bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of parental decisions on ‘drop out’ from cancer treatment for childhood cancer patients
Authors: Yeh Chao‐Hsing , Lin Chiou‐Fen , Tsai Jia‐Ling , Lai Yu‐Mei , Ku Hsueh‐Chen
Published: March 2003

Determinants of parental decisions on ‘drop out’ from cancer treatment for childhood cancer patients

Little is known about the psychosocial process of parental decisions on ‘drop out’ from cancer treatment for paediatric patients in Taiwan. This study, based on structured in‐depth interviews, attempted to document the determinants of parental decisions on drop out. A total of 19 parents of paediatric cancer patients who dropped out from a cancer treatment for at least a month within 3 years since first treatment were interviewed. Content analysis of qualitative data revealed six categories of determinants associated with parental decisions: suffering severe pain from medical treatments and adverse side‐effects; desire for better and less painful treatments; adverse effect of other patients’ experiences; searching for possible explanations for disease after prolonged denial of diagnosis; lack of empathy from health care professionals; and misinterpretation of improved prognostics. These findings reflected the deficiency of psychological and emotional support for parents from health care professionals prior to and during cancer treatment.
Practice innovation: a methodological maze
Authors: Tolson Debbie
Published: March 2003

Practice innovation: a methodological maze

Practice innovation is an inevitable feature of a health culture preoccupied with evidence‐based practice. The cyclical process of defining best practice, implementing and evaluating change represents an unparalleled opportunity for nurse researchers to engage in, and develop, practice through ‘realistic evaluation’. However, the methodological dilemmas and challenges inherent in evaluation research which informs policy should not be under‐estimated. This paper seeks to introduce and wrestle with some of the political tensions and methodological issues surrounding practice innovation when it is undertaken within an evaluative research framework. A critical pathway is presented to stimulate discussion and guide novice evaluators through this often perplexing methodological maze. A case study in audiological rehabilitation in elder care is used to illustrate the issues raised.
The critique of Heideggerian hermeneutical nursing research
Authors: Draucker Claire Burke
Published: March 2003

The critique of Heideggerian hermeneutical nursing research

Within the past decade, over 25 research reports claiming to be based on Heideggerian interpretive phenomenology have been published in the nursing literature. This article reviews this research focusing on two critical issues. First, do the reports reflect a convergence of researcher understanding and participant narratives as called for by the Heideggerian tradition? Second, do Heideggerian ideas inform and enrich the studies’ findings? The review reveals wide variations with regard to how these two issues are reflected in published reports. The author recommends that Heideggerian nurse researchers (a) seek to create a new narrative literature that allows for flexible and creative presentation of interpretive findings, while demanding adherence to sound interpretive scholarship, and (b) strengthen their partnerships with philosophers and other scholars so that ideas from Heideggerian interpretive phenomenology and other sources can not only guide their methods, but enrich their findings.
A cross‐cultural analysis of the use of the Edinburgh Post‐Natal Depression Scale (EPDS) in health visiting practice
Authors: Clifford Collette , Day Asha , Cox John , Werrett Julie
Published: March 2003

A cross‐cultural analysis of the use of the Edinburgh Post‐Natal Depression Scale (EPDS) in health visiting practice

This report describes a project that developed and undertook initial validation of a Punjabi version of the Edinburgh Post‐Natal Depression Scale (EPDS). A multi‐disciplinary and multi‐ethnic project team translated the EPDS from English to Punjabi. A pilot study indicated a high level of correlation between the two scales opening the way for a larger study in which a total of 98 bi‐lingual women completed both the English and Punjabi version of the scale 6–8 weeks after delivery of their child. Of these a further 52 completed the scales on a second occasion, 16–18 weeks post‐partum. A small sub‐group (n=15) was subject to independent clinical assessment by a community psychiatric nurse (CPN) to determine their mental state, enabling the outcome of the assessment to be compared with the EPDS score. The scores of the English and Punjabi versions of the scale were analysed using Spearman correlation coefficient and the Bland Altman test. A high correlation was found between overall scores and most individual items on the scale. Furthermore, the independent assessment of mental health state indicated that a number of those women who scored 12 or above on the EPDS scale (the cut‐off point for determining risk of post‐natal depression (PND)) were diagnosed as having a post‐natal depressive disorder by the CPN assessing them independently. Whilst the results to date are promising there is a need for further work to determine the validity, sensitivity and specificity of the Punjabi EPDS tool against international classification of depressive disorders and to establish optimal cut‐off scores when using the Punjabi version of the EPDS.
Can the needs of the critically ill child be identified using scenarios? Experiences of a modified Delphi study
Authors: Endacott Ruth , Clifford Collette M. , Tripp John H.
Published: March 2003

