bluuebunny/crossref_metadata_2025 huggingface dataset:
No more tears: a randomized controlled double‐blind trial of Amethocaine gel vs. placebo in the management of procedural pain in neonates
Authors: Moore Judith
Published: March 2003

No more tears: a randomized controlled double‐blind trial of Amethocaine gel vs. placebo in the management of procedural pain in neonates

Aim. During a comparative double‐blind study, the efficacy of Amethocaine local anaesthetic gel was compared with that of a placebo gel to establish their effect on the reduction of behavioural and physiological responses to pain in neonates.

Method. Forty infants were included in the trial, 20 being randomly assigned to each group. After topical application of either Amethocaine or the placebo for 30 minutes, cannulation was performed using a 24 gauge cannula. Assessment of pain was made with the aid of four point assessment tool incorporating facial expression, cry and heart rate changes and ease of cannulation. Additional baseline data were obtained including sex, gestation, weight and previous experience of cannulation, and analysed using Statistical Package for Social Sciences (SPSS).

Results. Good analgesic effects were demonstrated in the Amethocaine group, as there was a high level of significance (P < 0·01) in the difference in pain scores between the two groups using a Mann–Whitney U‐test. There was no correlation between gestation or weight and the degree of pain experienced during painful procedures. No significant relationship was found between cannulation and the degree of pain experienced.

Conclusion. It can, therefore, be concluded that Amethocaine gel is an effective local anaesthetic in the management of skin puncturing procedural pain in neonates, and that all infants regardless of maturity, weight or previous experiences probably experience a similar degree of pain and therefore warrant effective and appropriate analgesic intervention.
The utility of self‐care theory as a theoretical basis for self‐neglect
Authors: Lauder William
Published: March 2003

The utility of self‐care theory as a theoretical basis for self‐neglect

Aim. This paper sets out to explore the utility of self‐care theory in understanding self‐neglect. Further theoretical development of both self‐care and self‐neglect theory and attending core concepts is an important objective.

Background. The notions of self‐neglect and self‐care are frequently linked in the literature. The relationship between self‐neglect and self‐care is not clear and the strengths and limitations in using self‐care theory to facilitate a greater understanding of self‐neglect will be addressed. Specifically the issues of self‐care agency, self‐care requisites, objectivity, class and culture, and lifestyle choice will be critically evaluated in the context of self‐neglect theory.

Conclusion. Self‐care theory has a useful role to play in furthering our understanding of self‐neglect. Self‐care theory is able to explain some aspects of self‐neglect but not others, although this may be a reflection of the relatively underdeveloped state of self‐care theories or alternatively may reflect a more fundamental limitation in our ability to fully explain human behaviour.
A measure of patient empowerment in hospital environments catering for older people
Authors: Faulkner Mark
Published: March 2003

A measure of patient empowerment in hospital environments catering for older people

Aim. The principal aim of this research was to develop a valid and reliable measure of patient empowerment and disempowerment in hospital environments catering for older people.

Rationale. It is argued that empowerment is linked to Learned Mastery (Peterson, Maier & Seligman 1993) and increasing patient independence, whilst disempowerment is linked to Learned Helplessness (Seligman 1975) and increasing patient dependence. Consequently, the development of a measure of these concepts would represent a valuable quality assurance tool.

Method. Measures were developed using the ‘act frequency approach’ ofBuss and Craik (1983)whereby registered nurses (n=38) were asked to nominate empowering and disempowering acts relevant to interactions between staff and older patients. The resulting lists of 98 acts for each disposition were hypothetically judged by older hospitalized people (n=20) as to the extent they would be either ‘control giving’ (empowering acts) or ‘control taking’ (disempowering acts) if personally experienced. The twenty highest scoring acts in each category were incorporated into the Patient Empowerment Scale.

Results. Using this scale, older hospitalized people (n=102) resident on five different hospital wards were asked to judge how often they had encountered each act over a predetermined period of time. Wards varied in speciality including acute medicine, surgery and elderly care rehabilitation. The ward scoring lowest on the PES (i.e. the least empowering) was the elderly care rehabilitation ward. Moreover, this ward showed an inverse correlation between participant age and exposure to empowering care. Alpha scores ranged from 0·74 to 0·87 for empowerment and 0·65 to 0·87 for disempowerment.

Conclusion. The PES is offered as a valid and reliable measure of empowerment and disempowerment in hospital settings catering for older people. It enables the identification of environments which place patients at risk of becoming dependent, or alternatively facilitate increasing independence.
Development of a patient‐orientated instrument to measure service quality in outpatient departments
Authors: Hiidenhovi Hannele , Laippala Pekka , Nojonen Kaija
Published: March 2003

Development of a patient‐orientated instrument to measure service quality in outpatient departments

Aims of the study. To describe three stages in the development of an instrument to measure service quality from the patients’ perspective in hospital outpatient departments.

