bluuebunny/crossref_metadata_2025 huggingface dataset:
Token economy in a hospital rehabilitation system
Authors: Baker Roger
Published: December 2006

A ward‐based token economy programme which formed one part ofa larger rehabilitative serviee for long‐stay psychiatric patients is described. The elinical effectiveness ofthe programme is examined by the use of various nursing, psychological and psychiatric assessments before and after the patients' treatment on the ward, and the progress of former patients is foliowed‐up as they move to different parts ofthe rehabilitation service. Significant clinical gains in patients' psychiatric symptomatology and problem behaviour on the ward are reported, although there were indications that improvement was not fully maintained as the patients moved on to other parts ofthe service. Comparison ofthe present clinical programme with the earlier research programmes on the ward indicated that the present regime was superior. The advantages and problems of token economy as a rehabilitative facility are discussed, outlining the various different roles for token economy with psychiatric rehabilitation. Finally, the future of token economy for long‐stay patients is considered, questioning whether it might more appropriately be replaced by other structured ward programmes.
Improving recovery following cardiac surgery: a randomized clinical trial*
Authors: Gartner Susan R. , Gilliss Catherine L. , Shinn Julie A. , Sparacino Patricia A. , Rankin Sally , Leavitt Maribelle , Price Martha , Hudes Mark
Published: December 2006

To enhance individual and family health during recovery from heart surgery, this study employed nursing interventions based on self‐efficacy and family stress theory during the hospitalization period and for 3 months thereafter. The effectiveness of the interventions were assessed through a randomized trial in which 67 prospective bypass and valve surgery patients, aged 30‐77 years, and their spouses, were allocated either the experimental interventions or usual care and followed for 6 months. At 3 months post‐surgery, the only statistically significant differences between the experimentals and controls were on perceived self‐efficacy for lifting and tolerating emotional distress. At 6 months no significant differences were found on individual or family measures. Analyses revealed that age, gender and preoperative cardiac status significantly affected individual recovery. The study is continuing with a larger sample in order to explicate the recovery process and to better determine whether a low intensity nursing intervention can effect changes in individual and family recovery.
Stress factors, emotional stress and rheumatoid arthritis disease activity
Authors: Crosby Leanna J.
Published: December 2006

The purpose of this study was to determine the relationship between stress factors, emotional stress and rheumatoid arthritis (RA) disease activity. Subjects (n= 101) confirmed to have RA completed the Daily Hassles Scale (DHS) to identify daily stress factors and the State/Trait Anxiety Inventory (STAI) as well as a visual analogue (VA) to measure emotional stress levels. The investigator evaluated RA disease activity (RADA) and erythrocyte sedimentation rate (ESR). Pearson product‐moment correlation was used for statistical evaluation. A statistically significant, positive correlation was found between RADA and both measures of emotional stress; STAI r2= 0.16, VA r2= 0.25, P < 0.01. Utilizing a psychophysiological feedback loop model, it was hypothesized that emotional stress levels and RA disease activity each served as a driving force and a consequence, i.e. as emotional stress levels increased, RA symptoms intensified and, likewise, as RA symptoms intensified, emotional stress levels increased. Nursing interventions were identified which possibly would reduce emotional stress levels, and thus, perhaps, decrease the incidence and /or severity of RA disease activity.
Nursing care as a moral, practical, communicative and creative activity
Authors: Sarvimäki Anneli
Published: December 2006

In this paper nursing care is studied by philosophical inquiry. According to the outlined philosophical theory, nursing can be conceived as a moral, practical, communicative and creative activity. This means that nursing care is viewed as a manifestation of a conception of the good life, that it is related to some kind of changes or non‐changes with respect to the patient, that it is oriented towards reaching understanding and that something new, unpredictable and meaningful is created in the nursing interaction. The theory is defended by scientific, moral and practical arguments. Habermas' theory of communicative action plays a central part in the outlined theory of nursing care.
An investigation of anxiety following termination of pregnancy
Authors: Llewelyn S. P. , Pytches R.
Published: December 2006

This study reports the results of an investigation into the immediate effects of termination of pregnancy on levels of anxiety experienced by a group of 21 women, half of whom had supportive partners, and the other half of whom did not. Subjects were interviewed and administered the Spielberger State‐Trait Anxiety Inventory within hours of their operation, and the scores for the two groups were compared. Results indicated that support of a partner was the best predictor of state, but not trait anxiety, and that state anxiety was the only variable which distinguished the women with supportive partners from those without supportive partners. Implications for the provision of immediate post‐termination counselling support are discussed.
How hospital ward members treat learner nurses: an investigation of learners' perceptions in a British hospital
Authors: Hyland Michael E. , Millard Jenny , Parker Shaune
Published: December 2006

