bluuebunny/crossref_metadata_2025 huggingface dataset:
The work of community psychiatric nursing*
Authors: Pollock Linda C.
Published: December 2006

The findings of this study provide an explanation of how community psychiatric nurses make community psychiatric nursing work. The work of community psychiatric nursing can be usefully compared to that involved in making a theatre production. In the theatre there is a play with a plot which is conveyed through the parts played by characters. In the face of production limitations (size of theatre, costs and time constraints, for example) and the demands of sponsors, audience, theatre critics and others in the Company, the characters make use of the stage props and get the show on the road. The community psychiatric nurses can be likened to the characters in a play, whose title is ‘the provision of a community psychiatric nursing service’; the plot being the provision of individualized care. Similar to the production limitations in the theatre, the community psychiatric nurses have limited care options and resources and are faced with the varied demands of patients, carers and situations, other specialists and the bureaucracy. Yet the nurses have to produce the best match of needs to resources. Maintaining a theatrical analogy, the nurses have to use what props they have on the stage, not to ‘get the show on the road’, but to make the community psychiatric nursing service work. Unlike a theatrical production, however, community psychiatric nurses do not appear to have an overall director controlling the work; neither are there guidelines which limit or define practice. This results in individual community psychiatric nurses establishing their own modus operandi and defining their own work practices. Two major themes pervade this account of the work of community psychiatric nurses. Firstly, the nurses continually seek to legitimize their work and justify the care given. Secondly, they juggle resources. Both of these aspects of the work emerged because the nurses' expressed ideology of providing‘individualized’care (care tailored to the needs of individual patients and their carers) was impossible to sustain in the face of finite resources.
An investigation of the dependence of severely disabled people in a hospital*
Authors: Stride Norma M.
Published: December 2006

This paper describes a pilot study of the dependence of 20 severely disabled patients on nursing staff in a long‐term rehabilitalion ward. Dependence was measured as the number of 15‐minute periods spent by a patient in receipt of various categories of nursing care during fixed observation times. Measurements were made by patient activity sampling and were in reasonably good agreement with the results of nurse activity sampling. Severity of disability gradings of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) were adapted to give an overall disability score for each patient. Appropriately summarized numerical data are presented in the form of tables and bar charts. Patient feeding was firmly established as the most time‐consuming of the direct nursing care activities. There was also a high statistical correlation between feeding dependence and severity of disability and this finding is discussed at some length.
A study to compare the practice style of graduate and non‐graduate nurses and midwives: the pilot study
Authors: Bircumshaw Denise , Chapman Christine M.
Published: December 2006

This paper comprises essentially a discussion of the pilot of a study currently being undertaken to compare the practice styles of graduate and non‐graduate nurses. The background to the main study is described and discussed, as is the methodology. The problems encountered in the planning and executing of the data collection are particularly highlighted. The paper does not present data from the pilot study, but evaluates the methodology used and considers the implications for the main study.
Assessment of nurses' attitudes towards cancer: a critical review of research methods
Authors: Corner Jessica L.
Published: December 2006

There has been increasing interest in the attitudes that the general public and health care professionals hold towards cancer, the effect these have on an individual's likelihood to present early with symptoms, and the quality of care patients with the disease receive from carers. The research appears to indicate that the attitudes of both groups are largely negative and stereotyped, and cancer is seen as being more devastating than other life threatening diseases. These attitudes have been associated with patterns of poor communication and care for cancer patients. This paper looks critically at the research into the attitudes of nurses towards cancer and calls for more innovative methods than have been used to date. There is a need to increase our understanding of this complex problem before indications for education and practice can be made.
Lip function and eating after a stroke: a nursing perspective
Authors: Carr Elizabeth K. , Hawthorn Pamela J.
Published: December 2006

The social and psychological effects of eating and drinking difficulties are often overlooked. The collection of food around the lips during meals is an example of a little discussed but embarrassing and unsightly problem commonly experienced after a stroke. In a group of 20 stroke patients, the incidence of this problem was significantly higher than that found in a group of medical patients of similar age and sex (P < 0.001). It was a cause of some distress to patients. Analysis of the care given to this group of patients at mealtimes would suggest that there is scope for nurses to contribute more to the rehabilitation of patients' lip function after stroke. The efficacy of therapy has yet to be evaluated.
Application of King's Theory of Nursing to the care of the adult with diabetes
Authors: Husband Allison
Published: December 2006