Rationale. A reliable and valid service quality instrument is a valuable tool for collecting feedback from patients when improving outpatient services.

Design. A multiphase process with several versions of the questionnaire testing its validity and reliability. The first version of the questionnaire was constructed from information collected in a previous interview study of patients’ service experiences. Using this version (47 questions) information was collected in 15 outpatient departments (314 patients) and the second version of the questionnaire was developed. At this stage, a survey of employees (n=111) was included in the development process. This second version of the questionnaire (43 questions) was used to collect more data in three outpatient departments of a university hospital and in two outpatient departments of two regional hospitals on three different occasions (1416, 369 and 124 patients) within a period of 2 years. The reliability of the instrument was tested in terms of stability by using three repeated measurements, and using the Cronbach’s α coefficient as an indicator of internal consistency. Content validity was assessed by means of percentage agreement between staff and patients. Logistic regression analysis was performed to assess construct validity.

Results. The final version of the questionnaire contained 12 items. Agreement between patient and staff ratings was found to be acceptable for most questions (content validity). Two measurements on different occasions yielded a similar structure (construct validity). Internal consistency was acceptable (Cronbach’s α= 0·67–0·93 in the first and 0·71–0·94 in the second survey). The variance of the α coefficients was small in the retest (stability).

Conclusions. The instrument developed is general to the extent that it is suitable for assessing service quality improvement needs in individual units and for making cross‐departmental comparisons.
What do nurses and therapists think about the positioning of stroke patients?
Authors: Rowat Anne M.
Published: March 2003

What do nurses and therapists think about the positioning of stroke patients?

Background.  At present, there are a number of different positioning strategies for stroke patients, but these are mainly based on clinical experience rather than research. Prior to developing a study to evaluate the effect of positioning on outcome after stroke, it was important to establish if nurses in our hospital had given much thought to the positioning of stroke patients.

Aim of the study.  This study aimed to explore whether nurses working on the stroke unit at a Scottish teaching hospital held different views on the positioning of conscious and unconscious stroke patients to nurses working on other wards with stroke patients and therapists.

Methods.  Questionnaires on various aspects of patient positioning were sent to 150 nurses and 25 therapists working in five specialities where stroke patients are cared for in a large teaching hospital.

Findings.  Overall, the majority of nurses and therapists (74%) believed that the best position for conscious stroke patients was sitting in a chair. Also, 80% of them believed that the best position for unconscious stroke patients was lying on the nonparetic side. There was less of a consensus between nurses and therapists working in the five specialities as to whether it was appropriate for conscious or unconscious stroke patients to lie on their paretic side, lie supine or sit propped‐up in bed in either a 30 or 70° angle.

Conclusions.  The lack of consensus between nurses working in the five specialities is probably because at present there is little research to guide nursing practices for the positioning of stroke patients. Therefore, research to confirm which positions improves or hinders outcome after stroke is essential. Indeed, positioning is a simple inexpensive strategy, which could have a substantial public health impact, as stroke is so common.
Spiritual coping strategies: a review of the nursing research literature
Authors: Baldacchino Donia , Draper Peter
Published: March 2003

Spiritual coping strategies: a review of the nursing research literature

Aims of the paper.  This paper reviews some of the limited nursing research‐based literature, orientated towards the use of spiritual coping strategies in illness. This review aims at identifying those spiritual coping strategies used by the believers and nonbelievers followed by implications for holistic nursing care.

Literature search.  The CINAHL AND MEDLINE CD Rom databases were searched, identifying literature published from 1975 onwards which amounted to 187 articles. The majority of the literature traced were found anecdotal with only few studies investigating directly spiritual coping strategies. Following scrutiny of the available articles, only five research studies explored directly the spiritual coping strategies used in various illness, four of which were conducted in USA and one in UK. Because of the small scale research studies, generalization of the findings of this review is limited to the samples used.

Theoretical background.
 Research suggests that spiritual coping strategies, involving relationship with self, others, Ultimate other/God or nature were found to help individuals to cope with their ailments. This may be because of finding meaning, purpose and hope, which may nurture individuals in their suffering. Spirituality is oftenly referred by literature as being synonymous with religiosity. Thus the use of spiritual coping strategies is restricted to individuals who hold religious beliefs. However, the definition of spirituality indicates that this concept is broader than religiosity. The theories on stress‐coping (Folkman & Lazarus 1984) and the numinous experience (Otto 1950) outline the rationale for the use of these strategies which are applicable to both the believers and nonbelievers.

