bluuebunny/crossref_metadata_2025_split huggingface dataset:
Illuminative evaluation: evaluating clinical supervision on its performance rather than the applause
Authors: Sloan Graham , Watson Hazel 
Published: March 2003

Illuminative evaluation: evaluating clinical supervision on its performance rather than the applause Aim(s) of the paper. This paper gives a description of illuminative evaluation and argues for its use in process‐focused research investigating the reciprocal interpersonal interactions between clinical supervisors and their supervisees. Experiences from conducting an initial pilot study, which is a part of larger qualitative project concerned with individual clinical supervision in mental health nursing, are highlighted. Background. Research investigating fundamental process issues in clinical supervision and their influence on outcomes for nursing is uncommon. Previous work in this area has stopped short of exploring the supervisory relationship and illuminating the importance of this interpersonal process in the delivery of gains. At the heart of the present project are questions about which supervisor interventions facilitate and constrain the supervisee’s use of individual clinical supervision. Method. Data were collected using individual in‐depth interviews, critical incident journals, session documents and audio recordings of supervision using illuminative evaluation and a case study approach. Findings. Supervisor interventions included taking the lead, suggesting an option, exploring the supervisee’s work, reflecting back, conveying an understanding of client issues, being supportive and giving information. Using Heron’s framework, catalytic, prescriptive, informative and supportive interventions were identified. Interestingly, informative interventions related mainly to the sharing of team policy issues and were derived from the clinical supervisor’s agenda. Although undoubtedly relevant to the supervisee’s practice, such organizationally focused information giving may be at odds with progressing the therapeutic integrity and professional development of the supervisee. Degenerative interventions were also illuminated. Conclusions. Following the pilot study, it was concluded that the research approach known as illuminative evaluation using multiple case studies is an appropriate design to explore the supervisory process and the particular clinical supervisor and supervisee interactions which influence this. Potential outcomes from the supervisory experience will be contextualized with how mental health nurses engage in the supervisory process and the particular supervisor interventions delivered during supervision sessions.
What is consumerism and has it had an impact on health visiting provision? A literature review
Authors: Almond Palo 
Published: March 2003

What is consumerism and has it had an impact on health visiting provision? A literature review Aims. This paper analyses the concept of consumerism drawing on methods of concept analysis. It attempts to identify who the actual consumers of health visiting are before examining whether consumerism and the consumer’s voice has had an impact on health visiting provision. Background. Patients and clients are increasingly being referred to as consumers, but the term seems to be used simply as substitute for patient, client or service user. Consumerism is a complex concept and the extent of its usage in the context of health visiting has not been fully explored. Method. An integrative review of a range of literature relating to consumerism is presented. A focused analysis of consumer views of child health clinics is used to illustrate the concept of consumerism. Elements of concept analysis methods such as formulating a model case and a definition are used to illustrate the concept further. Results. The review suggests that consumerism is an outdated concept and has been replaced by other less emotive terms such as partnership and participation. The apparent lack of impact of consumerism research in health visiting is argued by examining empirical evidence relating to child health clinics. Conclusions. Consumerism has had relatively little impact on improving child health clinics although high levels of consumer satisfaction with the overall service exist. More methodologically sound studies are needed to explore users’ views of health visiting services and to implement findings to maintain or improve services.
Israeli nurses’ knowledge of health care reforms
Authors: Spitzer Ada , Golander Hava 
Published: March 2003

