bluuebunny/crossref_metadata_2025_split huggingface dataset:
Refracting experience: Reflection, postmodernity and transformations
Authors: Pryce Anthony 
Published: March 2006

'Reflection' might be characterised as a process that uses a number of relatively simple models for analysis of occupational practice. Such models structure ways of focusing on cause, effect and affect. On the other hand, the rhetoric of professional and personal empowerment is grounded in the language of reflexivity, self-knowledge, humanistic psychology and (postmodern) constructions of spirituality and the sacred. However, nursing literature appears rarely to address the postmodern, cultural contexts of reflection. This paper identifies paradoxes at the heart of reflective practice in nursing and some of the ideological functions of reflection. It focuses on the tensions central to reflection, some of which have the potential to highlight contradictions in practice, research and the production of theory. The aim here is to consider modernist assumptions that have framed nursing and nursing research while often failing to interrogate and explicate its own inherent contradictions. It is argued that a more critical reflexive process grounded in social context is potentially transformative through engaging with the postmodern destabilising of normative assumptions. This is considered in relation to modernity and postmodernity and the increasing emphasis on text and intertextuality. In conclusion, it is proposed that refraction might be a helpful concept. It is suggested that through a more sociologically prismatic lens, the realities and truths of the reflective narrative can be interpreted as a transformative means of resistance to the dominant medicalised discourses.
Moving towards a special kind of care for people with dementia living in care homes
Authors: Bruce Errollyn , Surr Claire , Tibbs Margaret Anne , Downs Maurna 
Published: March 2006

This paper considers the position of people with dementia in care homes, and the different understandings of their predicament. There are conflicting pressures on care homes. On the one hand there are reasons to ignore dementia, but on the other there are new expectations that a reasonable quality of life is both possible and desirable for people with dementia. These expectations are informed by a view of dementia which challenges narrow medical understandings and implies a kind of care that is based on sensitive interpretations of individuals, and is able to meet a broad range of needs. Drawing upon findings from a study of wellbeing among people with dementia in long-term care, the paper suggests that applying new understandings to care practice is a slow but worthwhile process. In a favourable care environment, people with dementia can maintain wellbeing, although staff need continuing encouragement and support, especially when residents' needs are complex. In their own way, people with dementia make efforts to hold on to the essential underpinnings of wellbeing, and these efforts need to be recognised and supported. Staff who develop a special understanding of the lived experience of dementia, together with skills to support broader needs, can make a significant difference to residents' lives. The challenge for care homes is to find ways of enabling staff to work in this way.
Raising the profile of nursing research among medical research charities
Authors: Crofts Linda , Mcmahon Ann 
Published: March 2006

The nursing professions' R&D priority-setting Initiative was established to increase the involvement of nurses, midwives and health visitors in research and development activities in the UK. A first phase of work explored the feasibility of establishing a systematic and coordinated process for identifying priorities for R&D for the nursing professions. The second phase aims to build on the collaboration and cooperation achieved in phase one to establish a process and structure to promote a united professional voice for nursing on R&D (Scott et al., 1999). To this end, proposals were developed to establish a strategic alliance of the professional interests which would be known as the Strategic Alliance for Research in Nursing, Midwifery and Health Visiting. Part of the role of this alliance would be to lobby for funding for research activity in nursing. This paper sets out to investigate the involvement of nurses with the nursing research charities and looks at ways nurses could improve their chances of obtaining funding from such sources.
Researching mental health: Pathology in a postmodern world
Authors: Freshwater Dawn 
Published: March 2006

The invention of madness led to the professional practice of mental health that has as its main aims the identification and treatment of mental illness. Traditionally, notions of madness and sanity are polarised, with sanity being linked to functionality and madness being aligned with dysfunction. While such a dichotomy is always questionable, currrent studies of mental illness reflect the social dissolution of such stark categorization. Indeed, it could be argued that this divergence is sensible, given that behaviours which might typically be described as indicators of mental illness could be considered as reasonable protective mechanisms. Contemporary approaches to researching mental health problems focus on the 'madness of the other', with little attention being paid to the madness of research itself or, indeed, to the researcher's own madness. This paper argues that paying attention to the madness of those producing mental health research in the academy (or is it the asylum?) may offer insight into the devolution of madness. Further exploration in this direction may show how the research process itself could be facilitated and enriched by the rehabilitation of such madness.
Young people with Parkinson's disease: Report of a pilot study to identify the research issues and approaches to data collection
Authors: Fontenla Marina , Gould Dinah 
Published: March 2006

