bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ perceptions: issues that arise in caring for patients with diabetes
Authors: McDonald Patricia E. , Tilley Barbara C. , Havstad Suzanne L.
Published: March 2003

Nurses’ perceptions: issues that arise in caring for patients with diabetes

Nurses’ perceptions in caring for persons with diabetes have been little studied. To address this gap in the literature, a sample of nurses from a large Mid‐western health care system were surveyed on nurses’ perceptions of: (i) problems encountered in the care of patients with diabetes; (ii) problems encountered by patients and/or family member(s) in diabetes management; and (iii) nurses’ suggested solutions. A randomly selected list of 200 registered nurses obtained from the health system’s Department of Human Resources included inpatient, outpatient, emergency department, medical centre and home health care nurses. The sample was stratified to include 25% inpatient and 75% outpatient nurses. Of the 200 surveys mailed, 136 were returned (68% response rate). Twenty‐four per cent of the 136 nurses reported they did not provide care for patients with diabetes. Of 103 nurses providing care to patients with diabetes, 98% were female, 91% were Caucasian, 76% were between the ages of 30 and 49 years, 57% worked in outpatient settings, 35% worked in primary care, and 42% had a bachelor’s degree or higher. Of those with practice guidelines, 84% found the practice guidelines helpful. These nurses also perceived that they, as nurses, needed more education to improve their care of diabetes patients; few nurses believed it was within the scope of their practice to change treatment regimens. The perception of most nurse respondents was that acceptance of diabetes, knowledge deficits and non‐compliance were primary patient problems in the management of diabetes. Nurses’ perceptions of solutions to the problems centred on education of nurses and patients, and reinforcement of the importance of follow‐up care.
Quality of life in women with symptomatic HIV/AIDS
Authors: Sarna Linda , van Servellen Gwen , Padilla Geraldine , Brecht Mary‐Lynn
Published: March 2003

Quality of life in women with symptomatic HIV/AIDS

Despite the increasing incidence of cases of human immune deficiency virus (HIV) infection and of acquired immune deficiency syndrome (AIDS) in women, there is a serious lack of information about those women’s quality of life (QoL). The purpose of this exploratory descriptive study was to describe QoL using an HIV‐specific instrument (the HOPES) every 2 months over a 4‐month period in a convenience sample of 44 women with symptomatic HIV/AIDS. Changes in physical, psychological, social, sexual dimensions, and overall QoL were evaluated along with the frequency of the most prevalent distressing items. The mean scores of the global QoL, physical and psycho‐social summary scales were significantly different over the 4‐month data collection period: quality of life improved. The most prevalent disruptions were in the psycho‐social domain, including financial problems, worry about the family, distress about losing others from HIV, and worry about disease progression. The most prevalent physical disruptions included reduction in energy, difficulties with daily activities and frequent pain. Married women appeared to be more vulnerable to disruptions in QoL over time. In addition to the use of conventional disease‐specific parameters for the ongoing follow‐up of women with HIV/AIDS, the systematic use of a QoL assessment can provide a focused approach to monitoring problems and targeting interventions. Such an approach is especially important for nurses who assist women living with the symptoms of HIV/AIDS.
The attitudes and attributions of student nurses: do they alter according to a person’s diagnosis or sexuality and what is the effect of nurse training?
Authors: Stewart David
Published: March 2003

The attitudes and attributions of student nurses: do they alter according to a person’s diagnosis or sexuality and what is the effect of nurse training?

The threat of an AIDS (acquired immune deficiency syndrome) epidemic in the early 1980s saw the emergence of strong negative attitudes from both the public and health care professionals alike. Certain ‘high risk’ groups in society, who were considered as susceptible to the disease, homosexuals and intravenous drug users in particular, became the victims of prejudice and discrimination. More recent research has indicated a possible shift to a more positive orientation, although the findings are far from conclusive. In this current study, the Prejudicial Evaluation and Social Interaction Scale (PESIS) was administered to four separate cohorts of student nurses approximately a year apart in training (n=192). Each cohort was divided into four groups, each one completing the PESIS after reading a version of a vignette that described either a person with AIDS or leukaemia, and who was either homosexual or heterosexual. The design therefore allowed for within‐group and between‐group comparisons. Overall the results showed that the student nurses held positive attitudes although they reported a significantly greater prejudice towards AIDS. No significant differences were found for sexual orientation. Additionally significantly greater levels of blame and responsibility were associated with the person with AIDS, but again there was no effect for sexual orientation. The findings suggest that a slightly more negative attitude continues to be associated with a diagnosis of AIDS but no longer with homosexuality. No effect across cohorts was noted either, student nurses being as positive at the beginning of training as at the end. Some of the limitations of PESIS and the difficulties of attitude assessment in general are discussed and future areas of research are identified.
Geographical mobility, children and career progress in British professional nursing
Authors: Ratcliffe Phil
Published: March 2003

