bluuebunny/crossref_metadata_2025 huggingface dataset:
Advocacy in nursing — a review of the literature
Authors: Mallik Maggie
Published: March 2003

Patient/client advocacy has been claimed as a new role for the professional nurse. This paper presents a critical review of the literature on advocacy in nursing. After briefly outlining the conditions which may have instigated the need for patient advocacy, meanings and models of advocacy role in health care, models proposed for the nurse as advocate are indeterminate which leads to multiple interpretation and lack of clarity in operationalizing advocacy. Much of the literature focuses on justification arguments for claiming the advocacy role. Key themes are outlined and include: patient advocacy as a traditional role, nurses are in the best position in the health care team, nurses have the knowledge to advocate and finally nurses and patients can be partners in advocacy. However, critical examination reveals many counter‐arguments to the above claims and finally concludes that advocacy is a potentially risky role to adopt. It is argued that support systems are inadequate except in low‐risk situations and ultimately acts of advocacy remain a moral choice for the individual nurse. Finally the need to conduct research into the interpretation o the patient advocate role by nurses in the United Kingdom is highlighted.
Nursing culture—some view points
Authors: Suominen T. , Kovasin M. , Ketola O.
Published: March 2003

The concept of culture is closely interwoven with the values espoused by a community. Culture is a deep structure that finds expression in people's knowledge, beliefs, convictions, morals, and laws. A few possible ways of approaching the culture of nursing are provided by rituals, gender and power.
A phenomenological investigation into the role the clinical nurse specialist
Authors: Bousfield Chrissie
Published: March 2003

This research study adopts a phenomenological approach to investigate how a group of clinical nurse specialists think and experience their role. It reviews the literature on the clinical nurse specialist from 1943, when Frances Reiter first coined the phrase ‘nurse clinician’, to the present time, when individuals are committed to a range of initiatives aimed at improving the quality of the British National Health Service and patient care. The study investigates and analyses their views and conveys the personal meaning of clinical nurse specialists ‘lived experience’ in the role. Findings of the study suggest that clinical nurse specialists are experienced practitioners who strive to be in positions in which they influence patient care and utilize advanced knowledge, expertise and leadership skills in a multidisciplinary environment. The literature proposes that for the role to be recognized and accepted individuals need to be educated at an advanced level, demonstrate practice based in research and have a firm base as a specialist in nursing. The findings clearly suggest that while the role of the clinical nurse specialist can be influenced in a positive manner by the organization and guided by the individual, it is important to acknowledge that the role is in a transitional phase. Finally, the research suggest the importance of establishing a clear role definition in a creative and supportive environment allowing for a autonomy, professional growth and the development of individuals as clinically competent nurse specialists.
Patient satisfaction in a nurse‐led rheumatology clinic
Authors: Hill Jackie
Published: March 2003

Patient satisfaction with a nurse‐led rheumatology clinic was tested using the Leeds Satisfaction Questionnaire (LSQ), which was specially developed and shown to be both reliable (Cronbach's alpha, 0.96) and stable (test‐re‐test r= 0·83). A total of 70 patients with rheumatoid arthrists, aged 22–75 years were randomly allocated to either a nurse's or a rheumatologist's clinic and seen on six occasions over a year. They completed the LSQ on entry and there were no significant differences between them. By week 48 the medical cohort showed significantly increased satisfaction with access and continuity (P < 0.05) but no change in overall satisfaction. The patients in the nurse‐led clinic recorded significant increases in overall satisfaction and in all subscales (P < 0.0001). Between‐group comparison at week 48 showed the nurse's patients to be significantly more satisfied than those of the rheumatologist.
Clarifying the concept of need: a comparison of two approaches to concept analysis
Authors: Endacott Ruth
Published: March 2003

Meeting needs is the aim of health care frequently espoused in textbooks, policy documents and reports of research studies; provision of health care is also now described as‘needs‐based’, rather than ‘service‐based’. The purpose of this paper is to explore the concept of need, using concept analysis, with the aim of providing greater clarity. Two approaches to concept analysis are compared: the linear model proposed by Walker and Avant and Rodgers’cyclical model. On both a philosophical and practical level, Rodgers’model was felt to be more appropriate for analysis of the concept of need. The rigid divisions which the Walker and Avant model seeks to establish (particularly in relation to the construction of additional cases) were felt to restrict, rather than clarify the concept. The attributes, antecedents, consequences and references of need are described, following stratified random sampling of the available literature, and a model case is presented. The themes of priority and perception of need arose consistently within the literature, highlighting the value‐laden nature of the concept and the importance of achieving a common understanding to enable purchasers, providers and consumers to better satisfy health care needs.
Strategies used by chronically ill older women and their caregiving daughters in managing posthospital care
Authors: Bull Margaret J. , Jervis Lori L.
Published: March 2003

