bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ ability to perceive patients’ fears related to coronary arteriography
Authors: Heikkilä Johanna , Paunonen Marita , Laippala Pekka , Virtanen Vesa
Published: March 2003

Nurses’ ability to perceive patients’ fears related to coronary arteriography¶This study describes the congruence of the perceptions of 180 patient–nurse dyads concerning patients’ fears related to coronary arteriography (CA). The perceptions were measured with a purpose‐designed instrument which listed 26 objects of fear. t‐Tests and chi‐square tests were used to compare the responses and the associations with demographic data. The results pointed to inconsistencies between patients’ and nurses’ perceptions. Nurses and patients had congruent perceptions of the 10 most intense fears related to CA. Otherwise nurses tended to overestimate patients’ fears. Nurses’ perceptions of the intensity of individual patients’ fears were incongruent so that before CA there was a tendency to overestimate the intensity of fears and after CA to underestimate it. The results suggest that nurses need to pay more attention to the assessment of individual patients’ fears and to avoid stereotypical views of patient fears. The use of an assessment instrument is recommended as one way of enhancing the quality of care.
The educational preparation of staff in nursing homes: relationship with resident autonomy
Authors: Davies Sue , Slack Russell , Laker Sara , Philp Ian
Published: March 2003

The educational preparation of staff in nursing homes: relationship with resident autonomy¶The following paper reports on a survey of nursing homes in three health regions in England which formed part of a wider study to evaluate educational preparation for the nursing care of older people. The aims of the survey were to describe the educational preparation of staff employed within nursing homes and to explore relationships between educational preparation and one indicator of quality of care. A self‐completion questionnaire was addressed to the senior nurse within a random sample of nursing homes. The instrument included a previously validated scale to measure resident autonomy. A total of 976 questionnaires were posted and 676 were returned, a response rate of 69%. The survey revealed wide variation in the educational preparation of staff in nursing homes and in the degree of contact with local centres providing nurse education. Statistically significant associations were found between resident autonomy and a composite measure of educational preparation, the proportion of qualified staff undertaking continuing professional education and the degree of contact with educational centres. The findings have implications for both purchasers and providers of education in this field.
The community gerontological nurse: themes from a needs analysis
Authors: Oberski Iddo M. , Carter Diana E. , Gray Morag , Ross John
Published: March 2003

The community gerontological nurse: themes from a needs analysis¶With the move of care into the community, the role of nurses caring for older people is changing. However, nurses may not be adequately prepared to cope with this changing role, especially if their training and experience have been primarily hospital based. This study involves an educational needs analysis of registered nurses working in the care of older people in nursing homes and clients' own homes. It is based on focus groups with registered nurses and individual interviews with other professionals, as well as group discussions with older people. The aim of this project is to provide research‐based input into the design of a new community care of older people module, to be offered at Napier University, Edinburgh from February 1998. The results presented here consist of three themes or patterns that have emerged from the interview data. The specialist/generalist theme concerns issues of role definition and gerontological specialism. The social/medical theme addresses the shift towards a social model of care when nurses move into the community settings. Finally, the physical health/mental health theme represents the need for greater integration of skills and knowledge from both mental health and general health nursing in the field of community care for older people. The results indicate the need for significant attitude changes and provide a major challenge to educationalists.
Aggression in clinical settings: nurses' views — a follow‐up study
Authors: Farrell Gerald A.
Published: March 2003

Aggression in clinical settings: nurses' views — a follow‐up study¶Results from this empirical study (n = 270) indicate that nurses from both the public and private sector are more worried about colleague aggression than aggression from other sources, that such aggression ranks as a major workplace distress factor for them, that different clinical settings have their own profiles of aggression, and following incidents of aggression, staff talk with colleagues and friends rather than with human resource or trade union personnel. These findings shadow those of a previous small scale qualitative study conducted by the author and they add to the growing recognition and concern that nurses, like employees in other settings, are subjected to high levels of interpersonal conflict at work.
The idea of nursing science
Authors: Edwards Steven D.
Published: March 2003

The idea of nursing science¶This paper addresses the question of whether or not nursing can legitimately be considered as a science. It is proposed that an adequate answer to this question requires consideration of recent developments in philosophy of science (as urged by Paley). It is shown that such developments call into question the `rational image' of science. However, a defence of the legitimacy of the scientific enterprise has been attempted by Laudan, an advocate of the `historical turn'. Two conditions necessary for the applicability of this `turn' are identified. It is shown that although they apply relatively unproblematically to science, they do not readily apply to nursing. Hence the conclusion is drawn that claims for the integrity of nursing science stand in need of much further development.
A concept analysis of empowerment: its relationship to mental health nursing
Authors: Ryles Shaun M.
Published: March 2003

