bluuebunny/crossref_metadata_2025 huggingface dataset:
The humanities and nursing: using popular literature as a means of understanding human experience
Authors: Moyle Wendy , Barnard Alan , Turner Charne
Published: March 2003

The rapid advances in technology during the twentieth century have encouraged science and technology to be the main focus of the nursing curricula The effect of this focus tends to hinder the importance of the human condition This paper discusses the benefits of including the humanities, particularly but not exclusively the inclusion of literary study in nursing curricula It is argued that the study of popular literature by students of nursing provides them with the opportunity to understand and to appreciate life expenences This assists them in gaming awareness and sensitivity to the many physical and psychological components of people's reactions to health, illness and hospitalization The power of literary study to promote an appreciation of the hurt and pain of disease is considered by the authors to be an effective teaching tool within a comprehensive programme for students of nursing
Long‐term care nurses’ moral convictions
Authors: Wurzbach Mary Ellen
Published: March 2003

Moral certainty and uncertainty have a profound impact on nurses’ ethical choices In order to describe these concepts, the author examined long‐term care nurses’ convictions about the issue of withholding or withdrawing artificial nutrition and hydration from elders A convenience sample of 25 BSN and MSN‐prepared long‐term care nurses were interviewed and asked to describe their experiences with this issue A qualitative analysis utilizing Colaizzi's (1978) methodology was performed Five categories of conviction emerged from the data These five categories included absolute moral conviction, strong moral conviction, moderate moral conviction, moral uncertainty with conviction and moral uncertainty Eighty‐four per cent of the sample was convinced that tube feeding was not always in the resident's best interest Sixteen per cent of the sample were uncertain, but were convinced that the resident should not suffer A pattern emerged from the interview results and the answers to three additional questions The pattern suggests that the more experience a nurse has with nontreatment the more likely she or he is to agree with it In this paper, the five categories of conviction are compared and contrasted, the pattern of conviction described, and the implications of the findings for nursing discussed
Continuing the dialogue: a response to Draper's critique of Fawcett's ‘Conceptual models and nursing practice: the reciprocal relationship’;
Authors: Kahn Steven , Fawcett Jacqueline
Published: March 2003

In their response to Draper's (1993) critique of Fawcett's (1992) paper ‘Conceptual models and nursing practice the reciprocal relationship’, the authors argue that Draper's critique is flawed They point out that Draper fails to acknowledge the diversity within the positivist movement, makes logical leaps, and fails to acknowledge Fawcett's long‐standing distinction between middle‐range theories and conceptual models and her discussions of the differences in the criteria to be used when evaluating conceptual models and theories
Reflection‐on‐practice: enhancing student learning
Authors: Richardson Gillian , Maltby Hendrika
Published: March 2003

The writing of a reflective diary is viewed as an effective tool for promoting reflection and learning in students, and for self‐assessment and evaluation of a clinical learning experience This work is a study of 30 undergraduate nurses and then‐ use of reflective diaries during a period of community health care practice The theoretical basis of the study is based on Schon's work on reflection‐in‐action The research tool, developed for the study of nursing practice by Powell, is based on Mezirow's levels of reflectivity The findings are that, in the sample used, students do reflect on their practice according to Mezirow's levels of reflectivity, but that the highest number of reflections occur at the lower levels of reflectivity (94% of the total number of scores) However, although only 6% of the total number of scores were found at the higher levels of reflectivity, some 22 of the sample of 30 students did attain conceptual and theoretical reflectivity, the highest levels of reflectivity
AIDS/HIV awareness training for young people with severe learning difficulties: an evaluation of two school programmes
Authors: Newens Andrew J , McEwan Robert
Published: March 2003

The need for sex education, counselling and HIV awareness training for young people with severe learning difficulties is discussed in relation to changes in community care over recent years A qualitative evaluation of two sex education programmes which include HIV awareness is presented using verbatim transcripts of observed sessions The involvement of nurses in such programmes and the relative merits of the two approaches observed are discussed
Nurse‐physician collaboration: a poststructuralist view
Authors: Henneman Elizabeth A
Published: March 2003

The impact of various world views on nurse‐physician collaboration is discussed in this paper The poststructuralist perspective, in particular that of Michel Foucault, is presented as a means of advancing collaborative relationships This approach allows nursing to move beyond the limitations and structure imposed by traditional philosophies Free of these encumbrances, nursing can achieve its goals as a practice discipline, which includes collaboration with physician colleagues
HIV and AIDS care: consumers’ views on needs and services
Authors: Beedham Helen , Wilson‐Barnett Jenifer
Published: March 2003