The purpose of this grounded theory study was to learn how older women and their caregiving daughters managed care following the mother's hospitalization because of a chronic illness. Data were collected in semi‐structured interviews with 33 mother‐daughter pairs at two weeks post‐discharge, and 32 pairs two months post‐discharge. Content analysis and constant comparison were used in analysing the data. The findings indicate that the posthospital period for both mothers and daughters was characterized by difficulties in managing care that were often related to lack of information about diet, medications and community services. In dealing with the difficulties, most mothers and daughters employed information‐seeking and problem‐solving strategies to move from the phase, finding out what works, to establishing new routines. Not all mothers and daughters established routines by two months post‐discharge. Nurses need to recognize factors that impede mothers and daughters in establishing routines in order to design effective interventions to ease the posthospital transition.
Caring — a masculine perspective
Authors: MacDougall Graham
Published: March 2003

The last decade has witnessed an increase in the published works dedicated to the issue of men and their masculinity. While the views are divergent, the overwhelming image of masculine identity today remains the traditional one. This traditional masculinity is underpinned by oppressive practices affecting women, gay men and black men. Within nursing, it would appear that men are assuming positions of power in ever increasing numbers and that these men tend to follow traditional masculine paths. Thus a situation is arising where a profession that consists overwhelmingly of women is being dominated by men being in positions of power. If these men occupy the traditional masculine standpoint then this may have a negative impact on care.
Attitudes towards people with HIV/AIDS: entropy and health care ethics
Authors: Hodgson Ian
Published: March 2003

Attitudes held by health care workers towards people with HIV and AIDS are on the whole negative, and numerous studies confirm the reality and complexity of this tendency. This paper will provide a related literature review, and identify four particular factors that go some way towards explaining the robustness of these attitudes. These are social, psychological, political and anthropological in nature. A model from classical physics will be used metaphorically to illustrate and articulate the apparent inevitability of this harmful process, and also a possible solution.
Support as experienced by patients with cancer during radiotherapy treatments
Authors: Hinds Cora , Moyer Alwyn
Published: March 2003

Patients diagnosed with cancer are frequently prescribed radiation therapy. The treatment is a source of much anxiety and worry for patients and their families. Support, a highly valued intervention strategy in nursing, is believed to assist patients to adjust to stressful experiences. A qualitative study was conducted to determine patients' experiences of support while receiving radiotherapy. Data from 12 patients were analysed using the procedures and techniques of grounded theory. A substantive theory of support emerged which showed that support is an interpersonal process embedded in an array of social exchanges which involves encountering support, recognising support and feeling supported. Three main types of support are encountered: being there, giving help and giving information. It is a multifaceted concept and all types of support are seen as important. Actions are interpreted within the norms and expectations of a relationship and labelled as supportive by the recipient. Family and friends are the principal sources of all types of support. Professional support is mainly informational. The findings raise many questions, one of which is should there be a rethinking of the concept of support in nursing?
Icelandic women's identifications of stressors and social support during the diagnostic phase of breast cancer
Authors: Fridfinnsdottir Elsa Bjork
Published: March 2003

The purpose of this descriptive exploratory study was to describe the nature of stressors Icelandic women identify during the diagnostic phase of breast cancer, what sources of social support they draw upon, and their satisfaction with the social support they receive. Lazarus and Folkman's theory of stress, appraisal and coping was used as a theoretical framework for the study. Semi‐structured interviews were conducted with 12 women in the diagnostic phase of breast cancer. Women experience the possibility of having cancer as an enormous threat. Social support was identified as a fundamental coping resource, where emotional support from husbands, family and close friends was of utmost importance. Health care professionals were not only the most important source of informational support but also a valuable source of emotional support.
Skin prick testing in general practice: a pilot study
Authors: Sibbald Bonnie , Barnes Greta , Durham Stephen R.
Published: March 2003

Allergy skin prick testing is regarded as a routine diagnostic procedure in hospital settings, but its role in general practice is not yet defined. Our aim was to explore the ways in which skin prick testing might facilitate the work of general practice nurses engaged in asthma patient care. A structured questionnaire was completed by 18 practice nurses before and again after administering allergy skin tests to four common aeroallergens (dust mite, grass pollen, cat and dog danders) to 319 consecutive attenders with known or suspected asthma. Nurses' decisions about whether or not to give allergen avoidance advice were reversed after skin testing in 63 (22%) cases for dust mite, 67 (23%) cases for grass pollen, 38 (13%) cases for cat fur and 49 (17%) cases for dog hair. Had allergen avoidance interventions been targeted only at patients with both a positive skin test and a positive clinical history, the number of planned interventions would have declined from 305 before skin testing to 142 after. The findings suggest that allergy skin prick testing was feasible and acceptable in general practice, and that one role may be to reduce the number of allergen avoidance interventions offered to patients unlikely to benefit.
Being a stroke patient: a review of the literature
Authors: Thóra B. Hafsteinsdóttir RN BSc MN  , Grypdonck Mieke
Published: March 2003