A concept analysis of empowerment: its relationship to mental health nursing¶The concept of empowerment is described as being intuitively attractive to nurses and the nursing profession. This concept analysis represents an attempt not only to clarify meaning but also to describe the relationship, if any, between empowerment and mental health nursing. It is the argument of this author that the conceptual ambiguity said to blight the implementation of empowerment practice is underpinned by a tendency to describe the concept without direct reference to theories of power. As regards mental health nursing the author concludes that there should be an end to the quest for professionalism personified by notions such as individualized care. In its place should be an approach that recognizes that nurses and users must unite to pursue forms of knowledge that precipitate a challenge to the current hegemony of the medical and scientific elite.
Meaning in caring: reconceptualizing the nurse–family carer relationship in community practice
Authors: Kellett Ursula M. , Mannion Jill
Published: March 2003

Meaning in caring: reconceptualizing the nurse–family carer relationship in community practice¶To date family caregiving studies have considered family caring in primarily practical terms such as `how to do' and `how to cope'. Research efforts have focused upon exploiting the productive elements of a certain conception of the essence of family caregiving. Thus despite a wealth of studies, the question of the nature of family caregiving is not well understood. This ontological‐hermeneutic study highlights the importance of understanding the human experience of family caring at home. The study involved in‐depth audio‐taped interviews with seven family carers who care for an older relative at home. Thematic analysis of the transcribed interviews uncovered a number of common themes which highlighted unique and shared meanings family carers ascribed to their everyday existence as carers. The findings will challenge practitioners to reconceptualize the nurse–family carer relationship, to appreciate the many ways in which family members' involvement in care provides meaning and significance to their lives, and to understand family carers through a process of human relating which fosters families' meaningful involvement in caring at home.
Family care‐giving for people with dementia: some implications for policy and professional practice
Authors: Clarke Charlotte L.
Published: March 2003

Family care‐giving for people with dementia: some implications for policy and professional practice¶The objective of this paper is to describe one study undertaken in the north of England which sought an understanding of family care‐giving for people with dementia. Data were collected by interview and diary with 14 family carers, by questionnaire with 60 professional carers, and by interview and diary from nine case studies. Family carers were found to value their continuing relationship with the person with dementia. This emphasis on their relationship together influenced the contact which they had with professional carers. The implications of this research for policy and professional practice are explored through illumination of the tensions in professional responses to family carers.
An exploratory study of patients' perceptions, memories and experiences of an intensive care unit
Authors: Russell Sarah
Published: March 2003

An exploratory study of patients' perceptions, memories and experiences of an intensive care unit¶In the research reported, 298 patients were asked to describe their memories of the Royal Melbourne Hospital's intensive care unit (ICU). The data were collected by either self‐reported questionnaires or structured interviews and examined from a bio‐psycho‐social perspective using both qualitative and quantitative methods. These recollections demonstrate that the close surveillance by both technological support and health care practitioners provide many patients and their families with a feeling of safety. Patients' memories of ICU also highlighted the presence of power relations which are inherent in clinical practice. This paper provides examples of actions and remarks within ICU that were not only remembered by patients and their families but also continued to effect patients 6 months after their discharge. The data in this research indicate that some of the psychological problems experienced after discharge may have been prevented by improved communication between staff and patients in ICU. This study also demonstrated the importance of providing feedback to the nurses working in ICU. This feedback raised awareness of patients' perceptions of both ICU itself and the behaviour of the staff. It also reminded staff that some patients remember everything about their admission of ICU. The data indicate that while patients found the presence of good communication in ICU both therapeutic and reassuring, they found the lack of good communication distressing. Poor communication not only caused anxiety while the patient was in ICU but also contributed to less than optimal recoveries after discharge. Finally, it will be argued that the provision of information from nurses not only diminished feelings of anxiety but also empowered patients to become involved in decisions about their care.
The role of the child primary mental health worker
Authors: Lacey Irene
Published: March 2003

The role of the child primary mental health worker

The purpose of the study was to explore how the child primary mental health worker role, as defined in the Health Advisory Service document, has been interpreted in each of the mental health trusts in England. Studies have indicated there is a deficit in recognition and treatment skills, by primary care workers, of psychological difficulties presented by children and young people, which could be supported by specialist mental health workers. A postal questionnaire was sent to 169 English mental health trusts. There were 98 returns (59%) indicating that 22 child mental health services had established this new role and a further 42 were planning to develop it in the near future. The child primary mental health workers were spending on average 35% of their time in primary care offering consultation and training to health professionals, rather than direct work with children and families. This development was found to be a growing area of advanced practice for nurses. Given the stated intention of the majority of services to develop or retain this role, further evaluation studies will be needed.
Developing realistic treatment standards in today’s economic climate: stroke survivor education
Authors: Rausch Michele , Turkoski Beatrice
Published: March 2003