Twenty‐five learner nurses who had just completed their first two wards were questionned about the behaviour of other ward members towards them. Although many ward sisters’ and charge nurses’ behaviour was positive towards learners, just under 50% of learners’ responses indicated that the ward sister/charge nurse was sometimes rude and did not make them feel ‘at home’. The ward sister/charge nurse's behaviour was, on average, more negative than another liked qualified staff, whose behaviour was more negative than a more experienced student on the ward. The ward sister/charge nurse's behaviour was the major determinant of ward preference by the learner. However, the behaviour of ward members tended to correlate, providing evidence of a ‘ward atmosphere’. There is a need for leadership and educational training for ward sisters and charge nurses.
Indwelling catheterization and related nursing practice
Authors: Crow Rosemary , Mulhall Anne , Chapman Robert
Published: December 2006

A survey of patients with an indwelling urethral catheter was conducted over a 14‐day period in five randomly selected district general hospitals in England. The demographic characteristics of the patients and the types of catheter and urinary drainage bags used were recorded. Observational techniques were used to describe nursing care during meatal cleansing and bag emptying Over the 14‐day study period 294 patients were catheterized giving an overall daily incidence of catherization of 11·2 per 1000 of the average daily population. Nurses inserted over 50% of catheters and subsequently maintained all closed urinary drainage systems. The closed system was broken for 42% of patients and only 48% of drainage bags were always observed in the correct position. Techniques aimed at preventing infection were observed more frequently when meatal cleansing was performed separately from daily hygiene. The frequency of hand washing, both before and after meatal cleansing and bag emptying, was low. It is concluded that the procedures and practices involved in the care of the urinary drainage system require re‐evaluation and re‐emphasis.
Writing behavioural objectives: an evaluation of a simple, inexpensive method
Authors: Sturmey P. , Newton T. , Crisp A. G.
Published: December 2006

This study demonstrated experimental control of nurse compliance with writing behavioural objectives in a National Health Service adult training unit for mentally handicapped adults. At the baseline, low rates of compliance in writing complete behavioural objectives (i.e. an objective referring to a resident, an action, a prompt and a target) were identified. A simple environmental manipulation, namely redesigning the activity charts, led to an increase in writing complete behavioural objectives. Experimental control was demonstrated using a multiple baseline design across two groups of staff. Nurse compliance with writing adequate prompts and targets was less than compliance with writing names and behaviours. Greater degrees of compliance may require alternative methods of staff management such as feedback procedures.
Professionalization—or struggle for survivalquest; A consideration of current proposals for the reform of nursing in the United Kingdom
Authors: Salvage Jane
Published: December 2006

Should the current proposals to reorganize nursing work and training in the United Kingdom be understood as part of a strategy of professionalization? Traditional sociology and traditional nursing historiography tend to regard professional status as a natural occupational goal, and the widespread use of the rhetoric of professionalism in nurses' own writings and speeches would seem to endorse this. However, more recent work which uses empirical studies rather than secondary accounts and adopts different starting points is offering new perspectives. The documents proposing reform should perhaps be viewed more fruitfully as a struggle for survival through the evolution of a new occupational model, rather than as a covert quest for traditional professional status.
A follow‐up of the graduates of the 3‐year post‐registration Bachelor of Nursing degree course in the University of Wales
Authors: Bircumshaw Denise , Chapman Christine M.
Published: December 2006

This paper considers several aspects of the graduates of the 3‐year Bachelor of Nursing course at the University of Wales College of Medicine. These include career progression, perceptions of the usefulness of aspects of the course, and the reactions of others to the fact that they have a degree. Information was elicited by a postal questionnaire which is administered annually to all graduates. The findings of the study are clearly limited due to a small sample size. They do, however, indicate that the graduates of the course so far have stayed in nursing posts, largely in teaching and administration, and the loss to the profession has been extremely small. Overall, the graduates found many aspects of the course very useful to posts held, and experienced various reactions of other professionals to the fact that they had a degree. Due to the relatively short time that this course has been in existence and the fact that the first groups were very small in number, the findings of the study merely suggest trends in the career patterns and perceptions of graduates which need to be continually monitored before statements can be made with confidence. They do, however, have implications when considering the function and contribution of these nurse graduates to the nursing profession.
Health assessment of the elderly at home: the case for shared learning
Authors: Runciman Phyllis
Published: December 2006

