bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing competencies: personal characteristics contributing to effective nursing performance
Authors: Zhang Zhi‐xue , Luk Weety , Arthur David , Wong Thomas 
Published: March 2003

Nursing competencies: personal characteristics contributing to effective nursing performance Aims of the study. Core competencies are important in enabling an individual to adapt to new environments and perform superior professional practice. This study was to identify the underlying competencies which contributed to effective nursing performance. Background. Most of the previous competencies are either derived from researchers’ conceptual analysis or based on practitioners’ direct report. Competencies derived from these methods either are subject to bias or are unable to identify the essential elements for effective nursing care. Method. Following the McBer method, 50 experienced nurses in China were asked to report 82 valid critical incidents in their jobs. Two individuals coded the scripts and decided the presence of each competency according to a pre‐established coding system. Results. Ten competencies including interpersonal understanding, commitment, information gathering, etc. were identified. Each competency was illustrated by behavioural indicators. Conclusions. Skills, traits, motives and attitudes all contribute to effective nursing performance. The findings assist in the delineation and development of nursing competencies and thus provide realistic working behaviours for nursing education and management.
‘Chatting’: an important clinical tool in facilitating mothering in neonatal nurseries
Authors: Fenwick Jennifer , Barclay Lesley , Schmied Virginia 
Published: March 2003

‘Chatting’: an important clinical tool in facilitating mothering in neonatal nurseriesAim. This paper explores the use of ‘chat’ or ‘social talk’ as an important clinical tool that can assist nurses achieve family‐centred care in neonatal nurseries.Background. The study was undertaken to increase knowledge of women’s experiences of mothering in the neonatal nursery and the relationship they share with nurses.Method. The discussion presented is elicited from a grounded theory analysis of over 60 hours of interview data with 28 women, a thematic analysis of 50 hours of interviews with 20 nurses and a content analysis of 398 tape‐recorded interactions between nurses and parents.Findings. The analysis identifies the importance of the nurse–mother relationship and demonstrates that it is both the context and method by which nursing care is delivered. We found the verbal exchanges that take place between nurse and mother influence a woman’s confidence, her sense of control and her feelings of connection to her infant. It appears from the data that the nurse’s ability to effectively ‘engage’ the mother is dependent on the use of language that expresses care, support and interest in parents.Conclusions. The data suggests that ‘chatting’ is the strategy and the process through which positive interactions are initiated, maintained and enhanced. This study confirms that nurses’ language acts as a powerful clinical tool that can be used to assist parents in gaining confidence in caring for their infants and in becoming ‘connected’ to infants resident in nurseries.
Doctors’ and nurses’ perceptions of ethical problems in end‐of‐life decisions
Authors: Oberle Kathleen , Hughes Dorothy 
Published: March 2003

Doctors’ and nurses’ perceptions of ethical problems in end‐of‐life decisionsAims. To identify and compare doctors’ and nurses’ perceptions of ethical problems.Rationale. Ethical problems are a source of tension for health professionals. Misunderstandings or conflicts may result from differing perceptions of ethical problems. If true collaboration is to be achieved, it is important to understand the perspectives of others, particularly when difficult end‐of‐life decisions must be made.Methods. In this qualitative study a total of seven doctors and 14 nurses working in acute care adult medical‐surgical areas, including intensive care, were asked to describe ethical problems that they frequently encounter in practice. Interviews were taped and transcribed. Thematic analysis followed.Results. All participants experienced ethical problems around decision making at the end of life. The core problem for both doctors and nurses was witnessing suffering, which engendered a moral obligation to reduce that suffering. Uncertainty about the best course of action for the patient and family was a source of moral distress. Competing values, hierarchical processes, scarce resources, and communication emerged as common themes. The key difference between the groups was that doctors are responsible for making decisions and nurses must live with these decisions. Each group, therefore, asked different questions when encountering and interpreting sources of moral distress.Conclusions. It was concluded that observed differences between doctors and nurses were a function of the professional role played by each rather than differences in ethical reasoning or moral motivation. Although this was a small qualitative study on one institution, and may not be generalizable, results suggest that doctors and nurses need to engage in moral discourse to understand and support the ethical burden carried by the other. Administrators should provide opportunities for discourse to help staff reduce moral distress and generate creative strategies for dealing with this.
Dilemmas in the provision of own‐home respite support for parents of young children with complex health care needs: evidence from an evaluation
Authors: Olsen Richard , Maslin‐Prothero Paul 
Published: March 2003