Developing realistic treatment standards in today’s economic climate: stroke survivor education

Teaching people about the risk factors and early symptom identification of stroke significantly decreases the incidence of both first time and recurrent strokes. Patient teaching has traditionally been a nursing responsibility. However, in the fiscal constraints of today’s health care delivery system, nurses’ time for teaching is highly restricted. This pilot study was designed to evaluate the impact of a short 1½ hour stroke education programme in a population of hospitalized stroke survivors prior to their discharge. The first session focused on the disease process of stroke and its warning signs. A second session addressed risk factors and behavioural strategies for exercise, stress management, or smoking cessation. Responses to the teaching programme were evaluated through patient interviews immediately following the teaching session and 3 weeks later. Responses indicated that short‐session patient teaching, in and of itself, is not always successful in changing behaviour but is successful for knowledge attainment. The findings from this pilot study suggests a need to consider new teaching strategies and a need to identify opportunities for reinforcement, support and encouragement that will meet the realities of today’s time constraints while still meeting our professional responsibilities for patient education.
Perspectives on surviving childhood sexual abuse
Authors: Wilshaw Gary
Published: March 2003

Perspectives on surviving childhood sexual abuse

This paper begins by examining sexual victimization and professional ‘thinking sets’ in relation to abuse. It goes on to offer an exploration of the literature in the area of childhood sexual abuse and its survival, and attempts to marshal some of this literature into naturally occurring conceptual groups with connecting theoretical threads. A summary of the theoretical paradigms which seem to produce dominant perspectives on the area is made. A cautionary discussion is introduced regarding the deterministic nature of the influence of these perceptual viewpoints upon research and therapeutic activity. Implications for nursing practice and education are drawn.
The experience of women with primary biliary cirrhosis: a literature review
Authors: Fahey Siobhan
Published: March 2003

The experience of women with primary biliary cirrhosis: a literature review

Primary biliary cirrhosis (PBC) is a serious and life‐threatening illness that mainly affects women. Epidemiological data on the prevalence of the illness are unclear. The experience of women with this chronic illness has not been explored within nursing research. A review of the literature concerning PBC therefore is based on general themes relating to chronic illness. A chronic illness has two meanings: the symbolic significance and the consequences for the individual. The symbolic significance of PBC can be related to symbolism relating to the liver in general and to the general assumption that liver disease is related to alcohol consumption. The consequences for the individual woman with PBC have been described as following a disease management trajectory. This may include appreciating the major symptoms of the illness. The main symptoms of PBC are fatigue and pruritus. These are both insidious and debilitating symptoms of unclear aetiology that can cause women with PBC problems when seeking an illness explanation. The symptoms may also interfere with the woman’s body image and her caring role. It is suggested that the factors that relate to PBC may result in social isolation for women with the illness.
A specialist nurse: an identified professional role or a personal agenda?
Authors: Hunt Jane A.
Published: March 2003

A specialist nurse: an identified professional role or a personal agenda?

Specialist nurses have existed for many years. Initially denoting a nurse with extensive clinical experience, implicit within nursing’s professional agenda for attaining ‘specialist’ status since the 1960s has been the requirement to achieve a high degree of ‘specialist’ knowledge through post‐basic education. Despite the professional agenda, much confusion surrounding definitions of specialist nurses prevails. In recent years this confusion has been compounded in the United Kingdom by the introduction of advanced nurse practitioners alongside existing clinical nurse specialists. This paper suggests that health care professionals’ perceptions of a ‘specialist’ are subjective, grounded in their own experiences. Drawing on a study which examined relationships between paediatric oncology outreach nurse specialists and other health care professionals, two types of personal agenda from which perceived ‘specialist’ status evolves are described: (1) ‘needs‐driven agendas’, and (2) ‘peer‐driven agendas’. When ‘specialist’ status is accorded to paediatric oncology outreach nurse specialists, ‘specialist’ knowledge is derived from: formal qualifications, hands‐on technical skills, previous ‘specialist’ work experience, in‐depth medical knowledge and/or insight into families’ dynamics. The relative contribution each of these makes towards constructing a ‘specialist’ depends on the experiences of individual health care professionals and the varying work locations and professional backgrounds of paediatric oncology outreach nurse specialists.
A hermeneutic textual analysis of suffering and caring in the peri‐operative context
Authors: Von Post Iréne , Eriksson Katie
Published: March 2003

