bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing students' and clinical educators' perceptions of characteristics of effective clinical educators in an Australian university school of nursing
Authors: Lee Woo‐Sook (Christina) , Cholowski Krystyna , Williams Ann Katherine 
Published: March 2003

Background . This study is a replication of research undertaken by Mogan and Knox in 1987, which investigated and described characteristics of ‘best’ and ‘worst’ clinical educators. They developed and used an instrument known as the Nursing Clinical Teacher Effectiveness Inventory (NCTEI), a 48 item checklist that describes discrete characteristics clustered into five subscales or categories: teaching ability; interpersonal relationships, personality traits, nursing competence and evaluation. The tool has since been used in several countries including Greece, Hong Kong, Israel and North America and is the instrument most frequently used to identify effective clinical teaching characteristics of clinical educators. Aim . The aim of the present study was to administer the NCTEI to undergraduate nursing students and clinical educators in a school of nursing at an Australian university to explore the perceived characteristics of effective clinical educators as rated by students and educators, and the significant differences and commonalities between these perceptions. Findings . Results indicate that the category of Interpersonal Relationships was the most highly valued characteristic rated by both Australian students and clinical educators, and both groups (students and educators) ranked the subset of personality as the lowest amongst five categories. In common with Mogan and Knox, this study found that students who had not been exposed to real clinical situations prior to commencing nursing studies ranked items related to interpersonal relationships more highly than students who had previous nursing experience. Although there were no statistically significant differences in the two groups, students were more concerned with evaluation while clinical educators were more concerned with nursing competence. Conclusion.  This study is the first research to be reported in Australia, which has simultaneously compared both students' and educators' perceptions and the first to replicateMogan and Knox's seminal work. Findings point to the need forclinicaleducators tovalue interpersonal relationships with students as well as clinical competence.
Comfort: exploration of the concept in nursing
Authors: Malinowski Ann , Stamler Lynnette Leeseberg 
Published: March 2003

Background.  Comfort is a substantive need throughout life. However, the rise of technological influence coupled with a desire to embrace the medical concept of cure has frequently relegated the importance of nursing comfort interventions to simple tasks that can be provided by non‐professional caregivers rather than an integral part of health promotion at all levels. Definition.  Comfort is a concept that has been explored by a number of authors. Various definitions have included comfort as an outcome of nursing, a function of nursing, a basic human need, and a process. No consensus on a definition of comfort was found in the literature. Theory.  This investigation attempts to link the ideas of comfort presented in the literature with the theories of Watson (Human Care) and Leininger (Culture Care), and discovers the existence of an integral locus for comfort in both. Implications.  Theory‐based strategies for nursing education are offered. Further research is clearly required, research methodologies based on Watson and Leininger would be appropriate for additional exploration of this concept. Practice implications include reflecting on the meaning of comfort to the patient in the context of his/her cultural values, and using this one as one of the factors in planning and implementing nursing care. Conclusion.  Given the current emphasis on health promotion and the importance of comfort to the process of healing, comfort is an indispensable element of holistic, culturally congruent human care.
Motivation for health behaviours: a systematic review of the nursing literature
Authors: Carter Kimberly F. , Kulbok Pamela A. 
Published: March 2003