Dilemmas in the provision of own‐home respite support for parents of young children with complex health care needs: evidence from an evaluation Aims. The aim of this article is to present some of the results of a qualitative evaluation of a United Kingdom (UK) nurse‐led, home‐based, respite service for the families of children under the age of five with complex health care needs. Background. Advances in neonatal medical and nursing care have contributed to a growth in the number of children who survive low birth weight, birth trauma, and various congenital anomalies. Many of these children are likely to have long‐term care needs which will require innovative nursing responses. Of particular importance is the need for parental respite, given the added demands of caring for very ill children at home. Methods. A parent‐centred, follow‐up evaluation, using in‐depth qualitative interviews with parents in 18 families consecutively referred to the Children’s Outreach Service between April and December 1997. Findings. This evaluation reveals the sometimes mixed reactions of parents to this innovative service, and the equivocal evidence about its role in contributing to family well‐being. We discuss, from the perspective of parents using the service, some of the dilemmas and problems in the provision of home‐based respite support to this client group. In particular, we explore the diverse ways in which families talk about their need for respite support and point to the need for flexibility in this kind of service provision if these support needs are to be met. Conclusion. We conclude by discussing the practice implications of our evaluation for those planning similar services.
Using psychological insights to help people quit smoking
Authors: Ward Tony 
Published: March 2003

Using psychological insights to help people quit smoking Aims.  This paper sets out to evaluate the possibility that smoking cessation interventions which make use of current psychological theories and constructs can be more successful than programmes based largely on nicotine replacement therapy and will be more satisfying to participants. Rationale.  Nicotine replacement therapy is currently the most widely used method for helping smokers give up the habit. Numerous studies have shown this to be a successful approach for many smokers, but the majority still fail to benefit. Typically three quarters of smokers given nicotine replacement are smoking again one year later. This study investigates whether nicotine replacement can be enhanced by the addition of psychological techniques. Design.  Smokers recruited via publicity in the local media were randomly assigned to one of two treatment conditions. The first condition consisted of a series of group sessions in which volunteers were instructed in nicotine replacement, and a number of psychological techniques, the most important being cognitive counter conditioning. The second condition was identical to the first but without the cognitive counter conditioning. Finally background quit rate was determined using waiting list controls. Results.  Both interventions were successful in helping smokers quit the habit, based upon an analysis at 6 months, compared with waiting list controls. The experimental condition incorporating cognitive counter conditioning produced a much higher quit rate than the condition based largely upon nicotine replacement, although the difference was not significant. Conclusions.  This study is highly suggestive that nicotine replacement therapy can be enhanced by the inclusion of psychological techniques in group work, resulting in abstention rates higher than nicotine replacement alone and increasing participant satisfaction. Further work is needed with larger numbers to verify that this is indeed a significant gain and to investigate whether psychological techniques can give longer term benefits.
Group reminiscence among people with end‐stage chronic lung diseases
Authors: Jonsdottir Helga , Jonsdottir Gudrun , Steingrimsdottir Edda , Tryggvadottir Bjarney 
Published: March 2003

Group reminiscence among people with end‐stage chronic lung diseasesBackground. Reminiscence is a process of recalling long‐forgotten memorable experiences and events through verbal interaction between the person eliciting memories and one or more persons. Reminiscence is considered an effective treatment for various groups of people, particularly the elderly.Aim. This paper describes an intervention study on group reminiscence intervention for people with end‐stage chronic lung diseases. The following hypotheses were proposed: (1) Depression in people with end‐stage chronic lung diseases will decrease after participating in a reminiscence group. (2) Self‐esteem in people with end‐stage chronic lung diseases will increase after participating in a reminiscence group. (3) People with end‐stage chronic lung diseases will report increased well‐being after participating in a reminiscence group.Methods. The research design was quasi‐experimental, using Beck Depression Inventory and Rosenberg’s Self‐Esteem Survey pre‐ and posttreatment, in addition to conducting semistructured interviews after the treatment was finished and qualitatively evaluating outcomes of selected nursing diagnosis. A total of 12 patients participated, 10 women (mean age 70 years) and two men (mean age 86 years). The treatment was provided by two nurses to a group of patients dwelling at a long‐term unit for people with end‐stage lung diseases located in Iceland. A total of 13 group meetings were held, with 5–8 participants each time. Each group meeting had a preselected focus. It started with a short period of relaxation followed by a selected reading from a biography or from Icelandic literature and then the group discussion started, focusing on the topic of the day.Results. The first two hypotheses were not supported. The following themes support the third hypothesis: (a) enjoyment, (b) feeling well and (c) closeness and affirmation of self and others.Conclusions. The purpose of the study was partly achieved. Although hypotheses one and two were not supported, the third was supported by the qualitative results, which clearly demonstrated that participation in the intervention increased well‐being.
Perceptions of labour pain by mothers and their attending midwives
Authors: Baker Angela , Ferguson Sally A. , Roach Gregory D. , Dawson Drew 
Published: March 2003

