bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurse practitioner: redefining the role of the community nurse?
Authors: Trnobranski Philippa H.
Published: February 2006

Currently there is considerable uncertainty regarding the future for community nurses in the United Kingdom (UK). Within the present social and political context the development of the nurse practitioner is examined as one possible means of redefining the role of some community nurses. The historical development of the nurse practitioner in the United States of America (USA) and the UK reveals that such a role has, previously, been a response to changing health trends and to deficits in the provision of care to communities. The evolution of an independent nurse practitioner role is suggested as a way forward for different groups of community nurses and should enable them to meet the health demands of people in a variety of settings. The ‘needs’ of patients and clients and a multidisciplinary approach are emphasized as being important to the redefinition of community nursing roles. The preparation of community nurses as nurse practitioners would have obvious implications for community education; this matter is briefly discussed. The future of nursing as a whole is set to change; it is imperative that all nurses delivering patient care in this arena should examine the changing needs of society in the context of political reform, and consider how their roles may be developed and redefined.
The Delphi technique: a methodological discussion
Authors: Williams Patricia L. , Webb Christine
Published: February 2006

As in nursing, recent curriculum reform in radiographer education has resulted in the development of undergraduate programmes, and a study referred to in this paper investigated the activities of supervising radiographers in support of the undergraduate curriculum. Following on from ‘ward learning environments’ research in nursing, the most important activities which assist radiography students'clinical learning were investigated by means of the Delphi technique. At the design stage, a deficiency in previous work using the technique was identified, in that decisions relating to consensus among research respondents appeared to be based on arbitrary or post hoc rationales rather than predetermined or objective criteria. As the Delphi technique is being increasingly employed in nursing and similar research, it is important to explore issues of consensus, validity and reliability. The paper makes recommendations for improving these aspects in future studies.
Measuring feeding difficulty in patients with dementia: developing a scale
Authors: Watson Roger
Published: February 2006

Feeding difficulty in elderly people with dementia is well documented and the need for research in this area of nursing care has been raised by several authors. One hundred and twelve elderly people with dementia were entered into a study of feeding difficulty. Data were gathered by means of a questionnaire administered to the nurses caring for the patients. The aspects of feehg difficulty which were investigated were based on reports of relevant behaviour in the literature and included refusal to eat, turning the head away, refusing to open the mouth, spitting, allowing food to drop out of the mouth and not swallowing. It was possible to arrange these different aspects of feeding difficulty under three headings: (a) refusal to eat, (b) spitting, and (c) inability to swallow, and to analyse the pattern of accumulation of these feeding difficulties by means of Guttman scale analysis. According to this analysis, the feeding Uculties investigated form a cumulative and unidimensional pattern. The implications of this pattern and the possibilities for further research are discussed.
Marital status, social support, and loneliness in visually impaired elderly people
Authors: Barron Cecilia R. , Foxall Martha J. , Von Dollen Kathleen , Jones Patricia A. , Shull Kelly A.
Published: February 2006

The purpose of this study was to investigate relationships between marital status, social support, and loneliness in visually impaired elderly people. The sample was derived from a larger study designed to examine loneliness in low‐vision adults (Foxall et al. 1992). Subjects were 87 visually impaired elderly people who were at least 65 years of age, had a visual acuity of 20/70 or less in the better eye, had been visually impaired for at least 1 year, and were not totally blind. Data were collected by interview using the Revised UCL4 Loneliness Scale, the Social Support Questionnaire, and a demographic and health information form. Results indicate marital status was not directly related to loneliness but may be indirectly related through social support. Loneliness was associated with greater network dissatisfaction related to caring and relaxation. Findings provide direction for nursing assessment of and intervention into loneliness with visually impaired elderly people.
Social networks: their relevance to mental health nursing
Authors: Simmons Susan
Published: February 2006

Research into social networks has been advancing over several decades, originally in relation to the general population and more recently in relation to their duences on health and mental health. The recent full implementation of the Community Care Act, with its stress on the role of carers and networks, reinforces the need for mental health nurses to be aware of these issues. This selective review examines some of the ways in which social networks can be analysed, explores the relationship between social networks and social support, and considers the effects of social networks and social support on mental health. Research into the social networks of people with long‐term mental ill‐health is discussed, and implications for mental health nursing in all care settings are addressed.
Issues in phenomenology for researchers of nursing
Authors: Jasper Melanie A.
Published: February 2006

