bluuebunny/crossref_metadata_2025 huggingface dataset:
The pricing of nursing care
Authors: Hendricks Joyce , Baume Pierre
Published: March 2003

Despite the poor performance of the general economy, the health care industry in Australia has experienced constant growth for several decades. Overall, Australia's expenditure on health is relatively high and, with an increasingly aged population, this expenditure is not likely to decrease. With the current concerns over cost‐containment in the health sector it is important to assess the value of nursing care in economic terms. This paper explores the issue of valuing of nursing care within the framework of the Australian Health Care System. Questions are posed of nurses as to whether they are prepared to confront the realities of the health care arena and whether they are ready to value nursing practice in terms of economic value. As well as answering these questions, the paper argues that nursing costs are not sufficiently reimbursed under the current Australian health benefits, and that this poor estimation of the worth of health care may stem from the historical and social influences of nursing and the care provided by nurses. The paper concludes that the Australian health care system is clearly no longer static and that the public cannot afford to support the costs associated with a growing health care industry. Moreover, nursing can no longer afford not to be viewed as an entity in it's own right. A greater awareness of nursing's output will result if organisational or institutional changes are encouraged for the benefit of the Australian society, as a whole, as well as for the nursing profession.
From nurse to teacher: recognizing a status passage
Authors: MacNeil Morag
Published: March 2003

The purpose of this study is to examine the career trajectories of nurse teachers. The main focus of the study is the process of transition from nurse to teacher. The study looks at the anticipations, expectations, contrasts and changes encountered by nurse teachers when first embarking on the role. The interest lay in obtaining the teachers’view of their career trajectories and their experience of status transition. An ethnographic approach was adopted, and in‐depth interviews were carried out with nurse teachers, to capture the breadth and depth of the teachers’experience. The teachers all volunteered to participate in the study, so are in no way statistically representative of their professional group. In analysing the data the mode of qualitative analysis called‘grounded theory’was modified and adopted. In this approach data collection, analysis and theory stand in reciprocal relationship to each other. The study operates at two levels. It relates to issues which appear to be meaningful only to the nurse education audience, but it also engages with the more anthropological concern of status passage. Finally, the results are discussed highlighting the many areas which were identified as causing concern and using the concept of‘identity’to offer an explanation for the‘troublesome‐duality’experienced by nurse teachers.
Psychometric evaluation of a squestionnaire to document side‐effects of chemotherapy
Authors: Sitzia John , Dikken Clare , Hughes Jayne
Published: March 2003

This paper reports the psychometric testing of the Worthing Chemotherapy Questionnaire(WCQ). The WCQ is a patient self‐report instrument to document side‐effects of chemotherapy. Literature review of relevant studies shows that psychometric testing of similar instruments is rarely rigorous. Content validity for the WCQ was established in five ways: literature review, Delphi review among oncology staff, pre‐pilot unstructured interviews, pilot study and amendment of the instrument and items for spontaneous reporting of problems on the questionnaire. A three‐stage approach to construct validity was used. The hypothesis adopted was that as certain cytotoxic agents cause stomatitis, incidence and severity of stomatitis will decrease following cessation of treatment. Stage 1: factor analysis confirmed the presence of a sole factor, with an eigenvalue of 5.3, for mouth problems which explained 65.5% of the variance. Stage 2: the hypothesis was confirmed using research findings. Stage 3: the Wilcoxon test showed highly significant results for during and post chemotherapy stomatitis scores. Reliability of the questionnaire was assessed using the test‐retest method. Weighted Kappa was chosen as the test statistic. A median value of wK=0.87 was obtained. The results indicate that the WCQ is a reliable and valid instrument.
Women's experiences of non‐invasive breast cancer: literature review and study report
Authors: Webb Christine , Koch Tina
Published: March 2003

