bluuebunny/crossref_metadata_2025_split huggingface dataset:
Still fumbling along? A comparative study of the newly qualified nurse’s perception of the transition from student to qualified nurse
Authors: Gerrish Kate 
Published: March 2003

Still fumbling along? A comparative study of the newly qualified nurse’s perception of the transition from student to qualified nurse An earlier study conducted in the United Kingdom, examining the newly qualified nurse’s perception of the transition from student to qualified nurse, highlighted the limitations of pre‐registration nurse education in respect of failing to provide adequate preparation for the qualified nurse’s role. In the intervening years, major reforms in pre‐registration nurse education and continuing professional education have occurred. Concomitant with these reforms have been major policy changes in health care delivery that have impacted upon the role of the nurse. Questions now arise as to whether the education reforms have served to equip newly qualified nurses more appropriately with the necessary knowledge, skills and confidence to function in contemporary health care settings. This paper presents the findings of a follow‐up study that entailed a secondary analysis of exiting data obtained from in‐depth interviews with 10 newly qualified nurses in 1985 and collecting additional data from 25 newly qualified nurses in 1998 in order to ascertain their perceptions of the transition from student to qualified nurse. Interview transcripts from both sources of data were coded and thematically analysed and comparisons made between the two sets of data. The paper focuses on one theme emanating from the original study. Entitled ‘fumbling along’, it described the haphazard manner whereby the nurses learned to perform their role in the light of what they perceived to be inadequate preparation and lack of support. Similarities and differences in the experiences and perceptions of the two cohorts of nurses are examined in respect of stressful aspects of the role, pre‐registration preparation and post‐registration development. Data from the follow‐up study suggest that although newly qualified nurses still feel inadequately prepared for their role, they have developed a more active style of learning and when supported through a preceptorship scheme appear to find the transition less stressful than nurses in 1985. However, further attention needs to be paid to the development of clinical, organizational and management skills in pre‐registration courses and the bridging period between the latter part of the course and the first 6 months post‐qualification, in order to enable the neophyte nurse to acclimatize gradually to becoming an accountable practitioner.
Using restraint with nursing home residents: a qualitative study of nursing staff perceptions and decision‐making
Authors: Hantikainen Virpi , Käppeli Silvia 
Published: March 2003

Using restraint with nursing home residents: a qualitative study of nursing staff perceptions and decision‐making The study reported in this paper applied a qualitative and interpretative approach to nursing staff perceptions of the use of restraint with elderly nursing home residents, and into nurses’ decision‐making on restraint use. The data were collected using unstructured interviews with a purposive sample of 20 trained and untrained nursing staff from two Swiss nursing homes. Data analysis was based on Colaizzi’s phenomenological method. Three main themes were extracted from the data: (1) understanding the term restraint, (2) situations in which the decision to apply restraint is considered justified and (3) situations in which nursing staff are uncertain about the use of restraint. The underlying bases with respect to decision‐making were: understanding restraint, the rights and responsibilities of both residents and staff, and the duties of staff. Staff members were ambiguous in their understanding of restraint and they showed positive as well as confused attitudes towards its use. Their behaviour was defensive and protective rather than challenging. Further research is required on what is meant by safety in care of the elderly nursing today. In nursing practice, as far as issues of restraint are concerned, greater attention should be devoted to the relationship between elderly residents’ self‐determination and responsibility for their actions.
The diagnosis and management of acute childhood illness: is there a role for health visitors?
Authors: Kendrick Denise , Young Anousha , Futers Debbie 
Published: March 2003

The diagnosis and management of acute childhood illness: is there a role for health visitors? Much of the published literature on nurse practitioners relates to nurses with backgrounds, training and nursing experience other than health visiting. Health visitors however may be ideally placed to develop their role in the identification and management of acute childhood illness, and such a development may benefit patients, the health service and health visitors themselves. This study examines the current practice and attitudes of heath visitors in identifying and managing acute childhood illness using a postal questionnaire survey in one community National Health Service (NHS) Trust. The majority of responding health visitors reported that they were already identifying and advising on a range of acute childhood illnesses. Their confidence in undertaking these activities varied by condition. They were less confident in identifying and advising on conditions requiring the use of diagnostic equipment, viral illnesses which are becoming increasingly rare, and those with potentially serious outcomes. More knowledge and more training were seen as methods for increasing confidence. Most health visitors could see advantages in taking on this role; almost two thirds felt it would become part of the role of the health visitor in the future and a high level of interest was expressed in developing such a role.
Accounting for overlap? An application of Mezzich’s κ statistic to test interrater reliability of interview data on parental accident and emergency attendance
Authors: Eccleston Philippa , Werneke Ursula , Armon Kate , Stephenson Terence , MacFaul Roderick 
Published: March 2003

