bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care: comparisons between a ward for severely demented patients and a similar control ward
Authors: Berg Agneta , Hansson Ulla Welander , Hallberg Ingalill R
Published: March 2003

The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses (n= 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward (n= 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses’ creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support
The health care needs of ethnic minority groups: are nurses and individuals playing their part?
Authors: Thomas Veronica , V THOMAS
Published: March 2003

The UKCC Code of Professional Conduct for nurses, midwives and health visitors stresses the need to have an understanding of the social and cultural determinants of health and illness There is as yet little evidence of what might constitute good practice in this area and it is difficult to ascertain why this basic philosophy is not translated into action Indeed, the nursing and midwifery professions’ ability to deliver adequate and appropriate health care more generally to Britain's multiracial, multicultural population has been questioned This literature review presents evidence which strongly suggests that although we are living in a multicultural society patients from minority ethnic groups are additionally disadvantaged because the initiatives by nurses, and others working in the National Health Service, to meet their health care needs are inadequate and often inappropriate
The politics of nursing: a framework for analysis
Authors: Hewison Ahstair
Published: March 2003

The phrase the‘politics of nursing’ has become part of the language of the nursing profession However, the meanings attributed to this phrase in the literature are not always clear The difficulties involved in arriving at an accurate definition of the term are discussed and the suggestion is made that this emerging area of study would be advanced if greater accuracy, in using the terminology, was employed when discussing and researching nursing politics A framework, drawing on approaches that have been taken to address similar problems in the study of power, is proposed as a means of arriving at‘tighter’ definitions for the terms involved The conclusion is that if a degree of conceptual clarity is introduced, the work to expand the field of knowledge can progress in a more systematic way through the investigation of specific areas and levels of interrelated political activity The debate is at an early stage and more work is needed to increase our understanding of this phenomenon
Preventing child maltreatment through community nursing
Authors: Browne Kevin
Published: March 2003

The role of community nurses, such as health visitors, in the prevention of child abuse and neglect by home visits is reviewed The paper evaluates the potential of community nurses for predicting and identifying families at high risk for child maltreatment in order to support them through the promotion of positive parental knowledge, attitudes, skills and behaviour The success of health visitor interventions to prevent family problems is also evaluated The review concludes that accurate prediction of child‐maltreating families requires more than one screening procedure to reduce the number of false alarms, and suggests that health visitors might be trained in the objective assessment of parent‐child interaction Few health visitor interventions were deemed a success, indicating that greater support and training is required for community nurses if they are to be used to prevent child abuse and neglect However, recent changes in the community nursing services and the purchaser‐provider split in health care has reduced this possibility
Theory from practice for practice: is this a reality?
Authors: Tolley Kim Ann
Published: March 2003

Dickoff & James assert that theory comes from practice for practice This paper will explore the reality of this statement in nursing today The nature of nursing knowledge from an historical perspective facilitates an understanding of where nursing theory development is today The purpose of theory is debated and the motivation for its development considered Practice theory, theory which is developed from practice for practice, is analysed, and this is advocated as one method to reduce the theory‐practice gap in nursing Whether practitioners are able to undertake the development of practice theory is discussed and some obstacles identified Reflection and action research have been offered as methods to facilitate the development of practice theory by practitioners
Changing nurses' pain assessment practice: a collaborative research utilization approach*
Authors: Dufault Marlene A , Bielecki Cynthia , Collins Elinor , Willey Cynthia
Published: March 2003

It is not uncommon for a decade to pass between the time a research problem is identified and the time that research‐based solutions are translated into standards for care This quasi‐experimental study demonstrated the effectiveness of a collaborative research utilization model directed towards the transfer of specific research‐based knowledge (pain assessment) into practice for the purpose of helping to solve pain management problems At the same time, nurses who participated in the model significantly improved their competency in research utilization and their attitudes towards research when compared to a control group who did not participate in the model
The nurse‐doctor relationship: a selective literature review
Authors: Sweet Sarah J , Norman Ian J
Published: March 2003

