bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining methodological approaches in research: ethnography and interpretive phenomenology
Authors: Maggs‐Rapport Frances 
Published: March 2003

Combining methodological approaches in research: ethnography and interpretive phenomenology This paper provides a detailed account of two methodological approaches commonly used in qualitative research: ethnography and interpretive phenomenology. It traces both methodologies through the various stages of a research study — data collection, analysis and validation, before considering the most appropriate methods of reconstructing the participant experience for the given audience. The author puts forward a case for the combination of methodological approaches through the triangulation of data, suggesting that this can enhance our understanding of nursing. In the case of ethnographic and phenomenological data, triangulation may enable the researcher to highlight their interpretation of the phenomenon under review, whilst at the same time considering that phenomenon in terms of the participant group, their cultural background and day‐to‐day experiences.
Hermeneutic‐phenomenology: providing living knowledge for nursing practice
Authors: Van der Zalm Jeanne E. , Bergum Vangie 
Published: March 2003

Hermeneutic‐phenomenology: providing living knowledge for nursing practiceThe phenomenological approach has gained popularity among nurse researchers as an alternative investigative method to those used in the natural sciences. As more nurse scholars and nurse researchers utilize phenomenology as a research approach, it becomes critical to examine the implications this may have for nursing knowledge development and for the utilization of that knowledge in practice. In this paper, an examination of the results of phenomenological inquiry is presented and compared with the types of knowledge considered important for nursing by Carper and White. It is clear that phenomenology contributes to empirical, moral, aesthetic, personal, and socio‐political knowledge development. Its contribution is not in developing predictive and prescriptive theory, but in revealing the nature of human experience. Although interpretive inquiry, such as hermeneutic phenomenology, does not prescribe action for use in clinical practice, it does influence a thoughtful reflective attentive practice by its revealing of the meanings of human experience.
Nurse stress associated with aggression in people with dementia: its relationship to hardiness, cognitive appraisal and coping
Authors: Rodney Vic 
Published: March 2003

Nurse stress associated with aggression in people with dementia: its relationship to hardiness, cognitive appraisal and coping This study examined the relationship between aggressive behaviour displayed by people with dementia and nurse stress. This was achieved by re‐examining the relationships between the hardy personality (total hardiness), primary appraisal (challenge and threat appraisal), secondary appraisal (coping options available), and coping methods (action and palliative coping) from the perspective of nurse stress in response to aggressive behaviour displayed by people with dementia. One hundred and two nurses from 15 nursing homes and hostels were sampled by way of a questionnaire. Hierarchical regression was performed to analyse the strong hypothesized relationships between the variables examined. Results indicated that resident aggression was significantly related to an increase in nurse stress (M=34·79,
SD=7·93). Of the variables examined, only threat appraisal was significantly related to nurse stress (β[94]=0·48, P < 0·05). Perceiving the possibility of aggressive behaviour by the resident as threatening was found related to a high stress level in nurses sampled.
Experiences of micturition problems, indwelling catheter treatment and sexual life consequences in men with prostate cancer
Authors: Jakobsson Liselotte , Hallberg Ingalill Rahm , Lovén Lars 
Published: March 2003

Experiences of micturition problems, indwelling catheter treatment and sexual life consequences in men with prostate cancer Men with prostate cancer (n=25) were interviewed, focusing on experiences of micturition problems, indwelling catheter treatment and sexual life consequences. Narrations were found to be practical and technical descriptions rather than emotional, and experiences were described with reduction and negligence regarding personal well‐being and the impact of problems. Phenomenological‐hermeneutic analysis was used and findings ordered in subthemes and themes of meaning. Micturition problems, catheter treatment and sexual life problems were all phenomena that radically affected the clients’ autonomy and life quality and changed the life continuum. Impact from the disease was either accepted or not and related to what had already been borne in life. Experiences were linked together, each of them giving rise to feelings of physical deterioration and fear of ridicule, and hidden from others. Maintaining self‐image and social role was important and connected with the degree of perceived deprivation of life content. Responsibility for medical decisions was left to professionals while everyday problems with micturition, catheters and sexual life were regarded as the men’s sole responsibility. Findings were interpreted to mean that comparing the personal situation with that of others worse off made the life situation look better. The clinical implication of this study was that because the men came forward with their problems when given time to talk in their own way these areas should be given time and interest in the nursing care. Interpretation did not provide a unified picture of problems. Thus, nurses will have to seek men’s individual experience actively and give legitimacy to patients’ problems by opening up opportunities to speak about otherwise concealed problems. Then it may be possible to provide solutions that may ease the men’s burdens.
The rhetoric vs. the reality in child care and protection: ideology and practice in working with fathers
Authors: Taylor Julie , Daniel Brigid 
Published: March 2003

