bluuebunny/crossref_metadata_2025_split huggingface dataset:
Humour between nurse and patient, and among staff: analysis of nurses’ diaries
Authors: Åstedt‐Kurki Päivi , Isola Arja 
Published: March 2003

Humour between nurse and patient, and among staff: analysis of nurses’ diaries Aim of the study. The aim of this study was to investigate the occurrence of humour both between nurses and patients and among nursing staff. Background. Humour has positive effects on both a person’s physiology and the psyche. Laughter signifies positive things to people; it may add to feelings of togetherness, closeness and friendliness. The use of humour is an indication of mental well‐being and it minimizes the effect of negative factors and protects from difficulties. Methods. The data consisted of diaries written by nurses (n=16), which were analysed inductively using content analysis. Findings. The main categories of humour between nurse and patient were nurse‐based humour, co‐operation‐orientated humour and patient‐orientated humour. Humour among staff consisted of the main category of resource‐orientated humour. Conclusion. The consequences of humour between nurse and patient enabled them both to cope with various unpleasant procedures. It helped them to manage difficult situations and led to an improvement in the working climate. Humour among staff helped nurses to cope with their work and created a better atmosphere on the ward.
Exploring the Nursing Minimum Data Set for The Netherlands using multidimensional scaling techniques
Authors: Griens A.M.G.F. , Goossen W.T.F. , Van der Kloot W.A. 
Published: March 2003

Exploring the Nursing Minimum Data Set for The Netherlands using multidimensional scaling techniques Rationale. To fulfil the need for a systematic collection of nursing data that give insight in nursing care and its benefits and costs, a nursing minimum data set (NMDS) has been developed and validated for Dutch general hospitals. A NMDS provides data describing the diversity in patient populations and variability in nursing activities that can be analysed in various ways. Aim of the study. To explore and compare the fundamental underlying dimensions describing patient problems and nursing interventions in Dutch general hospital wards. Methods. Data of predominantly nominal and ordinal measurement level that were collected with the NMDS for The Netherlands on 15 Dutch hospital wards underwent two consecutive steps: first, they were transformed into metric data by means of RIDIT (relative to an identified distribution) analysis; secondly, they were analysed by means of multidimensional scaling. Results. Multidimensional scaling techniques yielded a fairly good three‐dimensional solution of the NMDS data. Hospital wards could be distinguished from each other on the basis of patient problems and nursing interventions most common on some wards but not on others. The core aspects underlying patient problems concerned dependency problems, life threatening problems and endogenous–exogenous problems, while discriminating nursing interventions were cure–care activities, internally–externally oriented activities and psychosocial–physical interventions. Limitations. Not all types of hospital wards were represented, which limits the representativity of the results for Dutch general hospitals. Furthermore, the patient sample size over the 15 wards was relatively small. Conclusion. The constructs are consistent with NMDS findings in Belgium and findings from practice, which contributes to their content validity.
Thriving – a useful theoretical perspective to capture the experience of well‐being among frail elderly in nursing homes?
Authors: Bergland Ådel , Kirkevold Marit 
Published: March 2003

Thriving – a useful theoretical perspective to capture the experience of well‐being among frail elderly in nursing homes? Aim. The aim of this article is to discuss the concept of thriving and its adequacy in describing the experience of well‐being among physically frail nursing home residents. Background. There is a lack of theoretical perspectives describing nursing home residents’ experience of well‐being. Method. The article is based on a literature review and analysis of how the concept of thriving is used in different professional traditions. Three different theoretical perspectives are presented: (1) thriving as an outcome of growth and development; (2) thriving as a psychological state; (3) thriving as an expression of physical health state. In the second part of the paper, the three perspectives are discussed. Conclusion. The authors suggest that there is a need to develop a new concept: that of thriving in physically frail nursing home residents. The article discusses how each of the three theoretical perspectives may contribute to the formation of this concept.
The needs of children visiting on adult intensive care units: a review of the literature and recommendations for practice
Authors: Clarke Clare , Harrison Dawn 
Published: March 2003