The purpose of this paper is to review the research literature on the patient's experience of stroke. Four qualitative studies on how patients experience stroke were identified. The findings of these studies show that the stroke patient often has clear goals for himself in relation to functional abilities, against which he measures all success and forward progress in his rehabilitation. Even though the stroke patient accepts a lower level of functional ability, he is not willing to accept the rehabilitation professionals' prediction of his ultimate functional level if it is lower than his own goal. Furthermore, stroke patients see recovery as a return to the existence they had lived before the stroke, which is different from the health care providers' view. To the health care provider, recovery is measured in terms of isolated and discrete return of movement, whereas in the eyes of the patients, recovery is a return to previously valued activities. Further, studies on psychosocial function after stroke were reviewed. Recent studies show that the psychological impact of the stroke experience is immense and that stroke patients experience stress on a variety of levels. Also, depression exists in a large portion of the stroke population. The impact of stroke also influences the patient's social existence, as studies have shown that stroke patients do manifest diminished social function. However, the reviewed studies are not without limitations. Further studies, with a qualitative design, are needed to throw light on the patient's experience of being ill with stroke, and the process of his recovery.
A triangulation approach to the identification of acute sector nurses’ training needs for formal nurse practitioner status
Authors: Hicks Carolyn , Hennessy Deborah
Published: March 2003

The current confusion surrounding the definition and role function of the nurse practitioner (NP) has created a situation in which advanced clinical practice is delivered in a variety of ways and at many levels. Not surprisingly, this has led to difficulties in regulating educational provision for NPs. This study reports a survey of the perceptions of the role definitions and training needs of all nurses working at advanced clinical levels within an acute sector Trust. Although this concept is not a novel one in advanced nursing practice, the procedure adopted differed from previous studies in two fundamental ways: firstly, a unique training needs assessment instrument was used, which because of its validity and opacity, was capable of yielding a highly reliable data‐base, comprising a prioritized profile of real training needs as opposed to the standard wish‐list typically elicited. Secondly, it did not rely simply on the self‐reported needs of the nurse sample, but also included the perceptions of the sample’s immediate medical and managerial colleagues. In this way, a triangulation paradigm was adopted. The results indicated that overall, there was high agreement between the nurses and their managers, regarding both the definition of the NP role and the essential training requirements, with somewhat different opinions being offered by the medical staff. When the raw scores were standardized to correct for response bias, the data provided an operational definition of the role of the NP and a prioritized profile of training needs for nurses who wished to train to this level.
A comparison of the effects of patients’ pain on nurses working in burns and neonatal intensive care units
Authors: Nagy Sue
Published: March 2003

Nurses are more likely than other health professionals to be exposed to individuals who suffer severe pain for extended periods of time. Such exposure is likely to arouse emotional distress which not only has implications for their occupational health but may interfere with their ability to manage pain effectively. This study compared the emotional reactions to their patients’ pain, of nurses who were exposed to patients with severe and obvious pain (nurses working in burns units) and nurses whose patients’ pain is uncertain because they are unable to communicate (nurses working in neonatal intensive care units). The results showed that pain generated greater anxiety in nurses caring for patients with severe burns, but that they also demonstrated a greater sense of personal competence and control over the management of their patients’ pain. The findings also showed that when dealing with patients’ pain the morale of nurses was linked to: (a) perceived challenges to their images of themselves as alleviators of pain; (b) the extent to which their sense of personal vulnerability was aroused by contact with patients experiencing severe pain; (c) their beliefs about their ability to assess patients’ pain; and (d) the quality of their professional relationships with the medical staff who controlled the most powerful forms of pain relief.
The concept of spirituality in nursing theories: differing world‐views and extent of focus
Authors: Martsolf Donna S. , Mickley Jacqueline R.
Published: March 2003