The rhetoric vs. the reality in child care and protection: ideology and practice in working with fathersWithin child care and protection, practitioners can be paralysed by a fundamental gap between the rhetoric and the reality in engaging fathers in their children’s care. In an earlier paper we argued that there is a lack of an effective framework to guide practice with fathers in child care and protection work. We examined how health visitors and social workers could begin to assess how fathers could be categorized as either (or both) a risk or an asset to the child. Based on a review of the literature we now explore the limitations of current models of practice and trace the theoretical strands that influence them, drawing from the legal framework, attachment theory and models for anti‐oppressive practice. We then highlight messages for practice with fathers for health care professionals involved in child protection. The working context for this paper is Scotland, although we believe that the ideas may be extrapolated to other geographical areas.
Community development: a critical review of approaches to evaluation
Authors: Billings Jennifer Ruth 
Published: March 2003

Community development: a critical review of approaches to evaluationWith the growing interest in community‐based initiatives, this discussion paper focuses upon the evaluation of community development. It reviews three areas and highlights the complex and contentious nature of evaluation in this field. Commencing with approaches to evaluation, it critically reviews proposed methods and suggests that, rather than provide clarity and guidance, the competing designs are confusing for the potential researcher. Second, the discussion moves to evaluative terms that are applied to community development, suggesting that there is a mismatch between professional and lay interpretations with an ultimate impact upon the validity of their measurement. It uses the terms community and empowerment to make these differences more explicit. Finally, the paper argues that, although the aim of community‐based initiatives is to bring about community health gain, gauging the pervasiveness of discreet project work is testing. It concludes by suggesting that a move away from an evaluative model based upon empowerment towards one which considers health and social capital may be a way forward.
Dialysis as ‘deus ex machina’: a critical analysis of haemodialysis
Authors: Bevan Mark Thomas 
Published: March 2003

Dialysis as

‘deus ex machina’: a critical analysis of haemodialysis
An unexpected power saving a seemingly hopeless situation, god from the machinery. (The Concise Oxford Dictionary 1991)
This paper examines the context of dialysis from a critical and philosophical standpoint. The traditional attitude of dialysis as an all‐saving medical wonder is examined. An alternative interpretation is offered using the analogy of ‘experiment’ to emphasize the uncertainty, power and control surrounding the treatment of end‐stage renal disease. In order for the experiment (of dialysis) to occur, variables (patients) need to be controlled. Control can be found in the social structures around the experiment of dialysis which provide an environment conducive to its success.
Patients’ perceptions of seclusion: a qualitative investigation
Authors: Meehan Tom , Vermeer Cathryn , Windsor Carol 
Published: March 2003

Patients’ perceptions of seclusion: a qualitative investigation Twelve patients receiving acute in‐patient psychiatric care in Queensland, Australia, participated in semi‐structured interviews to elicit their perceptions of seclusion. All respondents had experienced time in seclusion within the 7 days prior to interview. Interviews were audiotaped, transcribed and analysed using content analysis. Five major themes emerged: use of seclusion, emotional impact, sensory deprivation, maintaining control and staff–patient interaction. The prevailing negativity towards seclusion underscores the need for ongoing critical review of its use. In particular, the relationship between patient responses to seclusion and the circumstances in which seclusion takes place requires greater consideration. Interventions such as providing information to patients about seclusion, increased interaction with patients during seclusion, attention to privacy and effective debriefing following seclusion may help to reduce the emotional impact of the practice.
German nursing students’ knowledge of and attitudes to HIV and AIDS: two decades after the first AIDS cases
Authors: Lohrmann Christa , Välimäki Maritta , Suominen Tarja , Muinonen Ulla , Dassen Theo , Peate Ian 
Published: March 2003