A hermeneutic textual analysis of suffering and caring in the perioperative context

Hermeneutic text interpretation is discussed in this paper as a possible way of releasing nurses’ knowledge, in order to develop a deeper understanding of professional caring. The text is a nurse’s story, which has been gathered by means of the critical incident technique. The intention is to elicit the knowledge of professional caring in the stories and the language of caring science, which is concealed in a nurse’s reality. Hermeneutic text interpretation through reading a text and having a dialogue with the nurse’s reality will give a voice and a language to silent knowledge.
User involvement in identifying health needs and shaping and evaluating services: is it being realised?
Authors: Poulton Brenda C.
Published: March 2003

User involvement in identifying health needs and shaping and evaluating services: is it being realised?

The rhetoric of user involvement has featured in health policy documents for over a decade. However, there is mixed evidence as to the extent to which it is being achieved. This paper explores what is meant by user involvement, proposing that it exists at a series of levels ranging from information giving to true empowerment. Examples are presented from two practice development projects. The first sought to develop multidisciplinary audit in primary care, attempting to involve users in defining health needs and determining services. Although the project co‐ordinators were highly committed to user involvement this was only achieved to a limited extent. It was concluded that there was a resistance to user involvement grounded in the fear that such involvement would increase user expectations and add to the pressures of overworked primary care teams. The second project used interviews with service users to assess the effectiveness of a team building initiative. Users were found to be knowledgeable about practitioner roles and how to access the care they required. The overall conclusion is that there needs to be a shift from rhetoric to reality at governmental and practitioner level if true user involvement is to be achieved.
An evaluation of the implementation of case management in the community psychiatric nursing service
Authors: Chan Sally , Mackenzie Ann , Ng Dominic Tin‐Fu , Leung Jessie Ka‐yi
Published: March 2003

An evaluation of the implementation of case management in the community psychiatric nursing service

This paper reports the preliminary results of a study on the implementation of case management in the community psychiatric nursing service (CPNS). The purpose of the study is to compare the outcome of case management service with the conventional practice of CPNS in the care of chronic schizophrenic clients. The impact of case management service on clients’ clinical status, functional level and satisfaction was measured. A matched, pre–post, case‐control group design was used to compare case management and conventional care groups. A specific case management model based on the practice at Carondelet Saint Mary’s Hospital and Health Centre in Tucson has been developed to care for the schizophrenic clients in the community. Subjects in the experimental group were cared for by CPNs using this case management model. Subjects in the control group were cared for by CPNs based on current practices in the CPNS. Pre‐ and post‐measures were taken upon recruitment and at 5 months later. Findings showed that the experimental group had better outcome in terms of their mental status and functional level when compared with the control group. They were generally more satisfied with the service. When comparing case managers’ role with that of conventional CPNs, case managers performed more in areas such as assessment, liaison, case discussion and life skills training. This study demonstrates that this particular model of case management can be effective in caring for clients with long‐term mental health problems in Hong Kong.
Validation of a new method for patient classification, the Oulu Patient Classification
Authors: Fagerström Lisbeth , Rainio Anna‐Kaisa , Rauhala Auvo , Nojonen Kaija
Published: March 2003

Validation of a new method for patient classification, the Oulu Patient Classification

At Vasa Central Hospital in Western Finland a further development of the Oulu Patient Classification (OPC) has been made by the development of weight coefficients and by estimating the nursing care intensity per nurse. The daily level of nursing care intensity of a ward is expressed by the number of nursing care intensity points per nurse. This article presents results from a validity test of the OPC at Vasa Central Hospital. The test was carried out by comparing the daily patient classifications by means of the OPC against measurements made by means of a new measuring instrument, the ‘Professional Assessment of Optimal Nursing Care Intensity Level’ (PAONCIL) developed at the Vasa Central Hospital. The study was implemented in eight wards during a period of 3 months. The data material consisted of two parts, the daily patient classifications based on the OPC (n = 19 324) and the measurements by means of the PAONCIL forms (n = 8458). Simple and multiple linear regression analyses were used as statistical methods in quantifying the linear relationship between the two interval‐scaled variables. In the test of concurrent validity the coefficient of determination was 0·366, i.e. the association between these two indicators is fairly strong (36·6%). The testing of construct validity showed that the construct validity of the indicator hardly deteriorates as a result of the patients being placed in separate nursing care intensity categories. There was a clear correlation between the scores allotted by the indicator to the six different sub‐areas of nursing care. When examining the construct validity of the OPC, no factors with independent explanatory power in predicting PAONCIL values were discovered other than those of the OPC. The OPC proved on the basis of this research material and these statistical methods to possess fairly adequate validity, and thus there is a good basis for further research and a development of nursing care.
Development of the Nursing Minimum Data Set for the Netherlands (NMDSN): identification of categories and items
Authors: Goossen  , Epping  , Van den Heuvel  , Feuth  , Frederiks  , Hasman
Published: March 2003