Implications.  This review suggests that the onset of illness may render the individual, being a believer or nonbeliever to realize the lack of control over his/her life. However the use of spiritual coping strategies may enhance self‐empowerment, leading to finding meaning and purpose in illness. This implies that holistic care incorporates facilitation of various spiritual coping strategies to safeguard the wholeness and integrity of the patients.
The quality of perioperative care: development of a tool for the perceptions of patients
Authors: Leinonen Tuija , Leino‐Kilpi Helena , Ståhlberg Marja‐Riitta , Lertola Kalle
Published: March 2003

The quality of perioperative care: development of a tool for the perceptions of patients

Aim of the study. To find out how surgical hospital patients (n=874) perceived the quality of perioperative care they received in an operating department and in the recovery room.

Background. Patients’ perceptions of the perioperative care have not been included systematically in the improvement of the care. Accordingly, there is no standardized, valid, and reliable instrument or system in common use that we could use for the evaluation. The nursing care in operating departments has an important role in modern health care, and therefore more research concerning perioperative care quality is needed urgently and the development of the measurement tool is urgent.

Method. The data were collected using a structured questionnaire in five operating departments in southern Finland during 1998.

Results. Physical activities (such as pain management and temperature maintenance) were rated as excellent, as were staff characteristics and the physical and social environment. The most critical comments were made with regard to supporting patient initiative, encouragement and educational activities. Patients stated they would have liked more information and it was felt that they should have been encouraged to ask more questions about unclear matters. Some of the patients said they had only very limited influence over their own care. The patients were very pleased with their care in the recovery room. There were only minor differences between the views of patients from different departments.

Conclusions. Overall the quality of care was considered extremely good, but comparisons of different quality categories did reveal some problems. Although it has already proved to be a useful tool, the questionnaire needs to be developed and tested further.
Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment
Authors: Sapountzi‐Krepia Despina S. , Valavanis John , Panteleakis George P. , Zangana Dimitra T. , Vlachojiannis Pantelis C. , Sapkas George S.
Published: March 2003

Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment

Aims. To explore the impact of bracing on the perceptions of body image, happiness and satisfaction of adolescents with scoliosis.

Design. The study was designed as compare of 134 girls and 16 boys who wore a Boston type brace for scoliosis treatment and a control group of 99 healthy girls and 51 healthy boys. All them were secondary school pupils living in Athens Greece and were interviewed. A semi‐structured schedule included general questions, and the Piers–Harris scale was used. Data were analysed using the SPSS/PC+ software, and descriptive statistics, factor analysis and the non‐parametric Mann–Whitney U‐test. Statistical significance was set at P=0·05 or less.

Results. The scoliosis group had a poorer perception of body image in comparison to the control group (P=0·048), while boys with scoliosis (P=0·030) had a better perception of body image than girls with scoliosis. Girls with scoliosis had a statistically significant difference (P=0·0388) in perception of happiness and satisfaction, in comparison with girls in the control group. Cohabitation with the mother seemed to be negatively correlated with body image, happiness and satisfaction perceptions because adolescents with scoliosis who were not living with their mother had a better body image perception (P=0·027) as well as better perceptions of happiness and satisfaction (P=0·047). Nevertheless, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings and problems with health professionals, while 90% of them declared that they wanted to have more opportunities to do this.

Conclusion. Adolescents with scoliosis face problems during bracing and they need to be supported by health care professionals.
The quality of nursing home care: do the opinions of family members change after implementation of emotion‐oriented care?
Authors: Finnema Evelyn , De Lange Jacomine , Dröes Rose‐Marie , Ribbe Miel , Van Tilburg Willem
Published: March 2003

The quality of nursing home care: do the opinions of family members change after implementation of emotion‐oriented care?

Objective. The present study focuses on opinions on the quality of nursing home care of family members of nursing home residents with dementia. Furthermore, we examined whether family members’ appreciation of the care increased as a result of the implementation of emotion‐oriented care.

Design. Randomized clinical trial.

Instrument. An 18‐item questionnaire was developed. The following subjects were addressed: communication activities between staff and family members; satisfaction regarding contacts with staff; the extent to which family members can participate in care; the contact that family members experience with the person with dementia, and opinions about the way in which nursing staff treat residents.

Results. Most family members already had a positive opinion on the nursing home care prior to the implementation of emotion‐oriented care. The most positive assessment concerned the way in which nursing staff treated residents. The lowest scores concerned communication activities between ward staff and family members. Comparison of the first and end measurements showed that in general opinions on the quality of care did not change.

