bluuebunny/crossref_metadata_2025 huggingface dataset:
The experience of stress in parents of children hospitalized with long‐term disabilities
Authors: Hayes Virginia E. , Kjiox Janet E.
Published: December 2006

This paper discusses parents' perceptions of their stress when their children are hospitalized with long‐term disabilities. The study used a qualitative method. Data were collected with 40 parents through in‐hospital interviews, and were analysed using the method of constant, comparative analysis. Parents' own interpretation of their stress experience is considered in relation to their perception of their role. The data suggest that the hospitalization of a child requires parents to make changes in their usual parenting role. In describing the nature of the changes required, parents identified the need to understand the illness experience; become familiar with the hospital environment; adapt to their changing relationship with the child and other family members; and negotiate with health professionals about their child's care. Verbatim accounts are used in this paper to illustrate parents' interpretations of their hospital experience. Parents perceive their role in their hospitalized child's care differently than health professionals do, and it would appear that much parental stress is attributable to the ‘space’ between health care workers' understanding of parents' experience, and parents' own comprehension. If nurses understood parents' own perception of their hospital‐related stress better, more effective nursing care could be developed. Further research is needed in this important area.
Development of an empathic interaction skills schedule in a nursing context
Authors: Clay Mary
Published: December 2006

This study was an attempt to develop a means of teaching and assessing empathic interaction skills in the classroom and in the clinical situation. A descriptive‐analytic system of interaction observation was formulated from a theoretical standpoint, with videotape recordings of nurse‐patient interactions used as an additional data base. The schedule was applied to both student and qualified nurses in a variety of clinical settings and in the classroom. The videotape recordings were used as a means of assessing the validity and reliability of the schedule. The validity was ascertained in terms of content validity and criterion‐related validity. These two aspects of validity were appraised by reference to the professional judgement of experienced qualified nurses. Positive validity coefficients were obtained. The reliability was determined by estimation of inter‐rater reliability and intra‐rater reliability. Positive reliability coefficients were obtained. Observer objectivity was also calculated.
Evaluation of treatment goals: the use of goal attainment scaling
Authors: Stanley Brian
Published: December 2006

Several observations are made on certain problems which psychiatric nurses may face during the evaluation phase of the nursing process. It is argued that the key to successful evaluation in this field lies in planning the evaluation itself, thereby strengthening the scientific basis of nursing practice by empirical methods. The use of goal attainment scaling is presented as one approach to this end.
Geriatric rehabilitation on an acute‐care medical unit
Authors: Jackson Marilyn R
Published: December 2006

This study examined a geriatric rehabilitation pilot project on an acute‐care medical unit. Over a 6‐week period, using a 35‐item geriatric rating scale and a mental assessment tool, changes in behaviours of 23 patients admitted to the geriatric rehabilitation module were compared to changes in behaviours of 10 elderly patients on a regular medical unit. The patients' demographic characteristics, their nursing and medical diagnoses, and discharge patterns were reviewed. Significant changes in behaviours of patients on the rehabilitation model included: increased ability to care for themselves, to maintain balance, and to communicate with others; decreased restlessness at night; decreased confusion; decreased incidence of incontinence; and improved social skills. The paper describes the geriatric rehabilitation programme and discusses implications for nursing of elderly patients in acute‐care hospitals.
Assessing cognitive functioning of the elderly with the ‘Inventory of Piaget's Developmental Tasks’
Authors: McCurren Cynthia A. , Ganong Lawrence H.
Published: December 2006

The purpose of this study was to examine the reliability, validity, and utility of the ‘Inventory of Piaget's Developmental Tasks’ (IPDT) with elderly persons. The IPDT is a paper‐pencil assessment of levels of cognitive functioning. Seventy elderly adults responded to a battery of instruments. Reliability and validity estimates for the IPDT were acceptable. Data indicated that the IPDT has promise as a clinical assessment of cognitive functioning. Implications for patient teaching by nurses is discussed and suggestions for clinical use are made.
An introduction to the evaluation of nursing care: a review of the literature
Authors: Wright Dominique
Published: December 2006

A review of the literature, mainly since 1975, examining ways and means of assessing the quality and consistency of nursing care, and maintenance of high standards. Reference is made to audits, tests and peer reviews.
A view toward hospitalization: the Mexican American experience
Authors: Mardiros Marilyn
Published: December 2006