A review of the post‐1990 literature on breast cancer has identified a large body of psychosocial research focusing on coping styles, quality of life and women's participation in choice of treatment. However, numerous methodological problems were found, including a variety of different diagnoses included in samples both within studies and between studies, making comparisons difficult. In particular, no article was traced which focused on non‐invasive breast cancer, or ductal carcinoma in situ (DCIS). Therefore a small exploratory study was conducted using qualitative methods to explore women's experience of DCIS, in an attempt to begin exploration of possible similarities or differences in the way women experience invasive and non‐invasive breast cancer. A convenience sample of 10 women treated at two hospitals in an Australian state capital city was interviewed, and three themes which emerged from these interviews are discussed in this article. These are discovering the problem, reaction to the diagnosis, and information. Most women unexpectedly reacted in a calm and accepting way to receiving the diagnosis of DCIS, and this may be because they had had no signs of disease but been recalled for further tests after routine screening. They felt well and had no cause to assume a poor prognosis. It is possible also that their reactions were affected by a television health education campaign at the time, which gave a very optimistic picture of the benefits of early detection of breast cancer. Information‐giving, as reported by the women, seemed deficient. None of them knew that they had had a non‐invasive condition, one thought her disease had been benign, and another that hers was‘evasive’. Findings are discussed in relation to the literature on information‐giving and on the role of the nurse in this area, and suggestions are made for further research to systematically compare women's reactions to having invasive and non‐invasive breast cancer in order that nurses may be aware of their possibly different needs and respond to them appropriately. (Kahane 1993 p. 105)
Parents’ viewpoint on reproductive health and contraceptive practice among sexually active adolescents in the Port Harcourt local government area of Rivers State, Nigeria
Authors: Briggs L.A.
Published: March 2003

The viewpoint of parents on reproductive health, specifically their attitude towards contraceptive use among sexually active adolescent daughters and general opinion on adolescent pregnancy, was examined. A sample survey of parents of pregnant adolescents in Port Harcourt was conducted. A greater proportion (79·1%) of parents did not favour the use of contraceptives by sexually active adolescents because according to their parents, contraception kills. Also, most (87·8%) parents did not usually discuss sexual matters with their adolescent girls. However, the majority (93·2%) of parents would want a sex education programme in schools in order to prevent unwanted pregnancy.
Using bioscience knowledge in nursing: actions, interactions and reactions
Authors: Jordan Sue , Hughes David
Published: March 2003

This paper draws on empirical data from a study undertaken to explore the outcomes of the applied physiology component of a post‐registration diploma in nursing (DN). Most students completing the DN were utilizing their new bioscience knowledge in clinical practice, and reported increased participation in interprofessional discussions and team decisions. Respondents found themselves better able to monitor and evaluate doctors’ decisions and this led to friction with some medical colleagues. However, the strongest resistance came from senior nurses, very few of whom had completed advanced nursing courses in bioscience and who were generally unwilling to allow respondents to develop new roles. General managers were also perceived as a major barrier to change. There is little evidence of tangible benefits to the nurses themselves: most saw the DN qualification as a way of protecting their status as professional nurses in the face of managerially driven organizational change, rather than as a route to occupational advancement.
Attitudes of health care providers and students towards tattooed people
Authors: Stuppy Dorothy J. , Armstrong Myrna L. , Casals‐Ariet Christina
Published: March 2003

Attitudes of health care providers and medical and nursing students (n=513) towards tattooed adults and adolescents were examined. No respondent group had mean scores reflecting a positive attitude towards tattooed persons. Overall, physicians (MDs) and registered nurses (RNs) rated tattooed people less positively than did students. Womens’ attitudes were consistently less favourable than those of men, especially towards tattooed professional women. Attitudes towards tattooed adolescents were generally less positive than attitudes towards the adult groups. Research has found that negative attitudes impact patient care. This study suggests that tattooed persons, especially adolescents, may be at risk of being negatively perceived when they seek health care. Increased efforts are needed to assure that those with tattoos receive non‐judgemental and sensitive care.
Evaluating a pilot community stroke service using insights from medical anthropology
Authors: Hart Elizabeth
Published: March 2003

This paper focuses on the evaluation of a pilot community stroke service. Its aim is to illustrate how the insights gained from the research of two medical anthropologists, Kaufman and Pinder, provided an understanding of the experience of chronic illness in the community. Two linked themes identified in the literature, which also emerged from the exploratory phase of the evaluation, are discussed: the tension between the patient’s goal of recovery and the professional’s goal of rehabilitation; and the management of uncertainty. It is argued that it may be very difficult, if not impossible, to reconcile these divergent goals of recovery and rehabilitation, and that this problem is exacerbated for patients and professionals alike by the challenge of how to manage the uncertainty of a chronic illness such as stroke. The empirical findings of the first phase evaluation corroborate Kaufman and Pinder’s findings. Furthermore, the present research suggests that the mismatch between the goals of recovery and rehabilitation, and the management of uncertainty are integrally related. The implications for practice are that there is a need for professionals to find ways of recognizing and taking account of the possible tensions between their goals and those of patients and families, and related to this, for the development of strategies which enable professionals to explain clearly the nature of stroke to patients and their carers.
People with learning disabilities who also have mental health problems: practice issues and directions for learning disability nursing
Authors: Gilbert Tony , Todd Margaret , Jackson Neil
Published: March 2003