Aims and rationale.  This research review examines nursing and allied health studies exploring motivation for health behaviours to identify the state of understanding of this construct within nursing. This review contributes to nursing science by synthesizing nursing research regarding motivation for health behaviour. Methods.  Integrative research review methodology. Findings.  Problems of existing research include nonprobability sampling of heterogeneous populations, low statistical power, and colinearity. Studies identifying predictors of motivation explained large proportions of variance using regression. Motivation was not a significant predictor of health behaviours for over one‐third of the studies. Overall, the studies suggest that either motivation is not being effectively measured because of a lack of conceptual clarity or that motivation is not an essential determinant of health behaviours. The latter cannot be verified until psychometric research advances current measurement of motivation to a higher level. Limitations.  The literature for this review was accessed through the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Databases for other disciplines were not included in this search. This work represents a first step towards understanding motivation for health behaviour as it is currently defined in the literature. Future studies are necessary to broaden this understanding beyond nursing. Conclusions.  Motivation is a frequently cited rationale underlying the adoption and maintenance of health behaviours in research and practice. Motivation is complex and multidimensional, and clearer definitions for motivation are needed. Populations that have been underrepresented in motivation research need to be targeted in future research. Researchers and practitioners are challenged to examine carefully the role of motivation for health behaviours and explore other factors that may more strongly influence health behaviours.
Sociological and psychological theories of self‐neglect
Authors: Lauder William , Anderson Isobel , Barclay Aileen 
Published: March 2003

Background. Self‐neglect can be defined as the failure to engage in those self‐care actions necessary to maintain a socially acceptable standard of personal and household hygiene and/or a failure to adequately care for one's own health. It is generally acknowledged that research and practice in the area of self‐neglect has been hampered by a lack of theoretical development. Socio‐psychological theories, such as ‘social constructivism’ and ‘negotiated interactionism’ can contribute to a deeper understanding of the phenomenon and to the further development of self‐neglect theory. Aims. This paper seeks to apply social and psychological theories to understanding self‐neglect. Self‐neglect is an underconceptualized phenomenon, which requires to be studied within a broader theoretical context than is at present the case. Implications. Sociological and psychological theories offer radically different ways of looking at self‐neglect, as opposed to the medical model, as they seek to explain and understand, rather than simply classify it as a medical disorder caused by some form of underlying psychopathology. These theories emphasize the dynamic and interpretative nature of self‐neglect and illustrate the arbitrary way in which this label is applied.
Nursing knowledge and assessment skills in the management of patients receiving analgesia via epidural infusion
Authors: Bird Annette , Wallis Marianne 
Published: March 2003

Background.  In Australian hospitals, epidural infusions are commonly used for the management of post‐operative pain in maternity and surgical patients, with little research evidence to indicate the efficacy of the educational preparation of nurses undertaking pain management. Aims.  To describe nurses' assessment skills and knowledge related to the management of a patient with an epidural infusion and to explore relationships between these variables and the levels of education/clinical experience of the nurses. Methods.  This descriptive correlational study used a convenience sample of surgical and obstetric unit registered nurses to explore relationships between the knowledge and skill in epidural management and the educational preparation of the nurse. Data were collected via survey and observation, using instruments developed by the research team. Results.  The nurses had a good knowledge base for the performance of sensory blockade assessment but scored less well in motor blockade assessment and clinical decision‐making. Nurses who had clinical experience, had completed a self‐ directed learning package and who worked in surgical areas scored higher on the survey than other nurses. Observation scores revealed a range of performance outcomes. There was only a weak correlation between knowledge and skill performance. There were no differences in scores for the observation exercise for different groups of nurses. Conclusion.  The results of this study indicated that the nurses' theoretical knowledge outweighed their clinical skill performance and clinical decision‐making. Education for nurses regarding the management of epidural infusions needs to be comprehensive, context specific and have the capacity to develop the nurse's autonomous critical thinking and clinical decision‐making skills. Strategies for this include self‐directed learning packages best supplemented by a demonstration of clinical skills and supervised practice.
Decision‐making in primary care: outcomes from a study using patient scenarios
Authors: Offredy Maxine 
Published: March 2003