Nursing today, with its individualistic approach to care, shares many of its underlying beliefs and values with the school of philosophical thought known as phenomenology. The research method derived from phenomenology considers that the true meaning of phenomena can only be explored through the experience of them as described by the individual. This paper explores the features of phenomenology as a research method in relation to its relevance for nursing by first discussing the philosophical underpinnings of the method, and then proceeding to an examination of the features of the method with relation to research design, and data analysis. The specific issues of validity and generalizability are developed further, with reference to the criticisms levelled at the phenomenological method from the alternative quantitative paradigm. Finally, the author discusses the relevance of phenomenology for nursing, and concludes that, as a research method within the qualitative paradigm, it has a great deal to offer nursing as a humanistic discipline.
Phenomenology without phenomena: a discussion of the use of phenomenology to examine expertise in long‐term care of elderly patients
Authors: Reed Jan
Published: February 2006

Phenomenological approaches to research have gained popularity in nursing research over past years, in particular the use of critical incident technique. Phenomenology can be traced back to existentialist philosophy where it is expounded in the work of Husserl and Heidegger. One of the most notable examples of phenomenological research in nursing has been the work of Benner who has used this approach to examine expertise in nursing. This paper is an account of a study which attempted to adapt phenomenological methods to the investigation of expertise in nurses working in long‐term care settings, which was curtailed by the apparent inability of nurses in the study to identify any sigrulicant incidents. The paper examines this problem in the light of existentialist philosophy and suggests that the apparent lack of expertise identified in the nurses might be due more to a tendency of phenomenological studies to focus more on articulation than on attunement or potential, the other elements of dasein. The paper concludes that attention to these elements is required when phenomenology is used.
Marketing: a process in health visiting
Authors: de la Cuesta Carmen
Published: February 2006

A grounded theory study was undertaken to gain insight into the processes underpinning health visiting. It was found that health visitors introduce their services into the client domain via a process constructed in this study as ‘marketing’. This process involves different strategies to adjust the content, presentation and distribution of health visiting to the particular client or situation. While the result of this process might also lead to gaining the client's collaboration, two undesirable effects are identified: that of creating dependence on the service and that of perpetuating unfair situations.
Confluent education: an integrative method for nursing (continuing) education
Authors: Francke Anneke L. , Erkens Till
Published: February 2006

Confluent education is presented as a method to bridge the gap between cognitive and affective learning. Attention is focused on three main characteristics of confluent education: (a) the integration of four overlapping domains in a learning process (readiness, the cognitive domain, the affective domain and responsibility); (b) the promotion of personal growth and interpersonal relationships by the development of awareness, and (c) the identification and dis‐identification of teacher and participants. How confluent education can take place in practice is illustrated by presenting the way in which this method is applied in a nursing continuing education programme entitled ‘Pain assessment and management in surgical‐oncological patients’.
Confronting patriarchal attitudes in the fight for professional recognition*
Authors: Carter Helen
Published: February 2006

Contemporary nursing practice and education belong to a dynamic process which is likely to change the structure of nursing, as well as the relationships that have been established with other professions. This paper is concerned with the professionalization of nursing and examines how nurses and doctors maintain, or challenge, patriarchal relationships in a clinical context. It also examines the wider social mate which upholds the subordination of women in the caring environment. The implementation of alternative therapies, emphasis on patient education, rehabilitation and individualized care all contribute to a climate in which nurses are able to develop an area that can be deemed as their own. Furthermore, the achievement of research‐based practice, and the implementation of primary nursing in many areas, indicate a collective approach to patient care. By linking these developments with a feminist discourse nurses are able to challenge their position within the sexual division of labour and highlight the ambiguous position they occupy.
A re‐evaluation of the effect of pethidine on the length of labour
Authors: Thomson Ann M. , Hillier Valerie F.
Published: February 2006

In a pilot study of a randomized controlled trial comparing pushing techniques in the second stage of labour, a surprise hiding was that there was a positive correlation between the amount of pethidine used for analgesia in the first stage of labour and an increasing length of both the first (F0.5687, P=0‐0001, CI=0.33 to 0.74) and second stages (r=0‐3204, P=0‐037, CI=0‐03 to 0.56). In order to investigate this further a review of the literature on the effect of pethidine on the length of labour was undertaken. The literature searched was the English‐language literature, and MEDLINE and Index Medicus were used to identify pertinent papers. Studies selected were randomized controlled trials of pethidine given for pain relief in labour compared with placebo. As only five studies were identified other pertinent studies using the drug were scrutinized. The findings of this review are that, due to methodological flaws and studies with small sample sizes, the effect of pethidine on the length of labour in women has not been adequately assessed. However, there is a strong suggestion in the literature that the use of this drug is associated with a lengthening of labour and this association is dose‐related. Studies in animals support this view. Those caring for women in labour should be aware of this side‐effect of the analgesic most frequently given in labour in North America and the United Kingdom. As pethidine frequently does not provide adequate analgesia and has other side‐effects, the search for an alternative analgesia should continue.
An investigation into factors that affect oesophageal temperature during abdominal surgery
Authors: Hind Martin
Published: February 2006