Parkinson's disease (Pd) affects over 120,000 people in the UK. Onset usually begins in people over 50 but in a significant number of people symptoms first develop at a much earlier age without affecting life expectancy. A pilot study to explore quality of life, psychological adjustment and service use for this population initially foundered because of difficulties in contacting a sample of younger people with Pd and motivating them to participate. The pilot study was then extended to determine these people's perceptions of their condition and their needs through content analysis of a magazine circulated by their user group, and a website. Information was also sought from key informants working with young people with Pd. This eventually resulted in contact with the target sample and the collection of valuable data through participation in a conference held by the user group. Reasons for reluctance to become involved in traditional research studies related to denial of having Pd; a desire to conceal it from others, and tiredness associated with Pd, resulting in the need to prioritise activities. This unorthodox piloting proved invaluable in refining the original study questions and identifying more effective approaches to data collection and sampling. The experience of undertaking the pilot study may be of wider interest because it indicated that despite NHS reforms focusing on the user perspective, some health consumers were not enthusiastic about participating in research or informing government policy. The importance of thorough pilot work to the success of the eventual investigation is also demonstrated.
Workforce and workload: Are nursing resources used effectively?
Authors: Jenkins-Clarke Susan , Carr-Hill Roy 
Published: March 2006

This paper describes key findings and implications from analyses of activity and workload of nurses of different grades and support workers based on data collected using Nursing Information Systems for Change Management (NISCM). 'Activity' refers to the amount of time on a shift spent on different tasks, and 'workload' refers to the number of patients in a variety of wards by demand/dependency group. The activity evidence is based on data from 5,208 staff recording their activity in 535 shift blocks in 19 hospitals and the workload evidence is based on data from 38,585 shifts across 90 wards in 17 hospitals. Four of the seven main findings have been selected for presentation here: variations, division of labour, skill-mix issues and flexibility. The findings show that there appears to be substantial systematic variation between hospitals in the grade mix of nursing staff and that there is little difference in the types of task undertaken by different grades of staff. As overall staffing increases, there is little increased specialization between staff groups and little flexibility in the deployment of nursing staff according to patient demand. The overall aim of the paper is to promote discussion relating to the development of appropriate and relevant strategies for changing skill-mixes in hospitals.
The emergence of professional doctorates in nursing in the UK: Where are we now?
Authors: Galvin Kathleen , Carr Eloise 
Published: March 2006

This study explored the views of course leaders and students taking doctorates in nursing science. Semi-structured telephone interviews were undertaken with a purposive sample of course leaders and students (n=8) from three UK courses running at the time of the study. One course had been established for six years, the other two were in the first year of delivery. The theme we have labelled 'new knowledge for improvement' describes what emerged from the data as the underlying mission and philosophy guiding the doctorates. Students were found to value the following course features: supportive systems; peer group support; being embedded in an academic department; exposure to multiple research methods; and preparation for clinically focused research. Some nurses were not attracted to what they perceived as a long and lonely route to a PhD, favouring instead the new-style doctorates because of the supportive networks these offer. While the focus of this paper is nursing, there is a long history of professional doctorates in other fields. This paper outlines the developments in professional doctorates and offers a definition and some differentiation between the new-style doctorate and the traditional PhD. The major themes that emerged from the data concerned problems in professional nursing doctorates, such as the inherent high volume of work; lack of opportunity to use skills in practice; for some students, the uni-disciplinary nature of the courses; negative views of 'taught' doctorates; issues about doctoral standards, and the credibility of the award title in the outside world. Questions and problems for future delivery of doctoral education are outlined.
Practitioner research: Exploring issues in relation to research capacity-building
Authors: Meyer Julienne , Johnson Barbara , Procter Susan , Bryar Rostamund , Rozmovits Linda 
Published: March 2006