Increasing numbers of people suffer from HIV infection, in many sectors of society However, the extent to which health care services meet their needs is open to question This study aimed to gather consumer views and assess the extent to which care was adequate, through interviews with 85 clients Their responses were then compared with those of service providers (published in this journal 2 years ago) Overall there was a general expression of appreciation and satisfaction, although in many cases financial and social deprivation was so extreme that it appeared that established services could not compensate However, the need for better housing and more confidentiality of records was emphazised The need for greater security from the consequences of prejudice was felt strongly and many distressing incidents were recounted The major contrast between consumers’ and service providers’ views focused on whether separate and specialist provision was required Providers were aware that care would need to be integrated with other generalist services in the future in order to cope with the scale of need, while consumers were keen to retain specialist clinics and wards to protect their confidentiality and sustain the level of expertise they appreciated Within this sample, however, minority groups wished to have their particular needs recognized, in particular women with children and heterosexual males resented being grouped with the majority group of consumers with HIV/AIDS
An explanation of the differences between expert and novice performance in the administration of an intramuscular injection of an analgesic agent to a patient in pain*
Authors: Noyes Jane
Published: March 2003

It has been stated that nurse education in the United Kingdom (UK) currently draws upon Schon's concept of the reflective practitioner, and Benner's concept of the expert Studies have explored the claim that experienced expert practitioners are unable to articulate all they know, and that their theoretical knowledge and clinical skills are of a qualitatively different type from that of novice practitioners This paper aims to explain the differences between expert and novice performance using the example of administering an intramuscular injection of an analgesic agent to a patient in pain Theoretical concepts concerning the nature of expertise are used to evaluate novice/expert performance in nursing Criticisms of Benner's theory are developed in relationship to her methodology and the interpretation and assessment of nursing practice
Health as an individual's way of existence
Authors: Häggman‐Laitila Arja
Published: March 2003

This paper examines health from the viewpoint of Finnish individuals. The goal of the study was to understand and describe the human being's health as an individual way of existence on the basis of life description. The methodology of the study were based on the existentialist phenomenological conception of a human being's existence and the essence of knowledge. The study answers the research question: How do Finnish adults who have been cared for in hospital experience health? The data were collected from 60 persons Via freeform thematic interviews. The data were analysed by applying the grounded theory method. The analysis led to the identification of five different way to experience health. To the interviewees, health meant independent coping, drifting with the current of life, developing one's personal existence, avoiding threats in one's life situation and taking care of the components of one's life situation. The results provide a deeper understanding of health within daily life and of a human being as a nursing client.
Parkinson's disease symptoms —‘patients’ perceptions
Authors: Abudi Soshana , Bar‐Tal Yoram , Ziv Leora , Fish Miri
Published: March 2003

Self‐assessment is significant for the accurate evaluation of patient's needs. This study examined the frequency and severity of symptoms suggested by the literature and by specialists as bothering Parkinson's patients. Four categories of symptoms were examined: (a) motor disability or activity loss, (b) mental change, (c) psychosocial difficulties, and (d) nonspecific symptoms. The findings show that there was correspondence between expert judgements and subject's reports regarding symptoms such as dyskinesia/tremor as well as walking, freezing gait, and changing position. Symptoms such as dressing self, getting in/out of bed, morning stiffness and deficit in cognitive sequencing, which experts described as characteristic of Parkinson's disease patients, bothered subjects less. In general, patient's mental and psychosocial symptoms were higher in their frequencies and perceived severity than problems of performing activities of daily living.
Sexuality, sexual abouse. Omissions in admissions?
Authors: Sharkey Valerie B.
Published: March 2003

The main focus of this paper is to highlight the evidence relating long‐term effects of childhood sexula abouse to presenting complaints on acute admission wards and to explore how sexuality, as an aspect of nursing concern, is broached by mental health nurses. There are few nursing articles on sexual abuse issues which are research‐based, this literature has to be drawn from a wider field. Several authors recognize this paucity highlighting the need for future research in this area. The evidence from the literature review (1985–1995) makes it clear that the environment, the perceived interpersonal skills of the nurse and a general lack of definition of the nurse's role has a large influence on whether or not these issues are addressed. Following discussion about these findings, recommendations are made for inclusion of teaching on sexuality and sexual abouse, interpersonal skills training and illumination of assessment practice, with space for personal growth and development, in pre‐and post‐registration nurse education. This theme is developed further by considering how these recommendations could be introduced on acute admission wards.
Sexual harassment in nursing
Authors: Robbins Ian , Bender Mike P. , Finnis Sarah J.
Published: March 2003