Geographical mobility, children and career progress in British professional nursing

Previous explanations for the proportional over‐representation of men at all levels of the British professional nursing hierarchy above the basic grade are flawed as they use a gender‐based framework of explanation. This study presents an empirical test of a non‐essentialist explanation which examines geographical mobility as a criterion of exclusion from promotions which has a disproportionately positive effect on the promotion prospects of men. The study uses a national sample survey of 400 male and 400 female nurses. Data are␣collected on career histories and associated life events. Data are modelled as␣survival data using a form of the Cox proportional hazard model with residual␣heterogeneity to examine explanatory variables which affect the hazard of promotion. Geographical mobility, children, decade of qualification, employer moves, part time work and private sector working are all significant explanatory variables (P < 0·05) for the hazard of promotion. Gender is not a␣significant variable in its own right but two variables exhibit significant interactions with gender. Children negatively affect the career progress of men and women but women’s career progress is affected most. Significantly, the effects of children are not due to career breaks or to part time working. Gender essentialist explanations have been shown to be inadequate. Institutional genderism through the process of gender differential application of apparently individualist criteria of exclusion has been exposed. There is now a requirement for policy makers and employers to review procedures in order to avoid these forms of structural institutional genderism and discriminatory practices in employment.
Methodological issues in the development and use of instruments to assess patient nutritional status or the level of risk of nutritional compromise
Authors: Lyne Patricia A. , Prowse Morag A.
Published: March 2003

Methodological issues in the development and use of instruments to assess patient nutritional status or the level of risk of nutritional compromise

This paper presents the results of an appraisal of the evidence for the effectiveness of methods of nutritional assessment currently in use by nurses and from this develops concepts which may be applied to many areas of nursing practice. The paper first shows how the approach to nutritional assessment by nurses has changed over time, producing the present search for methods which are relatively quick and easy to use. It then describes the limited nature of the evidence of effectiveness of these methods and considers the reasons for this situation. It suggests that the difficulty of validation is an important factor and describes the three most common approaches to validation, showing how problems arise from lack of clarity in the definition of terms and the assumption of a simple relationship between the level of risk of nutritional compromise and actual nutritional status. In conclusion, it is suggested that these difficulties illustrate principles applicable to many areas of nursing care, and a definition of ‘segments’ of care processes, each with well‐defined purposes and outcome measures, is proposed. Such an approach will help to demonstrate the complexity and value of nursing activity.
Practice development: ambiguity in research and practice
Authors: Clarke Charlotte , Procter Susan
Published: March 2003

Practice development: ambiguity in research and practice

Practice development activity occupies an ambiguous position in relation to both clinical practice and research. In practice, it is seen at times as an added extra to normal work despite arguably being an inherent part of professional practice. In research, it fails to demonstrate the rigour of being generalisable because of its explicit location in a specific care environment. The study reported in this paper explored the implications of this ambiguity for practitioners who seek to develop health care practice. Ten focus groups were held with health care researchers and practitioners concerning the processes of developing practice in the North East of England. The results demonstrate how people manage themselves and the uncertainty that surrounds the use of research in clinical practice. The paper argues for an appreciation of reflexive forms of research, such as action and practitioner research, which do not disassociate research and practice and in which practitioners have a role in knowledge creation as well as knowledge implementation.
An investigation of the components of best nursing practice in the care of acutely ill hospitalized older patients with coincidental dementia: a multi‐method design
Authors: Tolson Debbie , Smith Margaret , Knight Paul
Published: March 2003

An investigation of the components of best nursing practice in the care of acutely ill hospitalized older patients with coincidental dementia: a multi‐method design