Study limitations. A large number of incomplete questionnaires made it impossible to conduct factor analysis on the classification of the questions in various sections and therefore allowed us only to make statements at the item level.

Conclusions. For the most part family members had a positive opinion on the nursing home care. In general, implementation of emotion‐oriented care did not lead to a more positive assessment. Despite the generally accepted notion that involving family members in care is important, family members were regularly treated as outsiders. This demonstrates that there is room for improvement in the communication by nursing home staff with family members (e.g. more frequent contacts and information about the illness).
Caring in nursing: a different interpretation
Authors: Sumner Jane
Published: March 2003

Caring in nursing: a different interpretation

Aim. To applyHabermas’ (1995)Theory of Moral Consciousness and Communicative Action to the nurse–patient relationship, offering a different interpretation to the nurse–patient relationship that iscaring in nursing.

Rationale. Many authors have described the nurse–patient relationship, but Habermas’ theory synthesizes the components into a complex matrix that iscaring in nursing.

Findings. The theory offers three claims to normative validity: the claim to truth which is the factual objective knowledge; the claim to truthfulness which refers to the intrasubjective self; and the claim to right which is the intersubjective interaction. The validity claims explain the patient’s personal and illness self, the nurse’s personal and professional self, and the interaction/discourse. The interaction is situation specific, and is identified as moral because dialogue/discourse requires a ‘considerateness’ of each for the other. ‘Considerateness’ in discourse requires certain rules, including that each participant has an equal voice, be followed in order for the Principle of Universalization to occur. Habermas draws onKohlberg’s (1981), andSelman’s (1980)work to develop three levels of moral maturity of communication. These are preconventional, conventional, and postconventional. Initial moral maturity is egocentric, subjective, and obedient to authority. Maturity develops with recognition of other and reciprocity. At the postconventional level there is mutuality and the ability for abstract reasoning. There is a third person objectivity combining speaker and addressee/listener perspectives. Norms are not just accepted, they are reasoned through. This leads to justification of the norm, which is then accepted as valid. When the three validity claims are met and there is genuine ‘considerateness’ in the interaction there is communicative action. The reverse is strategic action, where the communication is coercive. When there is communicative action both patient and nurse are validated with a sense of fulfillment or .

Conclusion. Habermas’ (1995)theory offers a new paradigm for caring in nursing.
John Heron’s six‐category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom
Authors: Sloan Graham , Watson Hazel
Published: March 2003

John Heron’s six‐category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom

Aims. This paper provides a critique of how Heron’s six‐category intervention analysis framework has been adopted by nursing in the United Kingdom (UK) as a theoretical framework in nursing research and model for clinical supervision. From this, its merits as an analytic framework and model for clinical supervision in nursing are discussed.

Background. Heron’s six‐category intervention analysis has been acknowledged as a means by which nursing could develop its therapeutic integrity. It has also been used as a theoretical framework in nursing research focusing on nurses’ perceptions of their interpersonal style. More recently descriptions of this framework have been proposed as a structure for clinical supervision. However, its use as a theoretical framework to underpin research investigating the interpersonal skills of nurses and as a model of clinical supervision must firstly be scrutinized.

Findings. Returning to Heron’s original description and comparing this with its current adoption in the UK, misconceptions of this framework can be identified. Its value as an analytic tool investigating interpersonal relations in nursing has still to be evaluated. Furthermore, nursing’s emphasis on certain intervention categories has undermined the potential potency of this framework and its contribution as a model for clinical supervision in nursing.

Conclusion. We argue that Heron’s six‐category intervention analysis as a framework to investigate the interpersonal competence of nurses, particularly mental health nurses, requires investigation. This, in turn, would provide an opportunity to challenge the framework’s theoretical standpoint. In addition to its value as an analytic tool, all six categories of Heron’s framework have equal relevance to its contribution in nursing as a supervision model.
Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynaecology nurses
Authors: Jolley Sue
Published: March 2003

Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynaecology nurses

Aim. This study was designed to investigate the teenage sexual health service provided by gynaecology nurses at Queen’s Medical Centre, Nottingham, United Kingdom (UK), by assessing their knowledge, activities and perceptions in relation to teenage sexual health.

Background. Part of a gynaecology nurse’s work is caring for teenagers with sexual health problems, including unwanted pregnancies and sexually transmitted infections (STIs). Given the current national focus in the UK on improving teenage sexual health, there is clearly a role for gynaecology nurses to play, but this is rarely referred to in published literature and appears to be poorly defined.

Method. A cross sectional survey of all gynaecology nurses at Queen’s Medical Centre was carried out, followed by semi‐structured interviews with a small random subsample.