The purpose of this study was to examine factors which influence changes in body temperature during surgical operation. Variables included were ambient theatre temperature and humidity, duration of surgery, age of patient, index of body fat, blood loss during surgery, and the volume of intravenous fluids received. Subjects were 30 female patients undergoing elective abdominal gynaecological surgery. Body temperature was measured using oesophageal probes and data were collected for the duration of the operation. Patients sustained a mean reduction in oesophageal temperature of 1‐03°C. Bivariate correlations indicated that ambient temperature, age, body fat, volume of intravenous fluids and blood loss were associated with temperature reduction at the level of c0.05. Step‐wise multiple regression revealed two possible models including ambient theatre temperature, each of which accounted for 70% of the variance. Model 1 included age, while model 2 included volume of intravenous fluids and index of body fat. It was noted that older patients were generally in theatre at a time when the ambient temperature was lowest. Recommendations are made to minimize unnecessary reductions in body temperature during surgery for vulnerable groups, notably elderly and thin patients.
Nurses' medication errors
Authors: Amdt Marianne
Published: February 2006

This paper reports on a qualitative study of nurses' experiences with medication errors. Using discourse analysis within a framework of an interpretive research design, the phenomenon of a not too uncommon occurrence in nursing practice was examined. Insight into nurses' involvement with medication errors was gained from interviews, group discussions and self‐reports. Documents of disciplinary proceedings, where the Professional Conduct Committee of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting has dealt with incidents of medication errors, supplemented the data. Decisions made in situations of medication errors have moral implications at personal, institutional, and professional levels. The moral courage that is needed to learn from mistakes can be enhanced through honest dealings with the situation. Where the attention is shifted from the person involved onto the problem at hand, fair judgement may be advanced and the fear of owning up to a mistake be diminished. Only when reflected upon, can personal experience merge into the stream of development and progress. This study contributes to such reflection. Three key issues are discussed in‐depth as they evolved during analysis of the data: These issues deal with identification and change; with guilt and shame and the reconciliation with human precariousness; and with teaching and learning. The manner in which discourse analysis was used here represents an innovative attempt to advance qualitative methodology in nursing research.
The effect of chronic pain on the family unit
Authors: Snelling Jannice
Published: February 2006

The purpose of the study was to examine what kind of effect a relative with chronic pain had on his or her partner and the other members of the family. The methodology used was grounded theory. The sample was a convenience group of 18 chronic pain sufferers, their partners, and one adult child taken from two pain clinics. The subjects were briefed on the purpose of the study, and how their confidentiality would be protected. Informed consent was then obtained. Data were collected through audio‐taped interviews, which were conducted on an individual basis in the subject's home environment. Analysis was conducted through the constant comparative method. Findings revealed that two main variables emerged, that of social relationships and coping techniques. The aspects of social relationships affected were the marital partnership, sexual activity, contact with friends and relatives, and roles. This meant that chronic pain caused social isolation, role tension, marital conflict, reduced sexual activity and feelings of anger, anxiety, resentment and despondency in other family members. However, the results also suggested that the extent to which chronic pain negatively affected the chronic pain sufferer's respective partner and other family members was dependent to some extent on how effective the family was in coping with a relative with chronic pain.
Palliative care nursing education: a review of research findings*
Authors: Copp Gina
Published: February 2006

Recently, there has been considerable interest shown in research studies that identify the needs of dying patients and their families, as well as the needs of health care professionals who care for the dying. This particular type of research has significantly contributed to an increase in the awareness of health care professionals of the need to look critically at the ways dying patients and their families are cared for. Moreover, this awareness has led to demands for death education and, in recent years, advances have been made in identifying a body of palliative care knowledge to teach health care professionals. This progress has been particularly notable within nursing. This paper presents an analysis of some of the key education research undertaken, focusing specifically on studies related to death education. Some potential areas for future research in palliative nursing education are also discussed.
A nurse tutor's experience of personal and professional growth through action research
Authors: Stark Sheila
Published: February 2006