Israeli nurses’ knowledge of health care reforms Objectives. This study examines health care reforms’ implementation processes from the perspective of nurses’ knowledge regarding the reforms. The research has been carried out in the Israeli context, where health care reforms were initiated in 1995. Three specific research questions were formulated: (a) What is the level of nurses’ knowledge regarding the recommendations of the Netanyahu committee? (b) What is the level of nurses’ knowledge concerning the basic principals of the National Insurance Law? and (c) Are there knowledge differences relating to employment setting (hospital, community, and educational settings), nurses’ roles (managerial vs. staff nurses), years of experience, and level and type of education? Method. The stratified nonproportional random sample consisted of a total of 468 nurses. Of these nurses, 206 were employed in community settings (136 in curative care, and 70 in preventive care), 137 were employed in hospital settings, and 125 worked in schools and departments of nursing. Research tools, developed for the purpose of this study, included the nurses’ knowledge questionnaire comprised of five subscales, and the knowledge relevancy questionnaire. Results. Overall, data demonstrated a low to moderate level of knowledge on all knowledge scales. Knowledge level on the criteria questions was particularly low. Contrary to the low level of knowledge, nurses regarded health care reforms’ knowledge as highly relevant to their work life. Curative setting, an extensive work experience, managerial position, and non‐nursing academic degree were all positively related to higher levels of reforms’ knowledge. Conclusion. These findings should encourage both policy makers and managers in various health care organizations to develop programs for informing health care providers on central aspects of health care reforms considered most relevant to the practice setting.
Models of psychiatric nursing education in developing African countries: a comparative study of Botswana and Nigeria
Authors: Adejumo Oluyinka , Ehlers Valerie J. 
Published: March 2003

Models of psychiatric nursing education in developing African countries: a comparative study of Botswana and Nigeria Background. Against the perspectives of the mental health needs of the people of Africa, this study explored and compared the models of psychiatric‐mental health nursing education (PMHNE) in two sub‐Saharan African countries – Botswana and Nigeria. Method. Examination of the existing PMHNE programmes and responses to a self‐reporting questionnaire administered to psychiatric nurse educators from Botswana and Nigeria provided the sources of data. Findings. Findings from both countries revealed that participants used various terms to describe the same model for PMHNE programmes in the countries. Botswana adopted a more functional generalist basic diploma nursing education approach that encouraged an advanced postbasic diploma specialization and practice in community psychiatric‐mental health nursing. Nigeria’s model leaned towards a hospital‐based basic specialization with no defined role for the generalist nurse within the psychiatric‐mental health nursing care system. Although community theme occurred in both countries’ curricula, PMHNE in Botswana appeared to be more geared towards the community than in Nigeria. While PMHNE and nursing education generally is affiliated to the University with a clear pathway within the formal higher education system in Botswana, basic and postbasic nursing programmes are mostly run independent of the country’s formal higher education system in Nigeria. Conclusion. A model that streamlined PMHNE within the general system of education in both countries was proposed. It was stressed that one key concept that must underlie the development of PMHNE in the two countries, and Africa in general, was the need to create a psychiatric‐mental health nursing education programme and role that would be appropriate for people’s mental health needs and the provision of quality nursing care.
Interaction relating to privacy, identity, autonomy and security. An observational study focusing on a woman with dementia and ‘behavioural disturbances’, and on her care providers
Authors: Graneheim Ulla H. , Norberg Astrid , Jansson Lilian 
Published: March 2003

Interaction relating to privacy, identity, autonomy and security. An observational study focusing on a woman with dementia and ‘behavioural disturbances’, and on her care providers Aim. The study aims to illuminate how one woman with severe dementia and so‐called behavioural disturbances acts in relation to her care providers and how the care providers act in relation to her. Methods. Fourteen participant observations, including one woman with dementia and six care providers, were performed. A reflective dialogue focusing on the interaction between the woman and her care providers followed each observation. The tape‐recorded observational notes and reflective dialogues were fixed as a text, which was subjected to a thematic content analysis. Findings. The main findings are that the interaction between a woman with severe dementia and ‘behavioural disturbances’ and her care providers relates to privacy, identity, autonomy and security. The phenomena are intertwined and also in conflict with each other. Interaction is a complex dialectic process in which those who are engaged meet problems that can be solved and are involved in dilemmas that cannot be solved, only related to.
Gatekeeping and legitimization: how informal carers’ relationship with health care workers is revealed in their everyday interactions
Authors: May Judith , Ellis‐Hill Caroline , Payne Sheila 
Published: March 2003

