bluuebunny/crossref_metadata_2025_split huggingface dataset:
A critique of cultural education in nursing
Authors: Duffy Mary E. 
Published: March 2003

A critique of cultural education in nursingAim(s) of the paper. This paper critiques cultural education in nursing. Current approaches to cultural education, embedded in traditional anthropology, are obsolete and fail to acknowledge the global environment that impacts even the most remote and isolated cultures. The argument is made that new, tranformative approaches to cultural education are needed.Background. Cultural awareness of theotheris the foundation of existing strategies to teach cultural education. Students are encouraged to learn about each culture, often described as a monolith, by learning the unique characteristics of a group with a common race, ethnicity, or other distinguishing feature. Despite the increased emphasis on cultural education in nursing worldwide, culturally based problems persist. Nurse and health care researchers continue to report disparities in health, an unequal distribution of health care, and the lack of knowledge and sensitivity when caring for clients from another culture.Discussion. Globalization contributes to differences within cultures that may equal or exceed differences between cultures. Evidence is presented that current nursing education emphasizes cultural distinctions that do not persist in the postmodern world. Problems adherent to the continued use of cultural monoliths as the foundation of cultural education are discussed and expanded perspectives on culture and cultural education are presented.Conclusion. The principles of transformative education are offered as an alternative to the current approaches to cultural education. Students are encouraged to be vulnerable to personal change when interacting with people from other cultures because transformative education is as much about personal growth as it is about enhanced care of others. This modernized approach to cultural education transcends the standard adaptation of care from the dominant culture of the health care delivery system to the culture of the client/patient.
Relationship between nurses’ pain knowledge and pain management outcomes for their postoperative cardiac patients
Authors: Watt‐Watson Judy , Stevens Bonnie , Garfinkel Paul , Streiner David , Gallop Ruth 
Published: March 2003

Relationship between nurses’ pain knowledge and pain management outcomes for their postoperative cardiac patients Nurses’ knowledge and perceived barriers related to pain management have been examined extensively. Nurses have evaluated their pain knowledge and management practices positively despite continuing evidence of inadequate pain management for patients. However, the relationship between nurses’ stated knowledge and their pain management practices with their assigned surgical cardiac patients has not been reported. Therefore, nurses (n=94) from four cardiovascular units in three university‐affiliated hospitals were interviewed along with 225 of their assigned patients. Data from patients, collected on the third day following their initial, uncomplicated coronary artery bypass graft (CABG) surgery, were aggregated and linked with their assigned nurse to form 80 nurse–patient combinations. Nurses’ knowledge scores were not significantly related to their patients’ pain ratings or analgesia administered. Critical deficits in knowledge and misbeliefs about pain management were evident for all nurses. Patients reported moderate to severe pain but received only 47% of their prescribed analgesia. Patients’ perceptions of their nurses as resources with their pain were not positive. Nurses’ knowledge items explained 7% of variance in analgesia administered. Hospital sites varied significantly in analgesic practices and pain education for nurses. In summary, nurses’ stated pain knowledge was not associated with their assigned patients’ pain ratings or the amount of analgesia they received.
Problem behaviour, caregiver reactions, and impact among caregivers of persons with Alzheimer’s disease
Authors: Robinson Karen M. , Adkisson Pam , Weinrich Sally 
Published: March 2003

Problem behaviour, caregiver reactions, and impact among caregivers of persons with Alzheimer’s disease Background. Problem behaviours that occur during Alzheimer’s disease (AD) can have major impact on caregivers. How caregivers react to these behaviours may determine the total impact experienced from caregiving. Purpose. This study examined the relationships between problematic behaviours and caregiving impact in 30 primary caregivers of persons with AD. The first question explored the relationship between frequency of problem behaviour and impact; the second explored the relationship between caregiver reactions to problem behaviours and impact from caregiving. Methods. The frequency of problem behaviour and the caregiver reaction was measured using The Revised Memory and Behaviour Problem Checklist (Teri et al. 1992). The impact from caregiving was operationalized using the Cost of Care Index developed by Kosberg and Cairl (1986). Results. Significant associations were found for 11 of the 20 subscales that measured the association between the frequency of problem behaviour in the client and the impact from caregiving experienced by the caregiver. In comparison, the association between caregiver’s reaction to problem behaviours and impact from caregiving was even more significant in value with 15 subscales of 20 being significant. Female caregivers experienced a greater reaction to disruptive and depressive behaviour when compared with male caregivers even though both genders reported similar frequencies of problem behaviours. In regard to findings about the impact from caregiving, four of the six indicators were higher for women than for men. Conclusions. Caregiver reaction to problem behaviours was more highly associated with impact from caregiving than the actual frequency of the behaviours. These findings have great implications for intervention programs. Caregivers, especially females, need to receive individualized, specific education/training on how to understand and manage disruptive and depressive behaviour in persons with AD.
Parent involvement in children’s pain care: views of parents and nurses
Authors: Simons Joan , Franck Linda , Roberson Elaine 
Published: March 2003