Accounting for overlap? An application of Mezzich’s κ statistic to test interrater reliability of interview data on parental accident and emergency attendance Study rationale. The number of interview studies with service users is rising because of growth in health services research. The level of agreement between multiple interview data coders requires statistical calculation to support results. Basic κ statistics are often used but this depends on having mutually exclusive data. Researchers should be aware that this is not valid when an interview word or paragraph can be coded into more than one category. The ‘proportional overlap’κ extension by Mezzich et al. (1981, Journal of Psychiatric Research16, 29–39) has been investigated as an original solution. Objectives. To assess the level of agreement beyond chance between several raters of interview data by applying the ‘proportional overlap’κ statistic by Mezzich et al. to verbal interview data. The clinical area investigated was child attendance at an Accident and Emergency Department, where parental attendance experiences have been under‐explored. Methods. Two researchers using a coding schedule coded a random sample of interview transcripts. These data were applied to Mezzich’s procedure; coder 1 notes that a paragraph refers to category A and B but coder 2 notes A, B and C. The total agreement overlap in this case was 0·66 because two actual agreements out of three possible agreements were made. This was repeated for each paragraph and divided by the number of coding pairs. All agreement values were summed then subsequently divided by the total number of paragraphs to get Po (total number of observed agreements) and by the total number of coding pairs to get Pe (total number of agreements by chance alone). Po and Pe were used in the basic κ formula to assess interview coding reliability. Results. The overall mean Po was 0·61, the mean Pe was 0·32, with a κ score of 0·43; a moderate level of agreement which was statistically significant (t=4·8, P < 0·001, d.f.=23). Conclusion. Mezzich’s procedure may be applied to interview data to calculate agreement levels between several coders.
Chronic pain and coping: a proposed role for nurses and nursing models
Authors: Richardson Cliff , Poole Helen 
Published: March 2003

Chronic pain and coping: a proposed role for nurses and nursing models Aims. Activity of living based nurse models such as that proposed by Roper, Logan and Tierney are utilized commonly to rationalize, structure and guide practice. This paper proposes that their use, in the context of chronic pain, should be extended to incorporate the assessment of coping and its effect on disability. Background. As coping has been found to account for some of the variance in adaptation to chronic pain, generic models of coping and their utility in this context are considered. The need for reliable and valid means to assess coping are of paramount importance as this will facilitate and inform treatment and management of chronic pain. At the present time coping is most generally assessed using self report instruments which primarily focus on the number and type of strategies used to cope rather than their effectiveness in reducing disability and increasing function. Findings. A classification system which categorizes chronic pain patients in terms of how they function in daily life as either adaptive copers, interpersonally distressed or dysfunctional is outlined. The similarities between this and a routine nursing assessment based on an activities of living model are highlighted. Conclusions. It is proposed that the innovative use of nursing activity of living models could provide the framework for a pain clinic based assessment of coping that has greater utility for professionals and patients alike.
Going home from hospital: the carer/patient dyad
Authors: Procter Susan , Wilcockson Jane , Pearson Pauline , Allgar Vicky 
Published: March 2003

Going home from hospital: the carer/patient dyad Aims. This study aimed to provide an in‐depth understanding of the process of hospital discharge experienced by the carers of patients ‘at risk’ of unsuccessful discharge from medical wards in three hospitals in the North of England. Background. The Community Care Act and the Carers Recognition and Services Act placed responsibility on service providers to ensure the smooth discharge of patients from hospital making sure that appropriate community services are in place to support the patient and their informal carer following discharge from hospital. The study, from which this paper is taken, identified patients at risk of unsuccessful discharge and tracked the experiences of the patient and their carer through the discharge process. For the purpose of the study unsuccessful discharge is defined as unplanned readmission within 6 weeks of discharge or extended length of stay. Design. The study combined qualitative and quantitative methods to identify factors leading to unsuccessful discharge. Logistic regression was used retrospectively with the records of 1500 patients to identify factors predicting unsuccessful discharge. A sample of medical patients predicted to be at risk of unsuccessful discharge, their formal and informal carers, were followed through the discharge process using qualitative techniques to look at decision‐making and outcomes related to discharge. Findings. This paper presents findings relating to patient/carer experiences of the discharge process. It explores the obligate moral climate in which the role of carer is negotiated between professionals, patients, family members, friends and neighbours and the differing assumptions about duty associated with caring roles in hospital and in family and community settings. Conclusion. The discussion adopts a critical theory perspective to examine the contradictions confronting practitioners, patients and carers arising from hospital policies which promote cost‐effective and efficient use of expensive technical resources while simultaneously seeking to identify and meet the needs of patients and carers for care.
Methodologies analysing individual practice in health care: a systematic review
Authors: Watts Tessa , Jones Melanie , Wainwright Paul , Williams Anne 
Published: March 2003