Action research is growing in popularity as an approach to research in the nursing profession. Action research seeks to engage practitioners collaboratively into taking action to improve their situation; therefore, one could argue it is ideally suited to nursing since it is a practice‐based profession. This paper examines how the action research process, which is underpinned by self‐reflection, has the potential to develop practitioners both professionally and personally. A nurse tutor's experience of engaging in action research for the first time is outlined. The paper includes extracts from the tutor's diary to provide an insight into how she experienced, in particular, self‐reflection as part of her learning about action research. Her experience was initially painful, but over a few months it became pleasurable as she discovered the joy in initiating positive changes in her work as well as in herself.
Evaluating the purpose and benefits of continuing education in nursing and the implications for the provision of continuing education for cancer nurses
Authors: Ferguson Alison
Published: February 2006

In the light of increasing emphasis upon mandatory continuing education in nursing, the need for cancer nurses to update and improve their knowledge and skills is heightened. The challenges lie in how to keep nurses up‐to‐date, broaden their outlook and ensure that patients benefit. In this paper the literature on the purpose and benefits of continuing education is reviewed, and the implications of the Post‐Registration Education and Practice Project (PREPP) for cancer nurses are addressed. Arguments about a definition of ‘continuing learning’ rather than ‘continuing education’ are discussed, since outcomes vary depending upon the definition adopted. Inconsistencies between the benefits claimed and those measured are highlighted. Attention is drawn to the inconclusive nature of the studies that have measured impact; some of the problems encountered in the provision of adequate education and its accessibility to nurses; and the continuing discrepancy of perceived need between nurse and manager. Specific impact evaluation studies relating to continuing education in cancer nursing are reviewed. Recommendations for providing education with measurable outcomes are drawn from the literature, while a case is made for the alternative perspective of lifelong learning where outcomes are neither specific nor measurable. In conclusion, the questions of who should be responsible for education and the need for further development of impact evaluation tools are addressed.
The ministry of nursing
Authors: Widerquist Joanne , Davidhizar Ruth
Published: February 2006

Historically, the nursing profession has roots in the Christian concept of ministry. A caring ministry called for persons to serve their neighbours who were in need physically or spiritually. Persons were seen as wholes. As caring professions developed into separate and distinct entities, many continued to share a holistic view of people and to address similar needs. Nursing and pastoral care workers especially share concern for meeting common client patient needs; for example, providing concern and comfort, assisting persons to find meaning in their situation, responding to spiritual distress, and helping persons to experience hope. Many of the caring qualities of today's nurses are pastoral in nature, and contribute richly to healing. Examining nursing as ministry provides an opportunity to consider the nature of nursing as it moves into the 21st century.
Emotional experiences, empathy and burnout among staff caring for demented patients at a collective living unit and a nursing home
Authors: Kuremyr Dan , Kihlgren Mona , Norberg Astrid , Åström Sture , Karlsson Ingvar
Published: February 2006

Experiences of empathy and burnout were compared among staff caring for demented patients, at a collective living unit (n = 10) and a nursing home (n=10) in the middle of Sweden. In both milieus, the staff showed great confidence in their own caring ability and disclosed a deep care and concern for their patients. All staff had the requisite attributes of empathy, and none had burnout scores indicating risk of burnout. The staff of the collective living unit gave exclusively positive descriptions of their patients, but expressed an emotional exhaustion and a feeling of being overutilized. The staff of the nursing home gave positive and negative descriptions of their patients, and experienced physical exhaustion and a feeling of being only partly utilized. The study indicates that exhaustion in staff may be related both to overwhelming experiences connected with being close to demented patients, and to feelings of guilt for not being closely related to their patients.
The relationship between type of care planning system and patient outcomes in hospitalized AIDS patients
Authors: Bakken Henry Suzanne , Holzemer William L. , Reilly Cheryl A.
Published: February 2006

The purpose of this study was to describe the problems of HIV‐infected patients, hospitalized for Pneurnocystis carinii pneumonia (PCP), as documented in the nursing care plan and to examine differences in the number and type of activated patient problems and patient outcomes between manually generated, computer‐supported, and standardized care planning systems. Of the sample, 22% had no care plan. In the computer‐supported care planning system the fewest number of care plans were completed. The total number of problems generated for the 89 patients having care plans was 199. The problems were categorized as PCP‐related (37%), AIDS‐related (16%), psychosocial (23%), knowledge deficit (14%), and other (10%). There were significant differences among the three groups in the total number of problems, PCP‐related problems, and knowledge deficit problems. There were no statistically significant differences in patient outcomes, as measured by HIV‐QAM scale scores and patient self‐rating of physical condition approximately 1 week after admission, and length of stay among the three care planning systems. Future research is needed to examine the effect of type of care planning system on the quality of patient care.
Application of the Rotter scale of internal‐external locus of control to determine differences between smokers, non‐smokers and ex‐smokers in their general locus of control
Authors: Burgess Carole , Hamblett Mary L.
Published: February 2006