Gatekeeping and legitimization: how informal carers’ relationship with health care workers is revealed in their everyday interactions Aim(s) of the study. This study explores the relationship between informal carers of older people, and health care workers within the context of a hospital ward. Through an analysis of their language‐based encounters the purpose of the study was to identify the discursive processes involved in face‐to‐face informal carer‐health care worker interactions, during the course of carers’ visits to one elderly care rehabilitation hospital ward. Design. An ethnomethodological research design, which encompassed the concerns of conversation analysis and the study of institutional interaction, was used. The study involved videotape recording informal carers naturally occurring spontaneous interactions with a range of health care workers on the ward. Data collection was carried out for between 1 and 3 hours, two to three times a week over a period of 3 months. The data comprised: 30 dyadic and group interactions involving 19 different carers and 25 different health care workers, including nurses (qualified and unqualified), physiotherapists, occupational therapists, dieticians, ambulance personnel, housekeepers and nursing auxiliaries. Detailed transcriptions of the data were produced and analysis was undertaken using a modified conversation analysis approach. Findings. Analysis revealed that a central aspect of the way the relationship between informal carers and health care workers is framed is by the way information and access to information is obtained. This paper examines some of the aspects of informal carer‐health care worker discourse, which denote both parties as gatekeepers. In doing so it considers the roles that legitimatization of competence and knowledgeability have in facilitating informal carers interactions with health care workers. Conclusions. We conclude that the accomplishment of legitimacy is largely a collaborative undertaking on behalf of health care workers and informal carers. The implications of these findings for carers, health care workers, policy and future research are discussed.
Disability, facilitated sex and the role of the nurse
Authors: Earle Sarah 
Published: March 2003

Disability, facilitated sex and the role of the nurse Aim. The aim of this paper is to explore the role that nurses can play in acknowledging and facilitating the sexual needs of disabled patients within an holistic framework of nursing care. Background. Contemporary nursing claims to offer patient care within an holistic framework; this framework should encompass the biopsychosocial needs of patients, as defined by patients themselves. In spite of the importance of sexuality and sexual expression to the psychosocial welfare of patients, sexuality is often excluded from nursing practice. Method. Literature is reviewed from nursing, disability studies, and a variety of social science disciplines. Findings. The paper begins with a discussion of the concept of ‘holistic care’ and the ways in which this has been interpreted in the nursing literature. The biopsychosocial approach and the notion of ‘whole person’ holism seem particularly significant, although the lack of attention to patient sexuality is identified. Literature from the social sciences is used to explore the significance of sexuality to individual self‐identity and psychosocial welfare. This literature also highlights the way in which the denial of sexual identity is a significant feature of power relations. The disability studies literature catalogues the way in which disabled people are generally infantilized by society and perceived as asexual. This literature also highlights the professional neglect of disabled sexual identities. Using a variety of literature, the concept of facilitated sex is explored as a continuum of activities and the role of nursing, within a holistic framework, is examined. Conclusion. The paper concludes by arguing that an holistic approach to nursing care should include an appreciation of patient sexuality. In particular, it suggests that nurses can play an important role along the continuum of facilitated sex.
Self‐directed learning: views of teachers and students
Authors: Hewitt‐Taylor Jaquelina 
Published: March 2003

Self‐directed learning: views of teachers and students Aim. This paper reports the findings of an investigation into teachers’ and students’ understanding of the term self‐directed learning (SDL), and their views concerning its value in paediatric intensive care (PIC) nurse education. Methods. Qualitative methods of data collection and analysis were used. The findings from interviews with teachers and students across eight PIC nursing courses are reported. Local Research Ethics Committee protocols were followed. Data were analysed using constant comparative analysis. Findings. Teachers and students appeared to experience some difficulty in articulating a precise definition of SDL. Both groups saw it as one teaching and learning method to be used alongside others, and focused their definitions on the observable events thought to demonstrate self‐direction rather than the cognitive processes involved. Teachers and students considered SDL of some value, but only when used in conjunction with teacher‐led methods. Both teachers and students felt that students take more responsibility for learning in SDL than in traditional teaching. However, there was a difference of opinion as to the manner in which responsibility was devolved and accepted, and neither party was completely convinced that the other respected them. Limitations. The study explored only PIC nurse education, and was not intended to be generalized beyond this field. Conclusion. The evidence from this study suggests that SDL has elusive qualities which defy precise definition. It appears that attempting such a definition and reducing SDL to an observable form may detract from its perceived value. It can be inferred from this study that in order to implement SDL issues of control and autonomy within the learning environment merit further exploration, rather than simply focusing on observable teaching and learning tools or methods.
Premature menopause: multiple disruptions between the woman's biological body experience and her lived body
Authors: Boughton Maureen A. 
Published: March 2003