The needs of children visiting on adult intensive care units: a review of the literature and recommendations for practice Aim. The purpose of this paper is to review the current literature and research available and to identify specific, nursing interventions to meet the needs of child visiting within the ICU setting. Background. According to recent surveys children are still restricted from visiting their critically ill family and friends on many adult intensive care units (ICUs) within the United Kingdom (UK). Imposing restrictive visiting policies does not respect the rights of patients and their families to be together and to support each other during a period of stress and crisis. Method. The motivation to undertake the study was derived from a critical incident involving a small boy who was not allowed to visit his critically ill mother. She subsequently died. Reflection on the available literature identified the value and role of intuition in expert clinical judgement, but the need to support this with evidence based knowledge. Conclusion. The implications for practice are discussed and recommendations for further research are made.
The changing training needs of clinical nurse managers: exploring issues for continuing professional development
Authors: Gould Dinah , Kelly Daniel , Goldstone Len , Maidwell Anna 
Published: March 2003

The changing training needs of clinical nurse managers: exploring issues for continuing professional development Aims of the study. To identify areas where clinical nurse managers perceived that they would benefit from further training and to make recommendations for planning future programmes to meet their needs. Background. The effectiveness of the clinical nurse manager has traditionally been associated with maintaining standards of care. Continuing professional development (CPD) is essential to ensure this important group feel adequately prepared to perform their role and has been recognized as an important factor in maintaining job satisfaction and reducing wasteful staff turnover. A review of the literature indicated that since the 1980s the CPD needs of clinical nurse managers have tended to be overlooked despite increasing complexity of the tasks expected of them. Thus it appeared that a fresh study to address these needs would be justified and should take into account sources of work‐related stress and variables relating to job satisfaction. Methods. The study involved clinical nurse managers employed in all four acute hospital National Health Service (NHS) trusts where training needs were served by a major inner city educational consortium. Data collection proceeded in two stages. Initially interviews were undertaken with a random sample of 15 clinical nurse managers to provide in‐depth, qualitative data. This information was used to develop a survey questionnaire distributed to the remaining 182 clinical nurse managers in each of the trusts. Results. Data from the interviews indicated that clinical nurse managers appeared to feel clinically competent but generally experienced lack of confidence when dealing with a range of issues, in particular; human resources, managing budgets, deputizing for senior colleagues across the trust (‘acting up’) and using information technology in everyday practice. Response rate to the survey was good (65%). The results corroborated the interview findings, indicating a need for updating in the same wide range of topics. There were few differences in training needs across all four trusts. Clinical nurse managers who perceived that they had been well‐prepared for their role demonstrated higher levels of job satisfaction. Perceived preparation for clinical leadership was the same irrespective of the employing trust, length of time in post and other sociodemographic variables. Conclusions. The study findings confirm that CPD remains a major issue for clinical nurse managers in the United Kingdom (UK) and that providing opportunities for such development may be an important factor in enhancing job satisfaction. The study findings should help those providing CPD to plan more effectively for this group and have implications for staff recruitment and retention.
Rethinking the birthing body: Cartesian dualism and perinatal nursing
Authors: Goldberg Lisa 
Published: March 2003

Rethinking the birthing body: Cartesian dualism and perinatal nursing Aim of the paper. This paper highlights the pervasive influence of a Cartesian metaphysics on the medical paradigm and its profound impact on the practice of perinatal nursing in North America. Background. Modern perinatal health care practices are founded on a Cartesian metaphysics that reduce birthing women to the status of object. Such practices deny the holistic aims of perinatal nursing. Methods. A philosophical inquiry informs the tenets of this metaphysical discussion regarding the foundations of perinatal nursing practices. Findings. Although perinatal health care is founded on a Cartesian metaphysics, an alternative paradigm of embodied practice is suggested as a way of viewing birthing women as embodied subjects. Conclusion. If the foundations of health care, which have been built on a Cartesian metaphysics, are not re‐examined, perinatal nurses will be providing care that further reduce women to the status of object.
Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management
Authors: Idvall Ewa , Hamrin Elisabeth , Unosson Mitra 
Published: March 2003

Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management Aim of the study. To develop and evaluate psychometric properties, that is reliability and validity, of an instrument to measure strategic and clinical quality indicators in postoperative pain management. Background. Strategic and clinical quality indicators in postoperative pain management were previously developed from a tentative model of important aspects of surgical nursing care and assessed to have content validity, that is to be essential for the quality of care, realistic to carry out and possible for nurses to use to influence management. Methods. The quality indicators were converted to items suitable for a patient questionnaire and were scored on a 5‐point scale, with higher scores indicating higher quality of care. Inpatients from five surgical wards took part in this study on their second postoperative day. The response rate was 96% and the average ages of the female (n=120) and the male (n=78) respondents were 62 and 63 years, respectively. Results. Items in the total scale had an average inter‐item correlation >0·20 and an item‐total correlation >0·30. Cronbach’s coefficient α was 0·84 for the total scale. Four factors entitled ‘communication’, ‘action’, ‘trust’ and ‘environment’ emerged from an orthogonal factor analysis, with a cumulative variance of 61·4%. Patients who received epidural analgesia had higher scores on the total scale compared with those who did not receive epidural analgesia. Patients who reported more pain than expected had lower scores on the total scale compared with those who did not report more pain than expected. Correlation between the total scale and an overall pain relief satisfaction question was 0·53. Conclusion. The results suggest initial support for the new instrument as a measure of strategic and clinical quality indicators in postoperative pain management, but it must be further refined, tested and evaluated.
SHORT REPORT: Nursing education in Norway
Authors: Kyrkjebø Jane Mikkelsen , Mekki Tone Elin , Hanestad Berit Rokne 
Published: March 2003

Short Report: Nursing education in Norway Aim. The aim of this paper is to describe nursing education in Norway and some essential questions and challenges regarding the undergraduate and newly graduated nurses' competencies and functionally preparedness. Background. The first formal training of nurses in Norway started in Oslo in 1886. Since then the education has changed considerably. As long as society is changing, and nurses are going to meet and adapt to societies needs, the education of nurses will also have to change continuously. The present general plan of nursing education has gone through a long process. The discussions have concerned the content of medical and natural science subjects, the practical part of the training and the relation between theory and practice. Challenges. There are challenges in nursing education in Norway today. We have seen that recruitment has decreased, and that nurses seek jobs where they are better paid. To increase the accessibility distance and part‐time education has been established. The theory–practice gap will always exist. Therefore we should aim to prepare the students to minimize this gap in a way that they can combine training of nursing with training in improvement. The demand of a masters degree to be a nursing teacher has reduced the teachers' ability to keep up their practical skills. The government pays nursing teachers who want to practice as nurses for several months to maintain their salary level during that period. Conclusions. There are many possibilities to improve nursing education in Norway. We are on our way with highly qualified teachers and students, and we still have enough good applicants. The new general plan and new law for universities and university colleges offer great opportunities. However, the shortage of nurses is a great challenge for further quality improvement both in clinical practice and in education.
Defining and measuring nursing productivity: a concept analysis and pilot study
Authors: Holcomb Barbara R. , Hoffart Nancy , Fox Michael H. 
Published: March 2003

Defining and measuring nursing productivity: a concept analysis and pilot study Aims. The purpose of this article is fourfold. First we report a concept analysis of nursing productivity to show the complexity of the concept and its measurement. We then show how the concept analysis was used to design a method for measuring nursing productivity. Third, we describe how we used this measure in a pilot study of the impact of a differentiated Registered Nurse (RN) practice model on productivity. Finally, we identify the challenges encountered and present recommendations for nurse executives and researchers based on our findings. Rationale. We believe our experience can be useful to nurse executives and researchers who are interested in studying the impact of care delivery models on nursing productivity. Design. We defined productivity as the ratio of output (patient care hours per patient day) to input (paid salary and benefit dollars). We conducted a pilot test using the productivity measure developed from the concept analysis to determine the effects of a differentiated RN practice model on patient, staff, and organizational outcomes. The purpose of the pilot study was to determine whether the data needed to measure productivity could be obtained from administrative databases and to develop the steps and process for the analysis. We analysed data by 2‐week pay periods for two quarters prior to implementation of the differentiated nursing practice model and for two quarters after implementation to assess for changes in nursing productivity. Results. Pilot testing showed that we could detect changes in productivity using this measurement approach. It also revealed several challenges in using administrative databases to measure productivity. Conclusions. We discuss these challenges with recommendations for both nurse executives and researchers. The most reasonable approach for operational decision‐making is longitudinal monitoring of productivity by organizational units combined with indicators of quality of patient care.
Assessing practice of student nurses: methods, preparation of assessors and student views
Authors: Calman Lynn , Watson Roger , Norman Ian , Redfern Sally , Murrells Trevor 
Published: March 2003