The plight of people with learning disabilities who have mental health problems has become an issue of contemporary importance in the provision of health services to this section of the population. This paper will argue that learning disability nursing has a central role to play in the promotion of mental health for this client group ( Department of Health 1995a). However, learning disability nursing presently operates without a clear model of mental health. Therefore, before this potential can be realized there is a need to establish the common ground between the discourses of learning disability nursing and those of psychiatric nursing which might be related to this client group. This paper begins by identifying the background issues relating to the problems of meeting the mental health needs of people with learning disabilities. It then proposes that an applied behavioural approach has the potential to provide a coherent theory that can link the discourses of normalization, developmental psychiatry and mental health nursing, whilst also establishing the applied behavioural approach as a powerful technology upon which meaningful interventions can be designed.
A comparison of psychiatric nurses’ and general nurses’ reported stress and counselling needs: a case study approach
Authors: Muscroft Jane , Hicks Carolyn
Published: March 2003

Because of the increasing devolution of responsibility for health care, personnel management and organizational policies to the trust level, it is self‐evident that staff morale and job satisfaction will depend to an ever larger extent on the quality of the individual management style and the corporate culture it fosters. This study was prompted by mounting concern within a health authority about levels of absenteeism and workforce dissaffection. To examine the extent and nature of these problems, a survey of nurses in a psychiatric Trust and a comparable general acute unit was conducted. In particular, the study investigated occupational stress levels among the two cohorts of nurses and their preparedness to use workplace counselling to manage their problems. A stratified random sample of 50 psychiatric and 50 general nurses was selected from the cognate units and a questionnaire was distributed. The results were subjected to a range of statistical analyses. Overall it was found that general nurses reported stress levels that were significantly higher than those of psychiatric nurses (P<0·05) and that they would be more likely to use workplace counselling services (P<0·01). These results did not accord with previous studies of this type and are explained in terms of relative organizational cultures and potential interventions designed to reduce occupational stress. The need for local surveys in identifying stress levels and understanding both its sources and solutions is emphasized.
Collecting and analysing qualitative data: issues raised by the focus group
Authors: Sim Julius
Published: March 2003

The focus group has gained considerable popularity as a means of gathering qualitative data in nursing research. This paper examines some of the methodological issues raised by the collection and analysis of focus group data. In respect of data collection, the role of the focus group moderator and the method of recording data are crucial considerations. In particular, the moderator’s personal skills and attributes have a considerable influence on the nature and quality of the data gathered. When analysing the data, three principal issues arise. First, it is difficult, and probably misguided, to attempt to infer an attitudinal consensus from focus group data. An apparent conformity of view is an emergent property of the group interaction, not a reflection of individual participants’ opinions. Second, measuring strength of opinion from focus group data is problematic. The indicators used to measure attitudes in orthodox survey research are largely inapplicable to the context of focus groups. When comparing data from different focus groups, inferences may be drawn as to the presence of absence of certain views or issues across groups, but not in terms of their relative strength. Third, both methodological and epistemological objections can be raised against attempts to generalize from focus group data. Theoretical generalization is likely to be more feasible than empirical generalization, and if the latter is considered fruitful, it is likely to be of a provisional nature. The effective use of focus groups as a means of gathering qualitative data in nursing research requires due attention to problematic methodological issues such as those explored in this paper.
Loneliness: an epidemic in modern society
Authors: Killeen Colin
Published: March 2003