Development of the Nursing Minimum Data Set for the Netherlands (NMDSN): identification of categories and items

Rationale Currently, there is no systematic collection of nursing care data in the Netherlands, while pressure is growing from the profession, policy‐makers and society to justify the contribution of nursing and its costs. A nursing minimum data set can provide data to demonstrate nursing’s contribution to health care as it can be used to describe the diversity of different patient populations and the variability of nursing activities, and to calculate the associated nursing workload. Objective To identify categories and items for inclusion in the Nursing Minimum Data Set for the Netherlands. Design A multimethod, exploratory approach was used. This included interviews, document analysis, consensus rounds, seeking validation in the literature, and drawing up lists of most frequently occurring patient problems, interventions and outcomes of care. Eight hospitals, with a total of 16 wards, participated in the study. Results Relevant categories and items emerged after analysis and grouping of the material and included: five hospital‐related items, six patient demographics items, seven medical condition items, 10 nursing process items, 24 patient problems, 32 nursing interventions, four outcomes of nursing care, and three complexity of care items. Almost every item could be located in the existing documentation systems, the lists of patient problems, outcomes and interventions, or in the literature. Conclusion A set of categories and items of nursing data has been identified. The content validity of this set is partly supported by its consistency with the literature, findings from practice and the judgement of potential users. Nursing outcomes need further development. The data set will be tested in practice to find out whether the categories and items are useful, and whether they can be minimized.
Evaluating clinical supervision in community homes and teams serving adults with learning disabilities
Authors: Malin Nigel A.
Published: March 2003

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities

This paper provides a discussion of some of the professional and policy outcomes associated with implementing clinical supervision within a community service for adults with learning disabilities. It is based upon a small qualitative study whose aim was to examine how clinical supervision was operating, its strengths, its weaknesses and where improvements might be made. The study followed the introduction of clinical supervision 9 months earlier for nurses and carers employed in three community homes and one community multiprofessional team. The method consisted of direct observation of individual and group supervision and staff completing critical incident questionnaires, followed by semi‐structured, audio‐taped interviews with seven registered nurses and four community team members, including a social worker, psychologist and physiotherapist. Outcomes were expressed in two ways: in terms of the benefits of clinical supervision or of its ambivalence. The range of matters brought for discussion, or resolution, in supervision reflected some of the difficulties or dilemmas staff faced working in this area, for example promoting empowerment and assisting clients to make choices, and dealing with clients’ challenging and inappropriate behaviours. As for the role of supervisor there was some evidence of nurses expressing apprehension or unpreparedness, also a perceived general concern over the relatively low status of clinical supervision, thought to be due to absence of visible management approval or failure to articulate properly the objective of supervision. A limitation of the study was its small subject sample although considerable data were gathered in each of the units through relatively long‐term contact.
Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers
Authors: Arnetz Judith E. , Arnetz Bengt B.
Published: March 2003

Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers

The aim of this study was to implement and evaluate a practical intervention programme designed to help staff in health care work‐places to deal with patient violence towards staff. The programme was part of a controlled, prospective study that ran for 1 year. The study population was comprised of staff at 47 health care work‐places, randomly assigned to either the intervention or control group. The Violent Incident Form (VIF), a checklist designed to simplify the registration of violent events, was introduced at all 47 work sites, where staff were instructed to register all types of violent and threatening incidents directed towards them during the 1‐year study period. The intervention work‐places also followed a structured feedback programme, where the circumstances concerning registered incidents were discussed on a regular basis with work‐place staff. Baseline examination of the study groups revealed no statistically significant difference with regard to self‐reported violence in the past year. At the conclusion of the 1‐year period, the difference between groups was statistically significant (P < 0·05). Staff at the intervention work sites reported 50% more violent incidents than the control work sites during the year. Compared to the control group, intervention group staff reported better awareness: of risk situations for violence (P < 0·05); of how potentially dangerous situations could be avoided (P < 0·05); and of how to deal with aggressive patients (P < 0·05). Logistic regression analysis confirmed an increased risk for self‐reported violence in the intervention group post‐intervention (odds ratio 1·49; 95% confidence interval 1·07–2·06; P < 0·05). The structured feedback programme seems to have improved staff knowledge of risks for violence in the intervention group.
Illness narratives of persons with post‐polio syndrome
Authors: Wenneberg Stig , Ahlström Gerd
Published: March 2003