The main aim of this study was to examine, from the consumer’s perspective, the components of best nursing practice in the care of acutely ill hospitalized elderly people who coincidentally suffered from dementia. Due to the complexity of the problem under investigation a triangulated design was formulated. This design comprised survey methodology, audit and critical incident technique. Data derived from each of these approaches were analysed first in isolation and subsequently combined at a conceptual level. The sample comprised 213 people aged 65 years and older, who were consecutive admissions from two acute medical and two acute care of elderly people wards. Sixty‐six per cent of these individuals were found to suffer from cognitive impairment, 40% experiencing severe problems. The documentary survey revealed that patients with normal or severely abnormal cognitive functioning were more likely to have this noted than those with mild–moderate levels of impairment. No evidence of formal assessment was located and only 15% of these patients had items included in their nursing care plans associated with their chronic confusion. A sub‐sample of 41 chronically confused people and their main hospital visitor were invited to participate in critical incident interviews. These conversations led to the identification of four major themes which reflected the most valued aspects of the nursing care which had been received or observed. The relationship between documentary care scores and the proportion of positive descriptions of care within each of the four themes was explored. The findings indicate that acute nursing care is deemed only to be at its best when it is delivered in tandem with dementia care. Discrete areas for practice development are identified and standards to guide nursing care are proposed. In addition to the practice development issues raised by the work, the methodological lessons further advance the practice of multi‐method research.
Factors related to nurse communication with elderly people
Authors: Caris‐Verhallen Wilma M.C.M. , De Gruijter Ingrid M. , Kerkstra Ada , Bensing Jozien M.
Published: March 2003

Factors related to nurse communication with elderly people

This study explores variables that might influence nurses’ communication with elderly patients. Three groups of variables arise from the literature that seem to affect the quality or quantity of nurse–patient communication: variables related to nurses, to patients, and to the setting in which nursing care takes place. The study was conducted in two different care settings: a home for elderly people and a home care organization. In a sample of 181 video‐taped nursing encounters, involving 47 nurses and 109 patients a study was made of nurse–patient communication. In addition, relevant data related to patients, nurses and situation were gathered by questionnaires and were combined with the results of observations of videotaped nurse–patient interactions. It was found that the educational level of nurses was related most strongly to the way nurses communicate with their elderly patients. Patient characteristics such as age, gender and subjective state of health appeared to play a minor role in the way nurses communicate.
Respite care for frail older people and their family carers: concept analysis and user focus group findings of a pan‐European nursing research project
Authors: Hanson Elizabeth J. , Tetley Josephine , Clarke Amanda
Published: March 2003

Respite care for frail older people and their family carers: concept analysis and user focus group findings of a pan European nursing research project

This paper provides a concept analysis of respite care for frail older people and their family carers. The authors re‐examine the broader conceptualization of respite care delineated by Nolan & Grant, namely, users’ needs for information, education and support about respite care, based on a review of recent literature and on a user focus group study. This work was undertaken by the Sheffield arm of the ACTION Project research team. ACTION is a 36‐month project (1997–1999), involving Northern Ireland, The Republic of Ireland, Portugal, Sweden and England and is the largest nurse‐led project to have received funding from the European Union TIDE sector (DGXIII Telematics Applications Programme, Disabled and Elderly). The authors discuss the key elements of respite and, more specifically, how they can be successfully used so that the potential of respite may be realized fully by family carers. Recommendations within the context of the ACTION research project are put forward to enable family carers and the persons they care for to make informed choices about respite care.
The role of nursing partnership interventions in improving the health of disadvantaged women
Authors: Lazenbatt Anne , Orr Jean , Bradley Martin , McWhirter Liz
Published: March 2003

The role of nursing partnership interventions in improving the health of disadvantaged women

This paper describes a project which assessed the contribution that nursing professionals are making to improving the health of deprived women living in Northern Ireland. The study is set within the context of the Targeting Health and Social Need (THSN) Initiative an important theme within the Northern Ireland Regional Strategy entitled Health and Well‐being into the Next Millennium — A Regional Strategy for Health and Social Well‐being 1997–2002 which is concerned with addressing inequalities in health status and social well‐being. The paper describes the results of a survey (n=1000, response rate 39%) and the criteria used to select 22 interventions to provide evidence of ‘effective practice’ within THSN. The study highlights the work of previous reviews in the area and provides evidence concerning effective interventions in practice. Although the interventions described may be lacking in ‘pure scientific’ method and may not meet the rigorous inclusion criteria of systematic review methodologies, there is evidence to suggest that nurses are using well‐designed more qualitative evaluation methods and demonstrating improvements in health and social need for women in the lowest socio‐economic groups. In terms of equity the case studies show that community nursing may be a powerful vehicle for researching people previously neglected by the formal health care system. Health policies such as THSN can now articulate the methods needed for reform or change, setting directions and articulating the barriers to implementation and achievement.
The roles of Australian chairs in clinical nursing
Authors: Dunn Sandra V. , Yates Patsy
Published: March 2003

