses, doctors, hospital theologians) and five patients in a social‐psychiatric nursing unit, based on Christian ideology The results of the study show that the ‘what’ of suffering is unclear The nurses tend to describe more the ‘why’ of suffering, I e the reason for suffering The what of suffering is pain, fear, despair, lack of strength It is a form of lack of freedom and non‐motion It is a struggle between wanting and knowing, between guilt and responsibility The form of suffering tends to mould the caring relation To be touched in some way by another in a meeting can alleviate the deepest suffering Compassion will always alleviate suffering
Disclosure of terminal prognoses in a general hospital: the nurse's view
Authors: May Carl
Published: July 2003

Some of the issues which nurses confront when they deal with the disclosure of terminal diagnoses and prognoses to patients are explored In such circumstances, the nurse must respond to the competing demands of patients, relatives and medical staff The paper examines the way in which a group of experienced staff nurses in a general hospital accounted for their activities during and after the disclosure of a lethal diagnosis In particular, it explores the ways in which nurses are included or excluded from decision making about disclosure by medical staff
The role of the nurse providing therapeutic care for the suicidal patient
Authors: Reid Wendy , Long Ann
Published: July 2003

In this study, nurses perceived that the implementation of special supervision is the most effective preventive method in the nursing care of suicidal patients, but they also expressed the view that special supervision is non‐therapeutic The results of these findings show that it is possible to provide nursing care in the prevention of further harm to the patient but that nurses may not necessarily be proficient in demonstrating the interpersonal caring skills essential for the development of a therapeutic relationship and hence patient recovery This paper demonstrates there is now (a) a need for special supervision as a preventive method when caring for the suicidal patient, (b) a need for a planned therapeutic programme of care during special supervision, (c) a need for the development of essential interpersonal and counselling skills and dimensions for effective therapeutic intervention and empathic nursing care, (d) a need to bridge the gulf between theory and practice by giving nurses the opportunity to practise those skills in the clinical setting under the supervision of an expert clinician, (e) a need for the patient to experience that nurses do care, i e experience empathy, during the complete therapeutic programme including the period of special supervision, and (f) a need for further research regarding the patient's perception of nursing care experienced following a failed suicidal attempt
Making risk meaningful: developing caring relationships with AIDS patients
Authors: Reutter Linda I , Northcott Herbert C
Published: July 2003

A qualitative study was conducted in order to understand how nurses cope with the risk of contagion while providing care to persons with AIDS (PWAs) Data were collected through in‐depth interviews with 13 nurses who had cared for PWAs in an acute‐care hospital in a western Canadian city The data were analysed using the constant comparative methodology of grounded theory. The analysis revealed that caring for PWAs involved achieving a sense of control over uncertainty One aspect of this process, making risk meaningful, centred on efforts to justify caring for PWAs in the face of risk The purpose of this paper is to describe how nurses make risk meaningful A sense of meaning was found to be related to three major factors accepting the patient as a person who needs and deserves care, finding work enjoyable and worthwhile, and professional commitment to care for all patients Attaining a sense of meaning led to a reappraisal of the risk situation as worthy of investment and provided the motivation to care for patients in spite of risk The paper concludes with implications for practice and suggestions for further research
My death nearing its future: a Heideggerian hermeneutical analysis of the lived experience of persons with chronic illness
Authors: Gullickson Colleen
Published: July 2003

Although over 50% of individuals over the age of 65 live with at least one chronic illness, little research has been conducted on the individual lived experience For this phenomenological study, 12 individuals living with any long‐term illness participated in extended, non‐structured, audio‐recorded interviews Resulting verbatim transcripts were analysed hermeneutically using Heideggenan phenomenology as the philosophical framework The pattern ‘my death nearing its future’ emerged from this research The understandings gained from these individual narratives provide important insight for all individuals interacting with persons living with chronic illness
Identifying and defining abuse of elderly people, as seen by witnesses
Authors: Saveman Britt‐Inger , Hallberg Ingalill Rahm , Norberg Astrid
Published: July 2003

The aim of this study was to analyse how Swedish district nurses denned and identified abuse of elderly people in practice Twenty‐one district nurses were interviewed by means of open‐ended questions and their responses were analysed qualitatively The main findings related to a central theme ‘overriding the boundaries of a person's integrity/autonomy’ and four categories, the act of abuse, the relationship between the abused person and the perpetrator, the experience of the abused person and the intention of the perpetrator The reasoning of the district nurses focused on these issues The district nurses included various aspects in the process of identifying abuse of elderly people and the findings demonstrate the complexity of the practitioner's situation This seems logical since such abuse is complex and involves many aspects, which makes the diagnostic process difficult The findings may be useful for nurses when they assess and intervene in abuse of elderly people Thus, the significance of this study is mainly practical
Nursing and substance misuse: responding to the challenge
Authors: Rassool G Hussein
Published: July 2003