Little information exists in the literature to assist the nurse in understanding people of ethnic minority group status who become hospitalized in an acute‐care setting. Research on these populations has primarily centred on out‐patient service utilization and on folk health practices, yet the process of becoming hospitalized seems far more disruptive and traumatic to the individual and the family than receiving health care at a clinic. Observations made on a large medical‐surgical in‐patient unit in the south‐western United States indicated the specific concerns Mexican American patients experienced during their hospitalization. Seventy patients of Mexican descent were followed through their hospital stay. Seven socio‐cultural constructs influenced the hospital experience: social network, language proficiency, modesty, socio‐economic status, role expectations, folk beliefs and practices, and the medical diagnosis. Economic and educational status were seen as the most significant factors preventing patients from this ethnic minority group from constructing their hospital experience in accordance with staff expectations.
Group cognitive/anxiety management*
Authors: Jupp Hilary , Dudley Mike
Published: December 2006

A report on recent clinical work in group anxiety management was carried out by nurse therapists whilst undertaking the Joint Board of Clinical Nursing Studies Course 650, Adult Behavioural Psychotherapy (Short Term) in the Plymouth area, England. The group treatments described were based upon a three systems model of anxiety, and aimed to modify cognitive, behavioural and physiological deficits and excesses. The methods used and some collation of measures is shown, followed by discussion of the difficulties encountered. This discussion will relate to: the uses of measures; style of presentation of material, particularly in relation to cognitive change; and adaptability and scope of such groups.
Autogenic regulation training and sickness absence amongst student nurses in general training*
Authors: Bailey Roy D.
Published: December 2006

Sickness absence has been a long‐standing concern of the nursing profession. In this paper, sickness is construed as illness or the form a complaint takes. Absence is formulated as a form of coping. A longitudinal study using an experimental and control group design was carried out with student nurses using autogenic regulation training (ART). Comparisons of the relationship between ART and sickness absence records were recorded for: total days off; certificated and uncertificated days off; uncertificated days off; certificated days off; total blocks and total wards; first and second ward allocations; and average time sick. It is argued that ART helped significantly to reduce overall sickness absence in the experimental group when compared with the control group subjects. Reasons for this are discussed and issues for further research are raised. It is concluded from the present study that ART has a contribution to make in preparing student nurses to cope with the demands of nursing and sickness absence.
Educational achievement of nurses who completed the nursing education and the nursing administration certificate courses of the Department of Nursing Studies, University of Edinburgh, 1958–1975
Authors: Sinclair Helen C. , Hardy Leslie K. , Hughes Jill
Published: December 2006

This paper describes the educational activity of a group of 149 nurse teachers and administrators following completion of the nursing education and nursing administration certificate courses of the University of Edinburgh (1958–1975). The data were obtained by a postal questionnaire and three particular types of courses reported by the respondents are discussed. Emphasis is given to the analysis involving degree courses as this was a prominent educational activity, especially among nurse teachers. The conclusion discusses the potential of an all graduate nurse teacher group and suggests some implications for the nursing profession.
Nursing careers: findings of a follow‐up survey of graduates of the nursing education and administration certificate courses of the Department of Nursing Studies, University of Edinburgh, 1958–1975
Authors: Hardy Leslie K. , Sinclair Helen , Hughes Jill
Published: December 2006

The paper discusses the findings of a survey of the career progress of graduates of certificate courses in nursing administration and education, between 1958 and 1975, at the Department of Nursing Studies, University of Edinburgh. Five sections are presented: age, sex, career patterns, educational attainments and scholarly work. Issues arising within these sections are discussed.
Reflections on the cost of hospital nursing: a comparison of factors affecting time distribution in ward, theatre and outpatient departments
Authors: Monks Judith
Published: December 2006

An understanding of the influences upon nurses' time distribution is important for the evaluation of care and the justification of the cost of the nursing service. Time devoted to the care of breast cancer patients at different stages of their illness was studied by direct observation in ward, theatre and outpatient departments. Factors affecting the time spent with patients were found to differ in each location. In the ward and theatre, nurses' work was primarily patient‐orientated in that the most significant determinants of the amount of nurse‐patient contact appeared to be characteristics of the patients themselves. Particularly in the ward, nurses seemed free to make their own decisions concerning the patients who most needed their attention. In outpatient departments, organizational factors and the characteristics of the doctors conducting the clinics seemed most significant in determining nurses' time distribution. However, there were signs that nurses recognize differences between patients to which their current pattern of work organization does not allow adequate response.
A theoretical approach to nursing assessment
Authors: Campbell Janis , Finch Debra , Allport Charlotte , Erickson Helen C. , Swain Mary Ann P.
Published: December 2006