The roles of Australian chairs in clinical nursing

Australian chairs in clinical nursing have been established in order to achieve more effective partnerships between academia and the health care sector in education, research and quality of nursing care. The aim of this study was to describe the goals, obstacles, supports and outcomes of such appointments. The study explored the perceptions of a purposive sample of Australian professors holding clinical chairs, stratified to ensure representation of both the geographical and clinical specialty diversity of the population. Eight professors were interviewed using semi‐structured telephone interviews. The interviews covered three phases: role establishment, current foci and future developments. Qualitative analysis for common themes and areas of divergence was conducted with concurrent analysis providing the opportunity to seek confirmation for emerging themes. The participants highlighted the diversity of arrangements between university and health sector partners in establishing their respective roles. Clear communication was crucial to successful partnership arrangements. All roles included components of education, research and politics but the relative contribution of each of these areas depended to a large extent on the priorities of the employing partners. The participants felt the need to secure sustainable income sources and consolidate outcomes to ensure the continued viability of their positions. Clinical professorial nursing appointments provide one means of addressing perceived gaps in the links between the university and health care sectors, academia and clinicians, thus enhancing nursing education, research and politics. Through emphasizing common purpose and mutual respect, these positions can illuminate the crucial role nursing plays in Australian health care delivery.
Raising research awareness among midwives and nurses: does it work?
Authors: Hundley Vanora , Milne Joan , Leighton‐Beck Linda , Graham Wendy , Fitzmaurice Ann
Published: March 2003

Raising research awareness among midwives and nurses: does it work?

Objective The primary aim of the study was to evaluate the effectiveness of two approaches to increase research awareness among midwives and nurses. Design Quasi‐experimental with the attitudes of staff in the two groups being measured at two points (January and October 1997). Sample All midwives and nurses working in four clinical areas in an acute NHS Trust. The intervention arm of the study involved all midwives and nurses in the Clinical Directorate of Obstetrics and Gynaecology, while the control arm involved all nurses working in a specialist oncology and haematology unit and in the children’s directorate. Ethics The Joint Ethics Committee considered approval unnecessary because the study involved staff and not patients. Data collection Data were collected by self‐complete questionnaires. Interventions A programme of education with policy and practice interventions targeted at ward sisters. Outcome measures Staff attitudes to, knowledge of, and level of involvement in, research. Results The study demonstrated a significant increase in both knowledge and use of research resources. Following the programme of education, staff in the intervention group were significantly more likely to use resources associated with research utilization and to report that they had read a research paper within the last month. Study limitations The time scale of the intervention was restricted by the funding available; a significant Hawthorne effect was evident with both groups showing an increase in knowledge; the pragmatic nature of the study meant that it was not possible to randomize the study groups; the scale of the study did not permit an economic evaluation. Conclusions The introduction of clinical governance challenges healthcare providers to improve the care they deliver. There are huge opportunities for Trusts to invest in developing staff knowledge and use of research. However, staff will only seize these opportunities if there is an appropriate, enabling environment — an environment that delivers intensive interventions and is sensitive to the wider structural factors in the NHS affecting staff morale and commitment. In the absence of this environment, what may be seen as opportunities to managers may be regarded as just another burden by staff.
Patterns of caregiving when family caregivers face competing needs
Authors: Shyu Yea‐Ing Lotus
Published: March 2003

Patterns of caregiving when family caregivers face competing needs

‘Finding a balance point’ is a process used by caregivers to achieve or preserve equilibrium in caregiving while facing competing needs. This paper describes different patterns of ‘finding a balance point’. Interviews with 15 family caregivers receiving home nursing services and 14 family caregivers of hospitalized and discharged frail elders were analysed using constant comparison. Sources of competing needs and the strategies used to find a balance point were identified by participants. Findings suggest that caregivers in a stable situation maintain a balance point, caregivers experiencing major family change try to regain a balance point, and caregivers experiencing the transition from hospital to home work at establishing a balance point. These findings can sensitize nurses to family caregivers’ needs and conditions.
Developing health‐promoting practice with families: one pedagogical experience
Authors: Hartrick Gwen
Published: March 2003

Developing health‐promoting practice with families: one pedagogical experience

As the significance of social determinants of health has been revealed and the socio‐environmental perspective of health promotion has become prominent, family nurses have attempted to move away from disease‐treatment models of practice towards emancipatory, health promoting practice. This paper describes a multidisciplinary team’s pedagogical experience of developing emancipatory family health promoting practices. The discussion includes a description of the significant educational processes that supported the development of health promoting family practice and an outline of the transformative changes the team members experienced as they evolved their health promoting practices.
Collaborating with practitioners in teaching and research: a model for developing the role of the nurse lecturer in practice areas
Authors: Murphy Fiona A.
Published: March 2003