Sexual harassment is a problem faced by women in the workplace which can lead to adverse psychological consequences as well as impaired work performance. Sexual harassment is about the abuse of power and status rather than merely being about sex per se and has to be viewed in the context of than merely being about sex per se and has to be viewed in the context of institutionalized male power. Although there is a relative dearth of research, there is increasing evidence that sexual harassment of nurses is common and that it can have adverse effects on nurses physical and psychological health as well as a direct impact on patient care. Nursing, by its very nature of having to care for patients bodily needs, transgresses normal social rules regarding bodily contact. This is exploited by the perpetrator who relies on nurses' caring attitude to be able to harass. A descriptive model of the processes involved in harassment is presented which offers the possibility of being able to intervene at a number of points in the process. Interventions need to be aimed at both individual and organizational levels if there is to be a prospect of reducing a major occupational stressor for nurses.
Stress and quality of life in the renal transplant patient: a preliminary investigation
Authors: Fallen Maureen , Gould Dinah , Wainwright Steven P.
Published: March 2003

End‐stage renal disease is a chronic condition which reduces the life‐span of its victims. At present there is no cure. Renal transplantation, currently the treatment of choice for many patients, is potentially associated with a number of drawbacks: constant risk of rejection, especially during the first six months, the need to comply with a complex regime of medication capable of producing pronounced side‐effects and the need for ongoing medical supervision. Despite these problems, little research has been undertaken with patients following renal transplantation. The aim of the small‐scale, exploratory study reported here was to explore patients’perceptions of stress and quality of life at different stages following a first, functioning renal graft: within six months, between one and five years and over five years later (n = 10 in each group). From the results it became apparent that patients had a number of concerns, of which fear of rejection was the most frequently mentioned, followed by stress generated through altered body image (a product of immunosuppressive therapy). Nevertheless, all reported a significant increase in quality of life after transplantation, although improvement was least marked in patients in the intermediate group (1–5 years after surgery) who also experienced most stress. A larger scale study is recommended to increase the validity of findings which clinicians could then use to design patient interventions to enhance quality of care and quality of life.
The future of community nursing in the United Kingdom: district nursing, health visiting and school nursing
Authors: McDonald Anné‐Lise , Langford Ian H. , Boldero Nigel
Published: March 2003

This paper examines the future of community nursing, within the wider framework of a rapidly changing National Health Service. The research was commissioned by the Community Performance Review Network, as part of a series of comparative studies between community healthcare NHS trusts. Three questionnaires were sent to 24 trusts, covering three of the community nursing services: district nursing, health visiting and school nursing. Of the 24 trusts involved in the network, 22 responded to some or all of the questionnaires. A wide range of management structures and working practices were found between trusts, but several common themes and issues of concern emerged. For district nurses, these included the shift from secondary to primary care and the changing demands of the client population served, with increasing numbers of elderly and chronically disabled patients. This led to anxiety over the communication between different providers of care, such as community, acute and social services, and the skills mix and training requirements for nurses. Health visitors and school nurses were concerned about being marginalized in the move towards integrated primary health care teams. As the emphasis changes from treating illness to health promotion, concern was expressed about how performance could be measured on the less quantifiable outcomes of preventative care, and hence how jobs could be justified to purchasers of health care. A central theme was the potential role of the nurse practitioner in provision of primary care, and this formed a focus for other anxieties concerning both the current situation and future of community nursing services.
Self‐reported family health and well‐being after early discharge from maternity hospital: a phenomenological study
Authors: Paavilainen Riitta , Åstedt‐Kurki Päivi
Published: March 2003

This paper is concerned with the self‐reported health and well‐being of families discharged from maternity hospital within 24 hours of childbirth. The empirical data were collected in focused interviews with 12 families; background data were also drawn from hospital documents. Data analysis was based on the phenomenological approach developed by Colaizzi. The informants' accounts of their health and feelings of well‐being revolved largely around the process of growth to the new life situation as well as the importance of a sense of feeling at home in one's everyday environment. The well‐being of the newborn and other children in the family was highlighted in the parents' descriptions of the family's health. However, physical health was just one dimension in definitions of family health.
Paying to participate: financial, social and personal costs to parents of involvement in their children's care in hospital
Authors: Callery Peter
Published: March 2003

Parental participation now has become an accepted feature of the care of children in hospital. However, the costs to parents of their involvement in the care of their hospitalized children have received little attention. In this paper the financial, social and personal costs to a group of parents of children admitted to a surgical ward are described. Financial costs included loss of earnings, travel and subsistence. Parents’financial commitment was open‐ended and the burden of financial costs was inequitable. The organization of alternative care for siblings carried social costs including loss of privacy and autonomy in family relationships. Participation in care could be distressing and so result in personal costs. Differences between the socialization of parents and health care professionals explain some of these personal costs. Implications for policy makers and practitioners are considered.
Residential care placement: perceptions among elderly Chinese people in Hong Kong
Authors: Lee Diana T.F.
Published: March 2003