Findings. Results indicated that, although 65% of nurses had worked on the gynaecology unit for more than 5 years, there was poor knowledge, an inconsistent pattern of nursing interventions and negative perceptions of the service offered. A majority of the nurses (87%) had not received any specific training in how to nurse teenagers with sexual health problems and 65% considered that the quality of sexual health service offered to teenagers was poor. Unexpected findings included poor general knowledge of local teenage sexual health services, the emotional effect on some nurses caring for young teenagers undergoing medical terminations of pregnancy (ToP), and the complete lack of training and protocols for taking a sexual history.

Conclusions. The nurses felt that the teenage sexual health service provided could be improved by better staff training, better information for teenagers and better organization. Recommendations have been made as a result of the study but the staff will need management support to ensure that changes are effective. Generalizations cannot be drawn from a study in one hospital but the results could reflect the low profile given to the teenage sexual health aspect of gynaecology nurses’ work in the UK.
Well‐being of intensive care nurses (WEBIC): a job analytic approach
Authors: Le Blanc Pascale M. , De Jonge Jan , De Rijk Angelique E. , Schaufeli Wilmar B.
Published: March 2003

Well‐being of intensive care nurses (WEBIC): a job analytic approach

Aims of the study. This paper presents the results of a validation study of the so‐called well‐being of intensive care nurses (WEBIC)‐questionnaire that is designed to perform a detailed job analysis of intensive care unit (ICU) nurses’ jobs.

Background. The WEBIC‐questionnaire is based on modern sociotechnical systems theory, and distinguishes four integrated task categories: (1) operational, (2) organizing, (3) preparatory, and (4) supportive tasks. For each task, the WEBIC assesses (1) how demanding this task is, and (2) how satisfying the performance of this task is. Using the WEBIC, information is gathered about ICU nurses’ qualitative workload, and typical job‐related risks for ICU nurses’ well‐being at work can be mapped.

Methods. A cross‐sectional survey on work and well‐being of almost 2000 ICU‐nurses in 13 different European areas was conducted. Exploratory factor analyses were performed to study the validity of the factorial structure of the WEBIC‐questionnaire. The construct validity of the WEBIC‐questionnaire was studied by performing hierarchical multiple regression analyses of the WEBIC‐factors on two types of job‐related well‐being, i.e. burnout and general job satisfaction.

Results. Results of the exploratory factor analyses showed that the hypothesized four‐factor structure of the WEBIC is confirmed by our data. Internal consistencies of the different factors varied from 0·77 to 0·91. Intensive care unit nurses’ most central (operational) tasks turned out to pose the greatest demands, but also seemed to drive their satisfaction. With respect to the relationships between the four WEBIC‐factors, and burnout and general job satisfaction, it was found that, especially for the satisfying tasks, significant relationships with these outcomes were found.

Conclusion. The reliability and construct validity of the WEBIC‐questionnaire can be considered satisfactory. Furthermore, the questionnaire provides a systematical and detailed coverage of ICU nurses’ tasks. In relation to this, the questionnaire is not only useful for scientific purposes but also for practical use.
A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong
Authors: Yip Yin bing
Published: March 2003

A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong

Rationale. Low back pain (LBP) remains a common and costly problem among the nursing profession. Several studies have indicated that LBP is attributed to mentally straining or demanding work, fatigue or exhaustion or general work satisfaction.

Aims. This study aims to measure the magnitude of LBP among Hong Kong nurses and its association with the work‐related psychological strain and patients handling activities.

Research methods and measures. A cross‐sectional study of Hong Kong hospital nurses was conducted. Three hundred and seventy‐seven nurses were recruited from six district hospitals. They were registered nurses or enrolled nurses working full‐time for at least 1 month in the current ward. One hundred and seventy‐eight (47·2%) study subjects were randomly selected from two district hospitals and 199 (52·8%) study nurses made up the convenience sample. Possible bias from psychological distress, socio‐demographics and lifestyle factors was controlled for. Data were collected by face‐to‐face interviews. The data included work factors (both psychological stress and patient handling activities related to work), demographics, psychological distress and lifestyle factors and the occurrence of LBP.

Results. Of the 377 nurses interviewed, 153 (40·6%) reported having LBP within the last 12 months. With symptoms of LBP as the outcome, risks were increased where nurses self‐reported that they only occasionally or never enjoyed their work [adjusted odds ratio (OR) 2·07], where frequent manual repositioning of patients on the bed was required (adjusted OR 1·84) and where they were required to assist patients while walking (adjusted OR 2·11) after adjustment for other potential confounders.