This paper will relate to empirical research undertaken whilst studying for BA(Hons) in Applied Social Studies by Independent Study. The researchers are both nurses, and colleagues were among the participating subjects. The research took the form of applying the Rotter (1966) scale for internal versus external locus of control to three groups, namely smokers, non‐smokers and ex‐smokers. Previous studies have indicated that smokers have a more external locus of control than non‐smokers. A sample of 60 subjects included 20 in each group (smokers, non‐smokers and ex‐smokers), of whom a high proportion were nurses and white collar workers within the 25–50 age group. Analysis of the results revealed that there was no significant difference between the scores of the three groups. However, when analysing the scores of nurses only there was a significant difference between smokers and non‐smokers. Suggestions will be made as to why this difference in findings occurs.
Nurse practitioners in accident and emergency departments: reflections on a pilot study
Authors: Read Susan M. , George Steve
Published: February 2006

This paper reflects on the conduct of a pilot study which was intended to prepare the ground for a randomized, controlled clinical trial of the assessment and treatment of patients with minor injuries by nurse practitioners or senior house officers (junior doctors) in an accident and emergency department. The authors believe that such reflection makes a useful contribution to the growing debate about methodology in health services research. Following a brief literature review on nurse practitioners, the intended research design is explained. The authors then describe how observation in the chosen department led to a change in design, involving trial use of patient‐kept diaries as a means of assessing outcome. Despite promising results from the third diary exercise, doubts remained about the validity of the relationship between process and outcome. The small number of patients managed by nurse practitioners compared to the greater number managed by junior doctors posed difficulties for randomization; similarities in pathways of care for patients managed by the two staff groups made it unlikely that differences in outcome could be demonstrated. These problems led to abandonment of the plan for a clinical trial at that point, but the authors believe that further exploration of the idea is desirable.
Patients to people
Authors: Seed Ann
Published: February 2006

The ideas discussed in this paper are derived from a longitudinal study of student nurse socialization. The emergent views of a cohort of student nurses were explored by the researcher, over a period of 3 years, utilizing the approach referred to as grounded theory. ‘Patients to people’ represents a continuum of changing perceptions about those whom the students were nursing. It seemed that the cohort had to move along this continuum in order for them to be able to empathize with those they nursed. In the context of the students' changing perceptions, several things were of significance. For example, encounters with individuals who failed to demonstrate the passive and compliant attitude associated with ‘typical patients’, such as children, challenged the cohort's thinking about those they nursed. During their training the students matured as both nurses and adults and this was also important, as was their recognition of their own ‘personhood’. The cohort's emergent views suggested that there was a reciprocity between the way they viewed themselves and the perceptions they held about those they nursed. Such findings are important to people involved in preparing individuals to enter the caring professions. However, it should be noted that the experiences described in this study represent those of ‘traditionally’ trained rather than of Project 2000 students. The names used to describe people involved in this research are pseudonyms.
Skilled expert practice: is it ‘all in the mind’? A response to English's critique of Benner's novice to expert model
Authors: Darbyshire Philip
Published: February 2006

In a recent critique of the work of Patricia Benner in relation to expertise, skilled intuitive grasp and the Dreyfus model of skill acquisition, English (Journal of Advanced Nursing 1993, vol. 18, pp. 387‐393) uses the tenets of positivism and cognitive psychology to criticize Benner's work for lacking objectivity, validity, generalizability and predictive power. In this response to English's critique I show how he has misread, failed to read, and consequently misunderstood her work, and, equally importantly, its philosophical basis. Benner's work is developed from a philosophical foundation grounded in interpretive and Heideggerian phenomenology. This wholly different ‘take’ on the world and on human behaviour embodies a strong critique of those very same traditional‐science worldviews which English uses to damn her work. English's critique is valuable in highlighting the ways in which Benner's work can be misrepresented and this response tries to remedy this misunderstanding by attempting to clarify the fundamental differences between phenomenological and cognitive understandings. These differences are crucial to understanding Dreyfus's and Benneis work. Here, I also attempt to correct some of English's wilder assertions regarding Benner's work. Finally, I try to show how Benner's work has empowered, enthused and challenged, rather than being ‘denigrating to the majority of nurses’.
Utilization of nursing research: culture, interest and support
Authors: José Closs S. , Cheater Francine M.
Published: February 2006