Assessing practice of student nurses: methods, preparation of assessors and student views Aims. To describe the methods of measuring progress in achieving competence of preregistration nursing and midwifery students used by institutions of higher and further education in Scotland and to describe the philosophy and approaches to competence assessment in each institution. Background. Institutions of higher and further education in Scotland operate a variety of schemes to assess the clinical practice of student nurses. These are based on different philosophies and practices and this raises the question of which are valid and reliable. Methods. All institutions in Scotland providing validated Diploma of Higher Education programmes for preregistration nursing and midwifery participated in this study. Data were collected by postal questionnaire, review of programme documentation and supplemented with interviews with key stakeholders. The directors of the 13 programmes (seven nursing and six midwifery programmes) were surveyed and also 12 group interviews with students (six nursing and six midwifery student groups) from seven institutions. Students from all four branches were represented and 72 students (36 nurses and 36 midwives) were interviewed. Results. Four key findings were identified and related to competence assessment methods, preparation of practice assessors, consequences of failure to meet expected level of outcome and students' views. Conclusions. There has been a change in theoretical frameworks of assessment instruments used since the 1992 programmes commenced and only a limited number of approaches to clinical assessment are used in Scotland. Students' views suggested that they had little confidence in methods of clinical competence assessment and there was no formal validity and reliability testing within institutions. A lack of consistency in the training of student assessors in the clinical areas was identified. Some of these issues may be resolved with the development of a national instrument for competence assessment.
The construction of a modern epidemic: the implications for women of the gendering of coronary heart disease
Authors: Lockyer Lesley , Bury Michael 
Published: March 2003

Aim.  This aim of this paper is to examine critically the implications for women of a gendered construction of coronary heart disease. Design.  The paper takes the form of a literature review between 1969 and 2002 of nursing, medical and social science literature written in the English language that explores the experience of women with coronary heart disease. Findings.  Coronary heart disease has been constructed during the 20th century as a disease of affluence that affects high achieving men. However coronary heart disease is a major cause of morbidity and mortality among women. The literature suggests that this gendered construction has influenced not only health professionals' perceptions of coronary heart disease but also lay theories of candidature, so that the collective consciousness sees women as being at low risk. Moreover, that this construction of coronary heart disease as a male disease has led to a service provision engineered to meet male needs that arguably can be seen to militate against women. This has resulted in women being diagnosed when they are further along the disease trajectory. It also means that once diagnosis has made then they are less likely to be referred for investigations, treatment and rehabilitation. Conclusion.  The implications of this construction for the care of women with coronary heart disease may result in ‘gender‐neutral’ care. This may mean that decisions about care are made in the light of nurses' own knowledge and experience of nursing male patients, with the consequence that women patients' individual needs are not met.
Disability, spiritual beliefs and the church: the experiences of adults with disabilities and family members
Authors: Treloar Linda L. 
Published: March 2003

Aims.  This paper reports the findings of a qualitative interpretive study that explored how people with disabilities and family members use their spiritual beliefs to establish meaning for disability, and to respond to the challenges of lived experience with disability. The participants' perceptions of the evangelical Christian church's influence on their spiritual experiences related to disability suggest recommendations for improved integration by the church. Applications are drawn for helping professionals and religious leaders who provide holistic care. Background/rationale.  Although there is a well‐established literature on coping in families with disabled children, little is known about how people use spiritual beliefs to establish meaning for and respond to life with disability. Even less is known about how people with a particular set of shared spiritual beliefs make meaning for lived experience with disability. Design/methods.  The author interviewed 30 persons, comprising two major groups: 13 parents of children with mixed developmental disabilities and nine adults with physical disabilities. Predominantly white, the participants lived in a south‐western metropolitan area in the United States of America (USA) in 1998. Findings.  Trial or difficulty contributed to spiritual challenge, the breaking of self, reliance on God, and strengthened faith in God. The participants chose to live with thankfulness and joy despite difficulties common to experience with disability. The participants' spiritual beliefs stabilized their lives, providing meaning for the experience of disability, assistance with coping and other benefits. The participants' recommendations include increased assistance by the church in promoting theological understanding of disability, and religious support using a continuing model of caring. Conclusions.  Although the study design limits the generalizability of the findings, applications can be drawn for helping professionals and religious leaders who provide holistic care