This paper demonstrates how King's theory of goal attainment can be applied to the care of the adult with diabetes mellitus. Salient components of King's theory are presented followed by application of the theory using the nursing process as a framework. An example of a nurse‐patient interaction is used to more clearly present the application. The advantages of King's theory in relation to the care of the diabetic adult are also discussed.
Validation therapy with the demented elderly
Authors: Bleathman Christine
Published: December 2006

This paper describes validation therapy‐a method of communicating with disorientated people through the use of specific interactive techniques. It is compared with reality orientation as this is the most widely used therapy for demented patients. The method of evaluating the effects of validation group therapy is included. The authors suggest that validation therapy is an exciting and important therapeutic development which can restore self‐worth and ease the stress suffered by elderly people with dementia.
Values and ethical principles in nursing
Authors: Raatikainen Ritva
Published: December 2006

In this paper I explore what kind of values enter into the different dimensions of the human being and how the principles of freedom, brotherhood and equality relate to the well‐being of man, and further how technology, bureaucracy and specialization may curtail the observance of humaneness in nursing care I also discuss the compatibility or incompatibility of values in nursing and the increasingly scientific nature of nursing Respect for freedom is a condition for personal growth and development recognition of the value of brotherhood is a condition for social participation, and equality a condition for meeting physical needs However, these values are linked together and form a whole The scientific nature of nursing contributes to the clarification of values in nursing My doctoral dissertation, ‘Self‐care and nursing’, on which this paper is based, deals with values and principles in nursing
Issues in evaluation: evaluating assessments of elderly people using a combination of methods
Authors: McEwan Robert T
Published: December 2006

In evaluating a health service, individuals will give differing accounts of its performance, according to their experiences of the service, and the evaluative perspective they adopt The value of a service may also change through time, and according to the particular part of the service studied Traditional health care evaluations have generally not accounted for this variability because of the approaches used Studies evaluating screening or assessment programmes for the elderly have focused on programme effectiveness and efficiency, using relatively inflexible quantitative methods Evaluative approaches must reflect the complexity of health service provision, and methods must vary to suit the particular research objective Under these circumstances, this paper presents the case for the use of multiple triangulation in evaluative research, where differing methods and perspectives are combined in one study Emphasis is placed on the applications and benefits of subjectivist approaches in evaluation An example of combined methods is provided in the form of an evaluation of the Newcastle Care Plan for the Elderly
The nursing process: improving psychiatric admission assessment?
Authors: Mulheam Sue
Published: December 2006

The nursing process is a philosophy of individualized patient care, which states that all care sbould be planned on thebasis of a nursing evaluation of patients’ problems The first stage of the nursing process is assessment, which for good planning requires more information about patients than is usually collected In this study, in a psychiatric setting, an exploratory first phase was camed out to investigate whether the current admission assessment procedure assisted systematic careplanning The results revealed that nurses were dissatisfied with the admission assessment procedure, although half of them had received no training in the patient‐centred approach During phase 2 of the study a structured assessment form was introduced into two wards in separate hospitals for a period of 3 months In order to assess the form's usefulness in identifyingpatients’ nursing needs, and its acceptability to patients, an evaluative third phase was undertaken Respondents recorded satisfaction with the structured form in practice, whilst analysis of careplan statements suggested that assessment had improved The patients interviewed found the questions acceptable and viewed the assessment as a valued opportunity to talk to their nurse
Patients' and nurses' perceptions of symptom distress in cancer
Authors: Holmes S , Eburn E
Published: December 2006

A modified version of the McCorkle & Young Symptom Distress Scale, based on a linear analogue self‐assessment scoring system, was used to assess symptom distress in a heterogeneous sample of 53 cancer patients The scale was simultaneously completed by the nurses caring for those patients, who were asked to rate the patient according to how they perceived he was feeling with regard to each particular symptom The scores were compared for congruency This preliminary study suggests that, although nurses appear able to estimate the degree of distress due to changes in mobility and appearance or the presence of diarrhoea, constipation and tiredness, they are less effective in perceiving the degree of distress due to the less Visible’ symptoms such as pain, nausea, anorexia, sleeping disturbances, concentration and mood Perhaps surprisingly, the trend was for nurses to overestimate the degree of distress when this was compared with the patients’ self‐assessment
Debate: a strategy for increasing interaction in audio teleconferencing
Authors: Wuest Judith
Published: December 2006

Increased demand tor audio teleconferenced undergraduate nursing courses for registered nurses in New Brunswick, Canada, has resulted in nurse educators being challenged to meet the needs of adult learners within the constraints of this technology In this paper the problem of limited interaction among adult nursing students in a teleconferenced course is examined in light of the theoretical frameworks of adult education and distance education. The effects of implementing debate as a learning strategy to increase participation are discussed The debate process increased site to site interaction and encouraged nurses to consider pragmatic issues from new perspectives
The influence of a relative support group on carers' emotional distress
Authors: Russell Vanessa , Proctor Linda , Moniz Esme
Published: December 2006