Nurses use theory to sharpen their observations and to facilitate their understanding of the human responses to which they direct their interventions. An assessment tool, derived from the nursing theory ‘modelling and role‐modelling’, was developed by nurses at the University of Michigan Hospitals. This tool appears to elicit the data necessary to assess and diagnose the health status of clients. This article describes the assessment tool, why it was developed, the objectives in utilization of the tool and suggestions for implementation.
The Neuman Systems Model in nursing education: course development and implementation
Authors: Bourbonnais Frances F. , Ross Margaret M.
Published: December 2006

Nursing education programmes increasingly are integrating nursing models into their curriculum. The model chosen can provide a guide for curriculum content as well as strategies for learning content. In the clinical setting a model can facilitate the student's nursing practice by assisting in the organization of observations and interpretation of data. This paper describes the introduction of the Betty Neuman Systems Model to fourth year baccalaureate students at the University of Ottawa School of Nursing, Canada. The selection of this model for a senior nursing course reflects its congruency with the school's philosophy of learning and nursing and the purpose of the course. Course development and implementation, teaching strategies and outcomes are discussed and reflect an attempt at incorporating a nursing model into course design.
A study to compare two models of community psychiatric nursing care delivery
Authors: Brooker C. G. D. , Simmons Susan M.
Published: December 2006

This study analyses data collected by the community psychiatric nursing team in the Bloomsbury Health Authority. After the 1982 National Health Service reorganization one large CPN team was created from two smaller ones each operating a separate mode of care delivery. Four CPNs were based at a day hospital and five CPNs worked from primary health care bases. Regular statistics collected by all the nurses were used to examine two hypotheses. First, there is a type of client seen by a CPN who varies according to the main base from which the nurse operates. Second, that there were differences in individual CPN ‘caseload activity’ that are determined by main work‐setting. The results indicated that the characteristics of the two client‐referral samples were indeed different using various measures of social deprivation and isolation. Substantial variations in ‘caseload activity’ between the two teams were also found, the largest difference being the number of hours spent in clinical activity, face to face with the client. Various implications of these findings for the overall planning and management of the CPN team are discussed. The overall conclusion reached is that, as Mangen & Griffith have suggested, the planning of CPN services requires the systematic collection of evaluative data on which to base future policies.
The role of communication in nursing — perceptual variations in student/teacher responses in Northern Ireland
Authors: Eastwood Christine M.
Published: December 2006

The value of sound communication/interpersonal skills in nursing has been clearly demonstrated over recent years. However, precise definition of what constitutes such skills, and how these skills should be developed, remains comparatively ill‐defined. This lack of positive definition in turn presents considerable difficulties for nurse training in communication skills, where both the basic purpose and value of such training may be perceived quite differently by teachers and by student nurses. Based on a field study in Nothern Ireland, this paper not only highlights some of the existing inadequacies of current nurse training in communication skills, but also examines some of the disturbing wider educational implications of this problem.
Successful breast feeding: the mother's dilemma
Authors: Harrison Margaret J. , Morse Janice M. , Prowse Margaret
Published: December 2006

A content analysis of 141 articles on breast feeding by discipline revealed differences in the factors considered necessary for breast feeding success and in the criteria used to determine success. Whereas medical articles focused on maternal factors prenatally and infant health post‐natally, or the length of time breast feeding was maintained, lay articles focused on the relationship of the mother with her infant (the nursing couple) and the mother's ability to manage breast feeding within the family context. The implications of this discrepancy for nursing practice and research are discussed.
The attitudes of nurse tutor students to behavioural objectives: results and discussion
Authors: Martin Harry , Sheehan John
Published: December 2006

This small‐scale empirical study provides evidence of the attitudes of a group of nurse tutor students to behavioural objectives. The questionnaire items used ranged from questions about behaviourism and the use of behavioural objectives in teaching, to a question on whether the participants would use behavioural objectives in their teaching once they had finished their course. It emerged that while there was not an uncritical acceptance of behavioural objectives, they were seen as having a place in the process of teaching and learning nursing.
The relationship between nursing theory and nursing practice
Authors: Miller Audrey
Published: December 2006

During the past two decades, redefinition of many of the beliefs and assumptions which underly nursing appears to have contributed to an increasing divergence between nursing theory and nursing practice. Nurses who are theorists and educationalists, and nurses who are engaged in nursing practice tend to use different vocabularies, to have differing perceptions of patients and of nursing, and to value different kinds of nursing knowledge. Some of the divergences between nursing theory and nursing practice are considered, and suggestions made about how theory and practice might be reconciled.
Nursing theory: a vehicle of professionalization?
Authors: Gruending Debra Lee
Published: December 2006