The disciplines of nursing and medicine are expected to work in unusually close proximity to one another, not just practising side by side but interacting with one another to achieve a common good the health and well‐being of patients This selective review of literature addresses some of the issues arising from the frequently controversial subject of the nurse‐doctor relationship and seeks to draw out the principal themes emerging from the application of sociological theory to the nurse‐doctor relationship and research into its operation in clinical settings Particular attention is paid to the ‘doctor‐nurse game’, a stereotypical pattern of interaction, first described m the 1960s, in which (female) nurses learn to show initiative and offer advice, while appearing to defer passively to the doctor's authority This pattern of interaction seems less common in clinical practice today but the problem remains of each profession having ideal expectations of one another which inevitably fall short as a result of differing views of qualities of doctors and nurses to be valued
Role, role enactment and the health care practitioner
Authors: Scott P Anne
Published: March 2003

When thinking about the composition of ethics courses for health care practitioners it is necessary to consider carefully the role of the health care practitioner An analysis of the concept of role and of the role of the health care practitioner will, the author argues, help to clarify what it is reasonable for society to expect from its health care practitioners, from the moral point of view The author argues that the most helpful way to view the connection between a person and her/his role is one in which the individual interacts with and is formed by her/his role and in turn shapes and influences the role The latter is evidenced by the quality of the person's role enactment This interactive relationship between person and role has particular implications for the education of health care practitioners The author argues that the quality of the practitioner's role enactment and moral sensitivity has a direct bearing upon patient care Given that this is the case, emphasis should be placed on the ideas of role, role enactment and moral strategy during the education of health care practitioners
Project 2000: a review of published research
Authors: Elkan Ruth , Robinson Jane
Published: March 2003

The findings of research into the implementation of the Project 2000 reforms of nurse education in England and Wales are reviewed in this paper The work of nine research teams who have published their findings between 1990 and 1994 is reviewed Following a brief summary of the major Project 2000 recommendations, the findings of the various research teams are presented Both successes and difficulties in implementing Project 2000 are highlighted The findings are discussed in the light of the original Project 2000 proposals, and it is concluded that, notwithstanding‘teething’difficulties, the Project 2000 reforms are proving workable in practice
A sharing in critical thought by nursing faculty
Authors: Hendricks‐Thomas Joyce , Patterson Elizabeth
Published: March 2003

A critical analysis of nurse education programmes has revealed an overtand covert curriculum, the overt being the one underpinned by values which espouse humanism and critical thought, the covert being the one which reflects the patriarchal system and is directed by a means‐end rationality In response to this dilemma the ‘curriculum revolution’ mandate for change, which occurred in the latter half of the last decade, called for nurse educators to unveil, understand and criticize the assumptions and values which guided their practice, so that they, and consequently their students, could be more responsive to the needs of society, value subjective experience, acknowledge theoretical pluralism, and share an egalitarian relationship This paper explores the formation of a ‘critical collective’ of nurse academics who came together believing that, ‘if you always do what you've always done, you'll always get what you've already got’The major concern of this collective was to facilitate change within their work environment, through the development of strategies, so that the ideas of the‘revolution’ were not lost to the mere rhetoric of curriculum documents
Drug administration errors: a study into the factors underlying the occurrence and reporting of drug errors in a district general hospital
Authors: Gladstone Jill
Published: March 2003

Drug administration is one of the highest risk areas of nursing practice and a matter of considerable concern for both managers and practitioners The aim of this study, earned out in a district general hospital, was to identify any common themes that underlie the occurrence and reporting of drug administration errors Data were collected from a variety of sources drug error reports, questionnaires to nurses and nurse managers, and interviews with nurses who had been involved in drug errors Several areas of particular concern emerged, including the nurses’ confusion regarding the definition of drug errors and the appropriate actions to take when they occurred, their fear of disciplinary action, their loss of clinical confidence, the variation in managerial response, and a possible lack of nurses’ mathematical skills The results from the study demonstrated that it was likely that many drug errors were not reported, for a variety of reasons It is recommended that all of these issues are addressed as a matter of urgency, for the sake of both patients and nurse practitioners
The experiences of patients and their partners 1 month after a heart attack*
Authors: Thompson David R , Ersser Steven J , Webster Rosemary A
Published: March 2003