Loneliness: an epidemic in modern society Loneliness is a little discussed concept in today's self‐obsessed climate, where it is seen as a negative embarrassing condition. It is unique for every individual, and as such, it is difficult to define. There are other closely related concepts, for example, aloneness and solitude, that further complicate an already complex issue. Loneliness also has various causes and effects that can be one and the same, and so it can be confused with similar but different conditions, for example, depression and self‐esteem. But, at the end of the day, if the word loneliness is mentioned in conversation, everybody will understand what it means to them, and how distressing an ordeal it can be. Everyone is lonely to some degree, no matter how much they pretend they are not: it is part of being human. Nursing literature looks at loneliness from a rather basic, superficial perspective, when discussing whether such a traumatic state of being can be solved, but this is not a solution as such. It is such an innate part of the human psyche, that it cannot be solved like a puzzle; it can only be alleviated and made less painful. This can only be achieved by increasing humankind's awareness of this distressing condition that everyone has to endure in some way, shape or form, some time during their lives, about which there is nothing to be embarrassed. If non‐lonely individuals could spare a smile or a word for people who might be perceived as being lonely, even if in doing so they selfishly think ‘there but for the grace of God go I’, such a small gesture might just make their day a little less of an ordeal.
How patients spend their time in a hospice and in an oncological unit
Authors: Rasmussen Birgit H , Sandman
Published: March 2003

How patients spend their time in a hospice and in an oncological unit This paper presents the findings from a work sampling study. At 10‐minute intervals the activities of patients in a hospice, and in an oncological unit were monitored for a day or a night. In total, 5286 observations of patient activities were recorded. The findings showed that being a patient, especially in the oncological unit, was apparently a very lonely experience with limited social interaction and purposeful activity. Hospice patients, in contrast, were less alone, spending much of their time with their relatives. Although none of the patients at either site spent a major part of either day or night with nurses, hospice patients and nurses spent significantly more time together, and their encounters more often lasted longer. Nursing care at both sites was mainly related to ‘doing’ rather than ‘being’, i.e. when with patients, nurses most often had some task to accomplish. The study shows the importance of increasing our understanding of the use of time and the combination of doing and being that reflects good nursing care of the dying.
Lifestyle practices and the health promoting environment of hospital nurses
Authors: Hope Ann , Kelleher Cecily C. , O’connor Maire
Published: March 2003

This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self‐administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre‐ and post‐time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non‐smokers. The impact of intervention strategies around compliance with smoking policy and work‐site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.
The nature of philosophy of science, theory and knowledge relating to nursing and professionalism
Authors: Rutty Jane E.
Published: March 2003

It appears that nursing has devoted an extravagant amount of concentration to the subject of professionalism and professionalization. Consequently, it has created and persists to create some proportion of controversy amid nursing authors, particularly in the Western World at the present time. According to Silva, philosophy, knowledge and theory are intrinsically linked. These notions are important to consider independently and to clarify their relationships, if nursing’s knowledge base is to be built on a strong foundation. Perhaps then, if nursing wishes to continue on the trail of professionalization, nurses need to return to and reconsider its foundations and accomplishments. The aim of this discussion paper is to explore the nature of the philosophy of science, knowledge and theory and their interrelationships, with particular reference to professionalization by considering where nursing has come from and consequently the way forward to ascertaining professional status.
Evaluating clinical outcome and staff morale in a rehabilitation team for people with serious mental health problems
Authors: Brooker Charlie , Molyneux Philip , Deverill Mark , Repper Julie
Published: March 2003

Evaluating clinical outcome and staff morale in a rehabilitation team for people with serious mental health problems¶ Tameside and Glossop rehabilitation team (in England) have developed a progressive and targeted service for people with serious mental health problems through the systematic implementation of research‐based evidence in practice and service configuration. This study was undertaken to provide a method of auditing the clinical outcome of the service and monitoring staff morale in a manner which could be integrated in the day to day delivery of services, and which could inform future service developments. Changes in the functioning of the total population of rehabilitation team clients were assessed over a 1‐year period by Health of the Nation Outcome Scales (HoNOS) ratings at 6‐monthly intervals. Factors causing stress and stress levels among all staff were assessed using the Mental Health Stress Questionnaire. The findings give clear indications of areas of the service which needed improving or changing, and identify ways in which the ongoing process of data collection might be refined.
Coping strategies used by hospitalized stroke patients: implications for continuity and management of care
Authors: Close Helen , Procter Susan
Published: March 2003

Coping strategies used by hospitalized stroke patients: implications for continuity and management of care¶ This paper describes findings from an English study into the perceptions of multi‐professional practice given by stroke patients, their informal carers and hospital staff. Unstructured interviews were conducted with nine stroke patients and eight informal carers. Case studies were developed from the interview data which formed the basis of a questionnaire designed to ascertain the aims of care for the case studies and the location of professional responsibility for meeting these aims. This was returned by 31 respondents from a range of professional backgrounds. The findings indicate that patients and carers sought out relationships with staff and other patients in order to gain information to help them understand their uncertain futures. Professional staff were reluctant to pass specific information on to patients as it might be misleading in each individual case. The uncertainty surrounding individual recovery means that supportive relationships initiated by patients and carers may need to be recognized and nurtured.
Guide to practice or `load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland
Authors: Mason Carolyn
Published: March 2003