Nursing's bid for professional status has been and continues to be a hotly debated issue. Much of the debate rests upon the question of what exactly the word professional implies, for many nurses do in fact consider themselves to be professionals while others would disagree. This paper suggests that nursing is not a profession but it is engaged in the process of professionalizing. A professionalizing occupation utilizes various vehicles to reach its own ends and, for nursing, it is suggested that the development of nursing theory at basic and complex levels is one such vehicle. Selected professional criteria are examined and it is shown that nursing theory development aids in the attainment of these criteria, thereby allowing nursing to become more professionalized.
The needs of families who care for patients with cancer at home: are we meeting them?
Authors: Hinds Cora
Published: December 2006

A diagnosis of cancer in a family member has an impact on the entire unit. A study was conducted to determine needs perceived by families as they met the care requirements of such patients, to assess how families coped with these needs and to determine the resources they utilized. Families were selected from a stratified random sampling of patients who were receiving treatment at a local cancer clinic. Classification was by sex and site of disease. Families were interviewed in their homes. Descriptive statistics were used to summarize the data. Chi‐square test of independence was conducted on selective qualitative variables. Eighty‐three family members consisting of 43 males and 40 females with average ages 53 and 54 years respectively participated in the investigation. Families needed assistance with the physical care of patients. As many as 31% of them were coping poorly with this area of care. There were also several unmet needs in the psychosocial domain. The need most frequently expressed by families was for a place where they could turn to discuss their fears. Nineteen (23%) of the families knew of community services they could call on for assistance. Only seven (8%) of the families had utilized these services. These results suggest that fresh approaches might be needed in order to achieve our goal of family‐focused care.
Educational entry requirements for nurse registration: an historical perspective
Authors: White Rosemary
Published: December 2006

This paper examines the changing values in the General Nursing Council for England and Wales between the days before the National Health Service and the time when the minimum educational level for entrants to student nurse training was reinstituted in 1962. It discusses why the entry level was set at two ordinary levels of the General Certificate of Education, lower than the standard before the 1939 World War. The paper ends by arguing that the GNC became an agent of the government for the recruitment of nurses and the deskilling of nursing.
A comparison of recovery following hysterectomy and major cardiac surgery
Authors: Gould Dinah , Wilson‐Barnett Jenifer
Published: December 2006

Although monitoring progress is an everyday nursing activity, methods currently employed remain relatively undeveloped. In the past most studies documented physical recovery, tending to focus upon complications such as infection rates, which are quantifiable. Patients’ satisfaction with progress is seldom taken into account, although it may provide a more accurate reflection of progress. In this paper, recovery following major cardiac surgery and hysterectomy performed for benign lesions are compared in terms of psychological adjustment to the effects of surgery and resumption of a wide range of activities within and outside the home, in addition to physical progress. On the whole patients accepted the effects of hysterectomy and their own assessments of recovery proved favourable despite considerable residual physical problems of a minor but troublesome nature. In contrast, recovery from cardiac surgery was more difficult and proceeded more slowly, as expected following this major operation.
Non‐pharmacologic management of pain in the person with cancer
Authors: Mayer Deborah K.
Published: December 2006

Although non‐pharmacologic interventions have been available and have been described in the literature, it is questionable as to how effectively this knowledge has been translated into effective pain relief for the person with cancer. Little documentation is available about what is being used or how effective it has been. There is also very little research available to look at the various factors that relate to these issues. Therefore, more research in this area is needed to define actual practices, effectiveness of interventions, individuals most likely to benefit from this type of approach and the most effective combinations of the various interventions.

Another key problem may be the knowledge and past experiences of the nurse. Sanders et al. (1980) evaluated 37 nurses as to their knowledge of basic behavioural principles and terminology as well as which patients should have what principles applied. There was only a mean of 65% correct responses to a questionnaire designed to test their knowledge. Their findings suggest ‘that there is a need for more ‘formal’ training in behavioural principles and their appropriate application as part of nurses’ academic curriculum. Furthermore, such training should definitely include and emphasize methods to increase positive behaviour, as well as instruction in how to accurately discriminate when and with which patients behavioural methods would be appropriate’ (Sanders et al. 1980).

Nurses need to become more familiar and comfortable with these interventions and be aware of the benefits and limitations. This can be done through self‐study and practice as well as through formal courses.