Can the needs of the critically ill child be identified using scenarios? Experiences of a modified Delphi study

The Delphi technique enables the structuring of group opinion and discussion using a survey approach, maintaining the anonymity of panel members and preventing contamination of individual responses through peer pressure. The Delphi technique was used by the authors to form an expert opinion regarding the needs of a critically ill child. The abstract and evaluative nature of need was a key issue to arise during early pilot work and stimulated the first author to undertake a concept analysis of the term ‘need’. The defining attributes arising from the concept analysis were used to construct two hypothetical case studies for the modified Delphi; these were used as part of the questionnaire for all three rounds. In the first round, the panel was asked to identify the needs of the child in the two case studies; in subsequent rounds the panel activity involved modifying these need statements and indicating the importance, frequency and maximum acceptable delay in meeting each need. Extensive pilot work was required for each round of the modified Delphi. This article evaluates the use of this technique to identify needs, discusses key features arising from the results and examines the difficulties experienced by the respondents in completing the time scales.
Health visitors’ perceptions of domestic violence: the private nature of the problem
Authors: Frost Marion
Published: March 2003

Health visitors’ perceptions of domestic violence: the private nature of the problem

This study investigates health visitors’ perceptions of domestic violence with a focus on the abuse of women by their male partners. Criticism has been levied at health visitors for responding inappropriately to women who seek help. There has been limited research into the process of health visiting practice in dealing with this emotive health need. The extent of the problem is difficult to ascertain, but estimates would suggest that it is a major public health issue. The abuse frequently commences or intensifies during pregnancy, and many of the women who experience domestic violence have children of pre‐school age. It is during this time that they are most likely to come into contact with the health visiting service. The research was carried out in two National Health Service (NHS) trusts, one in the London region and the other in the south‐east of England. A brief questionnaire was sent to all health visitors within the NHS trusts to ascertain the numbers of abused women known to the health visiting service. The findings suggest that the majority of health visitors in both NHS trusts were involved with families where domestic violence occurs. One of the key themes which emerged from interviews with 12 health visitors from each NHS trust (n= 24) was the very private nature of domestic violence in terms of identifying the issue. Implications for practice are that health visitors need to be more pro‐active in their questioning techniques and in influencing public policy, but they also require support through the provision of appropriate training.
Trends in ophthalmology services, nursing skill‐mix and education: 2nd national survey
Authors: Waterman Heather , Waterman Christine
Published: March 2003

Trends in ophthalmology services, nursing skill‐mix and education: 2nd national survey

This paper reports on a replication study of the first national survey commissioned by the RCN Ophthalmic Nursing Forum to assess the changing skill‐mix of staff caring for ophthalmic patients and the nature of ophthalmic services. After minor modifications to the original questionnaire, it was circulated to the total population of ophthalmic units and hospitals in the United Kingdom (n=181). Following quantitative data analysis, it was found that the numbers of nurses holding ophthalmic nursing qualifications has risen to almost 50%, although this did not reach statistical significance. This increase has occurred alongside a significant rise in numbers of institutions offering ophthalmic nurse education and the expansion of day case surgery. Regional variations exist, however, to the extent that the increase in ophthalmic nurses and provision of ophthalmic nurse education has not been reflected nearly as much in Scotland as the rest of the UK. Overall, it was also found that the proportion of C, G and I grade nurses has fallen significantly, whilst the numbers of nurses graded D and F has risen. The implications of the results are discussed and recommendations for future research made.
An evaluative study of clinical supervision based on Proctor’s three function interactive model
Authors: Bowles Nick , Young Christine
Published: March 2003

An evaluative study of clinical supervision based on Proctor’s three function interactive model