This paper reports findings from a collaborative research project (Buckley & Runciman 1985) which examined, using video studies and questionnaires, the scope and content of health assessment of old people at home and the views and feelings of different groups of health professionals towards visiting old people at home The study sample included student and experienced health care workers and a number of elderly people, seven professional groups were represented A prompt list summarizing key content of health assessment was devised and tested in field studies in two primary health care teams Views and feelings about visiting old people are presented under four headings priorities and preferences, skills and training, work organization and the team, and the feelings and rights of the elderly themselves Educational recommendations from the study are made and the case for shared learning in relation to health care of old people is presented
Intracranial pressure monitoring: a study of nursing practice*
Authors: Allan Douglas
Published: December 2006

Differences exist within neurological centres with regard to the care of the patient with an ICP monitoring device in place A survey earned out to identify these differences shows that head injury remains the most common diagnosis associated with ICP monitoring and intraventricular catheters the most popular method, although the use of catheter tip pressure transducers appeared to be on the increase Some centres used more than one method The type of machinery used to process the data varied enormously Written guidelines or standards existed in only a few centres and none of these fully covered every aspect of care as quoted in the literature Many units appeared to rely on in‐service or one to one teaching situations with new or learner staff being supervised initially Some centres restricted the type of nurse who was permitted to care for these patients Unfortunately, the restrictions were not clearly identified Calibration of equipment was not considered a nursing procedure but some respondents felt that it should be
The social bases of discrepancies in health/illness perceptions
Authors: Molzahn Anita E , Northcott Herbert C
Published: December 2006

Health care professionals generally assume that their perceptions and assessments of their patients' health status are accurate and are congruent with those of the patient and other health care providers However, despite the patient education process, there is evidence that discrepancies in perceptions persist These discrepancies are of particular concern to nurses because they may interfere with the provision of quality patient care Poor communication, non‐compliance with the treatment regimen, inadequate or unnecessary treatment, and ethical problems could be outcomes of discrepancies in perceptions In this paper, the literature pertaining to discrepancies in health/illness perceptions is reviewed As well, several social factors that may affect perceptions are described These include cultural background, gender, socioeconomic status, experience and role The effect of occupational role on health/illness perceptions has not been examined systematically Regarding differences in perceptions of physicians, nurses and patients, further research is required to clarify and explain the nature of discrepancies in health/illness perceptions
Integrating nursing theory, practice and research through collaborative research
Authors: Denyes Mary Jean , O'Connor Nancy A , Oakley Deborah , Ferguson Sharon
Published: December 2006

The advancement of professional nursing requires integration of theory, practice and research One realistic mechanism to achieve this integration is collaborative nursing research A collaborative experience between clinical nurse specialists and faculty researchers is described and evaluated The collaborative research project focused on contraceptive nursing care and self‐care conceptualized within Orem's theory A major finding was that while job titles and settings of the participants differed markedly, role components were not disparate, rather, they were compatible and complementary The collaborative project strengthened both the theory base for a primary care nursing practice and the practice base for faculty research and theory development efforts
Teaching microcomputing to student nurses: an evaluation
Authors: Coates Vivien E , Chambers Mary
Published: December 2006

This paper describes an introductory computer course designed for student nurses facing a career in nursing in which computers will play a major part Questionnaires were given before and after the course The purpose of the questionnaires were (a) initially to gain information about the students' previous computing experience, motivation and expectations of the course, and (b) to enable an evaluation to be undertaken The course content, structure and results of the questionnaires are presented, modifications made to the course following the evaluation are mentioned and finally some of the issues which need to be considered when developing a computer course for nurses are raised
The experience of caring
Authors: Forrest Darle
Published: December 2006

Caring is inextricably bound to the belief system and practice of nursing Yet there is a lack of research on what caring is for the practising nurse It was the purpose of this qualitative study to investigate the phenomenon of caring with 17 hospital staff nurses who, in taped sessions, described their subjective experiences of caring Phenomenology, an inductive descriptive research method, was used with the data analysed according to Colaizzi's procedure Thirty theme clusters, emerging from specific themes, fell into seven categories under two broad classifications,‘what is caring’ and ‘what affects caring’ The essential structure of caring is described and implications for nursing education, practice and research discussed
Health care and the quality of life: a review
Authors: Holmes Colin A
Published: December 2006

The increasing requirement for evaluation of health care, either for purposes of quality assurance or deciding resource distribution issues, has brought into question a number of ideas concerning the aims of the health care enterprise This article suggests that the ultimate aim is to improve the quality of life, and examines the feasibility of adopting this as an evaluation criterion Difficulties concerning the concept and definition of the quality of life are outlined, and a plea made for the adoption of the broadest possible therapeutic aims Social indicators and subjective evaluations are considered in turn as measures of the quality of life, and their inadequacies and strengths exposed Relationships between the measures are discussed, and their uses outlined It is finally suggested that nurses should participate in the formulation of quality of life concepts and evaluations which reflect the values which underpin their own practice
Effects of information to patients undergoing intravenous pyelography: an intervention study
Authors: Hjelm‐Karlsson Kerstin
Published: December 2006