Nursing management of the person with cancer experiencing pain should include an armamentarium of both pharmacologic and non‐pharmacologic interventions. These interventions may enable that individual to develop physical comfort and psychological peace. The ultimate goal of nursing management is to alleviate suffering so that the person experiencing cancer pain can function in as full a lifestyle as possible. Once successful, we may begin to alter the strong negative association between cancer and pain.
A study of nurse tutors’ conceptualization of their ward teaching role
Authors: Jones Jennifer A.
Published: December 2006

It is generally agreed by the nursing profession that the art and science of nursing can only be learnt in the direct delivery of patient care and that, in order to do this, students need to identify with a practitioner role‐model in the clinical area. This research arose from the belief that nurse educationalists are failing to provide these learning opportunities for their students. The focus of the study was to identify factors in the nurse teacher's work role which mitigate against their teaching in the clinical area. The methodology was chosen in order to demonstrate the nurse teacher's conceptualization of her work role. In the first stage of the project this involved the repertory grid technique. From the results, a semantic differential questionnaire was built up and used for an attitude survey of a second sample of nurse teachers. The research samples consisted mainly of nurse tutors but a small group of both clinical teachers and senior tutors was included for comparison studies. Results showed that the main factors leading to a lack of clinical teaching by educational staff include lack of control and a sense of conflict, stress and anxiety in the ward‐teaching situation, lack of peer support and an inability to plan ahead for such work. The most pervasive feature which emerged, however, was the felt lack of available time for clinical work vis‐a‐vis their other duties. This is discussed in terms of role strain. Differences in response between teacher grades were studied and showed that all the problems found appear to be greater among the nurse tutor group. This may be a consequence of a further finding that clinical teachers are more likely to make finer and more frequent distinctions between the aims and problems of ward‐ and school‐based teaching.
District nurse training: a pilot survey of demand, provision and students
Authors: Lopez Mario J. , Radford Nancy H.
Published: December 2006

A pilot survey of district nurse training provision for the period April 1982–March 1983 was carried out to provide a profile of training institutions; their resources (human and physical), courses and students. Information was collected by means of a postal questionnaire sent to the 50 UK training institutions. The survey highlighted differences between district nurse and district enrolled nurse training; variations in entry requirements, size and length of courses, and staffing. It also gave an overview of students’ characteristics and provision of training for other professional groups. It proved the feasibility and value of collecting such information, and also provided the basis for a current study (Baseline Data Project), which will produce a package of survey material, and software for analysis to enable the subsequent collection of information.
A descriptive study of the attitudes of baccalaureate student nurses toward the elderly
Authors: Downe‐Wamboldt Barbara L. , Melanson Patricia M.
Published: December 2006

Using a questionnaire entitled ‘Opinions about People', the attitudes toward ageing and the elderly of 70 students beginning and 21 students completing a 4‐year baccalaureate nursing programme were compared with the attitudes of 31 registered nurses entering a 3‐year university nursing programme. Thirty students beginning the 4‐year baccalaureate physiotherapy programme were included in the control group which also served as the pilot study. Findings revealed few significant differences between students entering a basic or post‐registration baccalaureate programme. The cross‐sectional comparison of students entering and completing a 4‐year university nursing programme indicated a significant difference on one of the seven attitudinal scales (family responsibility for the elderly). Results, implications for nursing education, conclusions and recommendations are discussed.
Sleep patterns of aged persons in long‐term care facilities
Authors: Clapin‐French Eileen
Published: December 2006

The nursing staff of long‐term care facilities are often faced with the decision of whether or not to administer sleep medication when it is ordered ‘prn’. This decision should be made on the basis of information contained in the patient's nursing sleep history as well as knowledge regarding the effects of sleep medication. This study was carried out to assess the factors involved in changes in sleep patterns of elderly patients in long‐term care facilities and to evaluate the extent of use of the nursing sleep history. The sleep patterns of 102 elderly patients (mean age 78.7 years) in three long‐term care facilities were assessed by means of interview questionnaire. Patients’ records indicated that 71% were receiving some type of sleep medication on a regular basis. A quantitative analysis of their responses indicated that there were significant shifts in sleep patterns following admission. Only 54% of the patients in this study had a nursing sleep history and this contained only minimal information. The results indicate that the nursing sleep history is under‐utilized. A better appreciation of the patient's sleep requirements could lead to a reduction in the amount of sleep medication given and an improvement in the general well‐being of the long‐term care elderly population.
Social dramatics: social skills development for the chronically mentally ill
Authors: Whetstone William R.
Published: December 2006