Parent involvement in children’s pain care: views of parents and nurses Aim of the study. This study investigated the views of parents and nurses about the involvement of parents in the management of their child’s pain during the first 48 hours after surgery. Background. Children’s pain management has been found to be problematic and in need of improvement. Nurses are the key health care professionals with responsibility for managing children’s pain. Parents can make important contributions to assessment and management of their child’s pain. Methods. Using a phenomenological approach, nurses and parents were interviewed about their perceptions of parent involvement in pain management. Findings. The findings indicated that parental involvement in their child’s pain management is superficial and limited in nature. Parents described a passive role in relation to their child’s pain care and conveyed feelings of frustration. Only a minority of parents expressed satisfaction with their child’s pain care. Nurses perceived that there was adequate involvement of parents and adequate pain management for children. Conclusions. These findings may be somewhat explained by differing views and a lack of effective communication between parents and nurses. There is a clear need for nurses to discuss parent involvement with parents and negotiate roles in relation to pain management.
‘Your ears become your eyes’: managing the absence of visibility in NHS Direct
Authors: Pettinari Catherine Johnson , Jessopp Lynda 
Published: March 2003

‘Your ears become your eyes’: managing the absence of visibility in NHS Direct Aims. To identify and describe nurses’ perceptions of interactional practices they use to manage the absence of visual cues in telephone consultations with callers at an NHS Direct site. Background. A routine activity in telephone consultations is visualizing the patient and the situation from which the call is made, that is, ‘building a picture of the patient’. Little is known about interactional practices between nurse and caller that contribute to shaping a conception of the caller, or other activities that nurses do to manage the absence of visibility in the consultation. Methods. Qualitative analysis of semi‐structured interviews conducted with nurses new to NHS Direct telephone consultations, the first immediately prior to the NHS Direct site’s opening, and the second 6 months later. Findings. The activity of visualizing patients and their environment is closely linked to interactional practices carried out between nurse and caller. Nurses described a range of interactional activities that they perceive help callers to describe with more precision what the nurse cannot see. Nurses also tailor interaction to a nonvisual environment in order to manage the more emotional aspects of telephone consultations, such as delivering information, advice, reassurance, and building trust and rapport. Conclusions. Nurses developed skills to manage interaction with callers in order to compensate for the absence of visibility. Skills were based on their professional backgrounds and experience and developed in an ad hoc way. Further research could examine the efficacy of these strategies, and be a prerequisite to adding them to training programmes.
Profile of first‐line nurse managers in New South Wales, Australia, in the 1990s
Authors: Duffield Christine , Moran Phyllis , Beutel Jenny , Bunt Sue , Thornton Anna , Wills Jo , Cahill Philippa , Franks Helen 
Published: March 2003

Profile of first‐line nurse managers in New South Wales, Australia, in the 1990s Aims. To determine a demographic profile, employment history and career plans of a sample of nursing unit managers (first‐line managers) in New South Wales (NSW), Australia in 1999. To compare the profile of first‐line nurse managers in 1999 with those in 1989. Background. This study replicates another undertaken a decade earlier (see Duffield 1992). Tracking the changes to nurse manager positions is important, given changes to the educational preparation of nurses and restructuring within hospitals which have occurred in the past decade. Method. The same questionnaire was used in both studies, with minor amendments and the addition of two items to reflect changes to organizational structures, whereby nurse managers are now responsible for non‐nursing staff. In 1999 all first‐line nurse managers in the largest health service in NSW were invited to participate in the study. Results. A response rate of 77% was achieved. There were few differences of note in the demographic profile from 1989 to 1999. However educationally, first‐line nurse managers in 1999 were more highly qualified. A greater proportion had higher degrees and increasingly, in the management discipline. Conclusion. Perhaps reflecting these qualifications, more managers in 1999 indicated their intention to move to more senior management positions in the next decade. The mode for experience in this role of 1 year in both 1989 and 1999 reflects a worrying trend of high turnover and inexperience amongst this group of managers. While maternity relief might account for this result, further research needs to determine more precise reasons. The ad hoc bases on which expert clinicians (clinical nurse specialists) act as the manager in his/her absence need to be critically examined. Alternative strategies such as introducing a formal second‐ in‐charge position may ensure more successful recruitment and retention of staff to these critical management positions.
Nurses and English primary care groups: their experiences and perceived influence on policy development
Authors: Dowswell Therese , Wilkin David , Banks‐Smith Jennifer 
Published: March 2003