This paper reports on a study of the benefits reported from participation in clinical supervision by registered nurses (n=201) working in a large English community and mental health NHS Trust. It summarizes the emergent practical and theoretical ‘key ingredients’ of clinical supervision in the United Kingdom and argues that these provide a basis for generalizable research practice. The study is based on Proctor’s three function interactive model previously commended as a guide for supervisory practice and evaluation. Within this study, the three functions underpin instrument design but are also a primary focus of evaluation. The development of this instrument through semi‐ structured interviews with supervisors and supervisees is described. The study aims to assess and compare reported benefits in each of the three functions of accountability, skill development and support in order to examine the effects of contract use, length of experience of clinical supervision and length of service as a registered nurse on reported benefits by using non‐parametric statistical analysis. The results indicate that reported benefits are experienced in almost equal proportion across each of these three functions. Statistical analysis indicates a significant positive correlation between experience of clinical supervision and its reported benefits. An inverse correlation is reported between length of service and overall benefits; however, no similar reduction over time against normative benefits was found. There was no relationship between contract use and reported benefits. Limitations of the study are discussed with reference to bias, interview transcription and overlap between the three functions. The paper concludes that nurses report clear benefits from clinical supervision in each of the three functions. This validates the three function interactive model and demonstrates that clinical supervision is used to critically examine and change nursing practice. The content and usage of contracts is identified as an aspect that merits further study.
Transition to residential care: experiences of elderly Chinese people in Hong Kong
Authors: Lee Diana T.F.
Published: March 2003

Transition to residential care: experiences of elderly Chinese people in Hong Kong

A qualitative study was designed to explore the experiences of transition into residential care among elderly Chinese people in Hong Kong. With the elderly people’s consent, in‐depth interviews were conducted with 10 residents 1 week after their admission into a residential care home. The purpose of the interviews was to explore what the transition experience was like for the Chinese elders and how they settled into residential life. Content analysis of the interview data revealed the significance of cultural influences in the transition experiences. A number of issues suggested in the literature as barriers to adjustment to residential care, such as living with rules and regulations, lack of privacy and autonomy were not regarded as important by the Chinese elders. The Chinese values of balance, harmony and collectivism have made it easier for them to remain open and accept the communal way of living. Yet, these same values have restricted the elders in developing new relationships with staff and other residents. This appears to be the particular challenge facing Chinese elderly residents. Implications for professionals working with elderly residents are discussed in the light of these findings.
Caring: theoretical perspectives of relevance to nursing
Authors: McCance Tanya V. , McKenna Hugh P. , Boore Jennifer R.P.
Published: March 2003

Caring: theoretical perspectives of relevance to nursing

Caring as a central concept within nursing has led to the development of several caring theories, the most well known being Madeleine Leininger’s Theory of Culture Care and Jean Watson’s Theory of Human Caring, both of which were formulated in the 1970s. This paper explores a total of four caring theories: the two established theories presented by Leininger and Watson, Simone Roach’s theory developed in the 1980s, and a recent caring theory developed by Boykin & Schoenhofer. A comparison of these theories is presented drawing on a number of criteria, namely: origin of theory, scope of theory, definition of caring, description of nursing, key concepts of the theory, and goal/outcome. Additionally, simplicity as a central component of internal structure is examined in relation to each. Based on this analysis, similarities and differences are highlighted, concluding with a discussion of the utility of the caring theories within nursing practice.
Students’ perceptions of their psychiatric mental health clinical nursing experience: a personal construct theory exploration
Authors: Melrose Sherri , Shapiro Bonnie
Published: March 2003

Students’ perceptions of their psychiatric mental health clinical nursing experience: a personal construct theory exploration

Personal construct theory and repertory grid technique provides a suitable framework for exploring Registered Nursing students’ perceptions of their psychiatric practicum. This descriptive research was designed to understand students’ own ways of constructing knowledge during their mental health clinical experience. A constructivist conceptual perspective and George Kelly’s personal construct psychology were the theoretical bases of the research. A qualitative case study methodology allowed creation of and reflection on personal construct changes as provided in participants’ review of repertory grid ideas about psychiatric nursing. The participants were six Canadian second‐year nursing students in a Baccalaureate programme that integrated psychiatric and medical surgical nursing curricula. The following three overarching themes were identified and are used to explain and describe significant features of the psychiatric clinical experience: 1) students’ anxiety related more to feeling unable to help than to interactions with mentally ill patients; 2) students’ feelings of a lack of inclusion in staff nurse groups; 3) student emphasis on the importance of nonevaluated student‐instructor discussion time.
First‐time mothers and child care when the child is 8 months old
Authors: Tarkka Marja‐Terttu , Paunonen Marita , Laippala Pekka
Published: March 2003