The purpose of this study was to explore any patterns that may be evident in the experiences of 20 patients and their partners 1 month after a first heart attack An interpretive research approach was used to illuminate the illness experience of patients and its impact on their partners Semi‐structured interviews were conducted with the participants, and qualitative analysis of the data revealed six major categories These were expectations about advice and information, feelings about the future, reactions of the partner, playing down the significance of the heart attack, wanting to get back to normal, and the effect on the couple's relationship These findings are discussed in relation to the theoretical literature and other empirical research The results of this study may provide pointers to the implications for practice of nurses, particularly on ways to improve support for patients and their partners during early convalescence
In praise of ivory towers
Authors: Chapman Ernest
Published: March 2003

Mrs Gillian Shepherd, during her tenure as the United Kingdom's Secretary of State responsible for education, announced proposals for a national curriculum for the preparation of teachers — prescribing, for the first time in the United Kingdom, the skills that all teachers should be taught. It seems timely, therefore, to reflect on exactly what is happening to education in general and nursing education in particular in the United Kingdom. The developing climate of opinion (at least from the politician's viewpoint, and perhaps the general public's) is that education should be skills‐based — that is, that certain actions and behaviours should be taught that will produce an end product that is ‘marketable’ and competent to carry out certain ‘tasks’. These tasks may be mathematical skills, applying a wound dressing, writing correct English, or any precise measurable activity. The philosophical foundation of this approach is two‐fold: (a) with limited resources, it is right to target education towards the vocational needs of an industrial and commercial society improving competitiveness; and (b) that which produces practical end results has more moral worth than pure academic pursuits, no matter how intrinsically valuable they may seem to be.
A comparison of the reported early experiences of student nurses with those of a group of people outside the helping professions
Authors: Phillips Pauline
Published: March 2003

In order to investigate the psychodynamic concepts of ‘reparation’ and ‘compulsive caring’ as possible motivations for a career in nursing, a questionnaire was given to two groups of respondents, 115 nursing students 97 people not involved in any of the helping professions. Both groups were asked whether or not they had experienced specific, potentially distressing events and circumstances in their childhood and teenage years. The null hypothesis was that there would be no statistically significant differences between the two groups on frequency of affirmative responses to these questions. Chi‐square tests were used to determine the differential frequency responses to 11 of the 14 questions, and statistically significant differences were identified. The nursing students had a significantly greater total number of recollected adverse experiences, and there was a significantly greater number nursing students recollecting at least one. Significance on this result was maintained when males and females were analysed separately and together, with a higher level of significance reached for males than for females. Statistically significant differences between the two groups on their response specific questions were greatest for the questions about separations from mother or main carer and about the occurrence of major difficulties not covered in other questions. There is strong evidence for a rejection of the null hypothesis, the implications of which are discussed.
Encounters, endings and temporality in psychiatric nursing
Authors: Walsh Kenneth
Published: March 2003

This paper is derived from data obtained from a study in progress. The study is a phenomenological research project grounded in the work of Martin Heidegger and Hans‐Georg Gadamer. Psychiatric nurses were interviewed about their experience of the nurse‐patient encounter. During the course of the study it became apparent that the significance of encounters did not‘end’with the termination of the relationship.‘Endings’went further than notions of relationship‘termination’familiar in the psychiatric nursing literature. The ending of the encounter seemed to encapsulate much of the significance of the encounter for the nurse. It also became apparent that, for these nurses, time was not experienced in a linear way. Viewed in this non‐linear way, the past is no less meaningful for being past. The past is with us and influences the present, that is, our actions now. The future is no less meaningful for having not yet been. The future engages us in possibilities. So, unlike the narrow concept of termination, the lived experience of endings captures the totality of the relationship and the encounter and therefore lives on in the present. In the lived experience of endings the past and the future are both significant and have meaning.
Ethnography: studying the fate of health promotion in coronary families
Authors: Preston Rosemary M.
Published: March 2003

The concept of the‘mindful body’,‘coronary candidacy’and‘prevention paradox’are three of many interesting themes explored in this paper which examines how, and to what extent, health information is received and translated into the daily domestic setting by coronary family groups. Taking an ethnographic approach to collecting data highlights both the advantages and disadvantages of this methodology in practice. Certainly, the emergence of a health promotion orientation in health care is an area which is intimately connected to aspects of human culture and society that have long been a central concern of anthropologists. This mini‐ethnography provides an anthropological understanding of the knowledge, beliefs and behaviours associated with heart disease and its prevention. The concept of the‘mindful body’is provided as a critical interpretive approach to analysing the potential outcome of prescribed lifestyle changes, as given to coronary sufferers and their families during the period following coronary artery bypass surgery. Data drawn from this study confirms the evidence of lay epidemiology which works within the cultural field of fate, luck and destiny, and which has interesting implications as to how nurses might plan for their health promotion strategies in the future.
Nutritional intake and physical activity in leg ulcer patients
Authors: Wissing Ulla , Unosson Mitra , Lennernäs Maria A.‐C. , Ek Anna‐Christina
Published: March 2003