The widespread use and misuse of alcohol, drug and other psychoactive substances are major health and social concerns that affect the lives of many The social and health sequelae of psychoactive drugs and alcohol are preventable and manageable with minimal interventions Nurses and other health workers can effectively respond to substance misuse problems and their existing generic skills can be easily adapted in working with substance misusers This paper considers some of the issues such as the extent of the problem, attitudinal considerations, response to substance misusers and a brief outline of the role of the nurse The urgent need for education and training in substance misuse and addictive behaviour for nurse practitioners is also addressed
A future perspective on patient/health education in Canada
Authors: Jenny Jean
Published: July 2003

The current climate of health care redefinition and reform in Canada has prompted the need to review services and resources with a view to reducing costs, refocusing emphasis and maintaining the level of health care services of which Canadians are proud This paper reviews the process of patient/health education using the PRECEDE model This model encompasses the behavioural and non‐behavioural aspects of targeted health problems and their populations at risk, and three sets of strategic factors affecting educators and their clients The paper examines the particular challenges implicit in each of the process components which are suggested by current trends and their implications for the future
The meaning of incontinence: a qualitative study of non‐geriatric urinary incontinence sufferers
Authors: Ashworth Peter D , Hagan M Teresa
Published: July 2003

The meaning of the problem for incontinence sufferers is known to be a very significant influence on coping The present study was based on in‐depth qualitative interviews with 28 young or middle‐aged women who suffered urinary incontinence Analysis, aimed at discovering the meaning of their condition for the sufferers themselves, led to the following conclusions Incontinence is taboo, meaning not only that it is a socially unacceptable topic of conversation (inhibiting the approach of sufferers to health professionals), but also that it is difficult for sufferers themselves to focus on and think about clearly Sufferers can react with apathy, or may perpetually teeter on the edge of taking ameliorative action rational ways of tackling the problem are often not followed The problem is seen as one of personal control incontinence is lack of a grip on bodily propriety Sufferers may feel horribly unique, and also worry that the incontinence is their own fault They fear a guilty association with despised groups It is noteworthy that the maintenance of ‘normality’— allowing the sufferer to claim that there is no problem and that she is not incontinent — may involve a great deal of work Although there are indications of defensive denial in sufferers’ reactions to the problem, an additional interpretation is that they are fighting to subordinate the problem in favour of other priorities Implications for practice of each of these features of the meaning of incontinence are drawn out
The role of the clinical nurse co‐ordinator in the provision of cost‐effective orthopaedic services for elderly people
Authors: Shiell Alan , Kenny Patricia , Farnworth Michael George
Published: July 2003

Positions for nurses as coordinators and case managers have developed in response to demands for increased efficiency in the provision of hospital care The Fractured Hip Management Programme in Western Sydney is one example of this development The programme was introduced in response to mounting concern about the demands on hospital resources from elderly patients with hip fracture A central feature of the programme is the pivotal role given to the nurse co‐ordinator working within a multi‐disciplinary team This is not a new nursing role; rather it explicitly recognizes skills developed as part of the traditional nursing role Evaluation of the programme found that patients received surgery sooner and spent less time in hospital, without adverse affects on outcome The results show that recognition of the role of the nurse as patient advocate and care manager can lead to more cost‐effective and higher‐quality care
An international approach to master's‐level preparation for clinical nurse specialists*
Authors: Davis Bryn D
Published: July 2003

Nursing is seen as being increasingly a research‐based profession with a developing knowledge base that demands a continuing programme of education This is necessary to enable the practitioner to function with the level of expertise and skill required in today's health care systems There have been repeated calls for and developments in the establishment of a higher‐education approach to nursing, with degree courses for the advanced practitioner It is also argued that in terms of the European perspective there are many commonalities in nursing and health care in Europe, and although cultural and national differences are important there can be advantages to nurses from different countries studying together An example of a course which offers this European approach to higher education for nurses is described
Service evaluation: time to open both eyes
Authors: Nolan Mike , Grant Gordon
Published: July 2003

This paper draws attention to issues raised by the present emphasis on service evaluation It highlights in particular the limitation of many current models and argues the need to adopt a broad approach which takes account of the potentially disparate views of differing interest groups The central tenets of a pluralistic model are presented and the benefits of such an approach are illustrated by reference to a recent evaluation of a respite care scheme for elderly people and their carers
Towards a better understanding of patients with irritable bowel syndrome
Authors: Dancey Christine P , Backhouse Susan
Published: July 2003