First‐time mothers and child care when the child is 8 months old

The aim of the present study was to examine those resources and strengths that mothers find helpful for coping with child care when the child was 8 months old. This study is part of a more extensive longitudinal study project in which the growth into motherhood of first‐time mothers was followed for 8 months postpartum. Data were collected by using structured questionnaires between August 1995 and March 1996. The sample comprised 254 first‐time mothers and 248 mothers returned the questionnaires by mail. The multivariate method used was a stepwise regression analysis. Predictors included in the multivariate method to explain coping with child care were as follows: the mother’s competence, mother’s attachment to the child, mother’s self‐concept, relation to the spouse, breastfeeding, decision‐making support from the public health nurse and activity of the child. The strongest predictor was competence as a mother. The more competent the mother felt and the more attached the mother was to her child, the better her coping. The better the mother’s self‐concept and relationship with the spouse were, the better she succeeded in taking care of the child. If the mother still breastfed her child and received decision‐making support from public health nurses, she coped better in child care. Finally the more active the child was, the more the risk for unsuccessful child care increased. The results indicate that the first‐time mother’s successful coping with child care when the child is 8 months old is associated with her own resources and attachment to the child as well as activity of the child and breastfeeding. A good relationship between the spouses and support for decision making from the public health nurse also contribute to coping with child care.
The development of competency standards for specialist critical care nurses
Authors: Dunn Sandra V. , Lawson Di , Robertson Sally , Underwood Marianne , Clark Robyn , Valentine Teresa , Walker Nicky , Wilson‐Row Christine , Crowder Kerrie , Herewane Deb
Published: March 2003

The development of competency standards for specialist critical care nurses

In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry‐to‐practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into ‘domains’ or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or ‘elements’ and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non‐critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.
Hospital noise pollution: an environmental stress model to guide research and clinical interventions
Authors: Topf Margaret
Published: March 2003

Hospital noise pollution: an environmental stress model to guide research and clinical interventions

This commentary provides an expanded environmental stress model. Conceptual relationships between ambient stressors, ambient stress, and health are detailed. A three‐part intervention, enhancement of person–environment compatibility, is specified. Details are provided on how this approach to reducing environmental pollution/hazards and sustaining these changes may be influenced by sociopolitical values, technological advances, and motivation for control over hazards. Personal variables thought to mediate the impact of environmental stress on health, including intrinsic sensitivity to specific hazards, personality, restricted capacities, other stress, culture, personal preferences, stage of life, gender, and perceived social support, are highlighted. Research results on the stress and health effects of hospital noise on patients and nurses are summarized to provide support for the model. Future directions for research are recommended. Implications of the model for nursing, including an environmental activist role in an interdisciplinary effort to plan and implement noise abatement interventions, are described.
Mental health nurses and qualitative research methods: a mutual attraction?
Authors: Cutcliffe John R. , Goward Peter
Published: March 2003

Mental health nurses and qualitative research methods: a mutual attraction?

In response to issues arising out of curriculum developments, the authors wished to examine more closely the potential reasons why psychiatric/mental health (P/MH) nurses appear to gravitate towards certain research methodologies. This paper therefore briefly examines the essential differences between qualitative and quantitative research paradigms, focusing on philosophical, epistemological and methodological issues. It then proceeds to examine some of the essential characteristics and attributes of P/MH nurses and suggests some differences in emphasis between these and other disciplines of nursing. The authors posit that psychiatric/mental health nurses are drawn to the qualitative paradigm as a result of the potential synchronicity and linkage that appears to exist between the practice of mental health nursing and qualitative research. This apparent synchronicity appears to centre around the three themes of: (a) the purposeful use of self; (b) the creation of an interpersonal relationship; and (c) the ability to accept and embrace ambiguity and uncertainty.

Given this alleged synchronicity the authors argue that there are implications for nurse education and nursing research. Further it is possible that each nursing situation where the mental health nurse forms a relationship and attempts to gain an empathic sense of the individual’s world is akin to an informal phenomenological study, the product of which would be a wealth of qualitative data. However, as this would be a subconscious, implicit process, the data would remain predominantly unprocessed. The authors conclude that perhaps these data are the knowledge that expert practitioners draw upon when making intuition‐based clinical judgements.
The information needs and source preferences of women with breast cancer and their family members: a review of the literature published between 1988 and 1998
Authors: Rees Charlotte E. , Bath Peter A.
Published: March 2003

The information needs and source preferences of women with breast cancer and their family members: a review of the literature published between 1988 and 1998