The aim of the study was to describe the nutritional intake, meal patterns, physical activity and need for help in nine women living in their own homes and being treated for venous leg ulcers. Food habits were identified by use of interviews and food diaries completed by the women during a period of seven days. The intake of energy and nutrients from 304 eating events during seven days was calculated and meal patterns were evaluated using a qualitative system for meal classification. Physical activity and the degree of need were identified with the help of interviews. The intakes of energy and key nutrients for wound healing, such as protein, vitamin C and zinc, were not optimal according to the Swedish nutrition recommendations, although food habits were well organized. Most of the women had hardly any physical activities and the need of help and support varied, from daily visits to visits every second week.
Developing the nurse as a knowledge worker in health — learning the artistry of practice
Authors: Antrobus Sue
Published: March 2003

Nursing in the future will be a promoter of health and well‐being. This paper argues that health has been inadequately conceptualised and the knowledge base required by nurses to practice as‘knowledge workers’in health gain poorly defined. An epistemology for nursing is proposed that considers knowledge to be a construction of empirical, clinical and personal ways of knowing, contextualised within the activity of the nurse as ‘knower’. The difficulties nursing has in defining and developing this unique epistemology are discussed. Lastly, the implications this unique epistemology will have for nursing education are explored. The author draws upon personal experience to explore and propose the use of clinical supervision as a tool which can be used by lecturers to coach nurses in the artistry of reflection in action, thus developing the therapeutic skills and knowledge base necessary to promote health as a holistic, multi‐dimensional, dynamic, evolving and transforming process.
Family members’ experiences of their role in a hospital: a pilot study
Authors: Åstedt‐Kurki Päivi , Paunonen Marita , Lehti Kristiina
Published: March 2003

The purpose of the study is to explore the experiences of family members in their role of relative in a situation where a next of kin has been admitted to hospital. The questionnaire was used in data collection. The data reported here are form a pilot study. The sample consisted of 70 family members of patients receiving treatment on the neurological wards. It was found that family members spent a lot of time at their relative's bedside, most of them up to several hours a day. The daily routines of families and way of life were alos very much affected. The most important way in which the hospital supported families was to keep them informed about the patient's care and treatment. However, this was not possible without an active interest and involvement on the part of family members themselves. There were obvious problems and shortcomings in terms of family orientation: only one thrid of the family members felt that the nursing staff were seriously interested in the family's well‐being, and only one quarter had been told what they could do in hospital. About half of the family members needed to meet nurses to get support from nurses and over one third from doctors. The oldest respondents and women needed more help than did others. Men preferred to turn to doctors rather than nurses for help. In general family members had good experiences of visiting their relavtie in hospital. They believed that they were expected and that they were of help to their relative. Over half of the family members said they were actively involved in caring for their relative. Only four per cent of the family members reported bad experiences of their visits to hospital, in spite of the obviours shortcomings in family nursing. For this reason it is important that nurses facilitate the involvement and integration of relatives in the process of nursing.
A small exploratory study of the reaction of older people to an episode of delirium
Authors: Schofield Irene
Published: March 2003