This paper reports on the outcome of nursing intervention consisting of information‐giving to patients about to undergo a threatening medical event (intravenous pyelography) Thirty patients in an intervention group were given structured information on all aspects of the examination (sensory, procedural and temporal components, and a coping mechanism) Their reactions to the event as recorded in self‐reports were compared with those of 30 patients who did not receive such information (control group) No differences were found between the groups regarding physiological reactions to the stressful event, but there were dear and partly significant differences in the psychological outcome variables Less pain and discomfort were experienced during intravenous pyelography in the intervention group and the subjects of this group were better able to form mental images of the impending event
Staff nurses' attitudes toward nursing research: a descriptive survey
Authors: Bostrom Andrea C. , Malnight Margaret , MacDougall John , Hargis Dianna
Published: December 2006

Staff nurse involvement in clinical nursing research is dependent on the attitudes nurses hold toward research. An exploration of these attitudes was undertaken in a 464‐bed midwestern teaching hospital as it developed its nursing research procedures. A questionnaire was developed which incorporated the Boothe Attitudes on Nursing Research Scale. All registered nurses (n= 925) at the facility were surveyed with a response rate of 77.8% (n= 720). Findings indicated that many nurses were interested in research and believed that the institution would support research activities and the implementation of research findings. Some deterrences to conducting research included: time, lack of knowledge, and the nurses's perception of the supervisory support and the research support services.
Knowledge and perception of AIDS among Canadian nurses
Authors: Armstrong‐Esther Chris , Hewitt W.E.
Published: December 2006

Within the growing literature on AIDS, relatively little attention has been paid to the public's knowledge and perception of the disease. Even less is known about nurses’ understanding of, and attitudes towards AIDS, even though in large part, the treatment and care of AIDS patients rests in their hands. As a partial corrective to this deficiency, this study offers a comparative examination of AIDS‐related beliefs and attitudes held by nursing practitioners and nursing students in Canada. Briefly stated, what the research reveals is that Canadian nurses are less than fully informed about the disease and have over‐cautious attitudes towards the care of AIDS patients. Among nursing students, lack of information is also a serious problem, although this group does tend to view AIDS patient care in a somewhat more liberal manner. It is apparent from these results that more attention needs to be paid to enhancing knowledge of, and changing attitudes towards, AIDS in the education of Canadian nurses.
The menopausal hot flash: a procrustean bed of research
Authors: Levine‐Silverman Stacey
Published: December 2006

There are several scientific researchers from a variety of academic disciplines investigating the menopausal hot flash (MHF). Synthesis of all MHF research findings results in contradictory and inconclusive information available to health care providers and perimenopausal women. This study used epistemological construction and hermenuetical understanding to explore this information problem. Specific MHF exemplars, the problem‐solutions, were constructed from extant scientific literature; two models of health guiding MHF research were generated from these exemplars. These models, health as a shared and communicable experience and health as a medical‐physiological concept, provided a focus for hermeneutical understanding of the MHF information problem. Cooperative‐collaborative inquiry was proposed as an approach for future MHF research.
The competencies expected of first‐line nursing managers — an Australian context
Authors: Duffield Christine
Published: December 2006

The purpose of this State‐wide study was to identify the most important competencies expected of first‐line nursing managers. A list of 168 competencies was compiled from the literature and submitted to a panel of 16 expert nursing administrators and academics whose task it was to identify and rank in order the 20 most important of these.
Some ambiguities of the student's role in Undergraduate nurse training
Authors: Ashworth Peter , Morrison Paul
Published: December 2006

Proposed changes in the way in which nurses are educated and trained will lead to stronger links between the academic and practical worlds of nursing. However, little or no attention has been focused on the potential difficulties associated with such a move for the student in this new and changing role. Important ambiguities of the student's role need to be addressed if the degree nursing student is to make the most of available opportunities for learning. In this paper we draw a distinction between two kinds of ambiguity in the role of nursing degree student during clinical placements. The first type is essential to the very nature of degree education in nursing, since the ambiguities here all entail problems in bridging the gap between the world of practical nursing and that of education. They include whether he or she is to regard the role as one of learner or producer of work; whether to become unreflectively acculturated to the organization or to reflect on its norms and values; and the student function within the organization. A second kind of ambiguity is not essential to nurse education, but is an unintended consequence of placement arrangements. The student is thrust into the clinical field as a short‐term member of an organization; their position is anomalous and the motive for their involvement is largely different from that of permanent employees. These ambiguities of the role are also the source of important learning opportunities.
Changes in national child health care policies and their effects on the public health nurse's work in child health care in Finland
Authors: Lauri Sirkka H.
Published: December 2006