Guide to practice or `load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland¶ A nursing care plan is a written, structured plan of action for patient care. There is strong evidence that care plans are viewed negatively by nurses and poorly implemented, with little evidence to suggest that they have any positive effect on quality of care or patient outcomes. The project reported in this paper aimed to investigate how nursing care plans were being used in five clinical areas, and to assess their influence on nursing practice. An exploratory, predominantly qualitative research design was selected utilizing participant observation, focus groups and diaries. In four of the five clinical areas, the `activities of daily living' section of care plans had no apparent positive influence on nursing practice which was driven by other factors and sources of information. Care plans in the remaining ward were clinically led and locally owned, and in this setting they operated as an important guide to practice. It is concluded that a reinvention of the nursing care plan is needed without the constraint of a nursing model as its necessary foundation. New and imaginative plans of action for patient care should be encouraged, developed at ward level and tailored to the demands of the clinical area. These should contain a minimum of documentation and integrate with nursing practice.
Terminally ill patients' and lay‐carers' perceptions and experiences of community‐based services
Authors: Jarrett Nicola J. , Payne Sheila A. , Wiles Rose A.
Published: March 2003

Terminally ill patients' and lay‐carers' perceptions and experiences of community‐based services¶ This paper reports on terminally ill patients' and their lay‐carers' perceptions and experiences of community‐based services. It forms part of a larger investigation which examined the extent of service provision and any perceived gaps and problems from the perspectives of both clients and providers of community‐based assistance for the terminally ill. The participants were nine terminally ill patients and 12 lay‐carers receiving community nursing care. Fifteen face‐to‐face, semi‐structured interviews were conducted to elicit their experiences and perceptions of the care being provided. Qualitative, thematic analysis was carried out on the audio‐taped interviews. On the whole, respondents reported a high level of satisfaction and appreciation for the help provided. Several areas appeared more problematic, however, and warrant further consideration. These include perceptions of health professionals, particularly their role domains, power and expertise, and some of the practical disadvantages and problems faced by some patients and their families. These are illustrated and the implications for dying patients, their lay‐carers and community‐based health professionals are discussed.
An exploration of the preceptor role: preceptors' perceptions of benefits, rewards, supports and commitment to the preceptor role
Authors: Usher Kim , Nolan Carol , Reser Paul , Owens Jan , Tollefson Joanne
Published: March 2003

An exploration of the preceptor role: preceptors' perceptions of benefits, rewards, supports and commitment to the preceptor role¶ This Australian study, a replication of Canadian research by Dibert & Goldenberg, was undertaken to explore the relationship between preceptors' perceptions of benefits, rewards and support, and their commitment to the preceptor role. A convenience sample of 134 nurse preceptors involved in an undergraduate nursing course were invited to complete a four‐part questionnaire consisting of the Preceptor's Perception of Benefits and Rewards Scale, the Preceptor's Perception of Support Scale, the Commitment to the Preceptor Role Scale, and demographic details. The results, in the main, parallel those of the original research, with differences reflecting the distinct nature and the more recent use of preceptorship in Australia. The results indicate a clear commitment to the preceptor role and a perception that both material and non‐material benefits are derived from acting in the role. Additionally, support from the institution and coworkers was considered vital for participation in the role. This not only has implications for nursing educators, administrators and potential preceptors, but also for those being preceptored.
Parental autonomy and consent to treatment
Authors: Taylor Bridget
Published: March 2003

Parental autonomy and consent to treatment ¶This paper discusses the principle of autonomy in relation to minors and considers the complexities of parental responsibility regarding consent to treatment. The author considers the case of a child with leukaemia and draws on her own experiences as a parent to highlight the ethical dilemmas for health care professionals who may be in a position to support parents in consenting to treatment on behalf of their child.
Non‐verbal behaviour in nurse–elderly patient communication
Authors: Caris‐Verhallen Wilma M.C.M. , Kerkstra Ada , Bensing Jozien M.
Published: March 2003