Delirium or an acute confusional state, occurs as a result of disease or physiological imbalance secondary to impaired brain function. One of its main clinical features is widespread cognitive impairment, which causes patients to become disconnected from their immediate surroundings and misinterpret reality. It has a sudden onset and its duration is relatively brief. Some authors take the view that delirium might be interpreted as a precursor to dementia. The aim of the study was to retrospectively explore older peoples’ experience of an episode of delirium. In particular, whether they knew what had caused and cured it; and whether it had left them with any unresolved feelings of anxiety. A cross sectional design using grounded theory methodology was chosen, as being the most appropriate method for exploring this issue. A sample of 19 patients was selected using predetermined criteria, and engaged in a semi‐structured interview with the researcher, in the ward environment. The interviews were audiotaped, transcribed, and analysed using the constant comparison method. Those interviewees who had illusions and hallucinations, were often able to describe their experiences in detail. They ranged from being pleasant and entertaining, to horrible and frightening. They were also able to remember short verbal commands from nurses during the episode of altered perception. Others remembered, or chose not to remember, very little. Few interviewees appeared to know exactly what had caused and cured the delirium, although some were able to tentatively connect the experience to their present medical condition. There also appeared to be little evidence of therapeutic communication with nursing staff once the episode of delirium had resolved. Although no one connected the experience with dementia, there did seen to be some evidence of mildly disturbed feelings, on reflecting back over the episode. As interviewees were generally willing to discuss their experiences with the researcher, it suggests that it would be helpful for nurses to provide opportunities to do so. Nevertheless, interviewees appeared to regard the episode simply as a transitory event in the overall context of illness, admission to hospital and their future welfare. The latter was of prime concern; yet again it appeared that they did not always receive the information they required to maintain control over their personal destines.
Project 2000. Perceptions of the philosophy and practice of nursing: preparation for practice
Authors: Clark Jill Macleod , Maben Jill , Jones Karen
Published: March 2003

As part of a comprehensive study of perceptions of the philosophy and practice of nursing Project 2000 students and newly qualified diplomates were asked to reflect on their Project 2000 course as a preparation for professional practice. Data were collected from both students and diplomates through self‐completion questionnaires and a small number of interviews with diplomates in two study centres, one in the north and the other in the south of England. Nurse managers and G grade practitioners were invited in focus group interviews to discuss the Project 2000 preparation and assess the diplomates ‘fitness for purpose’. Findings suggest that the majority of students and diplomates acknowledged that the course had prepared them well. They acknowledged the importance of the inter‐personal skills component of the course, together with the life sciences input. The diplomates particularly valued the theoretical aspect of the course, being well versed in research and keen to continue their learning. Perceived limitations of the course were the management preparation and course organization. Practical skill deficits were perceived as initial skills deficits only. Managers and practitioners were keen to employ the diplomates, whilst acknowledging their need for support and preceptorship. Three important issues for nursing and nurse education are discussed, including the balance of the Project 2000 course, preceptorship and support, and preparation for a role in the community.
A chart audit reviewing the prescription and administration trends of analgesia and the documentation of pain, after surgery
Authors: Lellan Kathleen Mac
Published: March 2003

The report of the joint working party of the Royal College of Surgeons of England, Pain after Surgery, raised many questions in relation to the way pain is managed after surgery. This report questioned many of the existing practices of pain control and highlighted the need for the development of regular pain assessment. The report raised questions regarding PRN (pro‐re nata, as needed) prescribing and reinforced the importance of the role of the nurse. This study reviews the way pain is managed in this hospital with regard to analgesia prescribing and analgesia administration trends as well as the documentation of pain. The study was conducted by retrospective review of randomly selected patient charts. The results of this study conclude that documentation of pain following surgery is poor and needs improvement. Existing prescription trends, in particular PRN prescribing, may be hindering both good practice and the pre‐emptive administration of analgesia.
Learning readiness for patient teaching in stroke rehabilitation
Authors: Vanetzian Eleanor
Published: March 2003

Motivation and ability are attributes of learning readiness for patient teaching. Achievement motivation theory includes the assumption that the tendency to succeed in regaining functional losses due to stroke is related to patients' perceptions of how difficult activities will be to accomplish. Ability is assessed using the Functional Independence Measure. A framework is applied to a patient situation demonstrating that the tendency to succeed is greater when striving to achieve goals with an uncertain level of difficulty than when goals are either easy or hard. Implications for nursing and research are described.
Assessing strength of preference for abortion method using ‘willingness to pay’: a useful research technique for measuring values
Authors: Gibb Susan , Donaldson Cam , Henshaw Richard
Published: March 2003