Collaborating with practitioners in teaching and research: a model for developing the role of the nurse lecturer in practice areas

The integration of nurse education with higher education in the United Kingdom, has highlighted an uncertainty over the clinical role of nurse lecturers. Although benefits have been identified from lecturers maintaining strong links with clinical practice, the evidence suggests that nurse lecturer participation in practice areas is limited. This paper reports a strategy for developing the clinical role of the nurse lecturer through collaborating with practitioners in teaching and research. An action research project designed to implement and evaluate a teaching programme for pre‐registration nursing students was developed. The research aimed to evaluate the programme and identify the benefits for students, practitioners and the nurse lecturer in collaborating in teaching on the programme. Ethical approval was granted from the local research ethics committee. Data were collected in three ways: questionnaires to 17 students; focused interviews with nine practitioners; and analysis of the reflective diary kept by the lecturer. Findings identified the success of the teaching programme and also revealed substantial benefits for students, practitioners and the lecturer. Selected findings are used to demonstrate how the liaison, teaching, clinical practice and research elements of the nurse lecturer’s clinical role could be developed. The project was small scale and grounded within a specific context and thus may not be applicable to other settings. However, it is suggested that collaboration between nurse educationalists and practitioners in this way offers a potential model for developing the clinical role of the nurse lecturer.
‘I really feel I’ve let him down’: supporting family carers during long‐term care placement for elders
Authors: Nolan Mike , Dellasega Cheryl
Published: March 2003

‘I really feel I’ve let him down’: supporting family carers during long‐term care placement for elders

This paper considers placing a relative in a nursing home from a carer’s perspective. A largely structured, interviewer‐administered, questionnaire survey was conducted with 48 carers in the United Kingdom and 54 carers in the United States of America. While the data highlight differences between the two countries, shared experiences emerge which suggest that carers often have to make difficult decisions without adequate support. Implications for practice are considered. The need to develop more robust support mechanisms is stressed.
An international psychometric testing of the Care Dependency Scale
Authors: Dijkstra Ate , Brown Lauraine , Havens Betty , Romeren Tor Inge , Zanotti Renzo , Dassen Theo , Van Den Heuvel Wim
Published: March 2003

An international psychometric testing of the Care Dependency Scale

In an international study, psychometric properties of the Care Dependency Scale (CDS) were examined by analysing data gathered in Dutch, Canadian, Italian and Norwegian nursing homes. For that purpose, from these countries a convenience sample was developed consisting of 525 patients with dementia. The English, Italian and Norwegian research instruments were translations of the original Dutch CDS. Psychometric evaluations of the CDS were carried out for each country separately as well as for the four countries combined. High alpha coefficients between 0·94 and 0·97 were calculated. Subsequent test–retest and inter‐rater reliability revealed moderate to substantial Kappa values. Factor analysis resulted in a one‐factor solution. The scalability of the CDS was demonstrated by means of Mokken scale analysis. One of the main outcomes of the cross‐cultural comparison was that the findings in the four countries show more similarities than differences, so that the scale can be used appropriately in nursing home practice.
Beliefs about voices and their effects on coping strategies
Authors: Sayer Jane , Ritter Susan , Gournay Kevin
Published: March 2003

Beliefs about voices and their effects on coping strategies

Cognitive behavioural techniques are increasingly used as adjuncts to medication in the treatment of auditory hallucinations for people with schizophrenia. There are now literally hundreds of nurses trained in the use of cognitive behavioural interventions for psychosis. However, there is still disagreement about the nature of the cognitive processes that lead to deficits or biases in patients’ processing of information about their psychotic experiences. Using Chadwick & Birchwood’s Beliefs About Voices Questionnaire (BAVQ), the investigator collected data regarding voices from a sample of men and women being treated for schizophrenia by secondary mental health services. The investigator then carried out a cross‐lagged panel analysis of the data. The investigator found, as predicted, positive relationships between a resistive coping style and an attribution of malevolence to voices, and between an engaging coping style and an attribution of benevolence to voices. Coping and attributional styles were not necessarily stable over time. There was a non‐significant difference between women’s and men’s attributions and coping styles. There was less fluctuation over time in the women’s scores on the BAVQ. This research shows that one cannot assume that either coping or attributional style becomes more stable over time. However, while there are strong relationships between attributions and coping styles, and particularly between malevolence and resistance and benevolence and engagement, these relationships are not necessarily mutually exclusive and some people in the study believe their voices to be both malevolent and benevolent. These findings suggest that clinicians need to make a very careful assessment of attribution and coping with regard to hallucinations and that systematic reassessment is very important. Further research is necessary in both the phenomenology of attribution and coping, but also to relate these variables to other aspects of schizophrenic illnesses.
Managing the unmanageable? Nurse Executive Directors and new role developments in nursing
Authors: Cameron Ailsa , Masterson Abigail
Published: March 2003