A qualitative study was designed to explore the perceptions of residential care placement among elderly Chinese people in Hong Kong. Content analysis of the semi‐structured interviews with 20 community residents aged 60 years or over revealed that elderly people in Hong Kong generally had mixed feelings towards such placement. While they believed that residential care was an unavoidable alternative to family care in their later lives it was an important source of fear in their later years, especially for those who perceived their health as deteriorating. Residential care homes were generally seen as the ultimate ‘dumping place’ where one would ‘idle till death’ and the quality of care provided in these homes was anticipated to be problematic. It was found that most of these beliefs were formed as a result of indirect experience through ‘listening to stories of neglect or abuse from friends and relatives whose relatives were residential care home residents’. Implications for professionals working with elderly people are discussed in the light of these findings.
Nursing diagnosis and classification systems: a position paper*
Authors: Hogston Richard
Published: March 2003

There has been little professional debate in the UK literature about nursing diagnosis and this paper explores some of the reasons why nursing diagnosis has failed to gain momentum among nurses in the United Kingdom. The nursing diagnosis movement has now reached some European countries and in the light of the International Classification of Nursing Project (ICNP) and the Strategic Advisory Group for Nursing Information Systems (SAGNIS) project commissioned by the NHS Executive (NHSE), requires a close examination by British nurses. The unsuccessful attempt by the North American Nursing Diagnosis Association (NANDA) to have its taxonomy accepted for inclusion in the World Health Organization's 10th revision of the International Classification of Diseases, an innovation which would have made the NANDA taxonomy the definitive classification of nursing, should alert British nurses to the importance of nursing diagnosis. Although nurses effectively diagnose as part of the nursing process, adoption of the concept of nursing diagnosis as a driving force for practice evades many of them. This paper reflects upon some of the logistical and conceptual difficulties including issues of culture and terminology. It is suggested that nursing diagnosis has a great deal to offer British nurses in their efforts to improve the quality of care and to provide data in this area for both practice and research.
Ritual action and its effect on the role of the nurse as advocate
Authors: Martin Geoffrey W.
Published: March 2003

Problems related to the ability of the nurse to act as advocate for patients have caused dilemmas in the profession over recent years. This paper seeks to address the issue from the aspect of ritual action which pervades the day‐to‐day activities of nurses and could therefore have an effect on nurse–patient relations. By looking at a short study based on data from nurses working with dying patients, part of work in progress on the subject, it is possible to draw some conclusions about the effect that such rituals and routines have on practice. Examination of the work of Douglas leads to speculation about the ways that rituals associated with restricted language can undermine the nurse’s ability to advocate successfully. Results from the study are limited given the small sample, but they give some indication of trends and possibilities that more exhaustive research may confirm.
Job satisfaction and autonomy of Hong Kong registered nurses
Authors: Fung‐kam Lee
Published: March 2003

This research examines job satisfaction and need for autonomy of 190 registered nurses in Hong Kong using a cross‐sectional survey design. The level of job satisfaction towards six job components (autonomy, professional status, pay, interaction, task requirements and organizational policies) was measured using the Index of Work Satisfaction. Results showed that the sample was dissatisfied more than satisfied, they valued the job components of autonomy, professional status and pay more than interaction, task requirements and organizational policies. In addition, comparisons were made between nurses working in different hospitals and also different nursing units within a hospital. The level of need for autonomy was assessed using the autonomy subscale of the Edwards Personal Preference Schedule. Results showed that the level of need for autonomy of this group of nurses was below the mid‐score of the sub‐scale and there was no significant relationship between their satisfaction with job autonomy and their individual need for autonomy.
The role of reflection in single and double loop learning
Authors: Greenwood Jennifer
Published: March 2003

A recent review of the literature on reflective practice in nursing indicates that approaches to its promotion in the United Kingdom and Australia appear to differ. In the United Kingdom, these approaches promote single‐loop learning whereas in Australia the approaches adopted attempt to promote double‐loop learning. In this paper single and double‐loop learning will be defined and the limitations of single‐loop learning in nurse education will be discussed. In addition, definitions of reflective practice, the purposes it is claimed to serve and a range of frameworks developed to promote its development will be reviewed. Inconsistencies between espoused purposes and suggested frameworks will be discussed. The paper will also include a description of recent initiatives implemented in Western Sydney, Australia, to foster nurses’ double‐loop learning.
Nursing in the dialysis unit: technological enframing and a declining art, or an imperative for caring
Authors: Bevan Mark Thomas
Published: March 2003

