bluuebunny/crossref_metadata_2025_split huggingface dataset:
What do people need psychiatric and mental health nurses for?
Authors: Jackson Sue , Stevenson Chris 
Published: March 2003

What do people need psychiatric and mental health nurses for? The study reported here aimed to describe, by consulting with psychiatric practitioners of different disciplines, what people in contact with mental health services need nurses for, in terms of core nursing activity. Yet, recent trends have also been towards consumer‐led definitions of good practice. The views of service and ex‐service users can contribute much to an exploration of the role of psychiatric and mental health nurses and these perspectives were incorporated into the study. Given the lack of existing theory, a qualitative, grounded theory methodology was selected. In order to generate data rich enough for the analysis, focus groups of psychiatric nurses, social workers, service users, psychiatrists, carers and professions allied to medicine were sampled (13 groups, n=92) on the basis of the themes emerging from the data. Using critical incident technique (
Flanagan 1954), the groups were invited to give examples of effective and ineffective nursing interventions, in relation to specific patient needs. The taped material was transcribed and analysed with the help of a computer package (QSR NUD.IST). This led to the selection of a core category, ‘knowing you, knowing me’, which described service users’ and professionals’ expectations that nurses are best placed to second guess the needs of patients and present themselves accordingly. Thus, nurses were expected, moment by moment, to know whether to be the patient’s friend, a friendly professional, or take a more distant professional stance. The continuum entails different levels of knowledge and power, different language forms and different approaches to structuring time. Nurses themselves are most likely to prefer a position of friendly professional, from which they can move to a more intimate or distant role. Further study is needed to explore how nurses predict patients’ expectations of them using a symbolic interactionist framework.
Psychiatric nurses’ thoughts and feelings about restraint use: a decision dilemma
Authors: Marangos‐Frost Sandy , Wells Donna 
Published: March 2003

Psychiatric nurses’ thoughts and feelings about restraint use: a decision dilemma Patients continue to be physically restrained in psychiatric in‐patient units. Studies concerned with staff‐related variables have suggested that the emotional reactions of professionals to violent or potentially violent patients may influence their use of restrictive measures. However, no research existed that described psychiatric nurses’ thoughts and feelings while they were involved in restraint situations nor what effects their thoughts and feelings had on their decision to restrain. Therefore, an ethnographic qualitative study was conducted in order to describe systematically nurses’ thoughts and feelings toward restraint use in the in‐patient psychiatric setting. The conceptual approach guiding the study was Etzioni’s (1992) theoretical work on the role of normative‐affective factors in decision making. Following ethical approval of the study, ethnographic interviews were conducted with six nurses from an in‐patient psychiatric unit who had participated in a situation involving the physical restraint of a patient. The analysis of the nurses’ thoughts and feelings revealed that the restraint situation represented a decision dilemma for them. This overall finding was supported by four themes: (1) the framing of the situation: the potential for imminent harm; (2) the unsuccessful search for alternatives to physical restraints; (3) the conflicted nurse; and (4) the contextual conditions of restraint. The results indicated that restraint use is more complex than is currently conveyed in the literature in that normative‐affective factors influenced nurses’ restraint decisions. The findings advance our understanding of why restraints continue to be used in psychiatric units. Further research is necessary to examine the findings in other settings and with a larger and more diverse population in order to draw definitive conclusions about the continued use of physical restraints in the care of patients on psychiatric units in hospitals.
The minimization to clients of screen‐detected breast cancer: a qualitative analysis
Authors: Farmer Alison J. 
Published: March 2003

The minimization to clients of screen‐detected breast cancer: a qualitative analysis Previous research has shown a low incidence of psychological morbidity in women with screen‐detected breast cancer when compared to women with symptomatic breast cancer. Farmer et al. suggested that this might be due to the way the diagnosis of breast cancer is given to women with screen‐detected disease. In order to test this hypothesis a detailed, in‐depth, qualitative study was undertaken. The sample consisted of women with symptomatic breast cancer (n=5), women with screen‐detected invasive breast cancer (n=6) and women with screen‐detected in‐situ breast cancer (n=5). The ‘bad news consultations’ with the surgeons, and subsequent meetings with the breast care nurses (BCN), were tape recorded. The women were also interviewed in their own homes within 7 days. The results suggested that the women with screen‐detected breast cancer received more reassurance than the women with symptomatic breast cancer and that the benefits of breast screening were emphasized by the surgeons and the BCNs. This led to minimization of the significance of screen‐detected disease. Women were found to draw on a new conceptual model of early curable breast cancer which appears to be associated with a low incidence of psychological morbidity.
Advanced nursing practice: the case of nurse practitioners in three Australian states
Authors: Offredy Maxine 
Published: March 2003