Managing the unmanageable? Nurse Executive Directors and new role developments in nursing

This paper offers a unique insight into the factors affecting the functioning of the Nurse Executive Director(s) and their views on the realities of nursing management in the new National Health Service in England. It is based on the findings of the Exploring New Roles in Practice (ENRiP) project which was carried out for the Department of Health. As part of this project interviews were undertaken with Nurse Executive Directors from a 20% sample of acute hospital trusts in England. The interviews were designed to explore the Nurse Executive’s perceptions of the process of new role development. The findings highlight a tension between the drive for professional development and the pragmatics of service delivery in a health care system which lacks dedicated funding for nursing development. It was evident that most Nurse Executives vacillated between responding either in an ad hoc way to internal and external pressures or leading and supporting managed development.
The best interest principle as a standard for decision making in the care of neonates
Authors: Spence Kaye
Published: March 2003

The best interest principle as a standard for decision making in the care of neonates

In neonatal care, decisions are made on behalf of newborn infants by their parents or, in some instances, health professionals. This paper examines how the best interest standard is the most appropriate focus for decision‐making concerning neonates. The components of surrogate decision‐making are discussed from the perspective of the neonate’s interests and the contribution of the various persons involved in caring for neonates. An argument is presented for the use of best interests when making decisions and the interpretation of best interests is explored. By examining the ethical approaches using best interests, an argument is put forward for caring as an expression of best interests. How some nurses use the best interest standard in their practice is described. The unique perspective nurses may have because of their philosophy, circumstances, experience and concern for neonates is discussed. Examples are used from the literature to support the argument for nurses being in roles and relationships where the neonate’s interests are the basis of practice. How nurses classify infants on the basis of their future outcome is used to illustrate how nurses can apply the best interest standard. Ethical approaches of care and cure are used to show the best interest standard as applied to neonates. Caring as an expression of best interests is recommended for nursing decisions and actions using infant outcomes as a focus for caring and best interests.
Interviewing in phenomenology and grounded theory: is there a difference?
Authors: Wimpenny Peter , Gass John
Published: March 2003

Interviewing in phenomenology and grounded theory: is there a difference?

This paper explores the differences and similarities that may exist in respect of using the interview method in phenomenological and grounded theory methodologies. Baker et al. set out to differentiate between method in grounded theory and phenomenology and concluded that it was essential to ensure that the method matches the research question being asked. However, the paper, whilst clear in intent to differentiate between the methodologies of phenomenology and grounded theory, does little to help the researcher in the differences that may exist in carrying out such research using the same method, that is, interviewing. Interviewing has become synonymous with qualitative research and may become the accepted method of data collection irrespective of methodology. We postulate that the interview as a method of data collection may be inconsistent with the underlying principles of the methodology (phenomenology or grounded theory). Should this be the case then the interview as a means of collecting data may be viewed as generic and lack a clear connection to the methodological framework. Such a position could be consistent with a critique of qualitative nursing research on the grounds of rigour.
Individualized care: its conceptualization and practice within a multiethnic society
Authors: Gerrish Kate
Published: March 2003

Individualized care: its conceptualization and practice within a multiethnic society

This paper reports on the selected findings from a larger ethnographic study of the provision of individualized care by district nurses to patients from different ethnic backgrounds. Undertaken in an English community National Health Service (NHS) Trust serving an ethnically diverse population, the study comprised two stages. First, an organizational profile of the Trust was undertaken in order to analyse the local policy context. Data were collected by means of in‐depth interviews with managers and a review of policy documentation and caseload profiles. Second, a participant observational study was undertaken focusing on six district nursing teams. Purposive sampling was used to identify four teams with high minority ethnic caseloads and two teams with predominately white ethnic majority caseloads. Interview transcripts and field notes were analysed by drawing upon the principles of dimensional analysis. This paper focuses upon aspects of the second stage, namely how the nurses’ conceptualized and practised individualized care. Six principles underpinning the philosophy of individualized care expounded by the nurses were identified: respecting individuality; holistic care; focusing on nursing needs; promoting independence; partnership and negotiation of care; and equity and fairness. Each is examined in turn and consideration given to how they were modified in their transformation into practice. Some implications for patients from minority ethnic backgrounds of the nurses’ conceptualization and practice of individualized care are discussed. The lack of internal consistency within the nurses’ discourse, the impact of policy directives on care delivery and the influence of factors outside the nurses’ control, served to illuminate the complexity whereby the ideals of individualized care were adjusted and reworked in the realities of everyday nursing practice. This in turn raised questions about the appropriateness of the current interpretation and practice of individualized care in a multi‐ethnic society.
The recruitment crisis in nursing: placing Irish psychiatric nursing in context — a review
Authors: Wells John S.G. , McElwee C. Niall
Published: March 2003