The purpose of this study was to investigate the use of social dramatics as a clinical tool for teaching social skills to the chronically mentally ill on adult inpatient units of a state hospital. The research tested the hypothesis that patients exposed to social dramatics with videotape feedback would demonstrate greater ability to perform social skills as measured by the Nurses’ Observation Scale for Inpatient Evaluation (NOSIE‐30). Fifteen schizophrenic adults of both sexes meeting specific criteria were randomly assigned to experimental and control groups. Subjects were exposed over an 8‐week period to randomly introduced social dramatic scenarios. The Wilcoxin test for two independent samples was used for testing differences between experimental and control groups. The research findings supported the hypothesis for one positive factor, social competence. The findings did not support any treatment effect on either social interest and personal neatness or irritability, manifest psychosis, and psychotic depression. There were no significant differences on the total score NOSIE‐30. Recommendations for psychiatric nursing are made. Limitations of research methodologies and sample size were addressed.
Self‐esteem, types of attributional style and sensation and distress pain ratings in males
Authors: Feldman Harriet R.
Published: December 2006

This descriptive study focused on self‐esteem and types of attributional style, and their relationship to sensation and distress pain ratings. Negative correlations were hypothesized between self‐esteem and each pain rating, between positive internal type of attributional style and each pain rating, and between negative external type of attributional style and each pain rating. One hundred and nine healthy, non‐institutionalized males, aged 21–50 years, participated in this study. The Tennessee Self‐Concept Scale and revised Attributional Style Questionnaire were administered prior to the cold pressor test, a safe, short duration cold water hand immersion procedure for pain induction. Sensation and distress pain ratings were measured using visual analogue scales, and a pain history was obtained. The predicted relationship between self‐esteem and distress pain ratings was supported. All other correlations were not statistically significant. A pain history question, asking subjects to rate their pain tolerance as compared with other people, was significantly related to both pain ratings, the correlations being negative.
What 1357 hospital inpatients think about aspects of their stay in British acute hospitals
Authors: Moores B. , Thompson A. G. H.
Published: December 2006

Following on a long series of interviews and pilot studies a substantial questionnaire was devised for soliciting the reactions of patients to their stay in hospital. With the cooperation of health authorities it was distributed to ex‐patients in seven acute hospitals. A total of 1357 respondents returned a completed questionnaire. In this paper the responses to some 17% of the questions are presented. Most of these particular questions have been selected because they are concerned with nursing issues but a few others are included on account of their relevance. What comes across very clearly from the pattern of responses are the wide disparities between hospitals. Given that the questions were deliberately intended to be very specific a comparison of the results obtained in one institution with the overall averages does enable attention to be focused on areas where improvements are called for. In fact a number of health authorities, recognizing this feature, have since commissioned studies.
Nursing and health care in the twentieth century: myth, reality and dichotomy
Authors: Smith James P.
Published: December 2006

In this Fourth Ruth Langton Memorial Lecture, the author highlights some of the major health problems in children, mentally and physically handicapped people, and in the growing numbers of elderly people in society. Nurses’ roles are discussed. He identifies many major areas of concern and points out that many of the afflictions affecting people throughout the world, such as infectious diseases, blindness and malnutrition, could so easily be prevented. The author also focuses on the diseases caused by unhealthy lifestyles, in particular heart disease, cancers, drug addiction and obesity. He argues that a redirection of resources spent on arms and defence could do much to alleviate disease and suffering throughout the world. He also questions the present effectiveness of nursing education programmes and community care programmes. The paper concludes with a challenge to all nurses to explode the myth that society is becoming healthier, to face the reality of the urgent need for more primary health care and health education programmes, and to heal the dichotomy between present nursing and health care provision and the actual health needs of society.
Indicators of quality in nursing care — an alternative approach
Authors: Kitson Alison L.
Published: December 2006

Indicators of quality of nursing care were developed from a conceptual framework for geriatric nursing based on the twin concepts of care and having a positive attitude to the health and welfare of old people. These primary concepts were further developed using structural aids, in particular the theoretical guidelines for practice disciplines propounded by Dickoff et al. From this, a measure, called the Therapeutic Nursing Function (TNF) Indicator, was devised which attempted to identify those ward sisters who provided more patient‐centred or therapeutic nursing care from ward sisters who gave routine‐centred or non‐therapeutic nursing care. The TNF Indicator, based on the conceptual framework, comprised a list of statements to which ward sisters responded. The scaling system divided responses into more — or fewer —therapeutic nursing responses. A stratified random sample of 25 ward sisters was used in the study and from this the characteristics of ward sisters in the upper and lower range of the scale were compared. Distinct variations were noted between groups in relation to demographic information, perception of geriatric nursing, use of nursing information, management approach and the ward sisters’ concept of rehabilitation. A further instrument, the Therapeutic Nursing Function Matrix, attempted to measure the quality of care patients were receiving on geriatric wards. Nurse‐patient interaction on a ward where the ward sister had a high TNF Indicator score was compared to a ward where the ward sister had a low score. The results showed that quality of care seemed to be related more to the orientation and perception of the ward sister than to any number of extraneous variables such as medical and paramedical input, ward facilities and ancillary staff support.
Planning and evaluating innovations in nursing practice by measuring the ward atmosphere
Authors: Miline Derek
Published: December 2006