Perceptions of labour pain by mothers and their attending midwives Aims. The aim of the current study was to examine the perception of pain by labouring women and their attendant midwife, from the onset of labour to delivery. Rationale. Accurate measurement and appropriate management of pain is a significant problem for attendant medical and nursing personnel. Both the experience and perception of pain are regarded as subjective and are therefore difficult to measure objectively. Indeed, much of the literature reports that pain is often under‐ or over‐estimated by nursing staff who as a consequence consistently fail to administer adequate analgesia. Few studies have specifically examined the ability of midwives to assess the pain of labouring women. Design. The short form McGill Pain Questionnaire (SF‐MPQ), routinely used to assess pain in obstetric environments, was used to determine pain perception. Thirteen labouring women and nine midwives completed the SF‐MPQ every 15 minutes beginning at the time of admittance to the delivery suite. Peak pain ratings for the preceding 15 minutes were obtained without reference to prior ratings or each other’s scores. Further, midwives in the maternity unit of The Queen Elizabeth Hospital (TQEH), Adelaide, South Australia completed a survey investigating the cues they use to assess pain during labour. Results. On each measure of pain on the SF‐MPQ, the midwives scores correlated with the mothers’ scores across the entire pain range. Further analysis showed that mothers’ and midwives’ pain scores were similar at mild‐moderate pain levels, but midwives significantly underestimated pain intensity at levels that mothers described as severe. The survey responses indicated that midwives rely on both verbal and nonverbal cues to assess pain levels. Conclusions. The cues used by midwives to differentiate pain intensities and qualities are similar to those used in other clinical settings, but may have limited discriminatory value as pain levels become severe.
Clarification of conceptualizations of empathy
Authors: Kunyk Diane , Olson Joanne K. 
Published: March 2003

Clarification of conceptualizations of empathyBackground. If understanding our clients needs, emotions, and circumstances is fundamental to nursing practice, and empathy is the foundation of that understanding, then a conceptualization of empathy that can be used by nurses is of utmost importance to the profession. In 1992, Morse, Anderson, Bottorff, Yonge, O’Brien, Solberg and McIlveen analysed the concept of empathy in the psychological and nursing literature, and suggested the conceptualization of empathy was incomplete. Since that time, nurse authors have continued to publish conceptualizations and research on empathy.Purpose. The purpose of our analysis was to describe empathy as presented in the nursing literature between 1992 and 2000.Method. A concept clarification methodology of concept analysis was used because of the many definitions, the rich descriptions, and the application of empathy as a research variable in the reviewed literature.Findings. Five conceptualizations of empathy were revealed: empathy as human trait, empathy as a professional state, empathy as a communication process, empathy as caring, and empathy as a special relationship.Conclusions. The literature reviewed contained evidence that the concept is developing more depth and breadth. Nurse authors are approaching empathy from a variety of perspectives, time frames, measurements, and outcomes. While all are important to the development of the concept, further enrichment of the conceptual work on empathy is needed before a fully mature concept emerges that is fully useful in nursing practice, research, and education.
Effects of using videotaped vignettes on enhancing students’ critical thinking ability in a baccalaureate nursing programme
Authors: Chau J.P.C. , Chang A.M. , Lee I.F.K. , Ip W.Y. , Lee D.T.F. , Wootton Y. 
Published: March 2003