This paper acknowledges that the successful utilization of nursing research in practice is a highly complex task. Basic requisites include a positive research culture associated with the essential interest and support needed to promote change. Within this framework factors concerned with the research culture within nursing and the NHS are considered, as well as the research‐practice gap, the role of researchers, educational issues and the need for both local and national support. Comparisons are made with the more positive research culture in the USA, and some American research utilization models are mentioned. It is suggested that research is not highly regarded in the UK and that the required level of interest and support depend on nursing research becoming an expected, valued and rewarded activity. Some general suggestions for actions which should promote research utilization are made.
Failure to thrive in elderly people: a conceptual analysis
Authors: Newbern Virginia B. , Krowchuk Heidi V.
Published: February 2006

The concept ‘failure to thrive’ (FTT) has been in the pediatric and child development/child psychiatry literature for many years. Recently it has appeared in the medical literature in relation to malnutrition, weight loss and depression. This paper draws upon the wider concept as applied to infants and young children, as well as on relevant gerontological literature, to analyse FTT as it relates to elderly people. Attributes, antecedents and consequences are identified. Case studies that illustrate the attributes, some of the attributes, or none of the attributes are provided.
Measuring feeding difficulty in patients with dementia: replication and validation of the EdFED Scale #1
Authors: Watson Roger
Published: February 2006

A study was conducted in order to replicate a scale which was previously reported for assessing the feeding difficulty of elderly patients with dementia. The clinical significance of the scale was also investigated. It was demonstrated that the scale was replicable in two separate nursing units. Also, it was demonstrated that, according to criteria such as its correlation with levels of nursing intervention, for example physical help, and with an indicator of feeding difficulty, namely leaving food on the plate at the end of a meal, the scale was clinically significant. The consequences and limitations of the present investigation are discussed and recommendations for future lines of enquiry are suggested. Specifically, the possibility of analysing data from such studies by the use of multivariate statistical techniques is raised.
Factors affecting job satisfaction of nurses who work in long‐term care
Authors: Carr Katherine K. , Kazanowski Mary K.
Published: February 2006

A questionnaire developed by the authors was sent to 1000 nurses in various speciality areas. It was used to assess degree of job satisfaction, reasons for dissatisfaction, and the relationships of the work setting and sociodemographic data. Because the authors wanted to compare nurses who work primarily with older adults within and outside long‐term care, the percentage of time spent caring for patients aged over 60 was also studied. The degree of job satisfaction between nurses working in long‐term care was compared. A comparison of job satisfaction was also made between nurses working at least 75% of the time with older adults and nurses not working primarily with older adults. Factors causing job dissatisfaction in the long‐term care group and the non‐long‐term care group were identified. Strategies to increase job satisfaction in long‐term care were presented.
Who is in control? An investigation of nurse and patient beliefs relating to control of their health care
Authors: Smith Rachel , Draper Peter
Published: February 2006

This study compares nurse and patient beliefs regarding control of health and perceptions of the amount of patient control. Data were collected from 21 nurses and 32 patients on a mixed surgical ward, using a series of self‐report questionnaires. No difference was found between nurse and patient perceptions of patient control. However, nurses were found to have a significantly greater desire for control over their own health care and a significantly weaker belief in the influence of powerful others (i.e. doctors and nurses) than did patients. It is suggested that such differences in nurse and patient beliefs will have significant effects on how nurses and patients feel about the care patients receive. Implications of the findings for nursing theory and nurse education are also considered. In the light of previous research showing the stress‐reducing effects of giving control to patients who want and expect it, the study calls for the development of a tool to assess the amount of control desired by each patient. This should help to ensure that nursing care is congruent with the control beliefs of the patient, rather than those of the nurse.
Towards a new model of nursing research
Authors: Rolfe Gary
Published: February 2006

Nursing research is generally located within the paradigm of the social sciences, and therefore reflects the concerns and agenda of social research. In particular, nursing has become embroiled in the ongoing dispute between the advocates of qualitative and quantitative methodologies. However, it is argued in this paper that whereas the aim of social research is to develop knowledge, the aim of nursing research is primarily to advance practice. This paper offers an alternative model of nursing research which categorizes approaches to research not according to the methodology employed but on the extent to which the research process is likely to bring about change. These approaches are termed level 1, level 2 and level 3 research, where level 1 researchers are concerned with generating information for others to conceptualize and implement, while level 3 researchers see their aim as directly bringing about clinical change. Two approaches to level 3 research are suggested, and examples of projects at all three levels are examined. Finally, it is contended that only by adopting an appropriate model of research for a practice‐based discipline can nursing address the real issues of relevance to nurses and patients in clinical settings.
What is it precisely that interpretive social research researches?
Authors: Greenwood J.
Published: February 2006