German nursing students’ knowledge of and attitudes to HIV and AIDS: two decades after the first AIDS case This study describes German nursing students’ (n=180) knowledge and attitudes relating to HIV/AIDS, their homophobia level, willingness to care for people with AIDS, and their approach to possible sexual risk behaviours. A questionnaire was used to collect the data (response rate 97.8%). The results indicated that the nursing students had a rather high knowledge level concerning AIDS. However, there were gaps of knowledge, such as regarding AIDS immunopathology or the symptoms of the disease. Single nursing students and those having cared for a person with AIDS had a more thorough knowledge about the disease. In general, the attitudes towards AIDS and people with AIDS were tolerant and positive, and homophobia was only found with a small minority. Students having positive attitudes towards people with HIV/AIDS had less homophobia compared to those having negative attitudes towards persons suffering from AIDS. Those with positive attitudes were more willing to care for patients with HIV/AIDS, while those with a high homophobia level were less willing to do so. In addition, students having a high AIDS knowledge level tended less towards negative attitudes and homophobia than those with a low level of knowledge. The implications of the research for nursing education will be discussed.
The extent of nursing research utilization in general medical and surgical wards
Authors: Rodgers Sheila E. 
Published: March 2003

The extent of nursing research utilization in general medical and surgical wards There has been extensive speculation about the lack of research utilization in nursing but little attempt to quantify this phenomenon outside of North America. The current demands for evidence‐based practice necessitate research utilization as one element of the process. As part of a larger project, this study aimed to describe the extent of research utilization by registered nurses in general medical and surgical wards in the Scottish Health Service. A postal survey was conducted for nurses to self‐report their level of utilization of 14 research‐based practices. The 14 practices represented examples of direct, indirect and methodological utilization of research. A research utilization score was constructed for each of the 14 practices and a total mean score constructed for all 14 practices. A random two‐stage stratified sampling resulted in a total sample of 936 nurses from 25 hospitals. A 73% response rate was achieved. The total mean research utilization score for all nurses across all 14 nursing practices suggests that on average, nurses had heard, believed in and were beginning to use the practices. The sampling technique over‐represents nurses in large hospitals and charge nurses, hence a weighting calculation on all scores was completed. There was little difference in weighted and unweighted scores. Scores on individual practices ranged from 60% (405/680) of nurses never having heard of a practice to 85% (574/680) always using a practice. This approach provides a valid and reliable method of assessing the extent of nursing research utilization. In several of the practices, nurses are making significant attempts at research‐based practice. The level of research utilization compares favourably with research completed in North America and provides a baseline for United Kingdom and other country studies.
Innovations in the nursing care of the chronically ill: a literature review from an international perspective
Authors: Temmink Denise , Francke Anneke L. , Hutten Jack B.F. , Van Der Zee Jouke , Abu‐Saad Huda Huijer 
Published: March 2003

Innovations in the nursing care of the chronically ill: a literature review from an international perspective This literature review focuses on substitution‐related innovations in the nursing care of chronic patients in six western industrialized countries. Differences between primary and secondary care‐orientated countries in the kind of innovations implemented are discussed. Health care systems are increasingly being confronted with chronic patients who need complex interventions tailored to their individual needs. However, it seems that today’s health care professionals, organizations and budgets are not sufficiently prepared to provide this kind of care. As a result, health care policy in many countries targets innovations which reduce health care costs and, at the same time, improve the quality of care. Frequently, these innovations are related directly to the ‘substitution of care’ phenomenon, in which care is provided by the most appropriate professional at the lowest cost level, and encompass advanced nursing practice, hospital‐at‐home care and integrated care. The main conclusion of this paper is that integrated care innovations are implemented in both primary care as well as in secondary care‐orientated countries. However, innovations in hospital‐at‐home care and advanced nursing practice are primarily implemented in primary care‐orientated countries. Whether these innovations positively influence the quality of care, costs of care or patients’ use of health care facilities remains rather unclear.
An evaluation of nurse rostering practices in the National Health Service
Authors: Silvestro Rhian , Silvestro Claudio 
Published: March 2003

An evaluation of nurse rostering practices in the National Health Service The scheduling of nursing time on hospital wards is critical to the delivery of patient care, resource utilization and employee satisfaction. Over the past decade many hospital wards in the United Kingdom (UK) have moved away from the traditional planning of rosters by a single manager, towards more participative processes known as self‐rostering and team rostering. This paper tests the hypothesis, developed from the literature, that the three types of rostering approach may be positioned along a continuum. Self‐rostering at one extreme, is conducive to staff empowerment, motivation and roster effectiveness, whilst departmental rostering, at the other, leads to perceived autocracy, reduced empowerment, lower levels of staff motivation and roster effectiveness. Team rostering is positioned mid‐way on this continuum. This paper reports the findings of an empirical study of nurse rostering practices in the UK National Health Service (NHS), with a view to developing an understanding of the implications of implementing these three rostering approaches and testing the above hypothesis. The survey of rostering practices in 50 NHS wards, and in‐depth case studies of seven wards, revealed that each of the three rostering approaches has benefits and limitations and a picture emerges quite different from that implied by the research hypothesis. Whilst the literature suggests that the choice of rostering approach determines the level of perceived autocracy, staff motivation and roster effectiveness, it is proposed in this paper that selection of rostering approach should be contingent upon operational context. The paper concludes with a framework which stipulates that the choice of rostering approach for a ward should be determined on the basis of four contingent variables, namely, ward size, demand variability, demand predictability, and complexity of skill mix. It is recommended that departmental rostering be applied in large wards with complex rostering problems, whilst team rostering is more appropriate for medium sized wards, and self‐rostering appropriate for small wards.
Hospital nurses’ job satisfaction, individual and organizational characteristics
Authors: Adams Ann , Bond Senga 
Published: March 2003