A comprehensive and critical literature review was conducted to examine the information needs and source preferences of women with breast cancer and their family members. Relevant papers published between 1988 and 1998 were reviewed and despite their having several methodological weaknesses, a number of conclusions can still be drawn. First, women with breast cancer have distinct needs for information throughout their breast cancer journeys, indicating that information needs change with time since diagnosis and with treatment‐related events. Second, family members of women with breast cancer also have substantial needs for information. Third, women with breast cancer and their family members often prefer verbal forms of information from health care professionals (HCPs), particularly around the time of diagnosis. Women with breast cancer, however, are often dissatisfied with the information they receive from HCPs. Further, the family members of women with breast cancer often perceive their information needs to be ignored by HCPs. Finally, few studies have focused specifically on the information needs and source preferences of family members of women with breast cancer. These findings have a number of implications for nursing, both for clinical practice and nursing research, and these are discussed in the review.
The nurse–patient relationship: a consideration of its discursive context
Authors: Crowe Marie
Published: March 2003

The nurse–patient relationship: a consideration of its discursive context

This paper is a theoretical exploration of the discursive context that shapes the nurse–patient relationship. It represents a feminist poststructural consideration of the broader institutional and social context that influences the dynamics of that relationship. The characteristics of that relationship can be regarded as performances of subjectivity shaped by managerial, medical and nursing discourses. Both nurse and patient signify particular discursively constituted meanings to each other which shape the relationship. It is proposed that the discourses which inform how each should respond to the other encourage the utilization of disciplinary tactics by the nurse which relay to the patient what is expected of him/her. An effect of these disciplinary procedures is to rein in the caring potential of nursing practices. However, nursing’s relationship with women’s work and the social history of caring may provide it with a discursive context that recognizes the social significance of this work.
‘You feel helpless, that’s exactly it’: parents’ and young people’s control beliefs about bed‐wetting and the implications for practice
Authors: Morison  , Tappin  , Staines
Published: March 2003

‘You feel helpless, that’s exactly it’: parents’ and young people’s control beliefs about bed‐wetting and the implications for practice

Young people wet the bed when they fail to wake up to a full bladder. The causes of bed‐wetting are far from certain and this uncertainty is reflected in the diversity of treatments on offer and the lack of any guarantee that treatment will work in a particular case. Most young people are sad and ashamed about the bed‐wetting and want it to stop, but they vary widely in their belief in their own capacity to influence the situation, and in their optimism about what the future holds. The problem can persist into adolescence or even adulthood, with far reaching social and emotional consequences, both for the young people and their families. In an ethnographic study involving 19 families ‘perceived helplessness’ emerged as a key issue permeating the whole system and often activating a downward spiral, leading to abdication of effort and responsibility by the young people themselves, by their parents and sometimes by health care professionals. Informed by the insights gained from this study and an extensive review of the literature on perceived control the Family Perspectives on Bed Wetting Questionnaire has been developed to explore family members’ feelings, degree of concern and dimensions of perceived control relating to: effort, ability, luck, important others and the unknown. This questionnaire was used as a basis for structured interviews with family members in a longitudinal survey, involving 40 families attending one of nine community‐based, nurse‐led enuresis clinics in Greater Glasgow. It was found that only 38% of the young people were entering into treatment with the belief that they had the ability to be dry at night. This became self‐fulfilling, with only 33% achieving initial success of 14 consecutive dry nights in a 16‐week period (chi‐squared test, P=0·029). Seventy per cent of young people felt that luck was important, while most parents felt that luck had little part to play. Implications for practice include the need to assess the families’ readiness to engage in treatment, to create opportunities for effective control and to encourage realistic expectations.
A phenomenological study of early nursing experiences in Hong Kong
Authors: Wong Frances Kam Yuet , Lee Wai Man
Published: March 2003

A phenomenological study of early nursing experiences in Hong Kong

The experience of primary professional socialization is crucial for neophytes to learn to become a nurse. These early nursing encounters may also have long‐term effects on professional development of individual nurses. However, research into the early experiences of nurses has been poorly documented. This study endeavours to reveal the early lived nursing experience amongst a group of nurses in Hong Kong. This study adopts a phenomenological approach which involves the thematic analysis of the critical incidents provided by 77 subjects. Findings revealed that incidents associated with death and dying, and clinical learning embracing interpersonal relations and professional development, were the most memorable events. Nurses were in general not equipped adequately to communicate with the dying and the grieving relatives. The subjects disclosed that positive clinical encounters confirmed their value of nursing work and motivated them to stay in the profession. Conversely, the negative experiences made them seriously consider leaving nursing. A number of implications for nursing education have been drawn from the research findings.
‘Scraps’: hidden nursing information and its influence on the delivery of care
Authors: Hardey Michael , Payne Sheila , Coleman Peter
Published: March 2003