The purpose of this study was to clarify the public health nurse's work and decision‐making process in child health care during the years 1976‐1986. The first study was carried out in 1976 and a subsequent one in 1986. The population of both studies consisted of public health nurses working in child health care centres. During these years many reforms were implemented in national child health care policy. According to the results of the 1986 study the public health nurses used the decision‐making process, as a whole, better than in the study of 1976. The content of the health care they provided had become more varied.
A comparison of nurses’ and patients’ perceptions of intensive care unit stressors
Authors: Cochran Jane , Ganong Lawrence H.
Published: December 2006

This study was designed to compare intensive care unit (ICU) nurses’ and patients’ perceptions of the stressfulness of items in the environment for patients in an ICU. The sample consisted of 20 ICU patients and 23 registered nurses employed in the medical and surgical ICUs at a large midwestern university hospital. The patients were contacted 1 to 2 days after transfer from an ICU and asked to complete the Intensive Care Unit Environmental Stressor Scale (ICUESS), a Likert‐type questionnaire designed to measure the stressfulness or commonly occurring items in the ICU environment. The nurses were asked to complete the same questionnaire as they believed an ICU patient would complete it. They were asked to complete the questionnaire after the completion of a shift worked in an ICU. A series of one‐way ANOVAs were done to compare the patients’ and nurses’ responses. In every comparison, nurses rated the items as being significantly more stressful than did the patients. Items with the highest mean ratings by patients were: (1) having tubes in your nose or mouth; (2) being stuck with needles; (3) being in pain; (4) not being able to sleep; and (5) being thirsty. Patients and nurses also were asked to list the three most stressful items from the ICUESS. These responses were compared using chisquare tests for homogeneity. Nurses mentioned ‘being tied down by tubes’ and ‘not being in control of oneself’ significantly more times than did patients. The items ‘being in pain’, ‘having tubes in your nose or mouth’, and ‘not being able to sleep’ were listed most often by both nurses and patients.
Mothers' working models of infant feeding: description and influencing factors
Authors: Pridham Karen F. , Berger Knight Catherine , Stephenson Gordon R.
Published: December 2006

This study examined four aspects of mothers’ working models of infant feeding: (1) infant behaviour that cues feeding decisions; (2) infant self‐regulative behaviour; (3) importance of infant self‐regulative behaviour and maternal effort directed to it; and (4) maternal effort and value given to task‐oriented and efficient feeding. The relation of these aspects to maternal experience, age, formal education, family income, and feeding method was also explored. Subjects were 122 mothers of healthy, term infants between 14 and 60 days old. A telephone interview obtained demographic and attribute data and assessed the four aspects with 30 scaled items. Crying before and sleepiness during feeding were relatively compelling cues for maternal action. Most mothers gave only moderate ratings to the importance of infant self‐regulative behaviour and to task‐oriented and efficient feeding. Parity and feeding method affected response to specific items, with primiparae more concerned about length and regularity of feedings. Mothers who bottle‐fed their infants were more concerned about maintaining a feeding once initiated than mothers who breast‐fed their infants. Four‐factor analysis yielded two item clusters with good internal consistency: Cluster a. Maternal Effort to Accomplish Feeding Goals; and Cluster b. Importance of Infant Self‐Regulative Behaviour.

Cluster a. and b. were strongly correlated. Feeding method influenced both clusters, and the interaction of parity and feeding method had an effect on Cluster a. Mothers with lower family income had higher scores on Cluster b; multiparae with lower family income on Cluster a. How and when infant self‐regulation develops as a goal is a question in need of study.
The Verbal Protocol: a research technique for nursing
Authors: Jones Jennifer A.
Published: December 2006

This paper discusses the Verbal Protocol technique as presently used in the fields of psychology and computer sciences. It proposes that the technique is an appropriate design tool for studying clinical reasoning in many nursing contexts. An example is given, taken from a pilot study of a larger research project, of the use of the technique to demonstrate the nurse's thinking while assessing patient problems. Results show that the Verbal Protocol technique can reveal useful information concerning problem diagnosis in nursing and has the potential for further research into the cognitive behaviour underlying other stages of the nursing process.
The functioning of nursing routines in the management of a transient workforce
Authors: Procter Susan
Published: December 2006