Conclusion. The results indicate that an association exists between work stress, manual lifting and LBP prevalence. The main route to prevention of LBP among nurses is likely to lie in improved ergonomics and psychological health in their work place. Good posture and correct transferring techniques in ward situations should be reinforced with hands‐on practice performed on nurses’ common types of clients.
You can do it if you set your mind to it: a qualitative study of patients with coronary artery disease
Authors: Bergman Eva , Berterö Carina
Published: March 2003

You can do it if you set your mind to it: a qualitative study of patients with coronary artery disease

Aims of the study. To gain increased knowledge and understanding of what it means to be afflicted with coronary artery disease (CAD) and how it affects the life/lifestyle of the individual.

Background. Research has documented that education, counselling and behavioural interventions are important elements of cardiac rehabilitation and compliance with treatment. Compliance is generally better with medical treatment than with recommended lifestyle changes. Another influencing aspect is locus of control, i.e. people’s own understanding of control is the foundation for the decisions patients make more or less consciously regarding compliance with caring/nursing, treatment and lifestyle changes.

Methods. Eight individuals with diagnosed coronary artery disease were interviewed about their life situation, and the opportunities and obstacles they encountered in making lifestyle changes. These interviews were transcribed and then analysed using a hermeneutic approach.

Findings. The findings included three areas: (1) The causes of coronary artery disease describing different factors, such as heredity, lifestyle and demands. (2) Difficulties in the work of rehabilitation, which was explained in terms of informants’ feelings of confusion, uncertainty and sadness. (3) Successful rehabilitation consisted of two factors: the personality of the individual patient and external support.

Conclusions. Patients may comply well with follow‐up visits but less with lifestyle changes. By identifying different ‘characteristics’, ‘prerequisites’ and ‘difficulties’ that describe patients’ compliance, it should be possible to make treatment more individual. Nurses have a significant role in supporting these patients since they are more accessible than physicians. Nurses also have a responsibility to work together with patients to empower them, in order to make their lifestyle changes and self‐care activities manageable.
Living with post‐traumatic stress disorder: the wives’/female partners’ perspective
Authors: Lyons Margaret A.
Published: March 2003

Living with post‐traumatic stress disorder: the wives’/female partners’ perspective

Aim of the study. This phenomenological study examined what it was like for the wives/female partners to live with a Vietnam veteran who suffers from post‐traumatic stress disorder (PTSD).

Procedure. Audio‐taped interviews were conducted with 10 women and data were examined from three overlapping phases of the veteran/partner relationship: the early phase, the middle phase and the later phase.

Findings. The early phase was conceptualized as a period of adjustment in which three themes were identified: (1) attractors, (2) feelings and (3) communication. The middle phase, one of enmeshment, was characterized by six themes: (1) dealing with veteran PTSD symptoms, (2) substance abuse, (3) physical and/or emotional abuse, (4) roles, (5) feelings and (6) coping techniques. Three themes depicted the later phase of resolution/healing: (1) stress related symptoms, (2) staying or leaving and (3) activities that promoted an ongoing process of resolution/healing.

Conclusions. The central meaning statement that best described the experience of wives/female partners who live with a Vietnam veteran with PTSD is that the experience is a gradual process of becoming enmeshed in the veteran’s pathology, with all energies being directed at minimizing the effect on self and family, culminating in intermittent movement towards resolution/healing. This study has implications for practitioners who treat Vietnam PTSD veterans and their wives or female partners.
The personal and professional impact of undertaking an educational module on human caring
Authors: Hoover Janice
Published: March 2003

The personal and professional impact of undertaking an educational module on human caring

Aim of the study. To evaluate the personal and professional impact of undertaking a 15‐week degree level module on nursing as human caring.

Background. Little is known about how to teach and enhance caring practices. An innovative module was implemented on a 4‐year, postregistration nursing degree course in Wales to develop students’ capacity to be caring practitioners. An understanding of its impact was sought to facilitate better future preparation of students.

Research methods. A full cohort of 25 part‐time students, divided into four groups, participated in audio‐taped focus groups before and after undertaking the module.

Findings. From a personal perspective, the students experienced increased spiritual awareness characterized by: (1) enhanced connecting relationships with self and others, (2) finding purpose and meaning in life, and (3) clarification of values. Professionally, the module resulted in: (1) an increased knowledge and understanding of caring theory and related concepts, (2) a more holistic approach to care, and (3) enhanced caring practice.