‘Scraps’: hidden nursing information and its influence on the delivery of care

What nurses commonly describe as ‘scraps’ are defined as the personalized recordings of information that is routinely made on any available piece of paper (hence scraps) or in small notebooks. The use of scraps is common in practice and has been noted in research from across the globe. Drawing on an empirical study it is argued that scraps are a unique combination of personal and professional knowledge that informs the delivery of care. The overall aim of the study was to discover how nurses define and communicate information about patients and the delivery of care to each other on an elderly care unit. The processes by which information was constructed and the organizational structure and interactions that influenced this were also identified. The research design was an ethnographic one that involved: observations of formal nursing end of shift reports (23 handovers) and informal interactions between nurses (146 hours); interviews (n + 34) with registered nurses, student nurses and nursing auxiliaries; and analysis of written records. Data were collected from five acute elderly care wards at a district general hospital in the south of England. A grounded theory analysis was undertaken which revealed that scraps may have a significant role in the communication of information and the delivery of care. Therefore a categorization of scraps within three main themes was undertaken. First, the analysis revealed the processes involved in the construction of scraps. Second, the content and role of scraps in influencing the delivery of care was exposed. Finally, the potentially confidential nature of scraps and consequent problems of storage and disposal was recognized. The findings are discussed in relation to a suggested model of the interrelationship between paperwork, scraps, handovers and the delivery of nursing care. It is concluded that scraps are significant in facilitating nursing care and that this should be recognized in research, education and practice.
Developing the research capacity of departments of nursing and midwifery based in higher education: a review of the literature
Authors: Cooke Alison , Green Barbara
Published: March 2003

Developing the research capacity of departments of nursing and midwifery based in higher education: a review of the literature

The purpose of this literature review is to identify those factors which might affect the research capacity of departments of nursing based in higher education, and to make recommendations based upon the findings to enable departments to develop their capacity to undertake research. There is a dearth of published research which directly addresses this issue and therefore publications were reviewed which related to: the impact on nurse educators of the integration of nursing into higher education; nurse educators’ attitudes towards research and their research role; analysis of the results of the 1992 and 1996 Research Assessment Exercises and commentaries on them; developing research within nursing generally; and factors affecting research productivity within nursing and related disciplines. The papers were analysed according to the following themes: academic qualifications; research skills; time available for research; motivation to undertake research; a culture of research; subject specialization; subject areas for research; research quality; and a nursing research council. The conclusions are first, that whilst there is a dearth of literature which relates directly to research capacity development in academic departments of nursing, there is much advice which can be drawn upon. Second, the article concludes that the factors affecting research capacity development are numerous and complex and it is not something which can only take place at the departmental level. There are also issues which require consideration nationally, as well as factors which depend upon the individual academic, and these impact upon the research capacity of academic departments of nursing. The factors are summarized at the end of the paper in the conclusions and recommendations.
The expression of sexuality in people with psychosis: breaking the taboos
Authors: McCann Eddie
Published: March 2003

The expression of sexuality in people with psychosis: breaking the taboos

While mental health professionals should recognize that people suffering from schizophrenia have sexual and relationship requirements, there appears to be a failure to address adequately the subject of human sexuality, particularly in the area of psychosocial rehabilitation. The broad aim of this small study was to identify the sexual and relationship needs of people being cared for in hospital and preparing for a return to community living. The objectives of the study were to discover the clients’ sexual expressions in the past and present, and to try to elicit hopes and aspirations for the future. An attempt was made to uncover some of the obstacles to the expression of sexuality and explore some of the clients’ subjective experiences of the issues. The number of respondents was 11 from a possible 15. Data were collected through: a questionnaire on demographic characteristics; an adapted version of a questionnaire investigating the determinant factors of sexual behaviour through life; and a semi‐structured interview devised to elicit subjective experiences regarding sexual expression. The findings show that people with psychotic illness are prepared to discuss issues relating to sex and relationship matters. No interviews had to be prematurely terminated. No exacerbations of symptoms were noted. All of the respondents showed an openness to discuss a range of intimate feelings. Most respondents seemed hopeful about the opportunity to form intimate and fulfilling relationships in the future. A drive towards more rigorous holistic nursing assessments and appropriate psychosocial responses is proposed.
Path analysis of efficacy expectations and exercise behaviour in older adults
Authors: Resnick Barbara , Palmer Mary H. , Jenkins Louise S. , Spellbring Ann Marie
Published: March 2003