Project 2000 recommends supernumerary status for learner nurses This recommendation is derived, in part, from research into the educational effects of the current organization of nurse training However, little research appears to have been undertaken into how the current training programme influences the organization and implementation of patient care The research from which this paper is taken, addresses this question It demonstrates that the allocation of learners to wards gives rise to an unstable and transient workforce Currently, ward sisters and charge nurses are expected to plan and be accountable for care given This research suggests that nursing routines provide qualified nurses with a method for maintaining control, stability and accountability for the care given by an unqualified and everchanging workforce It is suggested, therefore, that the promotion of individualized care in nursing requires a reduction in dependence on the transient workforce which results from including learners in the staffing establishment of hospital wards
Bacteriuria and urinary incontinence in aged female nursing home residents
Authors: Whippo Christina C , Creason Nancy S
Published: December 2006

Although urinary incontinence (UI) is ldentified as a symptom of urinary tract infection (UTI), the incontinent elderly frequently are not treated for UTI unless clinically significant manifestations are present The purpose of this research was to identify vanables that may be associated with bactenuna m the female person who is already known to be incontinent A sample of 65 incontinent female nursing home residents was divided into three groups (1) those with negative urine screens, (2) those with a bacterial count of over 100 000 per ml of urine, and (3) those with a bacterial count of below 100 000 per ml urine Vanables examined were (1) physical symptoms, (2) physical examination findings, (3) mental status, and (4) functional abilities Significant group differences were found regarding awareness of the urge to void and ability to hold urine A near significance finding suggested that the higher the level of cognitive function the less likely the presence of UTI There was some evidence to suggest the higher the level of independence the less likely the presence of UTI Recommendations for nursing practice and future nursing research are made
Management behaviour of one commimity health nurse supervisor
Authors: Field Peggy‐Anne , Larsen Jenniece
Published: December 2006

Mintzberg's theoretical framework of management, which examines the roles and functions of a manager in relation to effective communication, is used to analyse observational data of managerial conflict within a community health setting In this setting the manager failed to establish sound interpersonal relations with her peers or with the clinic nurses This led to a poor information base from which she could make decisions The result was that the group became stressed and developed signs of disintegration
Chinese whispers: the folklore of community psychiatric nursing manpower planning targets
Authors: White Edward
Published: December 2006

The relatively recent establishment of manpower planning targets for community psychiatric nursing services in England are traced to their origins in 1976 The original mathematics are reworked and differences are found Methodological and substantive issues which flow from the findings are discussed, both in relation to post‐basic nurse education in general and for future planning of community psychiatric nursing in particular Future research directions are suggested
District nursing, the disabled and the elderly: who are the black patients?
Authors: Cameron Elarne , Badger Frances , Evers Helen
Published: December 2006

Community care research in central Birmingham has shown that disabled and old black people are under‐represented on thecaseloads of distnct nurses compared to their white counterparts Whilst factors suggested as contributing to this (service ethnocentnsm and general practitioners as ‘gate‐keepers’) are discussed elsewhere, this paper focuses on those few old and disabled black people who are distnct nurse patients Following comparisons between these black and white patient groups, the differing perspectives of black patient and distnct nurse are explored Stereotypes and myths, knowledge about each other and language/communication are discussed as important areas which may disadvantage black patients in their interaction withdistrict nurses Attention is drawn to the urgent need for distnct nursing to address the issue of black disabled and old people in the community and the accompanying central role of research
Sources of satisfaction and stress in nursing home caregivers: preliminary results
Authors: Cohen‐Mansfield Jiska
Published: December 2006

A study of nursing staff on two units of a long‐term nursing facility examined their reasons for enjoying and disliking their jobs, and daily reports of positive and negative events experienced along with their rating of the emotional intensity of those events Each of the 30 members of the nursing staff responded to a brief demographic questionnaire The nursing staff expressed strong positive attitudes towards their jobs They described a wide range of concerns, both positive and negative, relating to institutional, unit management, and direct patient care issues The mean intensities associated with positive and negative events at each of the areas of concern were above 7 5 on a 10‐point scale (10 = highest intensity), with the exception of the intensity of negative events at the patient level (mean = 62) The intensity for positive events at the patient level was among the highest (mean = 92) The difference between the two means at the patient level suggests that nursing staff have adjusted to their work by focusing on positive patient events and by tempering their reaction to negativepahent events
Spinal cord injured adolescents and young adults: the meaning of body changes
Authors: Dewis Marilyn E
Published: December 2006