Methodologies analysing individual practice in health care: a systematic review Aim of the review. The aim of the systematic review was to identify, explore and evaluate the current level of knowledge of methodologies used in comparative analyses of the individual practice of doctors, nurses and midwives. Rationale. The question of how roles and responsibilities might be shared differently between professional groups in order to promote improved, cost‐effective health care requires a systematic analysis of existing roles and practice. To do this effectively, knowledge of the methodologies available for such an analysis is essential. Methods. A systematic review of the literature published since 1989 comparing the practice of doctors, nurses and midwives was undertaken. Findings. The findings are presented in tabular format and include the following categories of published methodologies: experimental/quasi‐experimental; descriptive/nonexperimental and qualitative studies. The discussion centres on a critique of quantitative methodologies used to analyse individual practice in relation to role substitution and diversification. The potential contribution of qualitative methodologies in the analysis of individual practice is discussed. Conclusions. The authors conclude that the current level of knowledge is biased towards quantitative research. It is argued that the assessment of health care roles and responsibilities would be well served by a more balanced approach that recognizes the strengths of both quantitative and qualitative work.
Comparison of caloric intake and weight outcomes of an ad lib feeding regimen for preterm infants in two nurseries
Authors: Pridham Karen F. , Kosorok Michael R. , Greer Frank , Kayata Sahar , Bhattacharya Abhik , Grunwald Patricia 
Published: March 2003

Comparison of caloric intake and weight outcomes of an

ad lib

feeding regimen for preterm infants in two nurseries Background. Effects on caloric intake and weight gain of an ad libitum (ad lib) feeding regimen for preterm infants may be specific to a special care nursery. Objective. To explore across two nurseries the similarity of effect on caloric intake and weight gain of an ad lib feeding regimen compared with a prescribed regimen and the similarity of effect of caloric intake on weight gain. Methods. All infants participating in the multi‐site randomized clinical trial (RCT) of the ad lib feeding regimen were <35 weeks gestational age at birth and had birth weight appropriate for gestational age. Data on caloric intake and weight gain were collected at two nurseries (A, n=22; B, n=78) with the same feeding regimen protocols. Two strategies were used to explore similarity of regimen effect on caloric intake and weight gain. Repeated measures analysis of variance (ANOVA) was used to examine the effect on caloric intake and weight gain of time, feeding regimen, and time‐by‐regimen interaction for each nursery. Results. In both nurseries, regimen effects were reasonably consistent for caloric intake and weight gain. Caloric intake was lower across nurseries for infants fed ad lib. After accounting for caloric intake, the ad lib regimen did not affect weight gain. The time‐by‐regimen interaction effect on caloric intake was significant in both nurseries. Caloric intake for infants fed ad lib increased significantly over 5 days. Conclusions. Despite differences between nurseries in infant characteristics and in protocol implementation, the feeding regimen effect was consistent for caloric intake and weight gain. Further support was found for the development of infant self‐regulatory capacity.
The nurse specialist role in Hong Kong: perceptions of nurse specialists, doctors and staff nurses
Authors: Chang Ka Pik Katherine , Wong Kwok Shing Thomas 
Published: March 2003

The nurse specialist role in Hong Kong: perceptions of nurse specialists, doctors and staff nurses Aim. The purpose of this study is to review and delineate the impact in terms of the perceived importance as well as the role components of nurse specialists in Hong Kong. Rationale. The Nurse Specialist Scheme was launched in 1994 in Hong Kong. Studies in the West showed that there were impacts on the roles of other members among the health care team. However, minimal local published work has been carried out in reviewing the scheme. Design. The design of the study was nonexperimental. Data were collected by self‐administered questionnaires. The questionnaire adopted was developed by O’Mullan (1995), and the five roles studied were administration, clinical practice, consultation, education and research. To ensure the contextual relevancy and consistency of the questionnaire, content validity and test–retest reliability tests were performed. The content validity index was 0·85 and the test–retest reliability (Spearman’s ρ coefficient) ranged from 0·57 to 0·97. Subjects were obtained by stratified convenience sampling technique. The ratios for subject selection among the doctors, ward managers, nursing officers and registered nurses were 3:1:3:10, respectively. Because of the small numbers for nurse specialists, they were all included in the study. The final sample consisted of 11 nurse specialists, 47 ward managers, 56 nursing officers, 110 registered nurses and 15 doctors (n=239). Results. The results showed that there were significant differences in the perceptions of importance of the administration, clinical practice, education and research roles, and the frequency of occurrence of the clinical practice and research roles. This was further verified by the Fisher’s Least Significant Differences (LSD) test. Conclusions. A regulatory system of the nurse specialist was recommended to monitor the development of the nurse specialist role and practice and to ensure the safety of the public with regard to the emerging role. Both the implications and limitations are discussed.
An archaeology of caring knowledge
Authors: Paley John 
Published: March 2003