Although nursing has recognized spirituality as an important aspect of holistic patient care, exactly what spirituality means has remained rather amorphous. The purpose of this article is to present aspects of spirituality found in modern nurse theorists’ ideas. These aspects are presented both in relation to reciprocal interaction or simultaneous action world‐views and in relation to the extent of focus on the concept within the model or theory. This discussion will provide the researcher and practitioner with additional theoretical understanding on which to ground investigations and base practice.
The problem drinker’s lived experience of suffering: an exploration using hermeneutic phenomenology
Authors: Smith Brian A.
Published: March 2003

Research in the area of problem drinking has traditionally relied on quantitative methodologies which view the problem from the researcher’s perspective. The purpose of this hermeneutic‐phenomenological study was to describe and understand the problem drinker’s lived experience of suffering using a philosophy and research approach which preserves the uniqueness of the experience from the sufferer’s point of view. The method involved conducting in‐depth interviews with a sample of six problem drinkers. Interviews were analysed using an interpretive process, which aimed at generating a deeper understanding of the topic by facilitating a fusion of the world views of both participant and researcher. A reflexive journal recorded the involvement of the self of the researcher throughout the research process. Suffering was viewed as a spiralling vicious circle of physical, psychological, social and spiritual distress. Symptoms of physical dependence, shame and guilt emerged strongly as being both sequelae of heavy drinking and cues to further drinking bouts. Evoking memories of previous suffering through telling one’s story was found to be an empowering and motivating force. The results have relevance to specialist and generic workers, who are urged to pay greater attention to the social, psychological and spiritual care of problem drinkers.
Non‐compliance and professional power
Authors: Playle John F. , Keeley Philip
Published: March 2003

The non‐compliance of patients with prescribed treatments is considered as a barrier to effective health care. Non‐compliance has implications for the health of patients, effective use of resources and assessments of the clinical efficacy of treatments. Research into non‐compliance has increased over the last 30 years. This seems to indicate that it is seen as an important area of concern for all health care professionals. Definitions of non‐compliance are problematic, as are methods of assessment of its nature and frequency. Many factors which may account for non‐compliance have been proposed, as well as methods to improve compliance. Research into these factors however, mainly based on a positivist epistemology, has failed to provide any conclusive answers to the problem. Sound clinical reasons are suggested as the basis for the increase in interest in non‐compliance. It is contended, however, that it is not only these reasons that account for the identification of non‐compliance as a problem. Non‐compliant behaviour is seen as problematic, because it contravenes professional beliefs, norms and expectations regarding the ‘proper’ roles of patients and professionals. These have formed the basis of an ideology that views patients as passive recipients of health care. It has led to an inherent tendency to ‘blame’ the patient and view non‐compliance as irrational and deviant. The professional view of non‐compliance as irrational, is exemplified in the case of individuals with mental illness, where there are inherent assumptions that non‐compliance can be seen primarily as a symptom of illness. This denies the legitimacy of patient choice, and has led to attempts to control compliance via suggested legislative measures. Serious moral and ethical problems arise from such measures, and can be seen as the ultimate legitimization of an ideology of non‐compliance. The maintenance of professional power and control is suggested as central to the debates surrounding non‐compliance. The ideological assumptions underpinning the concept of non‐compliance need questioning, and a re‐conceptualization of the roles of patients and professionals is required. This must involve a view of patients as active participators in their own health care. Research based on an interpretative epistemology, aimed at understanding individual action, rather than control, would seem a more appropriate model to pursue.
A model of professional nurse caring: nursing students’ experience
Authors: Wilkes Lesley M. , Wallis Marianne C.
Published: March 2003

Research into caring from the perspective of nursing students is poorly documented. This paper presents a study which described the construct of caring as experienced by students in pre‐registration programmes at two universities in New South Wales, Australia. Qualitative data were collected using a questionnaire and semi‐structured interviews. From the analysis of the data a model of professional nurse caring from the student’s perspective was created. In this model, compassion, as the core of caring is actualized in the students’ nursing of patients by communicating, providing comfort, being competent, being committed, having conscience, being confident and being courageous. Communication is not only an actualization of this caring but constitutes an important medium for the expression of caring actions.
Student nurses’ lived experience of the sudden death of their patients
Authors: Loftus Linda A.
Published: March 2003

This phenomenological study looks at the lived experience of third‐year student nurses caring for dying patients in surgical, medical and elderly care units. Informal interviews were tape recorded and interpretive analysis was applied to narrative accounts of the nursing students’ experiences. Themes which emerged from the students’ narrative accounts included sudden death experience, vulnerability and support. These are evaluated in terms of their meaning for students and the possible implications for clinical care. In addition, the use of students’ narratives is also suggested as a valuable learning tool both within clinical and academic frameworks.
Weaving a fabric of moral meaning: how nurses live with suffering and death
Authors: Katherine Maeve
Published: March 2003