Lack of funding for research capacity-building in nursing and allied health research has been a long-standing issue (Rafferty et al., 2002; Scott, 2002). More recently, limited moneys have been made available in the form of doctoral and post-doctoral awards from the Health Foundation and the Department of Health, largely to prepare nurses and allied health professionals for a career in research. However, little attention has been given to the capacity-building required for practitioners who may now have research as a core component of their work: nurse consultants and research and development nurses working in NHS and primary care trusts, for example. These practitioner researchers tend not to have previously benefited from the luxury of full-time funding and have learnt their research skills through higher education courses — Master's or part-time PhDs — or 'on the job' experience. This paper reports findings of a three-year study, the CELEC [Central and East London Education Consortium (now the North East London Workforce development Confederation)] Action Research Project: Care for Older People, that focused on the development and evaluation of seven lead R&D nurses: Care for Older People. These posts were appointed at Whitley Council (Nurse) Grade I or Research and Analogous Staff Grade II, depending on whether the lead R&D nurses preferred their contract to be with the NHS or the university. It was anticipated that the project might prepare some practitioners for a future role as nurse consultants. The paper reflects on the lessons learnt from this project, in particular the lead R&D nurses' education and support needs. Although findings mainly relate to their work as action researchers, they are likely to be of wide interest given that nurse consultants are expected to engage in this form of practice development. Action research is concerned with improving practice. It seeks to do research with and for people, rather than research on them (Meyer, 2000). It is thus ideally suited for practitioners who may, in addition to their role in research, also have responsibility for developing services. The findings may also be of interest to lecturer practitioners, who might choose to use action research as a means of facilitating work-based learning.
Politics or paranoia: Reading between the lines when undertaking social research studies
Authors: Taylor Julie , Cantrell Jane 
Published: March 2006

Although reports of political issues in social research were popular in the 1960s and 1970s, more recent accounts of nursing research largely neglect this area. This paper highlights such political issues, offering guidance to help equip researchers to deal with these. Published reports of research studies necessarily present a linear account of how, and how well, the research question was answered. It is rare for research to follow so straightforward a path, because interwoven is a little discussed, but not uncommon, political arena. Standard texts offer plenty of guidance on research ethics, but there is little advice to help researchers walking a thin line between diverse political elements. This paper draws on the literature and provides examples from the authors' research to illustrate some of the key political scenarios researchers may face. The advantages and disadvantages of insider/outsider status are discussed in order to present a 'matrix of involvement' to illustrate key issues. It is suggested that as the pressure to undertake funded research rises there is likely to be an exponential increase in the complex political environments in which research takes place. This paper offers some pointers towards reading between the political lines and navigating research successfully towards a conclusion.
Researching patients in the vegetative state: Difficulties of studying this patient group
Authors: Geluing Leslie 
Published: March 2006

It is now generally accepted that all patient groups should benefit from the potential advances in knowledge and understanding that result from clinical research. Despite this principle, patients in the vegetative state remain a group that has been chronically under-researched by neuroscientists because complex ethical questions and logistical dilemmas are raised by such research. The vegetative state is one of the best known but least understood of neurological conditions. It affects a small but significant number of people who make a poor recovery after sustaining a brain injury and has been brought to public attention through high profile cases in the UK and the USA. This paper defines the vegetative state and explores four important issues that should be considered when planning clinical research in this field. It is demonstrated that not only is it possible to undertake such research but also that there needs to be more of it so that greater numbers of patients and their families will benefit.
Seconding health care assistants to a pre-registration nursing course: Evaluation of a novel scheme
Authors: Gould Dinah , Carr Graham , Kelly Daniel , Brown Pauline 
Published: March 2006

Traditionally in the United Kingdom, reliance has been placed on unqualified support workers, such as student nurses, to deliver a high proportion of patient care. However, the move of nurse education into higher education and the accompanying supernumerary status of student nurses in the 1980s resulted in a shortfall of staff to deliver that care. The government has made a number of suggestions for increasing recruitment. One possible solution regarded as very promising is to encourage health care assistants (HCAs) with at least 12 months' experience in the National Health Service to enrol on existing pre-registration programmes, providing them with financial incentives to do so. Very little literature directly concerned with training opportunities for HCAs could be traced, but it was evident that financial constraints and family commitments had, in the past, operated as disincentives to training, although some HCAs would otherwise be keen to register. In 1999 one of the workforce development confederations in London responded to government policy by seconding HCAs onto a pre-registration programme operated by the local university. Plans for evaluation were made at the outset. Interviews were conducted with two consecutive intakes of secondees at three time intervals: after three months; after 12 months and during the final placement of the 36-month course. Interviews with other stakeholders were conducted just before the course ended. A qualitative approach was taken and the data were analysed employing the sequence recommended by Miles and Huberman (1994). Evaluation highlighted important features of the secondment process contributing to its success and indicated pitfalls attached to introducing such schemes. It is recommended that evaluation should be extended to explore how the new staff nurses prepared by this novel scheme continue to develop their career trajectories. Given the emphasis now being placed on the 'skills escalator' model of staff development in the NHS, such approaches will assume even greater importance in future, and more extensive evaluations will be needed.
Exploring the use of complementary and alternative medicine by people with cancer
Authors: Corner Jessica , Harewood Jackie 
Published: March 2006