Illness narratives of persons with post‐polio syndrome

This qualitative study investigated the lifetime illness experience of individuals with the ‘late effects’ of polio or post‐polio syndrome. Fifteen individuals were interviewed twice about their illness experience and the interviews were transcribed verbatim. The empirical material first underwent a categorization process. The preliminary categories generated through this analysis were then condensed into broader categories which in the final analysis gave rise to the following temporal pattern or stages of the illness experience: (1) the acute phase of polio and subsequent treatment and care; (2) rehabilitation and care at institutions for the disabled; (3) adaptation to a new life; (4) living with the post‐polio syndrome today, and finally, (5) memories of the past and apprehensions concerning the future. In spite of the difficult experiences of falling ill and slowly recovering from a life‐threatening disease, these individuals have had a good life and accomplished most of their ambitions in the areas of work and family life. Their present psychosocial situation is complicated by the symptoms of the post‐polio syndrome which make them more vulnerable to stress, but they are able to handle this burden except when any added strain makes it overwhelming. This potential vulnerability may sometimes express itself as a sudden flashback to traumatic polio experiences and it is therefore important that nurses are aware of the illness history of this patient group.
Barriers to learning from reflection: a study of the use of groupwork with post‐registration nurses
Authors: Platzer Hazel , Blake David , Ashford Dorothy
Published: March 2003

Barriers to learning from reflection: a study of the use of groupwork with post‐registration nurses

There are few studies which describe the use of groups to facilitate reflection and even fewer which evaluate the effectiveness of such groups. Much of the literature discussing the techniques used to facilitate reflection suggests that learners willingly engage in such processes and find them enjoyable. This paper reports on a qualitative study of the use of groups to develop learning through reflection on a part‐time post‐registration diploma programme for nurses. The findings suggest that there are many barriers to learning which must be overcome before practitioners can use the opportunities to reflect on and learn from their experience. It is also contended that such learning may not necessarily be an enjoyable experience. The findings suggest that previous educational experience and the current culture in which nurses and midwives work, impose tremendous barriers to reflecting on, and learning from, experience. In particular these affect the willingness of learners to expose themselves to the judgement of others and their ability to be open to taking responsibility for their own learning. Other barriers to learning in groups are the effects of other group members, their commitment or resistance to shared learning, the ways in which group members interact with each other and facilitation styles.
An action research inquiry into a health visitor parenting programme for parents of pre‐school children with behaviour problems
Authors: Kilgour Christina , Fleming Valerie
Published: March 2003

An action research inquiry into a health visitor parenting programme for parents of pre‐school children with behaviour problems

Parent education programmes have recently been given a high profile in this country, such provision deemed necessary because of the commonality of children's behaviour problems and because of their potentially far‐reaching effects on the child, the family and society. This action research study, undertaken in Scotland, aims to explore a health visitor parenting programme for parents of pre‐school children with behaviour problems. Within this study, children with behaviour problems were identified as those whose parents perceived them to have such problems, the children eliciting a wide range of behaviours and to varying degrees. Critical social science is the chosen methodology, since it allows exploration of how people comprehend their social reality. Group interactions were recorded on audio‐tape and themes associated with the methodology of enlightenment, empowerment and emancipation were identified. The results of the study demonstrate how a liberating, collaborative approach to parental education can empower mothers, by increasing understanding and raising self‐esteem.
Moving on from interpretivism: an argument for constructivist evaluation
Authors: Walker Esther , Dewar Belinda Jane
Published: March 2003

Moving on from interpretivism: an argument for constructivist evaluation

This paper examines the research process in the context of an evaluation of work‐based learning. The findings of the evaluation are used to illustrate issues around roles and relationships within interpretivist research where a separation is maintained between the researcher, as investigator, and the participants, as the subject of their investigation. The discussion focuses on: the threatening nature of evaluation and the way in which that affects the process of inquiry and learning; the ways in which people's perceptions of research can act as barriers to the implementation of change; and the consequences of this role separation for practice development. In exploring these issues the paper argues for an approach to evaluation research which (a) emphasizes collaboration, (b) is orientated to change and (c) treats the evaluation process as a learning opportunity through which professionals acquire the skills and knowledge to investigate and advance their own practice.
How we live: participatory research with six people with learning difficulties
Authors: Richardson Malcolm
Published: March 2003