Non‐verbal behaviour in nurse–elderly patient communication¶This study explores the occurrence of non‐verbal communication in nurse–elderly patient interaction in two different care settings: home nursing and a home for the elderly. In a sample of 181 nursing encounters involving 47 nurses a study was made of videotaped nurse–patient communication. Six non‐verbal behaviours were observed: patient‐directed eyegaze, affirmative head nodding, smiling, forward leaning, affective touch and instrumental touch. With the exception of instrumental touch these non‐verbal behaviours are important in establishing a good relationship with the patient. To study the relationship between non‐verbal and verbal communication, verbal communication was observed using an adapted version of Roter's Interaction Analysis System, which distinguishes socio‐emotional and task‐related communication. Data were analysed in hierarchical linear models. The results demonstrated that nurses use mainly eyegaze, head nodding and smiling to establish a good relation with their patients. The use of affective touch is mainly attributable to nurses' personal style. Compared to nurses in the community, nurses in the home for the elderly more often display non‐verbal behaviours such as patient‐directed gaze and affective touch.
A case study of the effectiveness of nurse‐led screening programmes for cervical cancer among Hong Kong Chinese women
Authors: Twinn Sheila , Cheng Frances
Published: March 2003

A case study of the effectiveness of nurse‐led screening programmes for cervical cancer among Hong Kong Chinese women

Cervical cancer remains a cause of morbidity and mortality among women despite the efficacy of Pap smear screening. Uptake rates for Papanicolaou (Pap) smears among Hong Kong Chinese women remain low and evidence suggests that both intrinsic and extrinsic factors influence women's attendance for Pap smear screening, particularly the practitioner taking the smear. This study examined the experiences and perceptions of Hong Kong Chinese women of having a Pap smear taken by a female doctor or a female nurse using a case study design. A convenience sample of 50 women was selected from the two case study settings. Data collection involved a confidential structured interview, followed by focus group interviews with a sample of women participating in the structured interview. The findings relating to the technical quality and outcome of care provide the focus for this paper. Although women were highly satisfied with the care provided by both practitioners, women were more satisfied with the information given about the procedure by the nurse (P = 0·0130) and had more confidence in the nurse (P = 0·024). One of the five criteria used to assess the quality of smears demonstrated the doctor achieved a statistically significant higher number of smears containing the required percentage of endocervical cells (P = 0·0180). Nevertheless, none of the smears taken by the nurse required repeating due to an inadequate specimen. These findings suggest, despite the need for audit of Pap smears, that appropriately qualified nurses can make an important contribution to the uptake of Pap smears among this population.
Predictors of loneliness in elderly Korean immigrant women living in the United States of America
Authors: Kim Oksoo
Published: March 2003

Predictors of loneliness in elderly Korean women living in the United States of America

The purpose of this study was to examine the predictors of loneliness in elderly Korean immigrant women. The sample was derived from a larger study designed to examine loneliness in elderly Korean immigrants. Subjects were 110 elderly Korean immigrant women who were at least 60 years of age and lived in a large metropolitan city area in the United States of America. Data were collected by telephone interview using the Revised University of California Los Angeles (UCLA) Loneliness Scale (RULS), Social Support Questionnaire, Ethnic Attachment Questionnaire and Instrumental Activities of Daily Living (ADL) Scale. Measures were prepared using translation and back‐translation procedures. Results indicate that elderly Korean immigrant women were more lonely than those found in other studies. Satisfaction with social support, social network size, ethnic attachment and functional status were predictive variables of loneliness. Satisfaction with social support was the largest predictor of loneliness in elderly Korean women. Marital status was not a predictor of loneliness.
Health practices of adult Hispanic women
Authors: Higgins Patricia Grant , Learn Cheryl Demerath
Published: March 2003

Health practices of adult Hispanic women

The purpose of this focused ethnography was to discover the patterns and variability of health practices used by Hispanic women aged 20–40 years. Seven adult Hispanic women from an urban New Mexico county were interviewed four to seven times each about their health practices. The women described their views of good health. They were aware of current health promotion practices such as good nutrition and exercise. They also practised safety measures for themselves and their families. These women did not report any information on specific cultural disease prevention behaviours and described few practices related to their Hispanic culture. A theme that also emerged from the data was an emphasis on the importance of spirituality and the integration of the spiritual dimension as important to healthy living. Implications for health care providers include knowing that urban adult Hispanic women are versed in contemporary health literature and take better care of their families than of themselves.
Medication management: an exploratory study into the role of community mental health nurses
Authors: Jordan Sue , Hardy Billy , Coleman Mick
Published: March 2003