Nurses and English primary care groups: their experiences and perceived influence on policy development Aims of the study. To investigate the experiences and perceived influence of nurses serving on English primary care group boards. Background. The development of the nursing workforce and nursing services in primary care have been piecemeal and nurses have not always contributed to policy development. The recent establishment of primary care groups (PCGs) in the United Kingdom (UK) potentially offers nurses the opportunity to take a concerted and strategic role in developing professional roles and planning service developments. Research methods. As part of a longitudinal study of a 15% random sample of English primary care groups, nurse board members were surveyed in the winter of 1999. One hundred and forty‐four nurses were invited to return self‐completion questionnaires. Results. Completed questionnaires were returned by 106 of those invited to participate (73%). Respondents reported that combining their usual work with their role in the PCG was frequently difficult. Only 26% perceived that they had been well prepared for their new role. Compared with other board members [for example, general practitioners (GPs)], nurses perceived that their own influence was limited, with only a quarter rating the influence of nurses on decision‐making as great. Most of the sample were feeding back information to other primary care and community nurses working in the locality and 52% rated communication with this wider constituency as good or better. Nurse board members were enthusiastic about their role and optimistic about the positive future impact of PCGs on health. Conclusions. PCGs are still at a relatively early stage in their development. It is still too early to assess their impact on nurses working in primary care and community settings. Board membership offers nurses a voice in local health policy development.
Phenomenology as a method to investigate the experience lived: a perspective from Husserl and Merleau Ponty's thought
Authors: Sadala Maria Lúcia Araújo , Adorno Rubens de Camargo Ferreira 
Published: March 2003

Phenomenology as a method to investigate the experience lived: a perspective from Husserl and Merleau Ponty's thought Aim. By taking nursing as a human relationships activity, in spite of its strong technical – scientific features, this article reflects on the phenomenological method as one of the ways to develop an investigation and acquire knowledge of the topic. Rationale. Based on Husserl's phenomenology, which is opposed to the way of doing science based on the laws that regulate the physics and mathematics, the article introduces Merleau Ponty's existential phenomenology as the theoretical foundation for the method it proposes. My existential conceptions – people as historic beings inserted in a world over which they act but which, in its turn, determines them; the human perception as reference for our way of being in the world; the space‐time structure of perception – these are the key concepts that have led to the elaboration of an approach to phenomenological research. Proposal of a methodology. Steps are proposed for such an approach, namely phenomenological description, reduction and analysis. These lead to the building up of ideographic and nomothetic analyses, thus unveiling and describing general truths about the phenomenon studied. Finally, the possibilities for applying the methodology to nursing research are discussed, illustrated by my research into student nurses' perspectives on working on an isolation ward.
Laddered questions and qualitative data research interviews
Authors: Price Bob 
Published: March 2003

Laddered questions and qualitative data research interviewsBackground. Nurse researchers frequently make use of open interviews in their studies, hoping to understand the private world of respondents, and in particular the ways in which thought and behaviour are connected to each other. Unfortunately, there is scant guidance on how to translate such goals into the specifics of interview technique, particularly the use of probing questions. The success of such interviews rests on working ethically and understanding the respondents needs during interview.Aims. This paper explains a technique designed to direct the use of probing in interviews, and argues that its selective use might provide richer data than otherad hocapproaches employed by neophyte researchers.Conclusion. It is argued that the technique increases the awareness of the researcher to ethical concerns and enables her or him to respond more sensitively. Laddered question technique is evaluated with reference to my own research into the negotiation of student support amongst nurse distance learners.
Does training in psychosocial interventions reduce burnout rates in forensic nurses?
Authors: Ewers Paula , Bradshaw Tim , McGovern John , Ewers Bob 
Published: March 2003