This study was undertaken by sending a questionnaire to 148 people suffering from irritable bowel syndrome (IBS) The respondents all were members of the IBS Network, a national independent organization formed to help alleviate the suffering and distress of people diagnosed as having irritable bowel They were asked about their symptoms, the medical tests they had undergone, how they felt about the treatment they received, and how IBS affected their lives The study found that IBS affected all aspects of their lives work, leisure, travel and relationships Sufferers indicated that they felt they would have coped better if they had been provided with more information about IBS, its possible causes and treatment, and greater sensitivity from members of the medical profession in dealing with them
Core temperature measurement in adults: a literature review
Authors: Fulbrook Paul
Published: July 2003

This paper provides a comprehensive review of the literature related to the clinical assessment of core body temperature in adults It does not attempt to address temperature measurement in children It considers temperature‐taking instruments used in current practice, and predominantly investigates the use of the three main sites of rectum, mouth and axilla
An ethnographic study of nursing culture as an exploration for determining the existence of a system of ritual
Authors: Holland Catherine Karen
Published: July 2003

The idea that much of nursing is ‘ritualized’ activity which is harmful to patient care assumes that ‘ritual’ itself is unacceptable behaviour or practice At a time when market forces are clearly influencing the delivery of care and, in turn, changes in nursing practice, it has become important both to clarify what ‘ritual’ is and to determine its existence and ‘form’ within nursing This study explored nursing culture for ‘ritual’ in a ward setting and used ethnography as both method and description Rituals were found to exist in the working day of the nurses studied, but was not an indication that ‘ritualized behaviour’ is harmful to individualized patient care There is a clear need, however, to determine specifically the difference between ‘unsafe outdated practices’ and ritual in a cultural ‘sense’ This would ensure that what had to be relinquished would in no way jeopardize the future existence of nursing and nurses as socially cohesive groups with their own culture
The apparent desensitization of student nurses during their professional socialization: a cognitive perspective
Authors: Greenwood J
Published: July 2003

It is argued that the structures and processes of traditional patterns of pre‐registration nurse education in the United Kingdom led to an apparent and relative desensitization of student nurses to human need The processes underpinning this apparent desensitization were those which promoted both a ‘compartmentalization’ of concepts for theory and concepts for practice in the cognitions of student nurses and their habituation to examples of poor nursing practice These processes are described and their nursing pedagogical implications are discussed It is suggested that unless clinical learning environments are deliberately manipulated to foster the construction and utilization of ‘appropriate’ action schemata, the considerable opportunities offered by the implementation of Project 2000 to improve both nursing education and nursing practice could be wasted It is further suggested that this deliberate manipulation should include nurse tutors teaching theory and practice in clinical areas if they are seriously concerned to render nursing care more intelligently responsive to human need
Participation of caregivers in elderly‐patient hospital care: informal caregiver approach
Authors: Laitinen Pirjo
Published: July 2003

This preliminary study is part of an ongoing action research project in three different kinds of hospitals Two wards in each hospital volunteered for the study The purpose was to discover in which activities of daily living informal caregivers currently participate and to what extent Participation of informal caregivers consisted of 17 activities Elderly patients (n= 45) eligible for the study and informal caregivers (n= 147) completed a questionnaire They were asked in which daily activities informal caregivers participate and how often, options ranging from daily to never Responses of informal caregivers are reported in this paper Results indicated that relatives and other significant others visited elderly hospital patients often, however, their participation in activities of daily living in hospitals was limited Mostly they gave emotional support and helped the patient to drink, stand up/get into bed and sit Implications for nursing are discussed
The relationship between nursing and higher education
Authors: Fitzpatrick Joanne M , While Alison E , Roberts Julia D
Published: July 2003

The paper explores the relationship between nursing and higher education with particular reference to the development of nursing degree programmes in the United Kingdom The literature reveals that the contribution of nurse graduates to the profession has been examined to a limited extent however, this has predominantly taken the form of follow‐up studies, the majority of which were conducted in the 1980s No empirically based work could be found which explores graduates’ practice of nursing, the absence of which is significant in view of the more recent change in the conventional training programme, Project 2000, and the introduction of a number of 3‐year nursing degree courses
The problem of motivating teaching staff in a complex amalgamation
Authors: Kenrick Marona A
Published: July 2003