Research has shown that the supporters of relatives with dementia suffer high levels of stress and strain and it is the seventy of stress which determines whether the dependent remains in the community or becomes institutionalized This study evaluated the outcome of a 6‐week, closed group, educational programme on reported levels of stress and strain on five supporters Results showed an increase in the seventy of problems presented by the carers whilst there was a decrease in their emotional distress However, these results suggest that the carers in the present study were experiencing much higher levels of stress and strain than those of supporters in a larger investigation, where the eventual outcome was institutionalization of the dependents The implications for the future of community care are discussed and a large scale survey of carers, including monitoring of eventual outcome for dependents, is recommended
Postnatal depression: what can a health visitor do?
Authors: Taylor Elizabeth
Published: December 2006

Postnatal depression has been a subject that has provoked interest and research for many years Marce published a paper in 1858 on puerperal and lactational psychoses, and since then many other writers have pursued different avenues of interest, primary cause, affect and treatment A great deal of this work over the years has been done by psychiatrists and physicians, principally being interested in the more severe postpartum psychosis, when many of those suffering are admitted to an acute psychiatric hospital However, as research has continued the less severe forms of postnatal depression and the upsetting effect they have on the patient's family continue to be a source of concern, not only to the professionals themselves, but more importantly, to the mothers who are suffering from this very upsetting problem Professor Cox stated that he found it ironical that primary care workers regularly visited mothers in the puerperium and only rarely recognized postnatal depression This led me to believe that we, as health visitors, should set about trying to put this right As Professor Cox rightly said, it's a sad paradox that considering the medical scrutiny mothers receive over the antenatal and postnatal period, many depressed mothers still are not identified The author therefore attempts to devise some kind of strategies for health visitors to identify mothers suffering from postnatal depression, and considers whether any links can be found between those suffering from postnatal depression
Geriatric versus general medical wards: comparison of patients' behaviours following discharge from an acute care hospital
Authors: Jackson Marilyn F.
Published: December 2006

The objective of this study was to explore, from a nursing perspective, the effectiveness of geriatric wards in preparing elderly patients for discharge from an acute care hospital. A convenience sample of 40 patients aged 70 years or older was obtained from three geriatric medical wards and two general medical wards of a large British teaching hospital. Data were collected immediately prior to discharge, and after 6 and 13 weeks following discharge. No meaningful differences were found between the two patient‐groups in their ability to cope with activities of daily living following discharge. The majority of deaths and/or hospital readmissions occurred within 6 weeks of discharge. A major concern identified in both groups was patients’ lack of knowledge about medications and their side‐effects. A need for more effective teaching programmes for elderly patients was identified.
Teaching psychomotor skills in nursing: a randomized control trial
Authors: Love Barbara , McAdams Constance , Patton Diane M. , Jean Rankin E. , Roberts Jacqueline
Published: December 2006

Historically, McMaster University School of Nursing in Hamilton, Ontario, Canada has utilized self‐directed learning methods to teach psychomotor nursing skills to undergraduate nursing students. Second year students, in their postclinical evaluations indicated a desire for a structured laboratory setting to assist them in acquiring these skills. In response, faculty designed a randomized control trial to compare the effectiveness of teaching psychomotor skills in a structured laboratory setting with self‐directed self‐taught modules. The results of this study substantiated the hypothesis of no difference between psychomotor skill performance of students who learn in a self‐directed manner and those taught in a structured clinical laboratory.
Medications of elderly institutionalized incontinent females
Authors: Jones Keister Kathy , Creason Nancy S.
Published: December 2006

The purpose of the study was to explore drug use of elderly incontinent female nursing home residents, to identify potential drug—drug interactions, and to identify the number and categories of drugs taken having the potential to cause urinary incontinence. The medication administration records of 84 female residents were examined. The drugs were categorized by therapeutic classification as designated by the American Hospital Formulary Service. Potential drug—drug interactions were identified using The Hansten Drug Interaction Knowledge Base Program, a microcomputer version of Hansten's (1985) book Drug Interactions. Data were computer‐coded and analysed using the Statistical Analysis System (SAS). A total of 454 drugs was taken by the 84 subjects, with an overall average of 5‐40 drugs per person. The most frequently taken drugs were gastrointestinal drugs, central nervous system agents, electrolytic, caloric, and water balance drugs, and cardiovascular drugs. Fifty per cent (n= 42) of the subjects were identified as having 119 potential drug—drug interactions. Seventy per cent (n= 59) of the subjects were taking a drug having the potential to cause urinary incontinence. Suggestions for future research are presented.
Primary health care in public health nursing
Authors: Cloutier Laffrey Shirley , Page Ginette
Published: December 2006