Premature menopause: multiple disruptions between the woman's biological body experience and her lived body Aim of the study. The aim of this phenomenological study was to find out what menopause was like as an experience for women who were not yet 40 years old. Background. Women's bodies have naturally occurring rhythms and expected transitions related to their menstrual cycle. One transition that all women will experience, provided they live long enough, is menopause. Menopause involves hormonal changes that result, on average (for Australian women), in the cessation of menstruation around 51 years of age. When women experience menopause prior to the age of 40 years it is defined (medically) as premature. While there is abundant literature on menopause as a biological event, the experience of premature menopause has been paid little attention and dismissed as a `mystery'. This study intended to uncover some of the so‐called `mystery' of the experience from the perspective of the women. Research methods. Hermeneutic phenomenology and feminist philosophy informed this study involving 35 women, all of whom volunteered to participate. They responded to newspaper articles, a radio announcement and through a midlife and menopause support centre. Thirty women engaged in separate face‐to‐face conversational style interviews. The remaining five women participated in a collaborative interview after some themes were identified through preliminary analysis of the transcripts of the one‐on‐one interviews. With the consent of participants, all interviews were audio‐taped and later transcribed. Findings. This study revealed that the experience of menopause came as a shock for the women – it was perceived as a major epiphany in their lives and they were confronted with a multitude of issues related to the timing of the event and their embodied understanding of menopause. The experience of menopause resulted in multiple disruptions in the women's lives. The women discussed many aspects of their lives that now seemed to be `out of synchrony'.
Caring for maltreated children: a challenge for health care education
Authors: Paavilainen Eija , Åstedt‐Kurki Päivi , Paunonen‐Ilmonen Marita , Laippala Pekka 
Published: March 2003

Caring for maltreated children: a challenge for health care education Aim of the study. The aim of this study was to establish whether paediatric nurses and doctors in a university hospital need supplementary training in the identification of child physical abuse and whether there is a need to develop health care education on child abuse issues. Background. Child physical abuse was defined as actions of a parent or a primary caregiver of a child under 18 years of age, which have caused physical injuries to the child. Methods. The sample consisted of paediatric staff (n=513) in a university hospital. Data were collected with a questionnaire, and the response rate was 62%. The data were analysed using statistical methods and quantitative content analysis. Findings. Sixty per cent of respondents needed supplementary training in the identification of child abuse. Those having experience in caring for abused children considered the identification most difficult (P < 0·001) and needed training more often (P < 0·005) than the others. The need for training was explained by stating that their basic education had not addressed child abuse issues, and by the complexity of the issue. Conclusions. The findings indicate that research‐based knowledge of the identification and treatment of child abuse should be incorporated into health care education. Supplementary education should address the management of complex and sensitive issues with customers, legislation, division of labour and multiprofessional collaboration in which nurses and doctors have an important, family wellbeing promoting role.
Research and organizational issues for the implementation of family work in community psychiatric services
Authors: Jones Adrian , Scannell Tony 
Published: March 2003

Research and organizational issues for the implementation of family work in community psychiatric servicesBackground. The need for evidence‐based practice (EBP) to guide and develop mental health services remains fundamental for modern services.Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example.Method. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design.Findings. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors.Conclusion. The current drive to increase EBP requires a bi‐directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.