Medication management: an exploratory study into the role of community mental health nurses

The recent emphasis on community care for those with mental illness has changed working patterns and modified inter‐professional role boundaries within multi‐disciplinary teams. Clients with serious mental illness are usually prescribed medications, which have a wide range of side effects. However, it is uncertain who is responsible for monitoring clients for the side effects of their medications, ensuring clients' and carers' understandings of their prescribed medications and optimizing compliance with medication. This paper discusses the findings of the first phase of an ongoing study designed to assess the role of community mental health nurses (CMHNs) in managing clients' medication and the provision of appropriate continuing professional education. Our respondents were 14 CMHNs, seven of whom were preparing to undertake a pharmacology module as part of a higher education diploma, and seven who were to act as comparators. Data from questionnaires, interviews and clinical observations were triangulated. All respondents felt that issues surrounding clients' medication were not accorded a sufficiently high profile and that it was, in part, their responsibility to expand their roles to meet these unmet needs of clients. Administering and managing clients' medications were considered to be the main area of `occupational territory' which distinguished CMHNs from social workers. However, the nurses felt that their practice was limited by lack of appropriate educational preparation.
Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland
Authors: Barr Owen , Gilgunn John , Kane Therese , Moore Gordon
Published: March 2003

Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland.

Over the last 30 years there has been a considerable increase in the life expectancy of people with learning disabilities. This has resulted in changing patterns of morbidity and mortality and an increasing recognition of the health needs of people with learning disabilities. Major strides forward have been made in the reduction of preventable illnesses among the general population. However, among people with learning disabilities such illnesses have received only limited health promotion attention until recently. In the last decade major gaps have been identified in the ability of current primary health services to respond to the needs of people with learning disabilities. The need to respond effectively to this situation has been identified as a priority by the current United Kingdom Government. Following an overview of the literature in relation to the changing health profile of people with learning disabilities and the need for health screening, consideration is given to some of the key difficulties which may be encountered when attempting to utilize current primary health services. The analysis of data derived from the health screening of 373 people with learning disabilities by a community nursing service in Down and Lisburn Health and Social Services Trust reveals the need for further action in relation to cardiovascular status, sensory deficits, mobility and aspects of sexual health.
Chronic sorrow in parents of children with newly diagnosed diabetes: a review of the literature and discussion of the implications for nursing practice
Authors: Lowes Lesley , Lyne Patricia
Published: March 2003

Chronic sorrow in parents of children with newly diagnosed diabetes: a review of the literature and discussion of the implications for nursing practice

Childhood (type 1) diabetes is a chronic, life‐long condition, the diagnosis of which may represent multiple losses for parents. Their emotional responses to the diagnosis have been likened to the grief reactions experienced as a result of bereavement through death. The practice of health professionals who work with these families is informed by two contrasting theoretical views of the progress of grief reactions; the time bound and the chronic sorrow perspectives. This paper provides a critical appraisal of the evidence concerning grief reactions in parents of children with diabetes and evaluates the extent to which this supports the expectations of the time bound theorists, that parents normally reach an end stage of the grieving process, or those of the proponents of chronic sorrow, who anticipate lifelong, recurring sadness. It concludes with a discussion of the implications of the debate for nursing practice.
Child care responsibilities and participation in continuing education and training: issues relating to motivation, funding and domestic roles
Authors: Dowswell Therese , Bradshaw Gwendolen , Hewison Jenny
Published: March 2003

Child care responsibilities and participation in continuing education and training: issues relating to motivation, funding and domestic roles

Changes in the organization and funding of health services and in the education and training of NHS staff have placed increased influence in the hands of employers and individual students as users of continuing professional development. Against this policy context an interview study was carried out with students participating in a range of continuing professional development activities. The sample included 89 participants attending a range of courses. Approximately half of the sample had children. Many of the participants were attending courses in their own rather than in their employers’ time and several were self‐funding. The influence of domestic responsibilities on motivations, along with the impact of course participation on home and family life, were examined. Results revealed that those with children were less likely to perceive continuing education in a positive light compared to those without. The impact of course participation on home and family life was invariably negative and for some the consequences were serious. The policy implications of findings are discussed.
Care pathways: an evaluation of their effectiveness
Authors: De Luc Kathryn
Published: March 2003