Despite similarities between the goals of primary health care and public health nursing, several obstacles stand in the way of public health nursing's ability to perform its role in achieving an acceptable level of health for all by the year 2000. The purpose of this paper is to describe the essential components of primary health care and public health nursing, discuss obstacles in the way of public health nursing fulfilling its primary health care role, and to pose solutions at the levels of education, practice, and research for overcoming these obstacles.
Semantic differentials and the process of developing one to measure maternal role competence
Authors: Flagler Susan
Published: December 2006

The semantic differential (SD) technique is seen increasingly in studies by nurse investigators A better understanding of this technique will assist in the appraisal of findings based on SD data In taking a semantic differential the respondent describes the meaning of a given concept or stimulus by marking a senes of bipolar adjective pair scales Scoring and analysis can proceed in vanous ways but should not violate the semantic differential's multidimensional nature The evaluative, potency, and activity dimensions commonly seen in the technique are described How to construct an SD is explained The ease with which an SD can be completed makes this technique suitable for clinical populations The process of developing an SD to measure maternal role competence provides an example of using the technique in a new area of investigation Factor analysis of the SD to measure the concept myself as a mother revealed that the adjective pairs did not duster according to the typical SD dimensions Alternative dimensions are described These new dimensions gain support from their correlation with other measures of maternal role The SD provides a promising technique for the measurement of maternal role competence
How can we compare graduate and non‐graduate nurses? A review of the literature
Authors: Bircumshaw Denise
Published: December 2006

This paper reviews some of the literature comparing the graduates or ‘end‐products’ of two or more nurse education programmes The main focus of the paper is how graduate and non‐graduate nurses may be compared Since the amount of literature in this field in the United Kingdom is limited, much of that reviewed is from the USA The paper demonstrates that there are many problems associated with evaluating the ‘end‐products’ of nurse education programmes, particularly when quantitative approaches are taken It appears that future work may benefit from a more qualitative approach
The concept of reassurance in nursing
Authors: Teasdale Kevin
Published: December 2006

Reassurance is frequently mentioned in nursing literature and in nursing practice However, there is no generally accepted definition of its range of meanings, and some controversy over its therapeutic value This paper uses a structured approach to present an analysis of reassurance It identifies three main usages, and argues that it is the failure to differentiate between these usages which has caused the controversy over reassurance as a therapeutic approach in nursing.
Use of bladder washouts: a study of nurses' recommendations
Authors: Roe Brenda H
Published: December 2006

The performance of intermittent bladder washouts by nurses for patients with long‐term indwellmg urethral catheters forms a frequent aspect of nursing practice This study has interviewed 106 hospitai and distnct nurses to establish their recommendations conceming the use of intermittent bladder washouts Information collected comprised when a bladder washout should be performed, its frequency, the solutions to be used and the rationale for its prescnption It was concluded that nurses' recommendations were not always correct or consistent, and that there is a need for further educahon regardmg the use of bladder washouts so that recommendations are based upon saentific evidence The imphcations of the findings for nursing practice and the need for fundamental research are discussed
Nursing the statistics: a demonstration study of nurse turnover and retention
Authors: Barry JT , Soothill KL , Francis BJ.
Published: December 2006

This paper demonstrates how a health authority can use personnel records of nurses' working histories as an effective tool in manpower planning Suggestions are given as to how these histories might be analysed and interpreted Methods described range from the use of simple summary statistics and graphical methods to advanced statistical modelling techniques Data from a study by researchers at the Centre for Applied Statistics and Department of Sociology at Lancaster University are used to give examples of these approaches A description is also given of the practical difficulties experienced when attempting to extract the appropriate data from the health authority's personnel records.
An evaluation of a communication skills course for health visitor students
Authors: Crute VC , Hargie O D W , Ellis RAF
Published: December 2006