This paper addresses some of the problems brought about by the merger of a number of schools of nursing into a new complex amalgamation A very real concern in the new colleges of nursing and midwifery in the United Kingdom is the effect of amalgamation on management systems and staff morale The main focus of this paper is the motivation of staff during this time of change There is currently a lack of security amongst staff and in many instances the personal job satisfaction of nurse teachers and managers of nurse education has been reduced, which has made the task of motivating staff difficult Hence, two major theories of motivation and the implications of these theories for managers of nurse education are discussed The criteria used for the selection of managers within the new colleges, leadership styles and organizational structures are reviewed The amalgamations have brought about affiliation with higher‐education institutions Some problems associated with these mergers and the effects on the motivation of staff both within the higher‐education institutions and the nursing colleges are outlined Strategies for overcoming some of the problems are proposed including job enlargement, job enrichment, potential achievement rewards and the use of individual performance reviews which may be useful for assessing the ability of all staff, including managers, in the new amalgamations
Parents, nurses and paediatric nursing: a critical review
Authors: Darbyshire Philip
Published: July 2003

The desirability of encouraging parents to live‐in with their hospitalized child is widely accepted (Department of Health 1991) This review traces the historical development of parental involvement in paediatrics The literature reviewed shows that parental participation and living‐in has been viewed largely as philosophically and professionally unproblematic These ‘cardinal principles’ of paediatric nursing have been advocated and operationalized with little or no attempt made to understand what living‐in is like for either parents or for the nurses who work with them It is proposed that research approaches in this area are required which are more hermeneutic and dialogic
An investigation into the effects of hypoglycaemia in young people aged 16–30 years
Authors: Richmond Jennefer
Published: July 2003

This study investigates the effects of hypoglycaemia on the working, social and personal lives of young people aged 16–30 years (mean age 23 9 years) who have insulin‐treated diabetes mellitus A total of 52 questionnaires were returned from a sample size of 70 subjects Quantitative and qualitative analysis revealed that young people's lives are disrupted to varying degrees by hypoglycaemia Hypoglycaemia and the complications of diabetes were found to be a source of concern to the subjects in the study, although 19 (36 5%) rarely earned out any self‐monitoring A more flexible approach to diabetic management is indicated, together with an agreed consensus of diabetic control between patients and professionals
‘Holism’ in the discourse of nursing
Authors: Owen Martin J , Holmes Colin A
Published: July 2003

Holism is a turbid, amorphic term, of Quixotic character, the meaning of which alters according to the context in which it is located Coming to grips with holism has been likened to trying to hold ice, because it disappears in the attempt This paper assesses the variety of meanings attached to the term, and the extent to which the distinctive features of holism have melted away in the hands of nursing
Populations vulnerable to the ethics of caring
Authors: Olsen Douglas P
Published: July 2003

This paper presents the argument that any patient population which can be perceived as being culpable for the pain they are in is vulnerable to the ethics of caring First, both the ethics of caring and justice are reviewed, and the inadequacies of each, with regard to nursing, are discussed The problems of the ethics of caring are demonstrated empirically and with interviews done by the author Then the impacted populations are reviewed The conclusion presents an emerging vision of synthesis between the moral concepts of caring and justice
Ethical decision‐making processes used by health care providers
Authors: Grundstein‐Amado Rivka
Published: July 2003

This paper reports the results of a study conducted with 18 health care providers (HCPs) in two Toronto hospitals The study examined and assessed how these HCPs make clinical–ethical decisions in the light of a theoretical model of clinical–ethical decision making Nine nurses and nine doctors were interviewed through two‐phased, in‐depth, semi‐structured interviews The results suggest that, in relation to the two major elements of the model, namely the ethical component and the decision theory component, the HCPs did not follow a consistent and systematic pattern of ethical decision making Differences emerged between their actual self‐reported behaviour and their potential moral capability (i e their abstract thought process) The general picture that emerged was that decisions were made in a narrow, habitual manner, through the elimination of the most significant and demanding elements of the process HCPs’ ethical approaches affected the entire process of the decision making their perception of the problem, their search for and selection of information and evidence, and their development of alternatives and resultant consequences It is suggested to (a) further investigate and understand the subjective realities of the individuals involved in the decision making processes, their values and the meaning they ascribe to their choices, and (b) to establish extensive educational programmes to enhance HCPs’ decision‐making capacity and subsequently promote an effective and responsible professional practice
Nurses’ perceptions of patients’ feelings about breast surgery
Authors: Crockford E A , Holloway I M , Walker J M
Published: July 2003