Nursing has a long and rich history of caring for those who are sick and suffering, as well as for those who are dying. The threat of death, and/or the reality of suffering till death, for patients, is a reality in the lives of nurses. The purpose of this study was to examine how nurses live with patients who are suffering and dying. Founded on notions of relationship and embodiment, naturalistic inquiry was used to generate and analyse qualitative data from nine nurses who, at the time of the study, were working with patients whom they described as suffering or dying. Findings reflected how the nurses used the dilemmas of their patients’ lives to inform their own personal and professional lives through a process of ‘weaving a fabric of moral meaning’. Findings are discussed in terms of practice, research and education.
Bridging the research–practice gap: exploring the research cultures of practitioners and managers
Authors: Le May Andree , Mulhall Anne , Alexander Caroline
Published: March 2003

To ensure effective utilization of research in nursing more evidence is needed which illuminates the way nurses think about research, the value which they put on it, and how they envisage that it may help or hinder them in their everyday work. This English study aimed to meet these objectives by describing the research culture of practising nurses, health visitors and midwives, and their managers. It rests on two assumptions. Firstly that the reasons why practitioners do, or do not, base their practice on research are complex, and secondly, that interventions to increase research utilization must be grounded in an appreciation of this complex ‘whole’. Thus the study took a qualitative approach to exploring: what participants thought and felt about research; the current status of research based practice; and the opportunities and constraints to increasing research based practice. The results confirm the hypothesis that many factors, both individual and organizational affect research utilization. Furthermore, practitioners and managers hold differing perceptions regarding the nature of research, its role, and the opportunities and constraints which effect its dissemination and utilization. The implications of the results for education, policy and practice are discussed.
Predialysis patient education: effects on functioning and well‐being in uraemic patients
Authors: Klang Birgitta , Björvell Hjördis , Berglund Jonas , Sundstedt Christina , Clyne Naomi
Published: March 2003

This study evaluated the effects of a predialysis patient education programme on functioning and well‐being in 28 uraemic patients. The programme consisted of four group sessions with the following themes: renal disease and dietary restriction, active renal replacement therapy, physical exercise, and the impact of chronic renal failure on economy, family and social life. Three to 9 months after having started dialysis the patients were evaluated regarding symptoms, perceived health (Health Index), functional (SIP) and emotional (STAI) status. Twenty‐eight patients already on dialysis treatment informed according to conventional routines constituted the comparison group. There were no significant differences between the groups regarding age, sex, educational or social background, duration of kidney disease, choice of dialysis treatment, cause of renal disease and laboratory tests except for s‐urea. The patients who participated in the education programme scored significantly better mood, less mobility problems (HI), less functional disabilities (SIP) and lower levels of anxiety (STAI) compared to the comparison group. There were no significant differences between the two groups regarding symptoms and overall health. The differences between the groups prevailed during the first 6 months on dialysis treatment, after which the differences disappeared. In the comparison group age correlated significantly to anxiety and overall SIP, which was not the case in the experimental group. In conclusion, the experimental group that participated in a predialysis patient education programme, showed better functional and emotional well‐being than the non‐educated comparison group. The positive effects of participating in an education programme prevailed during the first 6 months of dialysis treatment. Moreover, the younger patients seemed especially to benefit from participation in a predialysis patient education programme. It is suggested that patient education should be ongoing for patients with end‐stage renal failure initiated during the predialysis stage and continued after maintenance dialysis has been established.
Specialist nurse training programme: dealing with asking for organ donation
Authors: Randhawa Gurch
Published: March 2003

The issue of cadaveric organ transplantation is by its very nature emotional as it is associated with the very traumatic time of a loved one’s death. Making a request for organs needs to be handled very sensitively by health professionals when discussing the issue with a family. Those nurses working in critical care areas are most likely to confront this issue and need to be equipped for dealing with ensuing events. The major challenge for the nurse is to address the concerns with brain death and organ donation in an environment of grief and sadness. Asking for organ consent is the most important element of all and needs to be done in the most sensitive manner, providing appropriate support to the donor family. To facilitate this process specialist training programmes in the nursing curriculum are imperative. Education programmes should incorporate presentations, role play situations and discussions based upon past experiences of organ requests. This would hopefully result in increased rates of donor consent and thereby a reduction in transplant waiting lists.
Record‐keeping and routine nursing practice: the view from the wards
Authors: Allen Davina
Published: March 2003