Conclusions. Education may enhance students’ capacity to be caring practitioners. Spirituality, in particular, was illuminated for the students as an important means of developing both themselves and their caring practices. They experienced transformative learning, and the focus groups, employed as the research method, served as a useful vehicle in this process. Reflective groups will be used as a teaching method on future modules.
A qualitative study of shift handover practice and function from a socio‐technical perspective
Authors: Kerr Micky P.
Published: March 2003

A qualitative study of shift handover practice and function from a socio‐technical perspective

Background. Shift handover plays a pivotal role in the continuity of patient care in 24‐hour nursing contexts. The critical nature of this communication system is recognized within the literature and by the nursing profession; however, there are few in‐depth studies. The rationale for this study is to gain a better understanding of handover practices and functions and their implications for effectiveness.

Method. Handover systems on two very different paediatric wards were selected as case studies. In each case, 20 handovers were observed and audio‐taped and 12 individual and two‐group interviews with nursing staff about handover were also conducted. Analysis involved categorizing the data and characterizing handover practices and functions using an inductive approach to generate qualitative themes. The ethics committees of the hospital and the university approved the research. All involved were fully informed about the study, with confidentiality maintained throughout.

Results. Handover practices are distributed over time, socially among the staff and technologically through a range of artifacts, while the system also accomplishes informational, social and educational functions. Handover effectiveness is characterized by flexibility in managing competing demands and tensions, such as maintaining confidentiality while practising family centred care. There are limitations in how far the findings can be generalized to other nursing contexts, and the possible effects of the researcher’s presence are also recognized.

Conclusions. Handover is a complex system based on several sound socio‐technical principles and the value of this nurse‐to‐nurse communication should be acknowledged. The multiple functions highlight the knowledge and expertise currently hidden within handover, which could be promoted in terms of nursing professionalism.
Perceptions of sex‐role stereotypes, self‐concept, and nursing role ideal in Chinese nursing students
Authors: Holroyd E.A. , Bond M.H. , Chan H.Y.
Published: March 2003

Perceptions of sex‐role stereotypes, self‐concept, and nursing role ideal in Chinese nursing students

Aim. This study examined the relationship between sex‐role stereotypes, self‐concept and the requisite personality characteristics of an ideal nurse in a cohort of Hong Kong nursing students.

Methods. To rate these concepts a measure of eight comprehensive dimensions of personality perception was administered to 177 nursing students, studying on preregistration and postregistration programs at a Hong Kong tertiary institution. Both male and female nursing students perceived an ideal nurse to possess a profile of traits including being high on the dimensions of emotional stability, application, intellect, helpfulness and restraint.

Results. No significant difference between the self‐ratings of the male and female students was found, indicating that male students had undergone a highly self‐selective process when choosing nursing education under the influence of Chinese cultural stereotypical attitudes towards nursing. A typical Chinese nurse was rated as similar to the typical female in Chinese society by both male and female nursing students. A typical Chinese nurse was rated relatively low on the masculine dimensions of openness, extroversion and assertiveness. The self‐ratings of male nursing students more closely approximated the ideal nurse than did the self‐ratings of female nursing students.

Conclusion. The conclusions highlight implications for the recruitment and education of both male and female nursing students in Hong Kong society.
The content of management of violence policy documents in United Kingdom acute inpatient mental health services
Authors: Noak James , Wright Steve , Sayer Jane , Parr Ann‐Marie , Gray Richard , Southern Dylan , Gournay Kevin
Published: March 2003

The content of management of violence policy documents in United Kingdom acute inpatient mental health services

Aim of the study. The aim of the study was to examine the content of Trust policies concerning the prevention and management of violence in acute in‐patient settings in order to establish their usefulness as guidance for staff in this difficult, complex, and controversial aspect of inpatient psychiatric care.

Background. Violence is a commonly encountered problem in inpatient psychiatric settings. There are legal requirements for workplaces in general and mental health care facilities in particular to develop safe systems of work based upon the findings of assessments of this risk. Policies have a key role to play in making explicit the responsibilities of both employer and employees, and specifying standards of acceptable practice.

Design. A cross‐sectional survey methodology was used, which entailed examination of the content of management of violence policies that had been forwarded to the authors from 40 Trusts providing acute inpatient psychiatric care throughout England, Scotland, Wales, and Northern Ireland.

Findings. Policies were found to vary widely in their content, and serious shortcomings were noted in the extent to which policies included information regarding their status and review, advice on the prevention of violence, the management of violent incidents, and postincident action.