Advanced nursing practice: the case of nurse practitioners in three Australian states This paper provides insight into the work of nurse practitioners in three Australian states. Using a case study approach, the aim of the study is to give an account of some of the types of cases/patients who consult with the nurse practitioners in the states visited and to offer insight into one of the policy changes required to support the introduction of the nurse practitioner role. A snowball sampling technique was used to obtain the sample population of both 10 nurse practitioners and other health care personnel. Semi‐structured interviews were conducted with the 39 respondents in both samples. The analysis of the 10 nurse practitioner interviews reported here shows that these nurses undertook a wide range of roles. The results of the semi‐structured interviews with the nurse practitioners are described using four of the 10 interviews and reporting them as case studies. The results highlighted the need to address legislation issues and to prepare nurses adequately for their clinical setting and address the difficulties of continuing education of rural nurses.
Drawing up and administering intramuscular injections: a review of the literature
Authors: Rodger Michael A. , King Lindy 
Published: March 2003

Drawing up and administering intramuscular injections: a review of the literature Intramuscular (IM) injections have been an integral part of drug administration in nursing practice for almost half a century. However, there are some conflicting practices which warrant investigation to determine their effectiveness in this aspect of patient care. To this end, this paper presents the results of a literature review which was carried out in order to establish current understanding of present day knowledge, procedures and guidelines for the administration of IM injections. Areas addressed within this review include injection sites used, injuries associated with IM injections, issues surrounding needle selection and volume administered through IM injections, injection techniques and nursing skills associated with IM injections. Synthesis of the research reviewed allows the development of research‐based guidelines for this skill. These guidelines offer a framework for nurses who wish to provide practice in line with current research into the process of drawing up and administration of intramuscular injections.
Barriers to using research evidence in nursing practice
Authors: Retsas Andrew 
Published: March 2003

Barriers to using research evidence in nursing practice The nursing profession has long recognized the importance of research as an essential basis for its development. More recently, the movement supporting evidence‐based practice has brought this point into focus. However, relatively little research has been conducted to identify factors that interfere with the ability of nurses to base their practice on research evidence. Using factor analysis procedures, barriers to the use of research evidence in practice which were perceived to be present by 400 registered nurses working in an Australian hospital, were grouped under four main factors. These were accessibility of research findings, anticipated outcomes of using research, organizational support to use research and support from others to use research. The most important factor was perceived to be organizational support, particularly in relation to providing time to use and conduct research.
Characteristics of severely mentally ill patients in and out of contact with community mental health services
Authors: Barr Wally 
Published: March 2003

Characteristics of severely mentally ill patients in and out of contact with community mental health services Community mental health nurses have been criticized for failing to prioritize work with people with a severe or enduring mental illness, many of whom have no contact with specialist mental health services and rely entirely on their general practitioner and primary care team. It is important to ensure that those in contact with specialist services actually need this level of input but, conversely, that those in contact with only primary care receive a service that is equipped to meet their needs. This study examines the differences between these two groups of patients. A sample of 253 community‐based patients with a severe or enduring mental illness was divided into those with mental health service contact and those without. Differences in the demographic characteristics of the two groups were assessed and further, more detailed, comparisons were made with a sub‐sample of 49 individuals randomly drawn from this larger sample. Instruments adopted for these purposes comprised the Camberwell Assessment of Need and the Life Fulfilment Scale. It was found that patients with a psychotic disorder were more likely than those with neurosis to be in contact with mental health services and patients with schizophrenia were significantly more likely to be on the active caseload of a community mental health nurse than those from all other diagnostic groups. However, patients’ levels of need, unmet need and quality of life did not differ in relation to their service contact. Whilst the study provides limited evidence that community mental health nurses are targeting people with the most serious disorders, questions remain about the large proportion not receiving specialist care. Because primary care plays a significant role in the care of severely mentally ill people living in the community, the further mental health training of general practitioners and practice nurses is becoming increasingly important.
The evolving educational needs of nurses caring for the older adult: a literature review
Authors: Joy  , Carter  , Smith  
Published: March 2003