An archaeology of caring knowledge Background. There have been repeated attempts, especially during the last 20 years, to say precisely what caring in nursing is. Authors who undertake this task usually begin with the observation that the concept of caring is complex and elusive, and suggest that their contribution will help to clarify this most confused of notions. However, they are always followed by other authors, who do exactly the same thing. We seem to be no closer, now, to a clarification of caring than we have ever been. Aim. The paper offers a diagnosis of this situation, and explains why the project of retrieving caring from its elusiveness is an impossible one. I will suggest that this has nothing to do with the concept of caring, as such. Rather, the impossibility of the task follows from what these authors take to be knowledge of caring. Method. I present an analysis of some presuppositions about what knowledge is. These presuppositions pervade the literature on caring, and can be summarized as follows: knowledge of caring is an aggregate of things said about it, derived from a potentially endless series of associations, grouped into attributes on the basis of resemblances, and conceived as a holistic description of the phenomenon. Further, I suggest that this analysis is akin to the one which Foucault offers of sixteenth century knowledge. Conclusions. The analysis suggests that this way of knowing is approximately 350 years out of date, and explains why the task of arriving at knowledge (in this sense) is impossible. Moreover, Foucault’s claim that sixteenth century knowledge is ‘plethoric yet absolutely poverty‐stricken’ applies, with equal force, to nursing’s knowledge of caring.
Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European study
Authors: Jonge Peter De , Zomerdijk Marieke M. , Huyse Frits J. , Fink Per , Herzog Thomas , Lobo Antonio , Slaets Joris P.J. , Arolt Volker , Balogh Nandor , Cardoso Graca , Rigatelli Marco 
Published: March 2003

Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European study Aims and objectives. The relationship between mental disturbances – anxiety and depression, somatization and alcohol abuse – on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal was to study the utility of short screeners for mental disturbances to select patients for case‐management on admission. Design. The study had a cohort design: patients were included on admission and followed through their hospital stay until discharge. The study was conducted within the framework of the European Biomed 1 Risk Factor study. Research methods and instruments. In the first 3 days of admission the patients were interviewed by a trained health care professional, who scored the SCL‐8D, a somatization questionnaire based on the Whiteley‐7 and the CAGE. At discharge, nurses rated the complexity of the patient’s care. Results. Patients with high scores on anxiety and depression (SCL‐8D) and on somatization received higher ratings on perceived nursing complexity than those with low scores, with and without control for age, severity of illness and chronicity. The actual nursing intensity and medical care utilization, as measured daily by means of a checklist, could not explain these relations. No differences were found between patients with high or low scores on alcohol abuse. Conclusions. The study shows a potential use of screeners for mental disturbances to detect patients for whom nurses might need additional help. However, mental disturbance is not the sole criterion: functional status and other variables that predict medical and nursing care utilization should be included in a screening strategy for case‐management programmes.
Validity in action research: a discussion on theoretical and practice issues encountered whilst using observation to collect data
Authors: Turnock Christopher , Gibson Vanessa 
Published: March 2003

Validity in action research: a discussion on theoretical and practice issues encountered whilst using observation to collect data Aim. The paper contributes to an understanding of validity in action research methodology by examining issues arising from our attempts to describe the role of an observer in an action research study. Background. Our experiences in observing patient care in intensive care settings are used to illuminate discussion on the nature of validity in action research. Content. The paper examines the nature of validity in action research methodology before briefly describing a study that included observing intensive care staff providing patient care. Various perspectives on observation as a research method are critically examined. These include observer role, level of participation, use of cover, structure and timing of observation. Validity in action research underpins the discussion in the paper. Conclusion. We conclude that it may not always be possible to categorize the role of the observer within existing definitions. It may be better to summarize the actual observer role as a way of illustrating validity so that the reader can judge the validity of the findings from an action research study.