Spinal cord injury primarily affects those aged 15 to 29 years, and thus the injury occurs at a time when critical developmental tasks are being confronted Not only may normal development be disrupted, but this age group may lack the life expenence required to cope with the enormity of the multiple sequelae of the injury The literature suggests that psychological adjustment to any disability is particularly difficult for adolescents and young adults, and that, as yet, psychosocial problems are minimally acknowledged in rehabilitation treatment programmes This preliminary study of 15 young people with recent spinal cord injuries had two purposes to describe the meaning of body changes from the perspective of the injured persons and to describe the strategies they used to respond to the changes The researcher conducted intensive interviews with the participants These interviews were transcribed verbatim, analysed and interpreted It was found that the behaviours of the subjects focused on a concern with feeling normal and being valued, and the use of deliberate strategies that helped to engender positive feelings in this regard Efforts to normalize were consistently seen in three areas physical appearance and function, physical and emotional independence, and social skills and interpersonal relationships The means used to maintain normalcy were ingenious and resourceful, and were, for the most part, developed by the subjects without direction from their caregivers. From the accounts given by the participants, numerous nursing implications can be drawn for assessment and intervention in the early post‐injury period that may help promote optimum rehabilitation
Action research: philosophy, methods and personal experiences
Authors: Webb Christine
Published: December 2006

This article discusses the philosophical basis of action research and the methods by which it may be earned out These are related to a ward development action research project, and the initial phase of this project is discussed Methodological and ethical issues arising during the project are considered, and themes emerging from the data are analysed The action researcher's personal experiences and feelings about being involved in the study are discussed, and this reflexive aspect is drawn together to suggest implications for the next and ‘action’ stage of the project
The nursing preparation of stoma patients for self‐care
Authors: Ewing Gail
Published: December 2006

The changes brought about by stoma surgery require that patients re‐learn self‐care skills with regard to elimination This is accomplished as an integral part of postoperative nursing care In this paper, some of the findings of a study are presented on the nursing preparation of stoma patients for self‐management of their appliance The observations made showed that, even at the end of their postoperative period in hospital, the patients in the study were receiving considerable nursing assistance in the management of their appliance and had not demonstrated new self‐care skills for all aspects of the physical care of the stoma It is concluded that these findings highlight a need to examine the methods of preparation for self‐care of stoma patients in hospital, as containment rather than control of elimination remains a key issue in their rehabilitation
Nursing and caring: a personal construct theory study of some nurses' self‐perceptions
Authors: Momson Paul
Published: December 2006

This report outlines the results of a survey of trained nurses' perceptions about themselves as professional carers Twenty‐five nurses of charge nurse grade were interviewed using Kelly's personal construct theory and repertory grid technique Nurses were asked to elicit eight bipolar constructs and to rate eight elements, including a ‘myself as a carer’ element and an ‘ideal self as a carer’ element, on a seven‐point rating scale A simple difference score was calculated to measure the degree of discrepancy between these two elements Observed differences were assumed to be indicative of the need for personal change Differences emerged for each of the 25 informants Some possible explanations for these findings are provided, in particular the personal cost of caring for the carer is emphasized Further research in this area must take account of this new finding
Research ethics and nursing science: an empirical example
Authors: Leino‐Kilpi Helena , Tuomaala Ulla
Published: December 2006

In recent years scientists and scholars have been paying increasing attention to the problem of research ethics Ethics are always basically to do with values, with what is right and what is wrong In the present study ethics are considered as a self‐critical approach to the solutions made in the course of the research process The aim is to identify those points in the research process where ethical problems assume central importance One such point is the treatment of human subjects in the field of nursing science there are certain special requirements that must be taken into consideration because here we often use the clients of the health care system as our main source of information Following the theoretical discussion, we present an empirical example of the treatment of ethical problems in theses produced by Finnish nursing science graduates
Expressed emotion and nursing the schizophrenic patient
Authors: Bryan Roger , Simpson Charles
Published: December 2006

The findings from the family studies of schizophrenic family members' readmission (which coined the term ‘expressed emotion’ to explain why some families have members who need readmission more often than others) are related to a variety of areas of psychiatric nursing research, including nurses' attitudes, nurses' behaviour, ward atmosphere, institutionalization, social therapy, and patient outcome This follows the Berkowitz & Heinel report that psychiatric nurses at one hospital behave like the families that have lower readmission rates A strategy for further research of psychiatric nurses ‘expressed emotion’ is proposed, in relation to the course and outcome of schizophrenic patients' hospitalization
The nursing auxiliary service and the care of elderly patients
Authors: Badger Frances , Cameron Elaine , Evers Helen
Published: December 2006