Nursing in haemodialysis units has been well established since the 1960s. Technological developments, open patient selection methods and economic pressures have altered the dialysis unit to become increasingly busy, where demand outstrips availability. For nurses it has become akin to working on a ‘production‐line’ in order to meet the need for treatment. The increasing demand has required the nurse to become technologically skilled often to the detriment of caring. What emerges is the nurse enframed by technology where the caring of nurses is focused through the demand of getting the patients processed. Here is a dilemma where caring becomes a moral imperative in order to overcome the dehumanising effects of technology, and the future of the dialysis nurse comes into question.
Countertransference in the nurse‐patient relationship: a review of the literature
Authors: O’kelly Gabrielle
Published: March 2003

Countertransference is a psychoanalytical concept which, when applied to nursing, refers to the unconscious response of the nurse to the patient. Psychoanalytical concepts such as the unconscious are infrequently mentioned in the nursing literature and have received little research attention. In this paper the literature about the nurse’s countertransference is reviewed. In order that the psychodynamic aspects of this phenomenon are more fully appreciated, both the concepts of the unconscious and transference are first described. The nurse’s countertransference has many expressions. The literature under review has highlighted the expression of countertransference through physical symptoms, through the nurse’s level of involvement with the patient and through the nurse’s positive and negative descriptions of patients. The value of recognizing countertransference is universally acknowledged. It is suggested that countertransference in the nurse‐patient relationship should be explored further. The knowledge provided would help provide greater insights into the nurse‐patient relationship, and ultimately will be reflected in the quality of care which the patient receives.
Nurses’ narratives about using coercion in psychiatric care
Authors: Olofsson Britta , Gilje Fredricka , Jacobsson Lars , Norberg Astrid
Published: March 2003

To illuminate nurses’ experience of using coercion against psychiatric patients, a phenomenological hermeneutic study was conducted with seven registered nurses and seven enrolled mental nurses. The findings revealed that these nurses desired to be seen by themselves, their co‐workers and patients as doing good, being good and providing good care but they experienced the use of coercion as not good. This conflict made it difficult for these nurses to question the use of coercion and consider alternative solutions. The theory of change byWatzlawicket al.(1974) served as a theoretical framework for the interpretation of all interviews regarded as one text. In order to explore alternatives to the use of coercion in psychiatric care, nurses need assistance to step outside the traditional way of regarding coercion in psychiatric care and seek to create new solutions.
Evidence‐based care of chinese men having transurethral resection of the prostate (TURP)
Authors: Callaghan Patrick , Yuk‐Lung Cheung , Ida Yao King‐Yu , Siu‐Ling Chan
Published: March 2003

Aim of study: To measure the effect of specific preoperative information on postoperative anxiety, satisfaction with information, and demand for analgesia, of Chinese males having transurethral resection of the prostate (TURP). Design: A controlled experimental design. The researchers allocated all patients (n=30) undergoing TURP in a general hospital in Hong Kong, during a 3‐month period, to one of two groups. The experimental group (n=15) received a specific information pamphlet and a general preoperative counselling video. The control group (n=15) received a video alone. Procedure and measures: Following ethical approval, a researcher took baseline measures of state and trait anxiety using the Chinese State‐Trait Anxiety Inventory (C ‐STAI). Five days after surgery the researcher administered the C‐STAI (A‐State), a patients’ satisfaction questionnaire, and, recorded requests for analgesia during the first 5 postoperative days. Results: Experimental subjects reported significantly lower anxiety levels post‐operatively and a significantly higher level of satisfaction with the preoperative information, than controls. Postoperative demand for analgesia did not significantly differ between groups. Conclusions: The findings support the importance of providing patients with specific, written preoperative information about their surgery and its effects to minimize their postoperative anxiety levels, and improve their satisfaction with the care provided.
Triangulation in nursing research: issues of conceptual clarity and purpose
Authors: Shih Fu‐Jin
Published: March 2003

The controversy concerning the value of qualitative, quantitative and triangulation approaches to nursing research for understanding human behaviour and increasing nursing knowledge has been an increasing source of debate among nurse scholars. However, the differences and similarities of these three perspectives have not been fully compared as either philosophies or methodologies. The purposes of this paper are to provide an understanding of the origin and development of the triangulation research method, clarify major sources of confusion in the presentation of a triangulation study, and discuss the problems and possible solutions of a triangulation study. Finally, an example of multiple triangulation in a nursing research within a Taiwanese cultural context —turning points of recovery from cardiac surgery during the intensive care unit transition — is presented. In the course of the paper, suggestions are also given to help nurse researchers recognize when it is most appropriate to use a certain research method, whether that be qualitative, quantitative or triangulation.
An investigation into the description of patients’ problems by nurses using two different needs‐based nursing models
Authors: Griffiths Pauline
Published: March 2003