Care pathways: an evaluation of their effectiveness

This paper reports on a quasi‐experimental case study of two care pathways — a midwifery‐led maternity pathway and a breast disease pathway developed within one British National Health Service Trust. Of the aspects evaluated, those reported here are: a comparison of clinical care delivered before (the control group) and after the introduction of the two pathways; a comparison of patient satisfaction levels before (the control group) and after the introduction of the two pathways; and views of staff involved in the development and operation of the two pathways. The results are mixed. In the breast disease pathway five of 12 clinical indicators showed change, but only two of these showed statistically significant changes; three were considered of clinical significance but could not be tested statistically. In the maternity pathway, after allowing for the effect of gravid status, five of 10 indicators showed changes between the pre‐pathway and pathway users and of these four showed statistically significant changes. Patient satisfaction levels showed little overall change — only 15% of the questions for breast disease and 9% for maternity showed any statistically significant change. However, both surveys indicated precise areas where a change resulting from the introduction of the pathway could be linked to an increase in satisfaction. The clinical staff interviewed highlighted many positive features of the tool (26/40 comments). The most frequently cited favourable comment was its ability to make staff focus on the clinical care they were providing and how this could be improved. It also highlighted some areas for concern, in particular the introduction of pathway documentation.
John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital
Authors: Alsop‐Shields Linda , Mohay Heather
Published: March 2003

John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital

Aims. John Bowlby and James Robertson, two men who were extremely influential in the latter part of the 20th Century, combined scientific theory with evangelism to bring about changes in the way in which children were cared for in hospitals and other institutions. This paper discusses their work together, their theories and their influence on the care of children and paediatric nursing.

Background. Bowlby and Robertson collaborated early in their working relationship on research about separation of mother and child. Bowlby was the scientist who developed classic theories about maternal separation. Robertson focused his research on separation of mother and child due to hospital admission. Between the two of them, they derived a classic theory about the phases of ‘protest’, ‘despair’ and ‘denial’ (Bowlby called this last stage ‘detachment’) through which small children pass when isolated from their mothers for a length of time.

Discussion. Bowlby became an internationally recognized theorist, widely acclaimed and considered an expert in the field of maternal care and child development. Robertson, with his wife, Joyce, not only continued Bowlby’s work investigating children separated from their mothers, but also took on the role of campaigner for the welfare of children in hospital. James Robertson, with his impressive speaking powers, established an international reputation proselytizing the need to admit parents to hospital with their children.  The work of Bowlby and Robertson coincided with new knowledge about cross‐infection, which had been one of the reasons for excluding parents from hospital wards. At the same time, and influenced by their work, community groups, which championed the idea of admitting parents with their children, developed. The combination of these factors provided a catalyst for changes within the health systems of many developed countries. Because of the theoretical work of Bowlby and Robertson’s missionary zeal, government policies, staff attitudes and parents’ expectations changed. Children’s wards and hospitals in developed countries today admit parents as part of normal routine and actively involve them in the planning and implementation of their child’s care.
Case studies of food shopping, cooking and eating habits in older women with Parkinson’s disease
Authors: Andersson Ingegerd , Sidenvall Birgitta
Published: March 2003

Case studies of food shopping, cooking and eating habits in older women with Parkinson’s disease

Aims. The principal aim of this study was to investigate how married and single‐living older women diagnosed with Parkinson’s disease managed to shop for food, cook and carry out their meals; and to observe whether their nutritional needs were satisfied. A secondary aim was to identify women with severe motor problems and describe their food‐related situation.

Background. Parkinson’s disease is associated with motor and eating problems, which, combined with age‐related declines in physical functioning, may affect activities of daily living and dietary intake.

Methods. Qualitative interviews and food survey were carried out in the homes of 10 women aged 67–80 years. The sample was recruited from outpatient registers.

Results. Decreased sense of smell, appetite and taste in combination with problems transporting food to the mouth and swallowing were risks for nutritional well‐being. Food shopping was most difficult to manage, but six cooked even if their cooking style was changed. Married women with healthy husbands received support from their spouses. Single‐living women suffering from motor problems had to call for help, which represented a threat to their well‐being. Independence was given high priority.

Conclusions. The whole situation – including psychosocial and stress factors – must be taken into account when discussing shopping, cooking and eating among old women with Parkinson’s disease. A home‐helper should not take over but facilitate procedures so that the woman can manage as long as possible. This gave them self‐esteem.