Conclusions. Further research is needed to tease out the extent to policies which are lacking in content, reflect shortcomings in the organizational approach to the prevention and management of violence by Trusts, and the extent to which such shortcomings result in harm being suffered by staff and/or patients. An alternative format for the presentation of management of violence policies is discussed, and items that should be included in inpatient units' management of violence policies are suggested.
Illness attributions and myocardial infarction: the influence of gender and socio‐economic circumstances on illness beliefs
Authors: King Rosemary
Published: March 2003

Illness attributions and myocardial infarction: the influence of gender and socio‐economic circumstances on illness beliefs

Aim. To present findings from a study conducted between 1996 and 1998 to investigate participants' perceptions of illness causation following a myocardial infarction.

Rationale. The underlying assumption of many practitioners is that perceptions of illness causation will influence emotions and adjustment to illness.

Design. Phenomenology was the research methodology used to examine perceptions of illness causation. A convenience sample was taken of 24 men and women who were admitted to a regional hospital in Victoria, Australia, with a provisional diagnosis of myocardial infarction. Participants were interviewed shortly after hospitalization, and interviews were taped, transcribed and thematically analysed.

Findings. Stress was the most commonly cited cause of illness. Men and women demonstrated distinct differences in illness attribution. Participants who verbalized concerns about their loss of autonomy and their subsequent ability for self‐management were predominantly female and uniformly members of the lowest socio‐economic group

Conclusion. The article concludes with a discussion of implications of the findings for practice.
Caring science and the science of unitary human beings: a trans‐theoretical discourse for nursing knowledge development
Authors: Watson Jean , Smith Marlaine C.
Published: March 2003

Caring science and the science of unitary human beings: a trans‐theoretical discourse for nursing knowledge development

Background. Two dominant discourses in contemporary nursing theory and knowledge development have evolved over the past few decades, in part by unitary science views and caring theories. Rogers' science of unitary human beings (SUHB) represents the unitary directions in nursing. Caring theories and related caring science (CS) scholarship represent the other. These two contemporary initiatives have generated two parallel, often controversial, seemingly separate and unrelated, trees of knowledge for nursing science.

Aim. This paper explores the evolution of CS and its intersection with SUHB that have emerged in contemporary nursing literature. We present a case for integration, convergence, and creative synthesis of CS with SUHB. A trans‐theoretical, trans‐disciplinary context emerges, allowing nursing to sustain its caring ethic and ontology, within a unitary science.

Methods. The authors critique and review the seminal, critical issues that have separated contemporary knowledge developments in CS and SUHB. Foundational issues of CS, and Watson's theory of transpersonal caring science (TCS), as a specific exemplar, are analysed, alongside parallel themes in SUHB. By examining hidden ethical–ontological and paradigmatic commonalities, trans‐theoretical themes and connections are explored and revealed between TCS and SUHB.

Conclusions. Through a creative synthesis of TCS and SUHB we explicate a distinct unitary view of human with a relational caring ontology and ethic that informs nursing as well as other sciences. The result: is a trans‐theoretical, trans‐disciplinary view for nursing knowledge development. Nursing's history has been to examine theoretical differences rather than commonalities. This trans‐theoretical position moves nursing toward theoretical integration and creative synthesis, vs. separation, away from the `Balkanization' of different theories. This initiative still maintains the integrity of different theories, while facilitating and inviting a new discourse for nursing science. The result: Unitary Caring Science that evokes both science and spirit.

”…While from the bounded level of our mind Short views we take, nor see the lengths behind; But more advanced, behold with strange surprise New distant scenes of endless science rise!„ Alexander Pope
Chinese women's perceptions of the effectiveness of antenatal education in the preparation for motherhood
Authors: Ho Irene , Holroyd Eleanor
Published: March 2003

Chinese women's perceptions of the effectiveness of antenatal education in the preparation for motherhood

Aim of the Study. This was an exploratory descriptive study using mixed methodology to investigate Hong Kong Chinese women's perceptions of the effectiveness of antenatal education in their preparation for motherhood.

Design. In the first phase, the structure and process of five antenatal classes on the topic of motherhood were observed using an observation guide. In the second phase 11 women who had attended the antenatal classes were interviewed in two focus groups, using a semi‐structured interview guide.

Findings. In respect to the structure of the classes women revealed that large class sizes and the didactic mode of teaching inhibited learning. While they were satisfied with the date and time of antenatal classes, and the information about self and baby care being provided, they felt unprepared for the demands of motherhood. Further themes identified from the analysis were: anticipating personal needs for antenatal preparation for motherhood, unrealistic preparation for breastfeeding problems, inadequate preparation for baby care, unfulfilled informational needs and conflicting advice from antenatal educators.

Conclusion. The conclusion highlights Chinese culturally specific changes needed in the content and mode of antenatal education. In addition, recommendations are made for antenatal educators to work within a framework of adult Chinese learning styles in order to meet the educational needs of Chinese women.