An investigation into the description of patients’ problems by nurses using two different needs‐based nursing models¶ This paper describes an investigation into how nurses describe patients’ problems and the possible effects of an espoused nursing model on these descriptions. A descriptive study was conducted on two medical wards in a Welsh District General Hospital. Data collected were subjected to content analysis using Gordon’s Functional Health Patterns to order the data. The two wards investigated, whilst being very similar in many ways, utilized different nursing models. Findings showed that the nurses studied, when describing patients’ problems, most commonly used medical diagnoses or the medical reasons for admission. Patients’ problems identified predominately addressed bio‐physical needs with scant attention given to psycho‐social needs. Despite the use of two different nursing models the language and emphasis of problem description were very similar and there was no evidence of the application of the conceptual underpinnings of the two models. It is suggested that although the use of a ready‐made nursing language may have drawbacks, the British nurse should understand and assess the value of the North American Nursing Diagnosis Association’s (NANDA) nursing diagnoses. Without such involvement this system may be implemented in the United Kingdom (UK) without the input and influence of practising nurses.
The power of the word: some post‐structural considerations of qualitative approaches in nursing research
Authors: Crowe Marie
Published: March 2003

This paper takes a post‐structural position to discuss some issues related to the use of qualitative research methodologies in nursing research. Two fundamental assumptions which underpin qualitative approaches are explored in relation to how subjectivity is constructed in the process of data collection. These assumptions reveal an ideological position which proposes that reality can be apprehended by capturing the individual’s point of view (subjectivity) and that qualitative researchers can directly represent this lived experience in language (linguistic representation). Post‐structural approaches challenge these assumptions which are often an uncritically accepted part of the common sense world and therefore taken to be natural. It proposes that these views of subjectivity and language are not natural but rather cultural. There is a recognition of the wider sociopolitical and historical context in which nursing research takes place and a displacement of normative constructions of subjectivity. It provides nursing with the possibility of challenging existing power structures which determine the individual’s experiences of health and illness.
Issues of non‐compliance in mental health
Authors: Lowry
Published: March 2003

This paper explores and questions the ideas and notions in respect of non‐compliant behaviours. Traditionally, research into this area has focused on identifying individual characteristics from within the adult branch of nursing and within the confines of the medical model of compliance. Little research has investigated the phenomena of non‐compliance within the specialty of mental health. It may be suggested that identifying characteristics in this setting is futile. There are many factors determining a client’s compliance behaviours. These include gender, social class, race and socio‐economic status. Those suffering from mental ill health are often the most vulnerable in society and it may be argued that as such are often coerced into accepting treatment with those who refuse frequently being labelled as non‐conformist. The ability of the client to refuse treatment should be based upon informed consent, but is often dependent upon the social prejudice of the health care professional, their misuse of power to bring about compliance behaviours and their inability to act as an effective advocate. Finally, by eliciting information, shared negotiation, planning and improved communication health professionals may improve compliance behaviours based upon the client’s needs and wishes.
A review of current theories of death and dying
Authors: Copp Gina
Published: March 2003

Recently, attention has been focused on the care of dying individuals and their families. Although this area of care remains topical for health care professionals, there have been few attempts undertaken to explore critically both the seminal and more recent theories of death and dying in order to extend and develop the theoretical scope and orientation of this field further. The purpose of this paper is therefore twofold: first, to provide a general overview of the current theories of death and dying, and second, to discuss some specific and general contributions and limitations of the current theories. To this end, a review of seminal and more recent theoretical frameworks is presented in this paper. Implications for future research in theory development in the field of death and dying are highlighted.
Caring in nursing: a multivariate analysis
Authors: Lea Amandah , Watson Roger , Deary Ian J
Published: March 2003

The dimensions underlying the perceptions of caring among nurses were investigated using the Edinburgh Caring Dimensions Inventory (CDI). Exploratory and confirmatory factor analysis techniques were used. While there was a general caring factor on which the majority of the items in the CDI loaded, there were two separable major dimensions to caring, namely ‘psychosocial aspects’ and ‘professional and technical aspects’. In addition, two smaller dimensions were identified that were both related to self‐giving, and it is postulated that these refer, respectively, to appropriate and inappropriate self‐giving in nursing.
The experiences of female spouses of survivors of acute myocardial infarction: a pilot study of Lebanese‐born women in south‐western Sydney, Australia
Authors: Daly John , Jackson Debra , Davidson Patricia M. , Wade Vicki , Chin Christine , Brimelow Vicki
Published: March 2003