The evolving educational needs of nurses caring for the older adult: a literature review Recent changes in long‐term care policies in the United Kingdom have resulted in many more older patients/clients, previously nursed in long‐term hospital facilities, now being cared for in the community. This change has had a significant impact on nurses, forcing many to make the transition from working in hospital to within the community. This transition calls for appropriate professional educational preparation to enable these nurses to undertake their new roles effectively. The literature search that forms the basis for this paper revealed relatively little material focusing specifically on the educational needs of such nurses in transition. However, literature that addresses the needs of nurses caring for the older individual in the acute setting, and in the community environment, was found and is explored.
Factors related to stress and coping among Chinese nurses in Hong Kong
Authors: Callaghan Patrick , Tak‐Ying Shiu Ann , Wyatt Peggy A. 
Published: March 2003

Factors related to stress and coping among Chinese nurses in Hong Kong Few empirical studies have investigated the issues linked to Hong Kong nurses work‐related health. The present study investigated factors related to stress and coping among Chinese nurses in Hong Kong. The researchers employed a cross‐sectional survey and made within‐group comparisons of nurses’ stress and coping. Using stratified random sampling the researchers selected nurses from the mailing list of a local professional organization. One hundred and sixty‐eight (33·6%) nurses responded. Nurses reported lower stress levels than other workers assessed with the same measure. Paediatric nurses reported the highest stress levels. Nurses at the lower grades reported higher stress levels than nurses at the higher grades. Single nurses had marginally higher stress scores than married nurses and females had slightly higher stress scores than males. However, none of these results were statistically significant. The respondents’ major sources of stress were related to nursing issues like too much work, interpersonal relationships, and dealing with hospital administration. The respondents coped with their stresses by seeking support from friends and colleagues, using different cognitive strategies and through leisure activities. There was a statistically significant link between the respondents’ stress and sickness levels. The results raise issues about the nature of nurses’ working experiences.
Increasing uptake rates of cervical cancer screening amongst Hong Kong Chinese women: the role of the practitioner
Authors: Twinn Sheila , Cheng Frances 
Published: March 2003

Increasing uptake rates of cervical cancer screening amongst Hong Kong Chinese women: the role of the practitioner Women’s attendance for regular cervical screening has been identified as a significant factor in the prevention of cervical cancer. Evidence suggests, however, that both extrinsic and intrinsic factors influence women’s attendance patterns for screening. Extrinsic factors, in particular the practitioner undertaking the screening procedure, have been shown to influence women’s return rates for further screening. In Hong Kong, where uptake rates amongst Chinese women remain comparatively low, a study was undertaken to examine Chinese women’s experiences and perceptions of cervical screening undertaken by either a female doctor or nurse. A multiple case study design using both qualitative and quantitative methods of data collection was employed. This paper reports the findings from the qualitative data obtained from 52 women participating in 12 focus group interviews held in the two case studies. Thematic analysis of the data demonstrated the importance of the caring nature, communication skills, experience and expertise of the practitioner to women’s attendance pattern for screening. The experience and expertise of the practitioner, described by women as teaching, minimizing pain and discomfort and being considerate, were considered more influential to uptake rates than the professional discipline of the practitioner. Findings such as these indicate the importance of the influence of the practitioner in determining uptake rates for cervical screening amongst this population group.
Discourse analysis of an ‘observation levels’ nursing policy
Authors: Horsfall Jan , Cleary Michelle 
Published: March 2003

Discourse analysis of an ‘observation levels’ nursing policy The practice of special observation (or constant observation) is widely used in inpatient psychiatric facilities for the care of people who are suicidal. In this study, the policy of special observation was examined using a discourse analysis method to discern prevailing ideas and practices highlighted within the policy. After reading, studying and analysing the special observation nursing policy, the authors briefly describe the document and outline the terms and phrases prevalent within the document. These recurrent ideas are then organized into five categories: professional responsibilities, suicidality, the patient’s immediate context, the patient’s observable behaviour and the nursing checklist. In discussion of the policy document, the invisibility of the authors, target audience and patients is noted. The authors attempt to elicit evidence for the therapeutic nurse–patient relationship in the document. In the analysis of patient, nurse and doctor roles and responsibilities, it is evident that the policy document reinforces the traditional medical hierarchy of power relations. Some assumptions that underpin the document are postulated. Questions regarding the nature of risk assessment and the evidence base for the medical prescription of special observation are raised. As well as ideas and themes evident in the document, the absence of some relevant issues is explored. While the need for succinctness and clarity in policy documents is acknowledged, the fact that patient rights, therapeutic processes and ethical dilemmas are absent is deemed significant.
Nursing student–patient relationship: a review of the literature from 1984 to 1998
Authors: Suikkala Arja , Leino‐Kilpi Helena 
Published: March 2003