Effects of using videotaped vignettes on enhancing students’ critical thinking ability in a baccalaureate nursing programme Aim. The aim of this study was to determine the effects of using videotaped vignettes in promoting nursing students’ critical thinking abilities in managing different clinical situations. Background. The impetus for undertaking this study came from recognition of the need to develop the level of students’ critical thinking within clinical nursing practice. Eight videotaped vignettes that simulated clinical situations were developed to promote baccalaureate nursing students’ critical thinking abilities in managing clinical situations. Guidelines were also developed to stimulate students’ discussion. Design/Methods. A pre‐test/post‐test design was employed to determine the effectiveness of videotaped vignettes in promoting critical thinking skills among these students. A final sample of 83 students completed all the pre‐test and post‐test questionnaires on critical thinking skills and nursing knowledge test specific to a vignette. Results/Findings. The findings indicate that students’ post‐test knowledge scores were significantly higher than the pre‐test knowledge scores. While the post‐test critical thinking skill test scores were slightly higher than those of the pre‐test for the students, the difference was not significant. One reason for such findings may be the limited exposure students had to these new types of videotaped vignettes. After the course had been completed both students and teachers were asked to reflect and to indicate their level of satisfaction with the new approach. There was overall satisfaction with the new approach to teaching clinical skills as reflected in the interview data from both teachers and students. Conclusions. While there were positive outcomes in terms of helping students to relate nursing principles to clinical situations, more time for students to learn using videotaped vignette in tutorial hours remains a challenge for teachers in planning the lectures.
Valuing people as individuals: development of an instrument through a survey of person‐centredness in secondary care
Authors: Coyle Joanne , Williams Brian 
Published: March 2003

Valuing people as individuals: development of an instrument through a survey of person‐centredness in secondary care Background. Person‐centred care is regarded as the optimum way of delivering health care and is defined as valuing people as individuals (Winefield et al. 1996). So how can practitioners find out if their service ‘values people as individuals’? Serious doubts have been expressed about the validity of the concept of patient satisfaction and the ability of instruments to measure patients’ views of care. However, qualitative research among people who had experienced problems with their health care has identified an alternative concept better able to articulate patient’s complex experiences (Coyle 1997). The study found that that patients’ identity was threatened by experiences perceived as dehumanizing, objectifying, disempowering and devaluing. Thus the concept of ‘personal identity threat’ showed the extent to which people felt valued (or not) as individuals. Aim of the study. The aim of the research reported in this paper is to build upon the earlier qualitative work and to identify the frequency and distribution of inpatients’ experiences of ‘personal identity threat’. Design/Methods. The study adopted a cross‐sectional survey design. Ninety‐seven patients from general medical, surgical and otolaryngology wards completed a questionnaire developed from the qualitative study containing items on dehumanization, objectification, disempowerment and devaluation. Findings. Although many patients expressed positive sentiments about their care, problems were highlighted around power/control, involvement in care, and the approachability and availability of staff. The findings also revealed that women were more at risk than men of ‘threats to identity’ in health care settings. Conclusions. Improvements are suggested to help promote a service that truly values people as individuals. These include improving health practitioners’ understanding of the impact of illness on everyday life, promoting practitioners’ listening and enquiring skills, and increasing the ‘visibility’ and availability of staff. Further research should also explore gender and age differences in perceptions of the lay–practitioner relationship.
What they talk about: conversations between child health centre nurses and parents
Authors: Baggens Christina 
Published: March 2003

What they talk about: conversations between child health centre nurses and parents Background. The voluntary child health promotion programme reaches virtually all children in Sweden and each child will visit the child health centre about 20 times until it has reached school age. The practical responsibility for the tasks at the child health centre resides mainly with the nurse. The nurse’s talk is the main instrument used to carry out health examinations, detect health problems and developmental deviations, pass on information and give individual advice and support to families. Aim. The aim of the study is to explore the content of the conversations and analyse its relationship to both the child health promotion programme and the question of which party decides what is talked about in these encounters. Methods. The empirical study, approved by the Committee for Ethics in Medical Investigation, was conducted at three child health centres in medium‐sized towns in Sweden. Data collection consisted of audiotapes of 44 visits to these child health centres. The tape‐recorded conversations were transcribed verbatim and constitute the material. The analysis was content‐orientated and was performed in four steps: coding and generating topics, categorization of topics, identifying the initiator and searching for regularities. Results/Conclusion. The results showed that the most common issues discussed concerned the child’s development (mainly physical aspects), situational matters and questions about procedures and routines. The nurses initiated most of the topics discussed and her dominance was established with the help of the official child health promotion programme. The findings evoke ideas about what possibilities the parents have of making their voices heard during the conversations. The conclusion is that the findings indicate a need for further research on nurse‐parent/child communication during visits to the child health centre to acquire knowledge about the interactional consequences in the conversation when some topics are discussed but others are not.