Although nurse auxihanes cornpnse a large and rapidly expanding part of the distnct nursing service, nursing research has largely neglected this group of nurses and the people they see Using a patient‐centred approach, which is a key element of the research, we studied the characteristics of patients who were either physically handicapped, frail elderly or elderly mentally infirm, who make up a large majority of the patients We found that auxiliaries' patients fell into a typical ‘at risk’ group, they were older and more likely to be living alone than qualified nurses' patients, and yet they received less frequent visits Motives for providing and continuing the service to patients were not always related to nursing need, and while recipients were grateful for the service, both they and auxihanes themselves identified areas of potential improvement The need to continue to monitor and improve the overall quality, effectiveness and efficiency of the service to patients and potential patients, demands that practitioners, managers and researchers systematically review referral to the service and the work of the nurse auxiliary using a patient‐focused approach
Comparative analysis of the perceptions of patients and nurses about the importance of nursing activities in a postpartum unit
Authors: Morales‐Mann Erlinda T
Published: December 2006

The perceptions of patients and nurses about the importance of nursing activities in a postpartum unit were measured by questionnaire This pilot study examined the following aspects how important particular nursing activities are to the consumer in a postpartum unit, the importance assigned to particular nursing activities by the nurse in actual practice compared to the importance the nurse would hke to give to these nursing activities, the reasons for the difference between the importance ratings assigned to the nursing activities by the nurse in actual practice and what the nurse would like to give It was hypothesized that there would be no significant difference between the importance ratings assigned by the patients and the nurses It was also hypothesized that there would be no significant difference between importance ratings assigned by the nurse in actual practice from what she would like to assign The null hypothesis was rejected relevant to several nursing activities in both cases The reasons given by the nurses for the difference in ratings is discussed The observations of patients are reviewed and possible explanations for the incongruence between importance ratings are examined Results provide some direction for improving nursing care in the postpartum area
The effects of training and social orientation on attitudes towards psychiatric treatments
Authors: Clarke Liam
Published: December 2006

The literature relating to psychiatric nurses' attitudes towards treatment is reviewed and a study reported which (a) compared the attitudes towards treatment of 51 trainee psychiatric nurses at different points in their training (in their first year, in their second year, and in their third year) using the Attitudes to Treatment Questionnaire (ATQ) revised by Caine et al, and (b) investigated the relationship between conservatism/radicalism as measured by the Wilson‐Patterson Attitude Inventory (WPAI) and attitudes towards treatment The results indicated that the groups differed significantly in their attitudes towards treatment, the first year group being significantly less liberal, having a more physical attitude towards treatment, than the second and third year groups Overall there was no significant correlation between conservatism and attitudes to treatment found However, there was a highly significant correlation between these two variables for the third year group of students For this group, higher conservatism scores were associated with less liberal attitudes to treatment The implications of these findings are discussed and suggestions made for further research
District nurses' patients — issues of caseload management
Authors: Badger Frances , Cameron Elaine , Evers Helen
Published: December 2006

Current pressures on all community services mean that practitioners must give more detailed attention to evaluahon of patient outcomes and caseload review District nursing caseloads in one health authority have been examined using a patient‐focused approach Random samples of patients who were either physically disabled, frail elderly, or elderly mentally infirm (n= 202) were examined for the distinctive and differing characteristics, if any, of recently referred and long‐stay patients. Recently referred patients in our sample were either terminally ill, or had more chronic physical disorders Patients who stayed on the books received either injections, general care from qualified staff or baths from nurse auxiliaries Although covering similar areas of the health authority, nursing teams varied in the proportions of recently referred and long‐stay patients, suggesting that individual nurses' caseload management is a crucial determinant of length of time on the books. In particular, nursing and medical review of all patients receiving vitamin B12 injections is urgently called for. In order for caseload monitoring to be facilitated, practitioners need relevant local and patient based data in order to make inter‐team comparisons. The findings also have training and management support implications
Caring for a child with diabetes: the effect of specialist nurse care on parents' needs and concerns
Authors: Moyer Alwyn
Published: December 2006

One hundred and sixty parents of 10‐ to 18‐year‐old children with diabetes were interviewed using Hymovich's Chronicity Impact and Coping Instrument (CICIPQ) Eighty‐two parents had access to a specialist nurse service, 72 parents did not Regardless of the age of the child or the duration of diabetes, parents expressed a need for advice and support with child care Parents with a specialist nurse needed information on more topics tending to focus on achvihes of daily living and child development rather than physical care and illness They were also more likely to seek and receive help from nurses Their level of concern was greater and, it is argued, may be the price parents pay for greater awareness The findings of this study suggest that a systematic assessment of parent coping is necessary if specialist nurses are to help parents in their role as primary health carers