This paper presents part of the findings of an extensive empirical evaluation of a communication skills training programme for health visitor students The programme was designed to develop the health visitors' ability to communicate with clients A wide range of interpersonal skills were addressed and the training format involved skill analysis, roleplay practice and video‐recorded feedback. The method of evaluation included an appraisal of the health visitors' social behaviour in a roleplay of a home‐visit to a pregnant client Data were collected, both before and following training, in an attempt to assess changes in trainee behaviour The analysis took the form of a detailed frequency measurement of behavioural elements of health visitor performance, and a global rating of social competence by independent judges Results of the analyses indicated that 14 out of the 20 behavioural variables changed in the desired direction Thus, for example, following training the health visitors used significantly more open questions and verbal encouragers, and significantly fewer multiple questions and interruptions when communicating with the client They were also rated significantly higher on the rating scale for social competence following training These findings would seem to suggest that the training programme had a considerable degree of success The findings are discussed in terms of the implications for development of health visitors' social skills, the need for more sophisticated measures of social behaviour and for the formulation of a model of competent professional practice in this area
The theoretical basis for nursing at the community level: a comparison of three models
Authors: Chalmers Karen , Knstajanson Linda
Published: December 2006

Although literature on community health nursing identifies a nursing role at the community level, there is a lack of clarity about the elements and expected outcomes of this role In this paper three models of community health prachce are presented and discussed in terms of their effectiveness as a basis for nursing practice at the community level These models are (I) the public health model, (2) community participation model, and (3) community change model Factors that affect the effectiveness of nursing to work at the community level are also discussed and questions for reflection and debate raised
Nursing turnover: literature review and methodological critique
Authors: Cavanagh Stephen J
Published: December 2006

Turnover represents a major problem for nursing and health care in terms of cost, the ability to care for patients and the quality of care given As a result, turnover has been the subject of a large number of investigations, both in nursing and non‐nursing fields However, many of the articles published report conflicting findings A further complication is the variety of methodologies researchers have used, there has been little agreement on definition, measurement or reporting strategies This has led to considerable confusion when attempting to compare studies This article reviews what is currently understood about nursing turnover from an organizational perspective, and examines some of the methodological considerations surrounding the study of nursing turnover Historically, nursing turnover research appears to have relied heavily on studies conducted in non‐nursing areas for methodological guidance References to non‐nursing studies are therefore important and are reported where appropnate
The nursing care of people experiencing affective disorder: a review of the literature
Authors: Barker Philip J.
Published: December 2006

Contemporary nursing concepts of care for people with affective disorder are a function, at least in part, of the available nursing literature. Cormack suggested that the literature could be defined in terms of ‘prescriptions of care’ and ‘descriptions of care’. This review summarizes some of the best‐known British and North American nursing texts of the last 30 years in an effort to identify the views of affective disorder used by authors and the main strategies recommended or described in relation to the care of people with such disorders. Some of the ‘descriptive’ studies reported in Britain over the past decade which highlight the nurses' orientation to care and methods used, are similarly evaluated. The trend away from reliance upon traditional intrapsychic concepts in favour of more eclectic approaches is acknowledged. However, many prescriptions for care fail to indicate whether or not research support exists for specific orientations to care. Also, given the size of the population, the number of published descriptive accounts, especially research reports, related to the care of people with affective disorder are a cause for concern. The review suggests a need for nurses to develop, research and report conceptual models of nursing for the care of the person with affective disorder.
Rehabilitation information and health beliefs in the post‐coronary patient: do we meet their information needs?
Authors: Murray Peter J.
Published: December 2006

Twenty‐five patients, admitted through a Coronary Care Unit with their first myocardial infarction (MI), were interviewed close to discharge home about (a) their perceptions regarding the causes of their MI and (b) their knowledge of coronary heart disease (CHD) risk factors. Psychosocial factors (overwork, stress, worry) were the most frequently cited causes of MI, with smoking and being overweight or overeating the most frequently cited physical causes. Knowledge of CHD risk factors concentrated on smoking, being overweight and dietary factors, although psychosocial factors were relatively frequently cited. High levels of satisfaction with staff‐patient communication were expressed, but knowledge of advice given was generally vague or imprecise and concentrated on dietary modification. Smoking was well‐recognized by smokers as a risk factor but less commonly related to their own Ml. The main recommendation is for coronary rehabilitation information programmes to be more individualized to the patients' specific needs, based on a Personal Risk Factor and Health Beliefs Assessment for all patients.
Nursing education in Canada: historical ‘Progress’—contemporary issues
Authors: Bramadat Ina J. , Chalmers Karen I.
Published: December 2006