A controlled evaluation of nurses’ and patients’ perceptions of the hospital ward atmosphere served to both define problems and evaluate the corrective changes that were implemented in a psychiatric day hospital. The results indicated that nurses and patients held similarly unfavourable views of the ward at a baseline assessment, including low levels of support, involvement, spontaneity and programme clarity. This finding then served as the basis for systematic changes, including staff training, the regrouping of patients, and revising the therapeutic programme. A repeat evaluation then indicated that these changes had significantly improved the ward atmosphere from the perspective of both nurses and patients. It is concluded that this approach holds considerable promise for the implementation of changes in nursing practice.
Two faces of nurse faculty: teacher and researcher
Authors: Hamilton Glenys A.
Published: December 2006

The purpose of this paper is to examine three topics related to nurse educators and research productivity. The first section is an analysis and synthesis of what is known about nurse educator involvement in research activities from published studies. The second section is an examination of factors that may enhance or deter nurse educators from engaging in research activities. The focus of the last section is on the relationship between research and teaching quality. Empirical data are examined and recommendations made for nurse faculty.
Nurse administered oral hygiene: is there a scientific basis?
Authors: Trenter Phyllis , Creason Nancy S.
Published: December 2006

The concept of nurse administered oral hygiene is developed in a summary of selected nursing, medical and dental literature. The purpose of the review is to identify implications for nursing practice and research. The significance of oral hygiene to nursing is presented from physiologic, pathophysiologic, psychosocial, epidemiologic and economic perspectives. Tools, chemicals and frequency for nurse administered oral hygiene are discussed in relation to dental theory and relevant nursing research is critically reviewed. The therapeutic value of common commercial products, such as the foamstick and the lemon and glycerol swab, is not established in the literature. Methodological issues, implications for practice and suggestions for future research are presented.
Morning care of patients with Alzheimer‐type dementia. A theoretical model based on direct observations
Authors: Sandman P. O. , Norberg A. , Adolfsson R. , Axelsson K. , Hedly V.
Published: December 2006

Five hospitalized patients in different stages of Alzheimer‐type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self‐care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12‐step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance.
Pressure sore prevention and treatment: an example of nurses’ failure to implement research findings
Authors: Gould Dinah
Published: December 2006

For more than 20 years pressure sore prevention and the treatment of established pressure sores have continued to generate research by nurses and those in allied disciplines. Pressure sore aetiology is established and much is known about the healing of chronic wounds, but little impact has been made on clinical nursing practice. The failure of nurses to implement research findings in this sphere is examined according to the framework suggested by Hunt (1981). One of the main reasons may be the failure of nurse educationalists to incorporate relevant material into basic and post‐basic teaching programmes.
Children's pain vocabulary
Authors: Jerrett Mary , Evans Kathleen
Published: December 2006

This paper will address children's pain vocabulary, that is, the self‐reported words provided by the children, in a descriptive study carried out to examine how a group of school‐age children view their pain. This was an initial step to demonstrate that children can describe pain and do possess a pain vocabulary. Our aim was to determine the feasibility of achieving a meaningful grouping of children's pain words and the pain intensity implied by the words. A sample of 40 school‐age children were the subjects for this study. All the pain word descriptors used by the children in response to the question‘Can you think of words to describe what pain feels like?‘were categorized on the basis of the Melzack classification.
Teaching practice experience: linking theory to practice
Authors: Ayer S. J.
Published: December 2006

This paper analyses the relationship between the theory and practice of the art of teaching as experienced by the author during a period of teaching practice in a school of nursing. It examines such concepts as ‘aims’, ‘objectives’, 'scheme of work’ and ‘lesson plans’ and sets these in the context of practical classroom teaching.
A stress management programme for inflammatory bowel disease patients
Authors: Milne Barbara , Joachim Gloria , Niedhardt Joseph
Published: December 2006