Policy makers and practitioners need to differentiate between patient preferences which are strongly held, and those which are not. This study measured not only women’s preferences for medical abortion versus surgical vacuum aspiration, but also the strength of these preferences, using a ‘willingness to pay’ (WTP) technique. Fifty women were recruited and interviewed prior to and following termination of early pregnancy. Due to the sensitivity of the situation, the WTP approach was administered by interview. Results revealed that 34 (64%) preferred to have the medical method. The amounts offered for each method were similar; however, a minority gave higher values for the medical method, thus for those women their strength of preference for that method was more intense. Validity of the technique was supported by the finding of a positive association with social class and the importance women attached to having choice. It is argued that WTP is an acceptable method for the elicitation of strength of treatment preferences. Its further use by nurses and midwives to assess health care preferences should be explored, particularly when considering aspects of care which are traditionally difficult to identify and measure.
Selection and retention of nurses
Authors: Muncey Tessa
Published: March 2003

The selection and retention of suitable nurses has occupied the thoughts of many people who have a vested interest in maintaining standards and avoiding loss of resources. By drawing conclusions from inadequate findings inappropriate recommendations may be made. In a study that considers the psychological profiles of nurses, it would appear that it is self‐esteem and a ’need to be needed’ that is a crucial facet of nurses ability to cope with the job of nursing; a job that encourages the characteristics of individualism, in a working environment involving caring, that epitomises the values of connectedness. This paradox leads to nurses’ inability to cope and subsequently leave the profession using one of the many acceptable labels that are widely documented. Acceptance of the underlying causes for this attrition would necessitate better support services for vulnerable nurses allowing them to recognize their own needs, and gain a personal understanding of how their vulnerability might echo that of people in their care.
Job satisfaction in preceptorship and its effect on the clinical performance of the preceptee
Authors: Barrett Celeste , Myrick Florence
Published: March 2003

This study was designed to examine the relationship between preceptor/preceptee job satisfaction and preceptee clinical performance. A correlational descriptive design using quantitative data was employed through a mailed survey. Seventy‐nine questionnaires were mailed to preceptors, 100 to preceptees. The response rate for preceptors was 49·4% while the response rate for preceptees was 33%. Herzberg’s theory served as the conceptual framework. Three baccalaureate schools of nursing in Atlantic Canada comprised the setting. Analysis of data included frequencies, percentages, t‐tests, and Pearson’s product‐moment correlation coefficient. Findings indicate that preceptors and preceptees differ significantly regarding aspects of their job, and their job in general. They also differ significantly in their rating of how often preceptees perform the planning/evaluation components of their care. A positive significant relationship exists between preceptee job satisfaction and clinical performance. No relationship was found to exist between preceptor job satisfaction and preceptee clinical performance. Additionally, in view of the limitations of the study (small sample, low response) limited conclusions can be drawn from the study.
Lecturer practitioners: a literature review
Authors: Fairbrother Pat , Ford Sue
Published: March 2003

Much of the existing literature on lecturer practitioners to date is comprised of the perspectives of individuals within the role and how they function in their specific setting. It is surprisingly difficult from this work, however, to define the role of lecturer practitioner. The authors were commissioned by a regional health authority to undertake a study of lecturer practitioners within that region. In the process of undertaking this study, a literature review was carried out. Whilst the authors found an abundance of literature surrounding the theory and practice gap, and the development of the lecturer practitioner role as one possible solution, they were not able to find a comprehensive review of the multifaceted aspects of the lecturer practitioner role. This paper is an attempt to provide such a review, and will address the following aspects: the need for lecturer practitioners; their origin within nursing and midwifery education; the development of the lecturer practitioner role; the debate surrounding academic and clinical credibility; and finally, the current situation for lecturer practitioners.
Getting going with clinical supervision: an introductory seminar
Authors: Jones Alun
Published: March 2003

Clinical supervision is an emerging force in nursing practice in the United Kingdom. However, much of the nursing literature suggests uncertainty with regards to what clinical supervision is and the resources needed for safe professional practice. This paper explores a method of introducing clinical supervision to nurses in such a way as to model the skills and competencies required for developing productive working relationships. The main recommendation of this paper is that procedures for introducing clinical supervision mirror qualities required for developing effective nursing relationships.
Living with high blood pressure
Authors: Van Wissen Kim , Litchfield Merian , Maling Tim
Published: March 2003