This paper examines general nurses’ views of the nursing record and its routine usage in contemporary hospital practice. It draws on ethnographic data generated on a surgical ward and a medical ward in a single District General Hospital in the United Kingdom (UK). A key research finding was ward nurses’ equivocal attitudes to the nursing record. On the one hand, because of its links with the nursing process, the nursing record was highly valued as a symbol of professionalism and ward staff were loathe to criticise it directly. On the other hand, however, the nurses in this study clearly found it difficult to reconcile their professional ideals with the ways in which the nursing record was routinely employed on the wards. In this paper it is suggested that at one level, nurses’ ambivalence towards the nursing record reflected the distortion of its founding philosophy by the new managerialism in the contemporary UK health care context. At another level, however, there are also difficulties which arise from the tension between the assumptions about the nature of nursing work which underpin the nursing record and the workplace reality on hospital wards.
Death and dying in contemporary society: an evaluation of current attitudes and the rituals associated with death and dying and their relevance to recent understandings of health and healing
Authors: O’gorman Stella Mary
Published: March 2003

This paper develops a model which is intended to help nurses and other health professionals in the understanding of contemporary views regarding death and dying and the associated issues of health and healing. The author contends that in the first half of the 20th century, society lost sight of the importance of rituals associated with death and dying and of the need for appropriate death education. Consequently patients and professionals alike found themselves unable to cope with the inevitability of death. Fear supplanted hope, and the health and well‐being of society was deleteriously influenced. During the second half of the century, there has been a proliferation of thanatology research and literature. Health professionals are realizing the inadequacy of their knowledge of an issue which fundamentally and unavoidably affects everyone including themselves. The holistic approach to health care has been recognized by many researchers as being essential to health and healing, and therefore death and dying have to be addressed. Often nurses are the professionals left to deal with the patients’ grief and anger, and it is therefore critical that they are conversant with the contemporary parallel issues of death and dying and health and healing. The author also firmly believes that before nurses can help people to overcome the fear of death and to optimize their lives, it is essential to examine the traditions of other cultures as well as personal experiences and coping mechanisms, before an understanding of other people’s fears and beliefs concerning death and dying can be reached.
A critique of studies exploring the experiences and needs of parents of children admitted to paediatric intensive care units
Authors: Noyes Jane
Published: March 2003

This paper is based on a critique of studies exploring the experiences and needs of parents whose children are admitted to paediatric intensive care units (PICU). The majority of studies have been conducted in North America and attempt to quantify parental feelings and experiences. Few qualitative studies have been published. Major theoretical concerns are developed in relation to the validity of quantitative and qualitative methods of data collection which currently serve to inform nursing practice. While methodological issues abound, consistency across studies supports the importance of certain features of parents’ experiences, such as being with their child and role conflict. None of the literature reviewed considered the specific needs of different ethnic and cultural groups, siblings, grandparents or the family as a unit. The views of fathers are also under‐represented. Recommendations are made for future well‐designed qualitative studies to be undertaken by experienced qualitative researchers from a holistic insider family perspective.
A concept analysis of personal transformation
Authors: Wade Gail Holland
Published: March 2003

A concept analysis of personal transformation Personal transformation, a multidimensional concept, is applicable to nursing practice, education, and research. Using a modified version of Walker and Avant's concept analysis model, personal transformation was analysed relative to Newman's Theory of Health as Expanding Consciousness. By integrating common themes from definitions of several disciplines with Newman's theory, a definition of personal transformation was derived. Personal transformation is a dynamic, uniquely individualized process of expanding consciousness whereby individuals become critically aware of old and new self‐views and choose to integrate these views into a new self‐definition. A conceptual map depicts the defining attributes, antecedents and consequences of personal transformation. A model case illustrates the applicability of the concept to nursing education. Because the transformation process is revealed through individual patterns, qualitative research for further analysis of the concept is recommended.
The use of questioning strategies by clinical teachers
Authors: Sellappah Sue , Hussey Tony , Blackmore  , McMurray Anne
Published: March 2003

By using questioning and other appropriate teaching strategies, clinical teachers can facilitate the development of critical thinking, decision making and problem solving in students. This study examined clinical teachers’ use of questioning and the variations in their use of questioning as a teaching strategy. Although there was a variation in the number of questions asked, predominantly low level questions were asked by 26 clinical teachers at two post‐clinical conferences. Based on the findings of this study, it is recommended that clinical teachers are taught how to ask questions, particularly high level questions.
The contribution of nursing to cancer prevention
Authors: Cutler Lee R
Published: March 2003