The recruitment crisis in nursing: placing Irish psychiatric nursing in context — a review

There is a decline in recruitment to pre‐registration programmes in psychiatric nursing in Ireland. This article discusses factors that may relate to the Irish situation in the context of relevant international literature on nurse recruitment. It is noted that disciplines and courses in Ireland, such as social care, that engage in similar work to that of psychiatric nurses do not suffer from such a shortage of applicants. Whilst it is difficult to account for this difference, a number of factors identified from the literature are discussed. The need to highlight differences with general nursing and the importance of career guidance are seen as important in overcoming prejudices and stereotypes. From a review of the literature it appears that studies dedicated to recruitment to psychiatric nursing alone are notable by their paucity, and absent in the case of Ireland. Therefore, the available literature fails to fully explain the fall in psychiatric nurse recruitment compared to the robust recruitment position of social care. It is argued that dedicated research on recruitment to psychiatric nursing within an Irish setting is needed if a sustainable recruitment policy is to be implemented to reverse the long‐term decline in recruitment.
Systematized HIV/AIDS education for student nurses at the University of Ibadan, Nigeria: impact on knowledge, attitudes and compliance with universal precautions
Authors: Uwakwe Charles B.U.
Published: March 2003

Systematized HIV/AIDS education for student nurses at the University of Ibadan, Nigeria: impact on knowledge, attitudes and compliance with universal precautions

This paper reports the findings of a study which examines changes in a group of Bachelor of Science (BSc) nursing students’ perceptions, knowledge of and attitudes towards human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), accruing from attempts at a systematized education for the cohort. Based upon a 3‐month study of 141 registered nurses enrolled in a BSc nursing programme at the University of Ibadan, Nigeria, it investigates alterations in knowledge and attitudes resulting from intense instruction on HIV/AIDS, AIDS patient care, and compliance with universal precautions. With regard to knowledge enhancement and attitudinal transformation, the research reveals that a number of positive changes occurred over the period of the study. Not only were the nurses better informed about AIDS than previously, but their attitudes towards the disease and patient care had become considerably more liberal, as well as their disposition to comply with universal precautions. The conclusion emphasizes that it is very important for education about HIV/AIDS to be incorporated within current undergraduate and in‐service training programmes for Nigerian nurses.
Crosscurrents: against cultural narration in nursing
Authors: Freshwater Dawn
Published: March 2003

Crosscurrents: against cultural narration in nursing

Nurses, like other groups throughout history, have been described as an oppressed group. Writers who describe nurses as lacking in self‐esteem, autonomy, accountability and power support this view in the literature. Indeed the cultural narration of nursing is for nurses to be subordinate. This article explores the emergence of horizontal violence within nursing and suggests that it is a result of unexpressed conflict within an oppressed group. The author aims to raise the awareness of horizontal violence in nursing so that practitioners come to understand how this in itself can be an expression of power. Drawing upon theories of reflective practice, the article examines how the educational system in nursing may have contributed to the felt oppression within the group by colluding with the cultural narrative. The crosscurrents of cultural narration are strong and it is argued here that the nurse needs to feel empowered in order to take action to swim against the tide. The author proposes that a model of transformatory learning based upon critical theory creates the possibility of emancipatory action in nursing, both locally and globally.
Social perceptions of cancer and their impacts: implications for nursing practice arising from the literature
Authors: Flanagan Jean , Holmes Susan
Published: March 2003

Social perceptions of cancer and their impacts: implications for nursing practice arising from the literature

At the millennium cancer still holds a special mystique and is imbued with socio‐cultural meanings, which extend far beyond the rational, scientific and biological facts of the disease. Excessive fear and dread may cause family and friends to display avoidance or overprotective behaviours to the ill person, who may subsequently perceive dissatisfaction with social support. Drawing on a literature review this paper explores the impact of cancer on social relationships. Interpersonal strain in relationship is often explained in the stigmatization of the illness and this concept is explored through contemporary social theorizing. These findings have direct implications for nursing practice where the goal of care is to enhance the support relationship.
Women’s views of counselling received in connection with breast‐feeding after reduction mammoplasty
Authors: Engström Britta Lena , Fridlund Bengt
Published: March 2003