Contemporary concerns in nursing education in Canada suggest that the earlier educational pathways have not always represented progress. The persistence of alternate routes for the preparation of registered nurses, and the continuing divisiveness among nurses with differing educational backgrounds are problem areas that still require resolution. Some problems, such as the development of the nursing curriculum, have been shared across educational settings. Nurse educators in Canada, as in other countries, have vested tremendous energy into this aspect of nursing education. In retrospect, it is recognized that much of this effort has been misdirected. Efforts to strengthen the theoretical underpinnings of the curriculum have resulted in the incorporation of borrowed theory from other disciplines, often without critical examination of the context in which the theory developed, or of its consistency with the philosophical perspectives of nursing. Attempts to build curricula around the major nursing models have also met with limited success. Separation of education and practice, persistence of multiple levels of preparation in nursing, and a continual search for viable curriculum models have led to uncertainty, to detours in the development of nursing education, and to occasinal reconsideration of previous approaches.
An investigation of the developmental influences on nurses' motivation for their continuing education
Authors: Mackereth Peter
Published: December 2006

This author investigated these influences by use of a questionnaire. It was distributed to 90 second‐year students and 89 staff nurses, working in three London hospitals. The tool was developed from a literature search, which looked at motivational theories, research into nurse retention and attitudes and interest in continuing education. No similar studies were found. An assumption was made that students are idealistic about their continuing education and staff nurses pragmatic. That is, the role change from student to staff nurse alters the perspective on career and continuing education needs. Eighty‐one per cent of the questionnaires were returned. Results indicated that students decided their future training needs on how much they enjoyed a particular experience, and on their expectation of furthering their skills in that area; whereas staff nurses wanted management training and skills and knowledge in looking after critically ill patients. A number of respondents were considering leaving nursing, because of poor staffing and salary; this dissatisfaction was greatest amongst the staff nurse respondents. The investigation identified the need for commitment from both service and education to the concept of continuing education for nurses as crucial to improving patient care, and support and help for staff and students to assess their needs and be informed of choices and resources.
Job satisfaction and attitudes of nursing staff on a unit for the elderly severely mentally infirm, with change of location
Authors: Humphris G. M. , Turner A.
Published: December 2006

Relocation of the elderly has stimulated research into its effect on this vulnerable group. This study, by contrast, focuses attention on the staff response to relocation. Nursing staff on an Elderly and Severely Mentally Infirm Unit (ESMI) who were caring for the 50–60 inpatients completed a questionnaire, measuring job satisfaction and work‐related attitudes, immediately and after the relocation to a newly refurbished unit. A follow‐up was conducted 8 months after the change of environment. Only after the 8‐month follow‐up had overall levels of job satisfaction improved significantly. No changes over time were found in attitude to caring for ESMI patients or views about providing more facilitative activities as opposed to traditional nursing care. On all occasions there was a great sense of co‐operation amongst staff, but they were unsatisfied with the pressure of work. Morale and feeling part of a team effort dropped after relocation but regained original levels on follow‐up. Staff turnover was high for the duration of the study. Opinions concerning work were not associated with staff leaving immediately on relocation but low satisfaction levels did predict a future exodus of staff from the unit after the relocation.
Concepts, analysis and the development of nursing knowledge: the evolutionary cycle
Authors: Rodgers Beth L.
Published: December 2006

Nursing currently evidences concern with the development and clarification of its knowledge base. As a part of this focus, attention has often been directed towards concepts and methods of clarification. Although the method of concept analysis has been employed often to provide conceptual clarity, the foundations and implications of conducting an analysis of a concept have not been well explored in nursing. In this article, the philosophical foundations of the approach to concept analysis popularized by Walker & Avant (1983) are examined. Modifications of this method are offered, along with a framework for interpreting the findings of an analysis. The result is a view of concepts and an approach to analysis that may be of use in the clarification of a variety of concepts of interest in nursing.
The effect of death education and experience on nursing students’ attitude towards death
Authors: Hurtig Wendy Austin , Stewin Len
Published: December 2006

Nurses face their own fear of death whenever they come to the bedside of a dying patient This fear must be confronted and reconciled before they can help others meet death with dignity Examining one's attitude towards death is a difficult task that needs to begin in the student years, when attitudes towards working with the dying are formed Nurse educators recognize that brief but effective ways of promoting this kind of personal awareness need to be found An experimental study is described that investigated the effect of death education programmes and personal experience with death on the attitudes of nursing students It was found that the death attitudes of mexpenenced students who were in an experiential programme were more positive than similar students who received a didactic or placebo programme Experienced students, however, were negatively affected by the expenential approach The implications of these findings for nursing education are outlined
A multidimensional scalogram analysis of the use of seclusion in acute psychiatric settings
Authors: Morrison Paul
Published: December 2006