The literature on interpretive/qualitative social science is maddeningly imprecise with respect to both the focus and aims of interpretive social science; this paper articulates an attempt to address these twin limitations. The dimensions of physical and social reality are compared and the definition of ‘meaning’ and its acquisitive processes are explored. It is argued that the focus of interpretive social science is the propositions that operate to create and sustain social realities and that the aims of interpretive social science are to construct, in the minds of observing interpretivists, valid mirror images of such propositions, prior to making them public. It is further argued that this can only be achieved by inferring the prior intentional inferences of the human agents being observed. Related methodological implications are discussed as they arise in the analysis.
Using the Delphi survey technique to develop a professional definition of nursing for analysing nursing workload
Authors: Procter Susan , Hunt Maura
Published: February 2006

This paper describes the use of the Delphi survey technique to develop a professional definition of nursing which is used as a framework for analysing the contribution made to care by learner nurses prior to the introduction of Project 2000. A detailed account is provided of the importance of generating a theoretical nursing perspective to structure the first round of the Delphi survey. The paper goes on to question the validity of developing a consensus about nursing priorities in subsequent rounds of the Delphi survey and argues instead that priorities about nursing care needs can only be determined in the context of practice.
Parents' experience of coming to know the care of a chronically ill child
Authors: Jerrett Mary D.
Published: February 2006

The family is the primary source of care for a chronically ill child, and it is the parents who must manage the child's illness on a daily basis. This qualitative study was undertaken to investigate the ways in which 10 two‐parent families of children with juvenile arthritis experience their child's illness. In this paper the theme of coming to terms with the management of the illness and what it entails for the parents is examined. The data provide evidence of how the parents learn, and their efforts and experience of learning to care for the child on a daily basis. This is a complex process and includes the different phases the parents experience as they move through the learning process. The findings suggest that the parents learn the child's care and make adjustments to the demands of managing the child's illness in a way that works best for them.
How can nurses build trusting relationships with people who have severe and long‐term mental health problems? Experiences of case managers and their clients
Authors: Repper Julie , Ford Richard , Cooke Anna
Published: February 2006

Despite the shift in recent policy towards people with severe and long‐term mental health problems, there is considerable evidence that mental health nurses tend to prioritize clients with acute, neurotic or short‐term problems and become demoralized when working with people with persistent needs and disabilities. Mental health nurses need to find ways of developing effective relationships with these people in order to offer a service which the client is not only willing to engage in, but takes an active part in, and which allows care providers to derive satisfaction from their work. Through 46 in‐depth interviews with case managers (working specifically with people with long‐term mental health problems) and their clients, this qualitative study provides some guidelines for mental health nurses working in this field. Analysis of the interviews revealed that both clients and case managers focused on the problems and strategies associated with developing and maintaining relationships with one another. Furthermore, the interviews suggested that case managers adopted a philosophy for working that enabled both clients and case managers to feel positive about the work. The principles of this value base, and the way it was used in the process of case management, are explored in this account.
How do nurses deal with their own grief when a patient dies on an intensive care unit, and what help can be given to enable them to overcome their grief effectively?
Authors: Spencer Lesley
Published: February 2006

There is an expectation that nurses are good at caring for relatives on the death of a patient. Who, though, cares for the nurses? Using both a quantitative and a qualitative approach, this study looks at how nurses overcome their own grief when a patient dies on an intensive care unit. Information was first collected using a questionnaire. Personal grief, however, is a very emotive area, so a proportion of the nurses from the initial study were then asked to take part in a semi‐structured interview, to explore their feelings in more depth. The quantitative data were analysed using the computer software Statistical Package for the Social Sciences and the results were related to the interview responses. This showed how nurses deal with their grief, and that many, but not all, felt that the Informal support network already present was sufficient. Some nurses, however, felt that a support group would also be helpful and some felt the availability of a counsellor would be useful. All nurses felt that more training about how to deal with their own grief was needed.
Professional uncertainty: nurses in the technologically intense arena
Authors: Conley Wichowski Harriet
Published: February 2006