Women’s views of counselling received in connection with breast‐feeding after reduction mammoplasty

The aim of this study was to generate a theoretical model of the experiences of women, who had undergone reduction mammoplasty, of counselling received in connection with breast‐feeding. Data were collected through interviews with 12 breast‐reduced women who had given birth to a child, and the material was analysed by means of the grounded theory method. Written permission to post notices at the child welfare centres had been obtained from the primary care managers. The women themselves applied for participation in the study. The results showed that their need for counselling from somebody who listened attentively to them and gave advice in connection with breast‐feeding, was considerable. The women could have a feeling of self‐reliance, ambivalence, acceptance or guilt, depending on the extent to which they perceived to have received counselling from their family members. At the same time, their experiences of the encounter with the nursing staff were of crucial importance. Lack of active listening and counselling from the nursing staff can be counterbalanced by support from relatives. However, when such support is not forthcoming, the nursing staff must be able to support the women in their role of a mother, which requires that education and supervision are given to the staff. The findings of the study can be used as a basis for further research into the need for support of the families concerned.
‘I don’t have any other choice’: spouses’ experiences of placing a partner in a care home for older people in Sweden
Authors: Lundh Ulla , Sandberg Jonas , Nolan Mike
Published: March 2003

‘I don’t have any other choice’: spouses’ experiences of placing a partner in a care home for older people in Sweden

The main aim of this paper is to consider the experiences of Swedish spouses who have placed a partner in a care home for older people. Data were gathered from semi‐structural interviews with 14 spouses (11 wives and 3 husbands) who had been involved in a care home placement within the previous 6 months. The results reported here are from the first component of a larger grounded theory study, the aim of which is to explore, describe and understand the experience of care home placement from a variety of perspectives and to identify the implications for policy and practice in Sweden. The focus here is on the experience of spouses, relating to the decision‐making process, the move into care and subsequent contact with the care home. Four themes emerged from the data – making the decision, making the move, adjusting to the move and reorientation. The results show a lack of planning for the elder person’s entry to a care home, and professional dominance of this stage of the process. The largely ambivalent emotional responses to the move that spouses experience and the difficulties in initiating and sustaining relationships with staff in the home are discussed in the light of previous research.
The theory–practice gap in nursing: the role of the nurse teacher
Authors: Landers Margaret G.
Published: March 2003

The theory–practice gap in nursing: the role of the nurse teacher

The increasingly complex requirements of today’s nursing practitioners, have been accompanied by demands on nurse educators to look at new ways to facilitate learning in the clinical area (Camiah 1996). In recent years nursing education has undergone a period of major change in many countries through integrating with universities. While nurse educators are striving to respond to changes in education the dichotomy between the theoretical input taught in the classroom and what is practised or experienced on the wards remains a problem (Ashworth & Longmate 1993, Ferguson & Jinks 1994). Dale (1994) postulates that theory provides the basis for understanding the reality of nursing, it would seem reasonable, therefore, to assume that the content studied in the classroom correlates with what the student experiences on the ward. It should also follow that if a gap exists between theory and practice, efforts should be taken for its reduction (Rafferty et al. 1996). According to MacNeil (1997) many initiatives have been introduced in an effort to bridge the theory–practice gap and these have focused around the role of the nurse teacher. These changes in education are redefining the role of the nurse teacher, therefore, the part that they currently play and will play in the future needs to be carefully considered (Phillips et al. 1996b). The aim of this paper is to provide an overview of the literature on the theory–practice divide in nursing. First, some of the reasons cited for its existence will be explored. Second, suggested ways of bridging the divide will be considered focusing on the role of the nurse teacher.
The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring
Authors: Rassool G. Hussein
Published: March 2003

The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring

Caring from Islamic perspectives is not well versed in Eurocentric nursing literature. There is widespread misunderstanding of the concept and practice of Islam within the context of health care and nursing practice. The areas of contention, in the context of health care systems, are whether the western paradigm to nursing care and management are applicable to Muslims and non‐Muslims in both Islamic and non‐Islamic countries. What is lacking in some of the conceptual frameworks and models of care is not only the fundamental spiritual dimension of care, but also the significance of spiritual development of the individual towards healing. The focus of this paper is to provide an awareness of Islamic health practices, health behaviours, code of ethics and the framework of Islamic perspectives of caring and spirituality. A brief overview of the Muslim world, the historical development in caring and health and the pillars of the Islamic faith provide the context of the paper. The development of a model of care based on the Islamic perspective is suggested.