This study was undertaken to explore the experience of people taking long‐term antihypertensive medication. The study contributes to the understanding health professionals have of people with high blood pressure and the antihypertensive treatments they receive. Consideration was given to the full life context of people taking long‐term antihypertensive medication and the health/medical culture in which people find themselves. A qualitative method of inquiry generated the descriptive data. Nineteen participants (four men and 15 women) were interviewed once, of which 16 were interviewed a second time. Data analysis involved extraction of concepts which in turn were clustered into themes. An organizing framework was constructed to integrate the six themes and 18 sub‐themes. The framework represents the individual’s experience as a sequence, starting broadly in the social context of her/his life, and narrowing down to the particulars of personal routine and patterns referring to living with hypertension and it’s medication regimens. The final theme refers to the broader context of the health culture. A vast range of experiences were described by participants taking long‐term antihypertensive medication. This accentuates the necessity for health professionals to address the uniqueness of the individual, and consider the context of a person’s life when prescribing and monitoring medications for people with high blood pressure.
A causal model of coping and well‐being in elderly people with arthritis
Authors: Downe‐Wamboldt Barbara L. , Melanson Patricia M.
Published: March 2003

The purpose of this longitudinal study was to test a model of the relationships among social economic status, gender, severity of impairment, stress emotions, coping strategies and psychological well‐being. A sample of 78 elderly women and men, 60 years old or over, and diagnosed as having rheumatoid arthritis since mid‐life, volunteered to participate in the study. Twelve months later, 64 of these elderly people were re‐interviewed. Path analysis was used to examine the empirical import of the Lazarus and Folkman theory of stress and coping. Analysis of variance for repeated measures was used to test for changes over time among the study variable. A consistent relationship between severity of impairment, emotions, coping strategies and psychological well‐being emerged from the data at time one and time two. Choice of coping strategies and psychological well‐being were primarily influenced by emotions. The best predictor of psychological well‐being at both time periods was the stress emotion of challenge. At both time periods, optimistic and self‐reliant coping strategies were used most often and evasive and emotive strategies the least.
The integration of nursing and midwifery education within higher education: implications for teachers — a qualitative research study
Authors: Barton
Published: March 2003

This study was a qualitative narrative that reviewed the historical developments that led to the integration of nursing and midwifery education with higher education in the United Kingdom (UK). A sample of teachers was investigated with particular reference to role conflicts they may have experienced as a result of integration. In addition to this the views of established academic university staff were assessed. The methodology adopted for the research was an eclectic qualitative one, drawing on several approaches, and sought to enquire into individuals personal perception of these events. In this paper the progression of events, nationally and locally, that led to the educational reforms in nursing and midwifery in the 1990s are examined. This narration includes a brief history of the creation of a new university department. Following this there is detail of how data were collected and analysed from a teacher population within this new department. The findings, whilst difficult to generalize to the wider population of nurse and midwife teachers, demonstrate that the sample of teachers examined, all of whom have been involved in the process of integration, have been exposed to stress that has resulted in role conflict. Established university staff, however, were more objective, expressing some broad anxieties regarding the resource demands and research capability of the new department.
The place of metaphor and language in exploring nurses’ emotional work
Authors: Froggatt Katherine
Published: March 2003

An understanding of the importance of language as a symbolic artefact, particularly with reference to metaphor, has been little addressed within the nursing literature. Consequently, the potential richness of people’s accounts may be missed. Data from a study which explored the nature of hospice work and nurses’ experiences of professional and personal bereavements are used to illustrate the different understanding which an exploration of metaphor can bring to research. Meanings of metaphor and its role in language are initially presented before drawing on data concerned with the emotional aspects of hospice work. Root metaphors of emotion are identified and examples from nurses’ accounts indicate how nurses draw on these metaphors to articulate their experiences. The strategies nurses employ to continue working within the hospice culture are identified both practically in their work and metaphorically in the language they use.
Quality of life following liver transplantation: physical and functional recovery
Authors: Gelling Leslie
Published: March 2003

Quality of life following liver transplantation: physical and functional recovery

Traditionally health care outcomes have been evaluated by measuring immediate and long‐term survival. This paper demonstrates the importance of quality of life as an alternative outcome indicator by considering two dimensions of quality of life and how they affect patients following liver transplantation. These two dimensions are physical recovery and functional recovery and they are considered by analysing the literature exploring quality of life following liver transplantation. Physical recovery is be subdivided into sleep, pain and mobility and functional recovery is subdivided into occupational rehabilitation and domestic rehabilitation.
An analysis of the effectiveness of focus groups as a method of qualitative data collection with Chinese populations in nursing research
Authors: Twinn Dr Sheila
Published: March 2003