This qualitative study was designed to gain insight into nurses’ perceptions of patients’ feelings and needs with specific reference to breast surgery A grounded theory approach was adopted, based on in‐depth, unstructured interviews with eight trained nurses working on surgical wards in a district general hospital It emerged that the informants believed breast surgery patients to be very vulnerable and to be suffering from extreme stress and trauma Patients were thought to lack knowledge regarding their treatment and condition The nurses thought it to be their moral and professional duty to act as advocates for the patient and the family Imposed restrictions on their advocacy role were found to cause a sense of frustration and powerlessness which appeared to be compounded by the nurses’ perceived lack of counselling skills and the absence of a readily available counsellor or specialist nurse Recommendations for improvements in the care of patients undergoing breast surgery are based upon these findings
Patient‐controlled analgesia: a new method for old
Authors: Thomas V J , Rose F D
Published: July 2003

Patient‐controlled analgesia (PCA) has successfully made the transition from a research tool for the investigation of pain, to a wider clinical utility as method of pain control Reliable and sophisticated PCA systems have been commercially available for some time The technique has been most commonly used for control of postoperative pain, but has also been successfully used during labour, after burns, in acute painful medical conditions and in terminal care It is generally more effective than the traditional methods of postoperative pain control but not automatically so The choice of opioid, the settings chosen for demand dose and the lockout interval will greatly influence the effectiveness of this method of analgesia Psychological variables are also important in predicting the efficacy of PCA
Activity nursing and the changes in the quality of life of elderly patients: a semi‐quantitative study
Authors: Turner Pamela
Published: July 2003

In recent years increasing awareness and interest in different approaches to caring for elderly people have produced improvements in their psychological and social care This paper evaluates the change in the quality of life which was brought about by the introduction of activity nursing into a continuing care unit Significant changes were observed in cognitive functioning and quality of life The benefits to both relatives and staff were also considerable
Retrospective document survey: identification, assessment and management of urinary incontinence in medical and care of the elderly wards
Authors: Cheater Francine M
Published: July 2003

Urinary incontinence is a common problem experienced by patients in hospital As part of a series of studies, a retrospective survey was earned out of 229 nursing and medical records of patients identified as incontinent of urine by the nurses‐in‐charge, in 14 acute medical wards and 26 health care of the elderly wards The aims of the survey were to investigate the extent to which urinary incontinence had been identified as a problem, and to examine the nature of its assessment and management The recording of the problem was found to be inconsistent and there was a paucity of information which might have contributed towards its assessment The causes of incontinence were rarely recorded and in approximately half of the nursing and medical records examined there was a complete absence of any information related to a management plan Where recorded, interventions reflected predominantly palliative measures such as routine toileting regimens and the use of continence aids The implications of these findings are discussed
Relationships between demented elderly people and their families: a follow‐up study of caregivers who had previously reported abuse when caring for their spouses and parents
Authors: Grafstrom Margareta , Norberg Astrid , Hagberg Bo
Published: July 2003

The aim of the study was to elucidate how relationships develop over time in abusive families Family members of demented elderly people who previously reported abuse in the care of the elderly relatives are interviewed in a follow‐up study In this current study the families did not mention any abusive behaviour They narrated their feelings toward their care recipient in the following main categories mothering, grieving, feeling guilty, distancing and objectifying When the family members expressed mothering thoughts, there were no expressions of guilt, objectifying or distancing, and the prior relationship was narrated as good The families who talked about the demented person at a distance or by objectifying did not express feelings of mothering or grief for the relative
Does the use of an assessment tool in the accident and emergency department improve the quality of care?
Authors: Christie Jane
Published: July 2003

The aim of this study was to evaluate the effect of introducing a nursing –record, using the SOAPE model, in the accident and emergency department A working group was formed to design and implement a new record and evaluate its effect A 6‐month teaching programme was run to prepare staff Quality of documentation was measured using the Phaneuf Audit Tool both before and after the implementation of the new record and the teaching sessions The results were compared It was concluded that, overall, the documentation showed significant improvement Therefore, it could be assumed that there had been an improvement in the quality of care
Towards clarification of convergent concepts: sense of coherence, will to meaning, locus of control, learned helplessness and hardiness
Authors: Sullivan Grace C
Published: July 2003

The multidisciplinary field of stress and stress‐related health outcomes has generated theoretical and practical knowledge which is of interest to nurses Theoretical developments which have assumed a prominent role in the study of stress, health and coping include the identification of various ‘stress buffers', several of which bear a strong conceptual resemblance to one another Antonovsky has developed a Salutogenic Model of stress and resistance, which is presented in this paper The model's central concept, the sense of coherence, is described and analysed The sense of coherence, with its three components (meaningfulness, comprehensibility and manageability), is then compared and contrasted with similar concepts The convergent theoretical notions which are distinguished from Antonovsky's coherence are will to meaning, locus of control, learned helplessness and hardiness It is hoped that this analysis will provide greater conceptual clarity for nurses who study and use these concepts in education, practice or research