The experiences of female spouses of survivors of acute myocardial infarction: a pilot study of Lebanese‐born women in south‐western Sydney, Australia¶ Lebanese migrants form a significant proportion of the population in south‐western Sydney (SWS), and in New South Wales, Australia. This pilot study was undertaken in south‐western Sydney, a rapidly expanding and socio‐economically disadvantaged region, to explore the experiences of English speaking women of Lebanese origin whose spouses had recently experienced an acute myocardial infarction (AMI). Semi‐structured interviews were conducted with seven Lebanese‐born women at 2‐ and 4‐week intervals, following the discharge of their husbands from hospital. Qualitative analysis of narrative text revealed four distinct themes. These were: struggle to resolve distress; intensive monitoring of the AMI survivor; searching for avenues of support; and reflecting on the future. Study findings are discussed in relation to the literature. Implications for nursing practice and research are drawn from study findings.
Shift work and its impact upon nurse performance: current knowledge and research issues
Authors: Fitzpatrick Joanne M. , While Alison E. , Roberts Julia D.
Published: March 2003

Shift work and its impact upon nurse performance: current knowledge and research issues¶ Previous research investigating shift work and its impact upon the quality of registered nurse performance and outcomes (including biological, psychosocial and organizational) is reviewed. The present study, which involved non‐participant observation of staff nurses (n = 34) within their first year of practice (Part 1 or Part 12 of the United Kingdom Professional Register), is described. The findings demonstrated support for earlier research which suggested that 12½ hour shifts are associated with less effective performance. This study, together with previous research, highlights important indicators for the design and management of future empirical work which is required to investigate the influence of shift work upon process as well as outcomes for nurses, service users and the employing organization. This is particularly pertinent in the light of recent changes in work patterns. The well‐being and effectiveness of the nursing workforce requires enhancement, and the effective management of shift‐work is a key strategy in achieving this.
The development of evidence‐based nursing
Authors: French Peter
Published: March 2003

The development of evidence‐based nursing¶ This paper argues that the current conception of evidence‐based medicine has its limitations in the promotion of research which effects the quality of service in any health care system. It also poses something of a difficulty for the development of evidence‐based nursing in particular. This paper advocates the more broad based concept of evidence‐based practice and discusses its potential for addressing theory/practice problems and the uptake of nursing research. The broader conceptualization of evidence‐based practice focuses on the integration of available evidence and the tacit knowledge of the investigator. An evidence‐based practice project undertaken in Hong Kong is outlined as this provided the basis of many of the conclusions made in this paper. Three vignettes are given in order to demonstrate the nature of the evidence‐based practice projects which have been conducted. The critical elements of evidence‐based practice projects are outlined. Finally issues concerning the process of generating evidence, the relationship to continuous quality improvement and the cost effectiveness of evidence‐based practice are discussed in more detail.
Individualized care: is it possible to plan and carry out?
Authors: Waters Karen R. , Easton Nicola
Published: March 2003

Individualized care: is it possible to plan and carry out?¶ The purpose of the study reported in this paper was to assess the reality of attempting to deliver individualized nursing care. An ethnographic case study research design was used on a nursing development ward. The organizational framework was a mixture of primary nursing and team nursing. Activities of three patients were observed over 4 days each, covering 16 hours of the 24‐hour period for each patient. The observations were unstructured, but attempted to relate activities to the nursing care plan. Informal, semi‐structured, tape‐recorded interviews were undertaken with 12 of the ward staff, qualified and unqualified. The interviews asked questions relating to aspects of planning care, delivering care and ensuring continuity of care. In addition, two nurses kept diaries of significant events for 5 days. Field notes of observations were coded for analysis, interviews were transcribed and coded and diaries were coded. The findings suggest that whereas the patient is offered choice on some occasions, at other times the patients fit into the routine. Supervision of meals and the use of the care plan were issues raised. Communication between nurses was reported to be well‐developed and helped to ensure continuity of care. Difficulties in delivering individualized care were related to issues of skill mix and lack of support staff.
Strategies for coping with labour: does antenatal education translate into practice?
Authors: Spiby  , Henderson  , Slade  , Escott  , Fraser
Published: March 2003