Complementary and alternative medicine are widely used by people with cancer, yet little information exists as to how such therapies are used or people's motivations for using them, and few studies have been conducted to assess the efficacy and safety of these in the context of cancer and its treatment. Therapies may be used in parallel to conventional cancer treatment in the belief that they may help cure the cancer, prevent its recurring, help manage the symptoms or simply enhance well-being. Little data exist for patients to help guide choices over whether or not to use complementary medicine. There is also a lack of information available to inform patients as to how to use therapies for their best effect; many patients manage complementary treatments themselves as there is little else to guide them. Pressure is increasing to fill in the large evidence gaps surrounding the efficacy and safety of complementary medicine through conducting large-scale clinical trials. This paper argues against launching, at this stage, a major initiative to conduct clinical trials to test the effectiveness of various therapies; instead, an approach using qualitative methods and drawing on biographical narrative research is advocated. We are in the process of collecting information about how people with cancer use complementary therapies in a longitudinal study of cancer patients who have declared that they are users or non-users of complementary medicine, funded by the NHS R&D Programme. Using a biographic narrative method, detailed maps of the ways in which patients' use complementary medicine and the intersection of this with individual cancer journeys and personal biographies are being acquired. Arguments for this novel methodological approach are presented.
American Registry of Diagnostic Medical Sonographers
Authors: Williams Carol , Benson Carol B. , Rhodes Anne , Schaefer Lyn 
Published: March 2006

The American Registry of Diagnostic Medical Sonographers administers certification examinations in various specialty areas. To ensure that these examinations reflect clinical practice, the American Registry of Diagnostic Medical Sonographers regularly surveys registered sonographers to determine current practice frequencies. The Abdominal Exam Development Task Force recently conducted a task analysis survey of a random sample of 2500 registered diagnostic medical sonographers in the abdomen specialty. The abdominal examination content outline was revised to reflect changes in practice since the previous survey, which was conducted in 1987. The most notable change is the widespread use of pulsed and color Doppler by sonographers. As a result, the examination content outline has a new section entitled “Abdominal Vasculature with Doppler.” In addition, Doppler examination items have been added to other sections of the examination. The new content outline, with the assigned percentages for each section of the examination, is included in this summary.
Improving Standards
Authors: Lea Jean H. 
Published: March 2006

The primary goal for this column is to provide a communication link between sonographers, student sonographers, physicians, and educators concerning the various aspects of sonographer education. A few examples of these areas include curriculum design, innovative teaching methods, implementing an AMA-approved program, and questions regarding the ARDMS examinations. I will also be conducting a survey to try to identify the needs and concerns of sonographer educators. Any sonographer, physician, or student who would like to submit an article for this column or has suggestions for topics of discussion in future columns may contact me at the following address: Beth Anderhub, BSRT, CNMT, RDMS Ultrasound Technology Program St. Louis Community College 560 Oakland Avenue St. Louis, MO 63110
Ultrasound as a Visual Feedback Aid for the Hearing-Impaired
Authors: Foss M. C. , Whitehead B. , Paterson M. , Whitehead R. 
Published: March 2006

Ultrasound was explored as a visual feedback aid to assist in improving the speech of the deaf and hard of hearing. A mechanical sector real-time scanner produced images of the volunteer's tongue while a speech pathologist provided therapeutic intervention. Pre and postarticulation tests were administered to evaluate change in speech. Ultrasound as a visual feedback aid may be potentially useful for improving articulation problems for some hearing-impaired speakers. Further research with this population needs to be carried out to explore the practicality of using ultrasound as a visual feedback aid and to gather quantitative data on the long-term effects of learning. This study has demonstrated that typical real-time sector ultrasound scanners, of the type found in the field today, can be modified to produce useful images of the human tongue during speech production. It is yet unknown what specific type of scanner as well as frequency range is best suited for tongue placement imaging.