Does training in psychosocial interventions reduce burnout rates in forensic nurses? Background. Mental Health Nurses working in secure environments with patients suffering from serious mental illness have been shown to be at risk of clinical burnout syndrome, this can have adverse effects both on the nurses' health and the standards of care that they deliver. Aim. To evaluate the effect of Psychosocial Intervention Training (PSI) on the knowledge, attitudes and levels of clinical burnout in a group of forensic mental health nurses. Design. Baseline assessments of knowledge, attitude and burnout were completed by asking a group of 33 nurses working in a medium secure psychiatric unit to complete questionnaires. Twenty of the nurses volunteered to be included in a PSI training course and were randomly allocated either to receive the training or to a waiting list control group. The duration of the training was 6 months and on completion subjects in the experimental and control group completed the questionnaires again. Results. Staff in the experimental group showed significant improvements in their knowledge and attitudes about serious mental illness and a significant decrease in burnout rates, whilst staff in the control group showed a small but nonsignificant improvement in knowledge and attitudes, and increase in burnout. Conclusion. The findings suggest that providing forensic mental health nurses with a better understanding of serious mental illness and training them in a broader range of interventions, helps them to be more positive in their attitudes towards the clients that they work with and experience less negative effects of stress resulting from their caring role. The implications of this study for clinical practice and future research will be discussed.
The cooling‐suit: case studies of its influence on fatigue among eight individuals with multiple sclerosis
Authors: Flensner Gullvi , Lindencrona Catharina 
Published: March 2003

The cooling‐suit: case studies of its influence on fatigue among eight individuals with multiple sclerosis Aim of the study. To study if the use of a cooling‐suit by individuals with multiple sclerosis (MS) influenced their experience of fatigue and consequent restrictions in daily life. Background. The majority of MS patients consider fatigue as one of their most disabling symptoms and as having a significant impact on their daily lives. Fatigue often increases in a warm environment. A cooling‐suit has been reported as a practical method of cooling, but the effect on fatigue has not yet been studied. Research methods. Eight individuals used a cooling‐suit in their own homes during a test‐period. In a single case–control design, their experience of fatigue was studied before and after. Quantitative and qualitative methods were used: self‐assessments using the Fatigue Impact Scale (FIS), open‐ended interviews and semi‐structured diaries. Results. All study participants reported a reduction in fatigue during the test period. On the FIS, they scored reductions in the physical, cognitive and psycho‐social dimensions of daily life. They experienced fatigue less often and for shorter periods. In their diaries and interviews they described decreased muscular strain, less sense of fatigue in relation to intake of food and positive effects on cognitive, social or affective problems related to fatigue. Discussion. The cooling‐suit is a practical method for cooling. It gives freedom and flexibility and can be used regardless of setting. Nurses who meet heat‐sensitive individuals with MS have the opportunity to give information on cooling methods, including how to use a cooling‐suit. In this pilot study we found that individuals with MS who suffered from fatigue reported a number of improvements in quality of daily life. Conclusions. The result indicates that use of a cooling‐suit by individuals with MS may decrease their sense of fatigue. In this sample positive outcomes on daily life situations were reported. Further studies are needed to support these results.
Balancing involvement: employees' experiences of merging hospitals in Sweden
Authors: Engström Agneta Kullén , Rosengren Kristina , Hallberg Lillemor R.‐M. 
Published: March 2003

Balancing involvement: employees' experiences of merging hospitals in Sweden Background. The health care of today stands in front of demands on financial and structural changes. New technology and global economy are forces driving on the change process. Aims. The aim of this study is to describe and broaden the understanding of the employees' experience of being involved in a merger between two health care districts in Sweden. Methods. This study was carried out from a qualitative approach according to the grounded theory tradition. From a theme guide with specific questions, 31 interviews were carried out with employees working in the health care. Findings. Five categories emerged from the body of interviews: balancing involvement, trust respect, challenge and commitment. Balancing involvement was defined as an overall core category related to the other categories. The categories trust, respect, challenge and commitment were related to subcategories and affected the core category balancing involvement. Conclusions. The overall findings point to the importance of balancing the employees' involvement in order to reach goal fulfilment change in a merger process.