How we live: participatory research with six people with learning difficulties

Drawing from the Social Model of disability, six people with learning difficulties participated over 18 months in researching their own lived experiences. The method involved weekly group discussions supplemented by participant observation. The study’s value stems from in‐depth inquiry, which included the participants in the data collection, analysis, dissemination and consequences that they found meaningful. The participants lived in nurse managed community homes. They described how they had faced social and economic exclusion, for example, concerning marriage, child rearing and decently paid employment. With the assistance of nursing staff, the participants had overcome many other social barriers and were enjoying a wide range of activities and choices. Consequently, the participants lived varied lives which they described as interesting and worthwhile. Contemporary models of nursing had successfully directed nursing staff to support ‘ordinary living’. However, some disabling assumptions were evident within contemporary nursing. Hence, models of nursing and service delivery were helping both to create lifestyles that the participants valued, whilst simultaneously contributing to their disempowerment.
Critical care cardiovascular nurse expert and novice diagnostic cue utilization
Authors: Reischman Rosalyn R. , Yarandi Hossein N.
Published: March 2003

Aim.  Critical care cardiovascular (CCCV) nursing diagnostic expertise was the focus of this research. The purpose of the study was to compare diagnostic cue utilization between expert and novice CCCV nurses.

Background.  Knowledge related to objective measures of clinical nursing diagnostic expertise would enhance effective and efficient recognition, utilization, and reward of clinical expertise.

Methods.  Five CCCV written simulations served as instruments in the study. Diagnostic content areas included left ventricular dysfunction, cardiac tamponade, sepsis, right ventricular failure, and hypovolemia related to internal abdominal haemorrhage. The sample was composed of 23 expert and 23 novice nurses. After reading each simulation, subjects were asked to verbally recall the simulation, give an impression of the predominant problem or diagnosis, and give a diagnostic explanation. Verbal recalls were audio‐taped for protocol analysis. Diagnostic accuracy and cue utilization were determined through comparisons of subjects' recalled diagnoses and cues with results from an expert panel review consensus. The major variable was the mean recalled proportion of highly relevant cues to total cues (HRC/TC) on accurately diagnosed simulations. Chi‐square analysis revealed that diagnostic accuracy was greater with experts than with novices. Differences between and among simulations, expertise, accuracy and the mean proportion of highly relevant cues to total cues were examined with a 4 × 2 × 2 factorial analysis of variance.

Results.  When considering all accurately diagnosed simulations, experts had a higher HRC/TC than novices. The major limitations were the use of low fidelity written simulations and virgin verbal protocol methods.

Conclusion.  The findings generally support the idea that the development of diagnostic expertise is associated with the ability to focus on highly relevant cues.
Impact of urinary and climacteric symptoms on social and sexual life after surgical treatment of stress urinary incontinence in women: a long‐term outcome
Authors: Lalos Othon , Berglund Anna‐Lena , Lalos Ann
Published: March 2003

Impact of urinary and climacteric symptoms on social and sexual life after surgical treatment of stress urinary incontinence in women: a long‐term outcome

Aim.  The aim of the present study was to evaluate the long‐term results of surgical treatment of stress urinary incontinence (SUI) using both subjective and objective methods.

Background.  Few studies have focused on the influence of biological and social changes in a woman’s life on the long‐term outcome of surgical treatment of stress urinary incontinence.

Methods.
 The study included 45 women with genuine SUI treated with either retropubic urethrocystopexy (n=30) or puboccocygeal repair (n=15). The assessment included interviews, questionnaires, urinary diary, pad test, continence test and urodynamic investigation.

Results.
 The results were evaluated at intervals of 3 months, 1 year and 5–7 years after the treatment. One year after the surgical treatment 71% of the women in the urethrocystopexy group and 80% in the pubococcygeal repair group were subjectively cured, while 5–7 years after surgery the corresponding values were 43% vs. 60%. However, according to pad test a 67% of the women in the urethrocystopexy group and 47% in the pubococcygeal repair group had ceased to leak urine 1 year after the operation whereas at the long‐term follow‐up the corresponding values were 64% vs. 71%. According to the questionnaire at the long‐term follow‐up only 35% of the women in the whole group had genuine SUI whereas 21% had urge‐incontinence. Moreover, 37% experienced sweating, 23% flushing and 44% vaginal dryness. The number of women with adiposity had increased significantly (P < 0·001) at the long‐term follow‐up. Twenty‐eight per cent of the women decreased their activities whereas the majority experienced no impediment. Seventy‐nine per cent reported that they were sexually active and the majority reported satisfaction with their sexual lives.