Although there has been a significant increase in the use of focus groups as a qualitative method of data collection in health and nursing research, literature on the use of this method with Chinese populations is limited. This study was therefore undertaken to explore the contribution of focus groups as a method of data collection amongst Hong Kong Chinese women. The study involved the comparison of the data obtained from two concurrent research studies which both employed case study design and focus groups as a major method of data collection. In both studies the samples involved Chinese women. The findings demonstrate that factors such as recruitment to the groups and interaction of group members did not adversely affect the quality of the data. Indeed the depth of data obtained on a range of sensitive topics suggests that the use of focus groups provides an effective method of collecting qualitative data with the Chinese populations in the described studies. However, a particular issue to emerge from this method of collection relates to the complexity of transcription and translation of the Chinese data which in the author’s view has implications for the quality of the data. This finding indicates the importance of undertaking data analysis in the language of the interview, rather than that of the translated data, to avoid compromising the quality of data obtained from non‐English speaking populations.
The philosophical and sociological context of mental health care legislation
Authors: Symonds Bob
Published: March 2003

This paper explores mental health legislation from a philosophical and sociological perspective. It is argued that mental health law exists primarily as a coercive social control instrument and that the maintenance of a separate legislative framework for the mentally ill is based upon dubious legal and philosophical grounds. The need for changes in mental health law has been accelerated by the move in Britain toward care in the community. One of the most important issues at the centre of the debate revolves around the concept of ‘dangerousness’ and mental disorder. The research into the extent to which the risk of violence can be predicted appears problematic from a reform perspective. Prediction is considered to be the overriding problem that leads to a violation of patients’ civil rights, especially in relation to black and ethnic minority groups. Equity in law is necessary for the protection of patient's rights and particularly for the protection of those people who enter mental health care systems concerned with issues of control at the expense of care.
The commissioning of nurse education by consortia in England: a quasi‐market analysis
Authors: Francis Becky , Humphreys John
Published: March 2003

The planning and commissioning of nurse education by consortia of NHS trusts and others in England is examined. These arrangements are analysed in terms of quasi‐market theory, investigating their ability to co‐ordinate effectively the demand for nurse education and workforce demand for nurses. Hence the paper examines evidence concerning the success or failure of consortia to co‐ordinate these aspects, discussing the arguments over nurse and student nurse shortages, and the procedure for assessing the demand for nurse training places. The paper argues that current nurse shortages illustrate past planning errors in commissioning nurse training. Consequently, the central body (National Health Service Executive) is still aiding consortia in their decision‐making concerning numbers of nurse training places, modelling workforce plans and suggesting increases in training places (and producing the money to pay for this). As such, it is argued, the quasi‐market is not as yet a completely devolved one. It is suggested in the concluding discussion that if qualitative benefits of consortia fail to materialize (as suggested elsewhere), and the quantitative functions are inadequate, the utility of consortia as planners and commissioners of nurse education may be questioned.
Motivational forces affecting participation in post‐registration degree courses and effects on home and work life: a qualitative study
Authors: Dowswell Therese , Hewison Jenny , Hinds Marian
Published: March 2003

Motivational forces affecting participation in post‐registration degree courses and effects on home and work life: a qualitative study¶ Over the past decade, pre‐ and post‐registration education for nurses and midwives in the United Kingdom has undergone major change, creating an atmosphere where continuing professional development is a matter of priority for individual health care staff. Against this context of change, and as part of a larger study of continuing education and training in the National Health Service, a cohort of participants in a part‐time health studies degree course were interviewed using a semi‐structured schedule. Twenty‐nine nurses, midwives and allied professional staff described their motives for participation in the course and its effects on their professional and personal lives. Data collected in interviews were analysed using qualitative methods and revealed that participation was encouraged by both professional and personal factors. For many staff participation was prompted by negative feelings about themselves and their professional status. Participation in the course was associated with (largely negative) changes in home and family life and most participants faced additional financial burdens. The findings of the study have implications for policy relating to the funding of continual professional education for nurses and other health care staff. Health care staff are receiving mixed messages about continuing education from policy makers and employers. Dependence on willingness and ability to pay for post‐registration degree‐level studies is unlikely to be an efficient or equitable means of ensuring lifelong learning for healthcare staff.