Path analysis of efficacy expectations and exercise behaviour in older adults

The benefits of regular exercise for older adults are well documented and include improvements in physical, functional, as well as psychological, health. The purpose of this descriptive study was to test a theoretically and empirically based model describing the factors that influence exercise behaviour of older adults in the United States of America. The hypothesized model suggested that age, gender, and mental and physical health have an effect on self‐efficacy and outcome expectations, and that all these variables influence exercise behaviour. Exercise behaviour was hypothesized to have a reciprocal relationship with self‐efficacy expectations and mental and physical health. The convenience sample was 187 older adults living in a continuing care retirement community (CCRC) in Baltimore, Maryland. A one‐time health interview was conducted which included a measure of self‐efficacy and outcome expectations related to exercise, a measure of health status (SF‐12), and gathering of information from participants about their actual exercise behaviour. Of the 187, 71 (38%) reported participating in 20 minutes of continuous aerobic exercise at least three times per week over the previous 3 months. Six hypothesized paths were significant. The model fitted the data and accounted for 32% of the variance in exercise behaviour. Interventions that focus on strengthening self‐efficacy and outcome expectations can improve exercise behaviour in older adults.
An investigation into the use of serum albumin in pressure sore prediction
Authors: Anthony Denis , Reynolds Tim , Russell Linda
Published: March 2003

An investigation into the use of serum albumin, in pressure sore prediction

Objectives To ascertain the relevance of serum albumin and serum sodium as predictors of pressure sores in addition to the Waterlow score. Design Observational study of patients at risk of developing decubitus ulcers. Setting Staffordshire, in the midlands of the United Kingdom. Participants 773 elderly hospital in‐patients of a district general hospital. Measurements Waterlow scores and serum albumin and sodium. Development of a pressure sore. Results Logistic regression analysis of serum albumin, serum sodium and the Waterlow score showed the Waterlow score and serum albumin were significant predictors of pressure sores. Conclusions Serum albumin may, in this patient group (in‐patients over 64 years of age), be a useful predictor of pressure sore occurrence, though further work is needed to establish whether this is the case. Risk assessment of pressure sores can possibly be improved by adding serum albumin to one of the pre‐existing tools such as the Waterlow score.
The psychometric properties of the Miller Behavioural Style Scale with adult daughters of women with early breast cancer: a literature review and empirical study
Authors: Rees Charlotte E. , Bath Peter A.
Published: March 2003

The psychometric properties of the Miller Behavioural Style Scale with adult daughters of women with early breast cancer: a literature review and empirical study

Several researchers have suggested that the information‐seeking behaviours of patients need to be taken into consideration when assessing their information needs. This study reviews published evidence of the psychometric properties of the Miller Behavioural Style Scale, a tool commonly used to identify the information‐seeking behaviours of individuals under threat, and examines its reliability and validity with adult daughters of women with early breast cancer. Ninety‐seven adult daughters completed the MBSS and a 30‐item, self‐administered questionnaire, a tool designed to explore the information needs of adult daughters of women with breast cancer. The internal consistency of the monitoring and blunting sub‐scales of the MBSS was α=0·65 and 0·41 respectively. The blunting sub‐scale fell substantially below acceptable limits and was discarded from subsequent analyses. The monitoring sub‐scale possessed good test–retest reliability (n=17) with a 5‐week time interval (r=0·71, P < 0·005), as measured using a Pearson’s correlation coefficient. Furthermore, the majority (73·4%) of monitoring items possessed moderate or substantial test–retest reliability, as indicated by kappa coefficients. Finally, the monitoring sub‐scale possessed good construct validity, both discriminant and convergent validity, as measured by the univariate associations between monitoring behaviour and selected items from the information questionnaire and a demographic questionnaire. In conclusion, adequate support exists for the psychometric properties of the monitoring sub‐scale of the MBSS and its use with adult daughters of women with early breast cancer in future research. These findings have a number of implications for nursing research and these are discussed in this paper.
The use of randomized control trials in complementary therapies: exploring the issues
Authors: Richardson Janet
Published: March 2003