Conclusions.  Accurate assessment of postoperative results of SUI demands rigorous recording of subjective and objective data taking into consideration psychological and social factors, otherwise there is a high risk of bias in the interpretation of the results of the treatment for SUI. This study indicates that, in order to give women with SUI adequate treatment the nursing care should comprehend the women’s divergent experiences of urinary incontinence and its impact on social and sexual life.
Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability
Authors: Richardson Anette , Adner Nils , Nordström Gun
Published: March 2003

Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability

Aims. The purposes of this study were to describe how persons with insulin‐dependent diabetes mellitus (IDDM) accept their disease and what sense of coherence they have, in order to determine whether a person’s acceptance of the disease is related to his or her sense of coherence. Whether acceptance of the disease and sense of coherence are related to the disease duration, complications of the disease, metabolic control and demographic data would also be determined.

Design. One hundred and seven, randomly selected, insulin‐dependent, diabetic subjects (47 men and 60 women) participated in the study. The Acceptance of Disability Scale Modified (ADM scale), the Sense of Coherence Scale (SOC scale), a study‐specific questionnaire and the patients records were used to collect the data.

Background. IDDM implies a major change in way of life. Ingrained procedures and patterns of behaviour must be adapted to the disease and its treatment.

Results. The results of the present study show that educational level seems to be an important factor for how well a person accepts the disease and the sense of coherence. Persons with higher scores on the ADM and the SOC scales had higher levels of education. Moreover, they also had a better metabolic control. Individuals with a poor metabolic control had more disease‐related complications. A significant correlation between the ADM and the SOC scores was found, indicating that persons with a high degree of acceptance of the IDDM also had a high coping capability.

Conclusions. It is important to individualize the care of subjects with IDDM and to identify the persons with low acceptance of their disease and a low sense of coherence.
Examining the process of community development
Authors: Lindsey Elizabeth , Stajduhar Kelli , McGuinness Lisa
Published: March 2003

Aim of the study. To present the results of evaluation research investigating a successful community development project.

Rationale. Many governments, health care agencies, and organizations require community participation in health care. As a result, nurses and other health professionals are often required to practice using a philosophy of community development. Although the theoretical, philosophical, and practical components of community development are well articulated, there is little evidence that exemplifies the experience of initiating and participating in a community development project. This paper provides evidence of how one organization successfully engaged the broader community on a respite care project.

Method. Using qualitative research methods and guided by the principles and practices of participatory action research, this evaluation engaged with the community in data collection, analysis, dissemination of finding, and in promoting effective change.

Results. Four themes emerged that provide insight into how one HIV/AIDS organization successfully undertook community development. These themes include: (a) identifying a community need; (b) addressing the various components identified in the community development process; (c) highlighting the strategies used to engage in successful community development; and (d) attending to factors that influence community development.

Conclusion. The results of this research contribute to the body of knowledge related to engaging in the process of community development. By highlighting the experiences of one community group, it is hoped that nurses can learn and incorporate this knowledge into practice.
Examining the effects that manipulating information given in the change of shift report has on nurses’ care planning ability
Authors: Dowding Dawn
Published: March 2003

Examining the effects that manipulating information given in the change of shift report has on nurses’ care planning ability

Aim of the study. To investigate the effect that manipulating the style and content of the nurse change of shift report had on an individual’s ability to plan patient care.

Background. The nurse change of shift report occurs on most hospital wards at least two if not three times a day. However, little research exists examining how changing the style and information content of the shift report may affect an individual’s ability to process the information they hear. It is suggested that how individuals structure their knowledge, in the form of schema, is an important consideration when examining how they process information.

Design. This was an experimental study where two independent variables, report style (retrospective vs. prospective) and schema information (schema consistent vs. schema inconsistent) were compared in a factorial design. A convenience sample of 48 registered nurses from acute medical and acute surgical wards were randomly allocated to one of the four experimental conditions. Outcome measures included the amount of information that subjects accurately recorded and recalled from the shift report, together with their ability to plan patient care.

Results. Results indicated that the type of report had a significant effect on an individual’s ability to plan patient care, and type of information content on their ability to accurately record and recall the information they heard.

Conclusions. The implications of the results, both for schema theory as an explanation of nursing knowledge, and for the type of report which should be used in acute medical and acute surgical wards are discussed, together with the implications of the study for further research.