The implementation of medical technology in health care continues to escalate. Using a grounded theory methodological approach, nurses were interviewed regarding their feelings about medical technology and its impact on their practice. Through the medium of participant observation nurses were observed as they worked in a technologically intense general hospital in the United States. Nurses were ambivalent regarding the benefits of medical technology to nursing practice and patient care. In particular, they questioned whether the use of techniques facilitated relationships with patients or detracted from them. Findings showed that, in the practice setting, it appeared that most of the nurses' time was spent in co‐ordinating, assessing and manipulating equipment. Technology structured nurses' time and gave their role some parameters. Technology also shaped the nurse‐patient relationship and limited interactions to educational instruction, physical assessments and strategies to support the technology. Nurses' ambivalence regarding the benefits of technology appeared to be symptomatic of professional uncertainty. The hospital focus on technology is contrary to the considerable appreciation of the psychosocial nurse‐patient relationship with which the neophyte nurse has been imbued. This practice‐educational dichotomy causes role uncertainty for the registered nurse.
Caring from the point of view of a Finnish mental health nurse: a life history approach
Authors: Nikkonen Merja
Published: February 2006

Finnish mental health care went through a major change in the 1980s. Its institutions were being run down and there was a shift to a caring system that stresses non‐institutional practices. The schooling and work of the mental health nurse had to adapt to the new situation. The purpose of my study was to describe and analyse the mental health nurse's work, i.e. caring, as it is experienced by a nurse in the preparation of long‐term psychiatric patients for non‐institutional care. The data consist of repeated interviews with Vuokko, who has been a mental health nurse for about 30 years and is now approaching her retirement. In the light of the data, the central features of caring are caring about and taking an overall responsibility for the patient, and teaching the patient to cope with everyday life. Caring is based on practical knowledge, the essential elements of which are intimacy and feelings.
The Delphi technique: a worthwhile research approach for nursing?
Authors: McKenna Hugh P.
Published: February 2006

Since its introduction as a research approach in the late 1940s the Delphi technique has had over 1000 published research utilizations. Most of these have been in the field of social policy. However, a review of contemporary nursing literature suggests that it is becoming a popular choice among nurse researchers. With its focus on maximizing participant's judgements and decision‐making abilities the Delphi technique is a useful tool in the research armoury of a young profession. However, questions remain about its scientific respectability. This paper gives an overview of what the Delphi technique is, the criteria for selecting it as a research approach, the studies where it has been used and its advantages and disadvantages.
Assessing the reading comprehension of adults with learning disabilities
Authors: Jones F. W. , Long K. , Finlay W. M. L.
Published: February 2006

Background  This study’s aim was to begin the process of measuring the reading comprehension of adults with mild and borderline learning disabilities, in order to generate information to help clinicians and other professionals to make written material for adults with learning disabilities more comprehensible.

Methods  The Test for the Reception of Grammar (TROG), with items presented visually rather than orally, and the Reading Comprehension sub‐test of the Wechsler Objective Reading Dimensions (WORD) battery were given to 24 service‐users of a metropolitan community learning disability team who had an estimated IQ in the range 50–79.

Results & conclusions  These tests were demonstrated to have satisfactory spilt‐half reliability and convergent validity with this population, supporting both their use in this study and in clinical work. Data are presented concerning the distribution across the sample of reading‐ages and the comprehension of written grammatical constructions. These data should be useful to those who are preparing written material for adults with learning disabilities.
A revised sexual knowledge assessment tool for people with intellectual disabilities: is sexual knowledge related to sexual offending behaviour?
Authors: Talbot T. J. , Langdon P. E.
Published: February 2006

Background  The aim of the current study was to update an existing short measure of sexual knowledge and generate some initial reliability and normative data. Comparisons of sexual knowledge across several groups were made to examine whether or not a lack of sexual knowledge is related to sexual offending.

Methods  The Bender Sexual Knowledge Questionnaire (BSKQ) was revised, and a new questionnaire, the General Sexual Knowledge Questionnaire (GSKQ), was created and administered to four groups of participants: (1) sex offenders with an intellectual disability (ID) and a history of engagement in treatment (n = 12); (2) sex offenders with an ID and no history of treatment (n = 13); (3) non‐offenders with an ID (n = 28); and (4) non‐offenders without an ID (n = 10). Between‐group comparisons were made; internal consistency, split‐half reliability and correlations were examined.

Results  The internal consistency and the split‐half reliability of the entire questionnaire was good. Non‐offenders without an ID scored significantly higher than non‐offenders with an ID on all sections of the GSKQ. Sex offenders who had undergone treatment scored significantly higher than non‐offenders with an ID on several sections of this questionnaire.

Conclusions  The initial findings from this study suggest that the psychometric properties of the GSKQ are promising. The assumption that lower sexual knowledge may be related to the risk of committing a sexual offence by people with IDs is possibly erroneous, and further research is required to clarify this possibility.