Nursing student–patient relationship: a review of the literature from 1984 to 1998 Aim and background. The aim of this review is to examine the research of the nursing student–patient relationship for planning an empirical study in this area. Methods. A literature search was made focusing on relationship from student and patient perspectives. The sample included 104 articles from 1984 to 1998. The articles were analysed using an inductive analysis of the literature. Results. The review shows that there has been an increasing research interest in the issue since the 1980s, with the main focus on nursing students. Most of the studies were of a descriptive nature, using both qualitative and quantitative approaches. It seems that the relationship with a patient is an important part of a meaningful learning process, teaching nursing students about the patient’s individualised care and promoting their personal and professional growth, confidence and self‐esteem. Patients are willing to participate in students’ learning process and they tend to benefit from therapeutic and social interaction with students. Instruction has the effect of changing students’ attitudes and improving their interaction skills, but it does not affect their feelings of anxiety in novel situations. Conclusions. In future empirical research should be based more firmly on theory‐based illuminations of the student‐patient relationship.
Observing washing and dressing of stroke patients: nursing intervention compared with occupational therapists. What is the difference?
Authors: Booth Joanne , Davidson Ian , Winstanley Julie , Waters Karen 
Published: March 2003

Observing washing and dressing of stroke patients: nursing intervention compared with occupational therapists. What is the difference? This study sought to compare the interventions of qualified nurses with those of occupational therapists during morning care with the same population of stroke patients. Nonparticipant structured observation was used to identify the activities and interventions carried out by each of the two groups in a naturalistic care setting. Approval for the study was granted by the local ethics committee. In order to allow comparison between pairs, staff–patient interactions during morning care (n=10) were observed by a single researcher, firstly, with an occupational therapist and within 3 days of this, with a nurse. Twenty observation sessions were recorded in total during which time the activities, contacts and interactions were coded and recorded at 20‐second intervals on a standard proforma. Analysis was undertaken using the Statistical Package for Social Sciences (SPSS) for windows. The results showed that occupational therapists used ‘prompting and instructing’ commands more than nurses and used facilitation techniques significantly more (P=0·0283). ‘Supervision’ interactions were preferred by nurses with 42·1% of their time spent performing this activity compared with 25·1% for occupational therapists. These results are limited to the group under observation. It is suggested that the reasons for the observed differences in intervention styles used by occupational therapists and nurses may be attributed to the approach taken to the assessment and treatment of stroke patients. This difference might be attributed to a lack of preparation for specialist neurological/neurovascular practices of nurses working in the field of stroke rehabilitation.
The use of metaphor in district nursing: maintaining a balance
Authors: Goodman Claire 
Published: March 2003

The use of metaphor in district nursing: maintaining a balance Aim of the study. To explore with practitioners and others, their priorities for and definitions of district nursing. Background/Rationale. This paper discusses whether the use of metaphor in nursing literature and research can offer particular insights about the situation and experiences of nurses. Design/Methods. A case study approach was used to examine district nursing during a time of policy change. The study was undertaken in two stages using a range of qualitative methods of enquiry. Participants of the study were district nurses, General Practitioners (GP) and Community Nursing managers. Results/Findings. Qualitative data from interviews and periods of observation revealed that district nurses, and to a lesser extent General Practitioners and nurse managers used a shared group of metaphors to try and capture district nursing work. The paper suggest that this recurring group of metaphors demonstrated coherence between the language used, observed practice and accounts of how district nurses worked which provided useful insights for district nursing. The metaphoric language revealed both negative and positive dimensions of district nursing work. It illuminated the context dependent nature of district nursing work and the conflicting interests they had to accommodate. It also revealed the emotional work, skills and strategies district nurses employed in order to achieve their work. Conclusions. The paper concludes that an examination of metaphoric language offers an opportunity to examine what otherwise would be tacit or even misunderstood in nursing work.