Seclusion is still an available strategy for managing difficult and disturbed behaviour in Bntish psychiatric hospitals and units While arguments for and against the continued use of seclusion remain, little empirical work has been done on the subject Most of the research to date has been completed in America, and findings may not be entirely applicable to the UK In this study, 109 records of seclusion in one health authority were examined, and each of the 52 patients involved in these seclusions were coded on six different variables These were analysed using the multidimensional scaling (MDS) procedure — multidimensional scalogram analysis (MSA‐1) — to explore possible relationships between the variables Three sets of relationship were observed (1) the length of time spent in seclusion was related to the status of the patient, (2) higher rates of seclusion were shown to be linked to higher levels of staffing, and (3) the sex of the patient was related to the number of different staff authorizing seclusion Some possible explanations for these findings are outlined, and suggestions for future research in this domain are offered
Relatives’ involvement in caring for the elderly mentally ill following long‐term hospitalization
Authors: RMN Tracey Sharp
Published: December 2006

The involvement of relatives in patient care is frequently associated with‘good nursing practice’ However, according to recent literature it is a practice that is not widely adopted The intention of this study was to ascertain the extent of relatives’ involvement in caring for the elderly mentally ill, from both relatives’ and nurses’ perspectives Following analysis of more than 130 questionnaires it was found that nursing staff responded very positively towards greater involvement of relatives wishing to encourage their participation In comparison relahves felt that their role in patient care was negligible, but despite this did not wish to seek greater involvement The discussion that follows examines possible reasons for these findings and the implications for future practice
Fungating and ulcerating malignant lesions: a review of the literature
Authors: BA(Hons) Olga Ivetiç , Lyne Patricia A
Published: December 2006

This paper presents a review of the literature concerning the care of cancer patients who develop fungating and/or ulcerating lesions The nature, sites of presentation, prognosis, different therapeutic modalities, incidence among cancer patients and characteristics of the patients affected are discussed In order to assess the current state of knowledge about wound management and to determine its applicability to malignant lesions, a review of the general wound healing literature was undertaken and is presented here in part The review demonstrates that there is little published research which deals specifically with this condition The reports which are available give little indication of the knowledge base and rationale on which nursing management is founded The authors conclude that an informed and considered choice regarding the use of conventional and non‐conventional topical agents and dressings is as pertinent to the nursing management of malignant lesions as it is to other wound types They also suggest that awareness of and sensitivity to the psychological problems that such pahents often present is as important as controlling the physical symptoms associated with this condition
Evaluating the efficacy of the infection control liaison nurse in the hospital
Authors: Ching T Y , Seto W H
Published: December 2006

The infection control liaison nurse (ICLN) is a nurse in the ward, appointed to participate in education for infection control, and to liaise between the ward and the infection control nurse (ICN) The efficacy of ICLNs was evaluated when a guideline on urinary catheter care was introduced in a 1000‐bed hospital in Hong Kong The 27 public wards were divided randomly into a test (24 wards) and control group (three wards), and ICLNs were appointed in the test group by the nursing administration For education, the ICN conducted in‐service lectures for both groups, while in the test group, the ICLNs also conducted tutorials for all ward nurses Before and after the education programme, prevalence surveys were conducted to detect incorrect practices on urinary catheter care Three practices were evaluated the securing of catheters, presence of kinking and the use of urinary bags with a drainage spigot Before education, the percentage of incorrect practices in the test groups was 63%, which was comparable to the 68% of the control group (P= 0 40, χ2= 0.71) After education, the percentage of incorrect practices in the test group (36%) was significantly lower than the 48% in the control group (P < 0.05, χ2= 4 25) This indicates that ICLNs can indeed enhance the education programme for infection control
The nursing management of elderly patients with pain in the community: study and recommendations
Authors: Walker Janet M , Akinsanya Justus A , Davis Bryn D , Marcer Donald
Published: December 2006

This study is designed to identify factors which influence quality of life for elderly people suffering from painful conditions It is based upon a theoretical model of control in which mood state is used as the indicator of coping One hundredand ninety elderly patients took part in semi‐structured interviews about their pain and coping experiences, and data were also collected from their nurses in the community Multivariate statistical analysis revealed that the key determinants of mood were having regrets about the past, being occupied, perceived level of pain control, additional personal problems (notably bereavement) and feeling informed about the painful condition Active personal coping strategies were identified as moretherapeutic than passive strategies Nurses’ data revealed that pain complaints were associated with perceived exaggeration Few nurses used formal pain assessment. Recommendations for the management of persistent pain in the community are given
Measuring the quality of nursing care: a consideration of different approaches
Authors: Redfern Sally J , Norman Ian J
Published: December 2006

