bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive behaviour therapy: teaching a client the ABC model — the first step towards the process of change
Authors: Lam Danny , Gale Julie 
Published: March 2003

Cognitive behaviour therapy: teaching a client the ABC model — the first steps towards the process of change Research suggests that clients need to be made aware of the relationship between thinking and emotional and behavioural reactions at the start of the therapeutic work. This paper looks at the clinical processes of educating the client about this relationship in a seven‐step ABC model. Rationales for each of the seven steps are given. The model illustrates the process of generating alternative beliefs in relation to a negative event and shows consequences of holding helpful and unhelpful beliefs.
Aggression and violence in health care professions
Authors: Rippon Thomas J. 
Published: March 2003

Aggression and violence in health care professions Although violence is increasing in most workplaces, it has become a significant problem in health care professions. Not only has the number of incidents increased but also the severity of the impact has caused profound traumatic effects on the primary, secondary and tertiary victims. More health care professionals than ever are suffering from symptoms of post‐traumatic stress disorder.Addressing the problem of violence in the workplace has been exacerbated by a lack of a clear definition of what constitutes aggression and violence. As a result, some administrators have been slow to commit resources to prevent further incidents and mitigate the impact. This article describes the magnitude of the problem from both an academic research and an operational perspective. A definition is presented as an initial step towards standardizing the research, and establishing an appropriate baseline upon which intervention policies and procedures can be created. This benchmark will also help to encourage empirical research into aggression and violence in health care professions and other professions. Further research needs to be conducted to create a comprehensive instrument that can more accurately measure the range of incidents and the severity of the impact.
Psychiatric nursing and compulsory psychiatric care
Authors: Clark Nicola , Bowers Len 
Published: March 2003

Psychiatric nursing and compulsory psychiatric care Community psychiatric nurses (CPNs) have long been involved in the operations of the English Mental Health Acts. Research has shown that compulsory detention is not used uniformly or consistently. Rates of involuntary hospitalization are reported to vary widely across Europe, but there is some consensus on patient profiles. The ethnicity, social status and gender of the patient, the involvement of the police, the availability of care, problems caused to relatives, and the country and particular legislative system where these judgements take place, all influence who is compulsorily detained.This article reviews recent evidence from Europe and argues that involuntary psychiatric care can no longer be seen as entirely dependent on the symptoms and behaviour of the patient and that CPNs should be aware of and reflect upon these factors before invoking the detention process.
Assessment of older people: politics and practice in primary care
Authors: Vernon Susan , Ross Fiona , Gould Mairi A. 
Published: March 2003

Assessment of older people: politics and practice in primary care This paper reviews some of the key policy changes in the United Kingdom in relation to older people that have influenced assessment practice across health and social care, and have implications for nursing within emerging primary care groups. The role of assessment in purchasing care packages raises tensions and paradoxes for health and social care professionals that the paper sets out to elucidate with particular reference to district nurses. The issues for nursing have not been well described previously and questions such as key accountability, rationing, multiagency and interprofessional working, and the consumer voice, are discussed.
‘We, not them and us?’ Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes
Authors: Hertzberg Annika , Ekman Sirkka‐Liisa 
Published: March 2003

‘We, not them and us?’ Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes This study describes relatives’ and staffs’ experiences of each other in their relationships and interactions in connection with the care of old people with dementia living in nursing homes. The aim was to identify obstacles and promoters concerning these interactions. A qualitative method was used. Data were collected from 27 hours of observations of group discussions about relatives’ and staffs’ communication, interactions and experiences. Three different groups, with eight participants, relatives, staff and a group leader in each, met six times during a period of 3 months. Findings indicate that the experiences that relatives and staff have of each other are related to issues about influence, participation, trust and measures to avoid conflicts. These conclusions build on concrete descriptions about care, activities, competence, communication and visits given by research participants. Experiences of situations were sometimes contradictory between relatives and staff. This implies that the potential for cooperation between relatives and staff in care of the elderly is not fully utilized. Suggestions for enhancing the relationships between relatives and staff are: pre‐planned informal, individual conversations between relatives and staff; development of ways to give regular two‐way feedback about matters concerning the resident and the relationship between staff and relatives; giving staff credit for measures taken to facilitate relatives’ involvement in the nursing home care; measures to improve documentation about families’ involvement; and working together with minor practical tasks.
Interprofessional relations between doctors and nurses: perspectives from South Wales
Authors: Snelgrove Sherrill , Hughes David 
Published: March 2003