The contribution of nursing to cancer prevention¶ Cancer is a major killer of modern man, yet despite recent advances in knowledge of cancer and its causes, prevention remains a significant challenge within healthcare. Theories of health promotion give an insight into the perspectives on disease prevention whilst frameworks for disease prevention can be useful in helping identify and address the difficulties inherent in preventing this deadly disease. Within this paper Caplan’s framework forms the basis for discussion of the issues related to cancer prevention in the United Kingdom as part of nursing’s health promotion role. It is suggested that a ‘chain of prevention’ would ideally exist linking the laboratory scientists researching cancer and the general public. ‘Weak links’ are identified prior to suggestions for remedial strategies.
The impact of knowing your child is critically ill: a qualitative study of mothers' experiences
Authors: Noyes Jane
Published: March 2003

The impact of knowing your child is critically ill: a qualitative study of mothers' experiences¶ Discussion in this paper is drawn from an exploratory study designed to elicit mothers' lived experiences of crisis and coping, and their experiences of nursing following the unexpected emergency admission of their child to the paediatric intensive care unit (PICU). An in‐depth critique of literature supporting this study has been published. Two theoretical perspectives serve as a basis for this exploratory study: firstly, the idea that in a crisis situation, a mother's ability to cope and function is influenced by therapeutic interventions of nurses by meeting her needs in a holistic way; and secondly, symbolic interactionism, that focuses on the meaning of events to mothers. Data were elicited through focused interviews with 10 mothers of children aged between 3 months and 15 years who had been admitted unexpectedly to the PICU with a life threatening condition. Findings reveal the major impact of crisis on mothers immediately following their child's critical illness and admission to PICU, and this specific aspect therefore warrants in‐depth discussion and analysis. The study did not generate a theory; however, important recommendations are made for nursing practice and research in relation to the impact of crisis experienced by mothers. Nursing practice issues include meeting the psychosocial needs of parents prior to and immediately after admission, and the importance of family‐centred nursing care. Issues for nursing research include exploring how families cope with the impact of crisis and critical illness.
Caring relationships with patients suffering from dementia — an interview study
Authors: Rundqvist Ewa M. , Severinsson ElisabethI.
Published: March 2003

Caring relationships with patients suffering from dementia — an interview study¶The aim of the study reported in this paper was to describe and analyse care‐givers' caring relationships with patients suffering from dementia. The theoretical perspective was caring science. Data were collected through interviews with six care‐givers in a ward for patients with severe dementia. From the qualitative analysis of the narratives, the following factors emerged as important for the caring relationships: `touching', mutual `confirmation', and the care‐givers' `values in the caring culture' in the ward. We conclude that communication skills are very important in a ward where patients with severe dementia reside, and that there is always a need for formulating the basic values. Theoretical education and clinical supervision are examples of means to improve competence and skills.
Compliance of patients with hypertension and associated factors
Authors: Kyngäs Helvi , Lahdenperä Tiina
Published: March 2003

Compliance of patients with hypertension and associated factors¶The purpose of the study reported in this paper was to evaluate compliance, and factors associated with compliance, in patients who had hypertension. Compliance with lifestyle recommendations, medication and attendance of follow‐up visits was evaluated. The data were collected using a questionnaire completed by 138 patients with hypertension aged under 63 years from one town and three municipalities in Finland. The patients responded when they visited a doctor or a nurse in a health centre or an occupational health station. The response percentage was 94%. The data were analysed using the SPSS for Windows software. The results are presented as frequency and percentage distributions. The connections between the variables were studied by cross‐tabulations and the chi‐square method. The series was 60% female and 40% male. According to the blood pressure readings, the control of hypertension was good in one‐tenth of the patients, average in two‐thirds and poor in one‐fifth. Based on the weight index, the control of hypertension was good in 28% of the patients, average in 30% and poor in 42%. Compliance with the dietary restrictions was poorest, while compliance with medication was best. Symptoms were reported by 61% of the females and 29% of the males. Non‐smoking, no symptoms, high level education and female sex were related to good compliance with dietary restrictions. Marital status and family size correlated significantly with smoking. Those who lived alone smoked more.
Close encounters: the use of critical reflective analysis as an evaluation tool in teaching and learning
Authors: Chambers Nadia
Published: March 2003

Close encounters: the use of critical reflective analysis as an evaluation tool in teaching and learning¶ Teaching and learning are complex activities which, when combined with professional practice‐based activity, take on additional dimension and depth. This makes the use of traditional, product‐based evaluation problematic in that a purely empirical approach does not facilitate thorough evaluation of every facet of such an encounter.