This paper argues that a preoccupation with cost‐effectiveness threatens to swamp nurses’ traditional concern with quality of care, and underlines the importance of clinical nurses becoming familiar with the complexities of quality measurement Terminology widely used in the nursing literature is clarified and research studies that address the quality of nursing care are reviewed It is suggested that whilst some of these have provided important theoretical insights into quality issues, the qualitative research methods employed have so far failed to provide a practical alternative to the more ‘objective’ measures of quality currently adopted by clinical nurses and their managers Generic measures of quality are identified and categorized and it is suggested that most of these are in need of extensive validity testing in relation to the concepts of quality that they purport to measure The measures of quality themselves may be less important than the content in and process by which they are applied ‘Top‐down’ and ‘bottom‐up’ approaches to measurement are discussed in relation to the notion of facilitative leadership The value of top‐down approaches is questioned on the grounds that they may violate the integrity of the quality‐assurance cycle and prevent clinical nurses from making the commitment that is necessary in order to assess and improve the quality of their nursing practice
The utilization of research findings in clinical nursing practice
Authors: Bircumshaw Denise
Published: December 2006

This paper considers the issue of utilizing research findings in nursing practice It covers the justification for utilizing research in practice, and whether research is actually implemented Previous studies focusing upon the process of utilizing research are analysed, and consideration is given to how research should be evaluated and implemented and the factors affecting this The literature reviewed demonstrates that the implementation of research in clinical practice is a complex operation Attempts to achieve research‐based practice need to be well thought through and organized, with those involved at all levels being interested and committed to its success
An experiment in psychiatric community care in north Staffordshire: the experience of working with relatives of mentally‐ill people
Authors: Platt C
Published: December 2006

This paper describes the changing nature of the relationship between the consumers and providers of services, following the transition from a hospital to a community‐based service One aspect of this change, the development of a relatives’ group, is considered in more detail Those attitudes and approaches which help or hinder staff working with relatives are discussed
Smoking habits of nurses and midwives
Authors: Sacker Amanda
Published: December 2006

A study was designed to examine the hypothesis that increased awareness of the health hazards of smoking aids smoking cessation in female health care workers One hundred and thirteen nurses and midwives completed a questionnaire about their smoking habits When the group was tested as a whole against the national average for the same socio‐economic group, it was found that there was a strong similarity between the subjects’ smoking habits and the national average However, when the nurses and midwives were separated into two groups, the nurses smoked significantly more than the national average, whereas the midwives smoked significantly less In addition, there was an intriguing finding that a highly significant number of the midwives had never smoked compared to the national average
The contribution of the basic sciences to nursing practice research
Authors: Mulhall Anne
Published: December 2006

The scientific knowledge on which nurses may base their clinical practice is often lacking Not withstanding this, scientific knowledge in isolation is sterile unless it is invoked to address nursing hypotheses This paper explores how such nursing questions can be both identified and answered within a scientific framework Using the example of infection control, the complexity of the problem is examined and the contribution that various research approaches, including in vitro investigations, can offer is evaluated Nursing practice research has a vital role to play in determining the effective prevention of nosocomial infection The necessity for a collaborative and flexible approach to such research and the value of multidisciplinary teams of nurses and other scientists is emphasized
A description of clients nursed by community psychiatric nurses whilst attending English National Board Clinical Course No. 811: clarification of current role?
Authors: Brooker Charles G D
Published: December 2006

The English National Board Clinical Course No 811 is a 36‐week preparation for community psychiatric nurses (CPNs) Unlike health visiting or district nursing the course is not yet a mandatory prerequisite for practice and it has been estimated that, nationally, 23% of all CPNs have been awarded the certificate to date There are currently 24 course centres in England, offering 420 places annually The completion of a care study by the course student is a curriculum requirement The present study aimed to establish the characteristics of clients chosen by course students for such work whilst attending the course in an attempt to obtain a ‘proxy’ measure of the current CPN role nationally A stratified random sample of eight course centres was selected — four based in schools of nursing, and a further four located in establishments of higher education Then within each course centre a stratified random sample of students was selected, who each completed a postal questionnaire A 79% response was obtained The results are described and discussed within the context of the CPN's developing role The findings suggest that many CPNs conceptualize their role and function, to use Caplan's terminology, at the primary prevention level, and see their work as being located firmly in primary health care settings The desirability of this orientation to CPN intervention is examined, acknowledging both mental health service developments and the wider educational implications