Background.  Various documents emphasize the importance of new roles and new ways of working to modernise delivery of health service and improve the public's health. In particular nurse practitioners are seen as crucial in the modernization process. Aim.  This paper reports the outcomes of a study conducted in 1998 to ascertain the differences, if any, in the decision‐making processes of nurse practitioners and general practitioners for diagnosis and treatment when given the same patient scenarios. Methods.  Information processing theory together with ‘think aloud’ approach were used to understand the cognitive processes of the 22 participants, 11 general practitioners and 11 nurse practitioners, in the study. A reference model was developed for each of the six scenarios of the study; three medical photographs were also used. The data were analysed using NUD*IST computer software. Results.
The outcomes of each scenario are presented and comparisons are made with general practitioners. The results show that there were more similarities than differences in the decision‐making processes of the two groups. Hypothesis evaluation appears to be
the critical component in the decision‐making process. Explanations given by the two groups at the end of their ‘think aloud’ procedure justify their diagnoses and treatment/management plans. Conclusions.  The research adds to existing evidence that encourages health care providers to use nurse practitioners more flexibly and to develop service‐based approaches to the delivery of health care as set down in government policies. It also adds to the body of literature using information processing theory because it demonstrates that the two groups use similar decision‐making processes to arrive at similar diagnoses and treatment options.
Implementation of the pain and symptom assessment record (PSAR)
Authors: Bouvette Maryse , Fothergill‐Bourbonnais Frances , Perreault Annie 
Published: March 2003

Background.  Symptom control is a major component of care for the terminally ill patients. Although uncontrolled pain is distressing for patients and families, there are other symptoms that can be distressing such as dyspnea and fatigue. Determining methods to consistently assess and manage pain and other symptoms is a challenge for nurses, physicians and other health care professionals. In the Ottawa Region of Canada, health care providers raised concerns related to inconsistencies in pain assessment due to a variety of formats used, as the patient moved through the health care system. Recognizing the need for a common assessment tool, a working group was formed composed of 14 nurses associated with institutions and agencies delivering palliative care services in the Ottawa region, as well as a faculty member of the School of Nursing of the University of Ottawa. The mandate of the working group was to develop a consistent method to assess patients' pain and symptoms in order to facilitate communication among health care professionals within various health care settings. The Pain and Symptom Assessment Record (PSAR) was developed over 24 months. Aim.  To determine the feasibility of implementing the PSAR in a variety of settings. Methods.  This exploratory study used focus groups and chart audits to gather data related to the utility of the PSAR. Education sessions were used to introduce the tool to nurses in the various settings. Results.  The tool was implemented in 12 settings. Thirty‐seven education sessions were given to nurses prior to use of the tool and the feedback revealed that this is an important process in tool introduction. The results of the chart audits indicated that pain was assessed 93% of the time. Symptoms were less documented but fatigue was most prominent. Overall, patients were satisfied with their pain and symptom control. Data from the focus groups were analysed using content analysis and the two themes that emerged related to the tool were ‘structure’ and ‘process’. Conclusion.  There were many challenges in this project and lessons learned will be discussed. Based on the results, the tool has been modified and is currently utilized in diverse settings.
Patient injury and physical restraint devices: a systematic review
Authors: Evans David , Wood Jacquelin , Lambert Leonnie 
Published: March 2003

Objective.  To investigate physical restraint‐related injuries. Areas of interest were the prevalence of injury, types of injuries, risk of sustaining an injury and specific restraint devices associated with injury. Definitions.  Injury in the context of this review was considered to be either direct injury, such as lacerations and strangulation, or indirect injury considered to be an adverse outcome such as increased mortality rates or duration of hospitalization. Method.  A comprehensive search was undertaken that involved all major databases and the reference list of all relevant papers. To be included in the review studies had to involve people in acute or residential care settings and report data related to injury caused by restraint devices. A number of different types of research designs were included in the review. The findings of studies were pooled using odds ratio and narrative discussion. Results.  The search identified 11 papers reporting the findings of 12 observational studies. These studies were supplemented with the findings of a number of other types of studies that reported restraint‐related data. The review highlights the potential danger of using physical restraint in acute and residential health care facilities. Observational studies suggest that physical restraint may increase the risk of death, falls, serious injury and increased duration of hospitalization. However, there is little information to enable the magnitude of the problem to be determined. Discussion.  Many of the findings highlight the urgent need for further investigation into the use of physical restraint in health care facilities. Further research should investigate the magnitude of the problem and specific restraint devices associated with injury. However, given the limited nature of the evidence, this association should be investigated further using rigorous research methods.
Living on dialysis: concerns of clients in a renal setting
Authors: Polaschek Nick 
Published: March 2003