This paper describes the use of critical reflective analysis as an alternative method of evaluation. The reflective framework facilitating this process has been adapted from three key sources: patterns of nursing knowledge; evaluative paradigms based upon knowledge — constitutive interests; descriptors for a reflective practicum. The reflective activity is structured around a teaching and learning encounter in a care‐based setting and focuses on `doing the drug round'. Descriptive vignettes are used to facilitate reflection‐on‐action and, through critical reflective analysis, the author identifies the essential value (e‐value‐ation) of the encounter in terms of credibility, utility and worth.
A summative evaluation of clinical competence: students' and nurses' perceptions of inpatients' individual physical and emotional needs
Authors: Löfmark Anna , Hannersjö Solveig , Wikblad Karin
Published: March 2003

A summative evaluation of clinical competence: students' and nurses' perceptions of inpatients' individual physical and emotional needs¶The ability to assess individual patients' physical and emotional needs was used as one foundation for evaluation of clinical competence for Swedish student nurses. Each of the randomly sampled 48 student nurses and their corresponding supervisors (48 nurses) assessed the perceived needs of a patient they both knew well by separately answering a questionnaire concerning basic physical and emotional needs. Simultaneously the selected patients (n = 48) were interviewed about their perceived needs. Student nurses' and nurses' assessments were compared with the individual patient's opinion. Both the students' and the nurses' assessments showed close similarities with the patients' own estimations, although certain under‐ and overestimations for both physical and emotional needs were found, with a predominance of overestimation of emotional needs. Student nurses and nurses also showed uncertainty in some of their assessments, mainly concerning emotional needs. Their assessments were closer than student nurses/patients or nurses/patients, and also closer for physical than for emotional needs. The conformity in student nurses' and their supervisors' assessments might be understood as the supervisors' influence as role models. Attention should be paid both in nursing education and in clinical practice to the need for individualization of patient care.
Caring and curing revisited: student nurses' perceptions of nurses' and physicians' ethical stances
Authors: Joudrey Ron , Gough Jim
Published: March 2003

Caring and curing revisited: student nurses' perceptions of nurses' and physicians' ethical stances

As a result of a research study involving nursing students, we have discovered some interesting patterns in the way that nursing students perceive physicians' ethical stances in comparison to their perceptions of their own profession's ethical stances. Some of the findings of this study confirm what writers in the literature have pointed out regarding how the nursing profession defines and perceives itself with reference to the medical profession. As a result of our findings, it may be useful for nursing programmes to revise and re‐think the ethics of their profession vis‐à‐vis that of doctors.
Transition in care: family carers′ experience of nursing home placement
Authors: Kellett Ursula M.
Published: March 2003

Transition in care: family carers’ experience of nursing home placement

This paper explores families’ experience of nursing home placement, which emerged as a significant aspect of a larger hermeneutic phenomenological study of family caring in nursing homes. Hermeneutic analysis of 14 family carers’ stories of nursing home placement uncovered five shared meanings: experiencing a loss of control; being disempowered; feeling guilt, sadness and relief simultaneously; possessing a sense of failure; and having to make a forced and negative choice. Discussion of the findings focuses upon the importance of family carer support during the transition period from home care to nursing home care and the subsequent benefits realized as a result of having received such support. Particular emphasis is placed upon how such support assists family carers to begin the process of reconstructing a valued and positive identity through which new possibilities for meaningful caring within a nursing home context can be realized.
The management of embarrassment and sexuality in health care
Authors: Meerabeau Liz
Published: March 2003

The management of embarrassment and sexuality in health care

In this paper, the literature on embarrassment, the related topics of delicacy and privacy, and the implications for nursing and medical practice are discussed, drawing on empirical data from an observational study of fertility clinics, plus other studies involving consultation and/or examination relating to sexual issues. It will be argued that current data are too patchy to give clear guidelines for professional practice, but that the issues should be explored in a more systematic way in (inter)professional education.
Observations on positivism and pseudoscience in qualitative nursing research
Authors: Johnson Martin
Published: March 2003

Observations on positivism and pseudoscience in qualitative nursing research

In this paper I will examine the boundaries between positivism, interpretivism and pseudoscience, arguing that some qualitative researchers may risk the credibility of nursing research by utilizing concepts from the margins of science. There are two major threats to the perceived rigour and credibility of qualitative research in its many forms. First is a trend in some work towards a mystical view of both the methods and the content of the qualitative enterprise. This can be detected, I will argue, in the work of Rosemary Parse in particular. The second potentially damaging trend is almost its epistemological opposite, towards excessive reliance on precise procedures, strict definitions and verification exemplified by Juliet Corbin and others. I will suggest that this is nothing to fear, but something to be clear about. This is not social constructionism or interpretivism but a ‘qualitative’ version of positivism. The paper concludes that students and researchers should be cautious in the uncritical acceptance of theories and ‘research’ which approach the boundaries of pseudoscience on the one hand, and ‘hard’ science on the other.