Strategies for coping with labour: does antenatal education translate into practice?¶ There is little evidence to associate attendance at antenatal classes with a reduction in psychological distress or increased satisfaction with the experience of labour. There may be several reasons for this, including failure to implement coping strategies. A within‐subjects research design explored the use in labour of coping strategies taught in antenatal classes and the role of practice. Women's views about using these strategies and their expectations of their midwives and birth companions were also identified. Following Ethics Committee approval and providing informed consent, 121 nulliparous women completed a questionnaire at their final antenatal class. This included questions on confidence and the amount of effort required to use coping strategies, the involvement hoped for from birth companions and midwives in using coping strategies in labour and satisfaction with the amount of practice of coping strategies. Within 72 hours of delivery, women were interviewed to obtain a narrative of the events of labour and their use of the coping strategies (sighing‐out‐slowly breathing, Laura Mitchell relaxation and postural change). A questionnaire obtained information on the involvement of the midwife and birth companion. Women used the three coping strategies to different extents. Midwives were not involved to the extent that women had hoped for antenatally. Birth companions achieved a level of involvement closer to women's hopes than that achieved by midwives. A significant proportion of women expressed dissatisfaction with the amount of practice of coping strategies during antenatal classes. The findings of this study of a group of well‐prepared women raise questions about the correct components of antenatal classes and how midwives and birth companions can be involved optimally in this aspect of a woman's labour. Further research is required to determine how women can best be helped to cope with the experience of labour.
Assessing nursing students' basic communication and interviewing skills: the development and testing of a rating scale
Authors: Arthur David
Published: March 2003

Assessing nursing students' basic communication and interviewing skills: the development and testing of a rating scale¶This study explores the communication skills of a group of nursing students who were required to interview a simulated client as part of their studies. In order to assess the students and to improve the process of learning discrete skills, an instrument was developed and tested as part of this process. The subjects were 212 nurses enrolled in a bachelor of nursing programme, in New South Wales, Australia, who were studying a problem‐based learning package the focus of which was `alcohol early intervention'. The sub‐groups within the sample included registered nurses, a significant percentage of whom had completed their basic nursing education in overseas countries. The Simulated Client Interview Rating Scale (SCIRS) was developed to assess basic humanistic communication skills as well as beginning motivational interviewing skills. The students were required to interview a simulated client and demonstrate competence in interviewing. This was assessed by the SCIRS which was completed by the students and the simulated clients. The instrument proved to be a reliable and valid means of assessing student interview technique as well as a flexible educational tool, while valuable insights into students' interviewing techniques were gained.
Clinical Development Units (Nursing): the western Sydney approach
Authors: Greenwood Jennifer
Published: March 2003

Clinical Development Units (Nursing): The western Sydney approach¶ On 24 September 1997 Western Sydney Area Health Service and the University of Western Sydney, Nepean (Australia) launched a network of nine Clinical Development Units (Nursing). The approach taken towards the development of CDU(N)s in western Sydney differs substantially from those taken elsewhere in terms of preparation for CDU(N) leadership and the role of CDU(N) criteria in the designation (`accreditation') process. The rationale underpinning the western Sydney approach, together with details of a leadership preparation programme, are discussed.
An investigation into community psychiatric nurses' use of humour during client interactions
Authors: Struthers John
Published: March 2003

An investigation into community psychiatric nurses' use of humour during client interactions

Community psychiatric nurses' (CPNs') accounts of interactions with clients often reflect benefits of using humour appropriately. This is despite the use of humour as a specific therapeutic form of communication generally being ignored during CPNs' professional development. With the growth in community care, mental health nurses are required to function more autonomously within the client's home environment, thus the contextual nature of the nurse's use of humour may have to be adjusted accordingly. How nurses makes this adjustment of their use of humour appears to be left to their own experiences. Yet inappropriate use of humour may be costly to the nurse–client relationship. The research described in this paper used a descriptive qualitative methodology to explore the perceptions of seven CPNs working in Scotland in relation to their use of humour during client interactions. As this study did not specifically access clients, ethical permission was not required from the local research and ethics committee. This did not excuse the author from recognizing ethical considerations of the subjects in relation to sharing information about being volunteers, their rights of withdrawal and the risks and benefits of the study. Confidentiality and anonymity were also maintained by the use of pseudonyms. Data collected through critical incident analysis and interviews were subjected to content analysis. Findings confirm the paradoxical nature of humour. Humour, when used appropriately, assisted the development of trust and changing the client's restrictive perceptions. Damaging effects were reported, however, if the humour was misinterpreted or perceived by the client as demeaning their experience. Although the CPNs had not received any formal education about the use of humour, recommendations centred on raising student nurses' and CPNs' awareness about their own use of humour.