Background.  This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. Methodology.  The study used a critical interpretive methodology. The renal setting was critically viewed as a specialized health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Methods.  Initially participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualizing them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. Findings.  From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. Together these model their shared perspective, which underlies each of their individual accounts of their experience of illness and therapy. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. Conclusion.  One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse.
Older people in persistent pain: nursing and paramedical staff perceptions and pain management
Authors: Blomqvist Kerstin 
Published: March 2003

Background. Persistent pain is a common problem for older people. Knowledge about how nursing and paramedical staff perceive these people and what they do to relieve the pain seems scarce. Aim. To explore nursing and paramedical staff perceptions of older people in persistent pain and their day‐to‐day management of pain. Methods. Interviews in Swedish with 52 nursing auxiliaries, Registered Nurses, physiotherapists and occupational therapists were collected from February to May 2000. The analysis was based on their stories (n = 150) about older people in persistent pain who received help in their own homes or in special accommodation. A typology of staff perceptions of pain in older people was developed. Activities to manage pain were examined using content analysis. Results. Respondents perceived the pain as real, exaggerated, trivial, care‐related, endured, concealed, self‐caused or inarticulate. Older people perceived as exaggerating the pain, those with care‐related and self‐caused pain evoked frustration in the staff, while those perceived as enduring their pain evoked satisfaction. Various strategies to manage pain were used: no activity, medication, mediating contacts, distracting activities, physical therapies, mobility, work in a gentle way, rest or relieving pressure on body part, and communication concerning pain. The activities differed between the types, as well as between staff with different professional backgrounds. Conclusion. Care and treatment provided by staff should be based on older people's needs rather than on staff attitudes and preferences. The typology revealed that staff perceived older people in pain as a heterogeneous group and that their perceptions affected the pain‐relieving activities that were offered. It seems urgent to address how to handle pain in older people who never complain and those who complain a great deal, as well as how to handle pain in people with impaired communicative ability. Reflective discussions on feelings related to different individuals are needed.
Nurse cadet schemes in the British NHS – challenges and opportunities
Authors: Culley Lorraine , Genders Nicky 
Published: March 2003

Rationale. Nurse cadet schemes are locally developed initiatives which prepare participants for entry to preregistration nurse education. The paper discusses the political context in which modern day nurse cadet schemes have developed in the British National Health Service and explores the diversity of schemes currently operating in the United Kingdom (UK). Background. Nursing recruitment is a high priority for the National Health Service in the UK which, in common with many countries, is facing a nursing shortage. In addition, the government is committed to increasing flexibility in the education and recruitment of staff. The entry gate to health professional education needs to be widened to improve access for hitherto under‐represented groups. Methods. The paper provides a critical commentary on key issues in the development of nurse cadet schemes as discussed in a range publications, together with information gathered from ‘grey’ literature and personal contacts in nurse education. A wide range of health care and social science databases was used to collect material for the discussion. Findings. Approximately 800 cadets are currently engaged in around 60 cadet schemes in a number of localities in Britain, and it is proposed that these will be expanded to over 2000 nurse cadets by 2004. Nurse cadet schemes have developed to meet local needs and priorities and, in the absence of a strong national framework, a wide diversity of participants, curricula and funding arrangements have emerged. Conclusions. Serious consideration needs to be given to further standardization in the structure and funding of schemes to reduce the degree of inequality which currently exists for cadets, together with development of national benchmarks to ensure that a set of minimum standards is met. Any future development must be built on a systematic evaluation of current schemes, which has yet to be undertaken.