Hospital nurses’ job satisfaction, individual and organizational characteristics Using the Ward Organizational Features Scales (WOFS), relationships between aspects of the organization of acute hospital wards, nurses’ personal characteristics and nurses’ job satisfaction are examined among a nationally representative sample of 834 nurses in England. The analysis contributes to a growing body of evidence demonstrating the importance of interpersonal relationships to nurses’ job satisfaction. In particular, the positive contribution of the cohesiveness of ward nursing staff is highlighted, but the potential for many current NHS staffing strategies and work environments to undermine the development of cohesive working relationships is also noted. Other influential factors are nurses’ relationships with medical staff, perceptions of their workload and their evaluation of the appropriateness of the system of nursing being practised. The importance of measuring nurses’ subjective assessments of their work environment is emphasized. A weak association was found between grade and job satisfaction. Individual nurse characteristics were found not to be associated with job satisfaction.
Re‐thinking stroke rehabilitation: the Corbin and Strauss chronic illness trajectory framework
Authors: Burton Christopher R. 
Published: March 2003

Re‐thinking stroke rehabilitation: the Corbin and Strauss chronic illness trajectory frameworkThe dramatic effects of a stroke can have far‐reaching implications for patients and carers. Effective recovery involves a considerable array of coping strategies that facilitate and promote engagement in the social world. Their development is a long‐term process that requires considerable effort, motivation and enterprise on the part of patients and their families. Traditional approaches to the provision of stroke rehabilitation services, however, appear to be underpinned by frameworks that are short‐term in outlook. As a consequence, nursing interventions often focus on the progression of the patient through the care system, rather than on facilitating future recovery. Much of the work of stroke recovery is consequently done by patients and their families at home, with little provision of ongoing professional help and advice. This paper explores the application of the Corbin and Strauss Chronic Illness Trajectory Framework for stroke. In particular, the major concepts of the framework are applied to a vignette derived from a longitudinal study of patients’ experiences of recovery. The trajectory framework is shown to be a useful structure that has the potential to enhance the appropriateness of nursing interventions for stroke patients. However, the validity of the framework can only be established through its application and evaluation in clinical practice. The purpose of this paper is to contribute to a debate that encourages consideration of the framework's utility for nurses to enhance the stroke rehabilitation experience.
Nurses’ experiences of being present with a patient receiving a diagnosis of cancer
Authors: Dunniece Una , Slevin Eamonn 
Published: March 2003

Nurses’ experiences of being present with a patient receiving a diagnosis of cancer This paper reports the findings of a study which describes the experiences of nurses who were present with a patient when they received a diagnosis of cancer, cancer recurrence or prognosis of terminal cancer. Semi‐structured interviews were conducted with six nurses who had experience of caring for patients with cancer in an acute surgical setting. Data were analysed using a phenomenological descriptive approach. Participants’ descriptions revealed the following seven core themes: ‘What if it was me?’; divergent feelings; being there; becoming closer; method of disclosure; time as an influence and learning by reflection. Possible implications for nursing practice and education are discussed and recommendations are made for future research.
On the use of narratives in nursing research
Authors: Frid Ingvar , Öhlén Joakim , Bergbom Ingegerd 
Published: March 2003

On the use of narratives in nursing researchNarratives have always been a path to knowledge in nursing care but are a recent element within nursing research. Therefore, this article deals with the narrative and its use within nursing research. First, the use of narratives in nursing care and nursing research is examined. Second, Paul Ricoeur's narrative theory with its dimensions of interpretation, time, action and ethics is presented as a possible methodological basis. Third, the use of Ricoeur's narrative theory in nursing research is examined, showing that, at present, support mainly comes from Ricoeur's text interpretation theory. Finally, a nursing research approach to the narrative, based on the life‐world, is suggested.