The use of randomized control trials in complementary therapies: exploring the issues

The current popularity of complementary therapies presents an interesting challenge to nurses and midwives. If they are to deliver such therapies themselves, or support patients in choosing appropriate therapies they will need to consider the professional and legal issues, in particular those regarding safety. Evidence for the effectiveness for complementary therapies is also a requirement in order that their integration into nursing practice can be justified. Purchasers are currently hampered by the lack of credible evidence for effectiveness and until that evidence is provided, access to such therapies through the National Health Service (NHS) will remain limited. The form that evidence should take has led to a lively debate about possible methodological approaches. There appears to be a clash between the medical profession and those working in the field of complementary therapy research, with the medical establishment advocating randomized control trials (RCTs). This contrasts with the view held by some advocates of complementary therapies that the RCT approach is reductionist and not applicable to such approaches. The pivot of the debate on the methodological approaches for evaluating complementary therapies is the contrast of two apparently different and diverse world‐views, and the assertion that methods developed in one world‐view are not transferable to the other. There is also some confusion within the field of complementary therapy over the applicability of RCTs to therapies such as acupuncture, and the mistaken assumption that trials which include a control group, are also required to be double‐blind. This paper is based on the need for good quality evidence of effectiveness in complementary therapy. It will set out the concerns associated with the use of RCTs within complementary therapy, together with the benefits and limitations of this approach. The paper will go on to review research options and propose some suggestions for future methodological approaches.
A model of burnout and life satisfaction amongst nurses
Authors: Demerouti Evangelia , Bakker Arnold B. , Nachreiner Friedhelm , Schaufeli Wilmar B.
Published: March 2003

A model of burnout and life satisfaction amongst nurses

This study, among 109 German nurses, tested a theoretically derived model of burnout and overall life satisfaction. The model discriminates between two conceptually different categories of working conditions, namely job demands and job resources. It was hypothesized that: (1) job demands, such as demanding contacts with patients and time pressure, are most predictive of exhaustion; (2) job resources, such as (poor) rewards and (lack of) participation in decision making, are most predictive of disengagement from work; and (3) job demands and job resources have an indirect impact on nurses’ life satisfaction, through the experience of burnout (i.e., exhaustion and disengagement). A model including each of these relationships was tested simultaneously with structural equations modelling. Results confirm the strong effects of job demands and job resources on exhaustion and disengagement respectively, and the mediating role of burnout between the working conditions and life satisfaction. These findings contribute to existing knowledge about antecedents and consequences of occupational burnout, and provide guidelines for interventions aimed at preventing or reducing burnout among nurses.
Quality of life in old age described as a sense of well‐being, meaning and value
Authors: Sarvimäki Anneli , Stenbock‐Hult Bettina
Published: March 2003

Quality of life in old age described as a sense of well‐being, meaning and value

The purpose of the study was to present a model of quality of life and related factors, to study quality of life in a group of elderly subjects, and to do preliminary testing of the model. Quality of life was defined as a sense of well‐being, meaning and value. The model includes health, functional capacity, and coping mechanisms as intra‐individual conditions for quality of life, while factors in the biophysical and sociocultural environment are described as external conditions. The study sample consisted of 300 subjects, aged 75 or older and living in Finland. Data were gathered by means of structured personal interviews. The participants’ quality of life was generally quite good. The correlations among the variables related to quality of life were significant, but the results of the regression analyses showed that the individual aspects of quality of life did not have identical explanatory models. The internal consistency of the instruments was good. The results give preliminary support to the model, but in future studies more attention must be paid to the conceptual and theoretical validity. In order to achieve results that can be applied in gerontological nursing practice, different groups and contexts must be investigated.
Care under threat in the modern world
Authors: Peacock John W. , Nolan Peter W.
Published: March 2003

Care under threat in the modern world

Despite enormous progress in the understanding and treatment of disease during the 20th century, the amount of care individuals receive from health professionals is arguably less than in previous decades. Being in the presence of caring people who practised human caring has always been the bedrock of services to individuals who were ill. With the rise of scientific positivism in the mid‐19th century, traditional ways of caring for sick people, not susceptible to scientific investigation and intervention, were either abandoned or discouraged. The spread of outcome‐orientated health services has led to care being redefined as the provision of the finest form of treatment that is financially viable. The spectre of a service in which the human dimension of caring is either prescribed or seen as invalid gives cause for concern. This paper argues for urgent re‐examination of what we understand by ‘care’.