This randomized controlled trial was designed to determine whether practising stress management techniques would decrease disease activity and promote psychosocial functioning in inflammatory bowel disease patients. Eighty ambulatory adults received a pre‐intervention interview, at which time baseline data about disease activity and psychosocial functioning were collected. They were then randomly assigned to either the intervention or control group. The intervention group received six classes on stress management which included autogenics, personal planning skills and communication techniques. All 80 subjects were followed up at 4‐month intervals for 1 year by interviewers who were blind to group designation. The data collection instruments, which were used at all assessment points, comprised three questionnaires: the Crohn's Disease Activity Index (CDAI) and the Inflammatory Bowel Disease (IBD) Stress Index. These instruments produced scores which decreased with improvement in physical and psychosocial well‐being. At all assessment points, both the CDAI and IBD Stress Index scores dropped significantly (P<005) from baseline in the treatment group. However, there was no significant change in the scores ofthe control group throughout the study year. There were no significant changes in medications at any assessment point in either group that could account for changes in the scores. The results of this study indicate that stress management techniques may have therapeutic benefits for IBD patients.
The influence of a positive environment on the attitudes of student nurses towards the nursing process
Authors: Bowman G. S. , Thompson D. R. , Sutton T. W.
Published: December 2006

The attitudes of 67 student nurses towards the nursing process were studied by means of a questionnaire. Attitudes became more favourable over the 8‐week study period. The results indicate that a positive environment is influential in changing the attitudes of student nurses towards the nursing process. These findings lend further support to our original work.
Burnout and professional depression: related concepts?
Authors: Firth H. , McIntee Jean , McKeown P. , Britton P.
Published: December 2006

In 1978 Oswin documented a process of ‘professional depression’ affecting some nursing staffin long‐stay hospitals. This study tested the hypothesis that ‘professional depression’ in long‐stay nursing and ‘emotional exhaustion’ as a component of burnout describe a similar phenomenon. This hypothesis was supported. The results are consistent with Cherniss’ characterization of burnout, which appears to show considerable similarities to the concept of depression. In this study professional depression demonstrated a substantial correlation with depressed mood. Personality demonstrated significant relationships with burnout variables, extrapunitive hostility correlating with hardening toward others, intropunitiveness with avoidance as a coping response. These findings, although confined to hospital nurses, support the usefulness of approaches stressing the interaction between the work environment and the individual.
Health care students’ attitudes towards, and intention to work with, patients suffering from senile dementia
Authors: RN Sture Åström
Published: December 2006

Health care students’ attitudes towards and intention to care for patients suffering from senile dementia were measured by questionnaire during the last week of their education. The relationship between curriculum content and attitudes and other variables which affect student training is discussed. It was noted that education on dementia lagged behind the needs of students. Factorial analysis of the respondents’ answers on the attitudinal items indicates generally negative attitudes to demented patients. Few female, and none of the male, students stated an intention to work with demented patients. Fear of death and experiences of patients dying are described, and are seen as crucial factors in the care of demented patients.
Sickle cell disease: implications for nursing care
Authors: France‐Dawson Merry
Published: December 2006

Abnormal haemoglobins produce a variety of anaemias which range in effect from being very mild to lethal. The most common of these are the sickle cell disorders and thalassaemias. In London, thalassaemia affects 3‐5% of the Maltese population, 2‐5% of the Italian population and 1‐5% of the West Indian population respectively. Seventeen per cent of the Cypriot population carry a thalassaemia gene. Sickle cell disease occurs in 500:100 000 people in Britain's black population but is not exclusive to people of Afro‐Caribbean origin. The gene is carried by 1 in 10 people. Sickle cell disease is statistically more prevalent among the host population than is phenylketonuria (10‐12:100 000), hypothyroidism (20:100 000) and cystic fibrosis (62‐63:100 000) in the general population. Although these diseases are routinely screened for at birth, there is no general strategy among district health authorities for sickle cell screening. It has been shown that of 76 health districts with a 3 +% ethnic minority population, 30 of which have an ethnic minority population of ‘over 10%’, only 6 have a comprehensive health care policy for people with sickle cell disease.
The doctor‐nurse relationship: an historical perspective
Authors: Keddy Barbara , Jones Margaret , BN Pat Jacobs , Burton Heather , Rogers Maureen
Published: December 2006

The purpose of this historical research was to explore the evolution of the doctor‐nurse relationship. Specifically, older nurses were interviewed regarding their nursing interactions with physicians approximately 50 years ago. A grounded theory approach was employed to analyse the data. Inherent to the difficulties nurses experienced was the dominant power position assumed by doctors in the health profession. The data give added insights into the development of this relationship. It was found that because nurses were educated primarily by doctors and because they were hired by doctors if they were considered to be ‘good’ nurses, a sex role stereotype of the nurse emerged. Historically these roles have influenced and continued to influence the nursing profession.