Interprofessional relations between doctors and nurses: perspectives from South Wales This paper discusses findings from a study of interprofessional relationships between doctors and nurses in medical wards in three provincial general hospitals in south Wales. The aim of the research was to investigate the changing nature of doctor–nurse relations, and in particular, how far the notion of the doctor–nurse game, as developed by Leonard Stein ( Stein 1967,
1990), remains relevant to contemporary hospital work. The present paper concentrates on a subset of the findings concerned with doctors’ and nurses’ accounts of the hospital division of labour and the extent of any overlap in their work activities. Semi‐structured interviews were conducted with 20 doctors and 39 nurses in their places of work over a period of 4 months. Inductive analysis of the data indicated that, whilst doctors and nurses perceived their roles in largely traditional terms, there was some recognition of blurring of occupational boundaries, especially when considering work pressures, working at night and differences in practice in more specialized clinical areas. Although nurses were generally reluctant to challenge doctors’ authority, some used the notion of patient ‘advocacy’ to frame and justify their questioning of particular decisions. Whilst doctors valued ‘experience’ in nurses and saw experienced nurses as the group who might most legitimately move into doctors’ territory, nurses valued formal education and saw advanced nursing qualifications as the route to role expansion.
Exploring the risks associated with induction of labour: a retrospective study using the NIMATS database
Authors: Duff Carol , Sinclair Marlene 
Published: March 2003

Exploring the risks associated with induction of labour: a retrospective study using the NIMATS database Induction of labour is a valuable obstetric procedure, providing obstetricians with the means to intervene should the health of the fetus be in jeopardy. Currently the most common reason for induction of labour is prolonged pregnancy, as obstetricians and midwives are concerned about the risks of postmaturity such as stillbirth, intrapartum asphyxia and birth trauma which are often associated with prolonged pregnancy ( Lagrew & Freeman 1986). A retrospective comparative study was carried out in a large maternity unit to identify whether or not there was clinical evidence to support a policy of elective induction for post‐term pregnancy. Three years’ data were extracted from the Northern Ireland Maternity System (NIMATS) by writing new queries to the system. These data on 3262 women who delivered during 1994–96 were analysed to compare the outcomes for women who were induced with women who delivered spontaneously. Although the findings from the study in many instances failed to demonstrate statistical significance between the groups they did however, have important clinical significance. For example, those women who were induced had a 5% higher rate of caesarean section, 17% higher rate of epidural analgesia and on average a greater estimated blood loss. Statistical significance was evident when the apgar scores of the infants were compared; those induced had lower apgars at 1 minute (7·78 in the induced group compared to 7·9 in the spontaneous group [P < 0·01]) and at 5 min (8·99 in the induced group compared to 9·05 in the spontaneous group [P < 0·02]).
An evaluation of process and outcomes from learning through reflective practice groups on a post‐registration nursing course
Authors: Platzer Hazel , Blake David , Ashford Dorothy 
Published: March 2003

An evaluation of process and outcomes from learning through reflective practice groups on a post‐registration nursing course Small groups were set up purposefully on a part‐time post‐registration Diploma in Professional Studies in Nursing programme to enable students to reflect on and learn from experience. The use of these groups was qualitatively evaluated by the use of in‐depth interviews. Although there were many barriers to such learning, some students made significant developments in their critical thinking ability and underwent perspective transformations that led to changes in attitudes and behaviour. These are identified as an increased professionalism, greater autonomy in decision making, more self‐confidence to challenge the status quo and make their own judgements, and a less rule‐bound approach to their practice. The processes by which these changes occurred are identified as support and challenge within the groups offered by both the facilitators and other group members.
Project 2000: a study of expected and experienced stressors and support reported by students and qualified nurses
Authors: Brown Hilary , Edelmann Robert 
Published: March 2003

Project 2000: a study of expected and experienced stressors and support reported by students and qualified nurses The present study was conducted in the light of major reforms to nurse education which have taken place in the United Kingdom since 1989. The study aimed to identify initially perceived stressors and coping resources and subsequently, to compare these with actually reported stressors and available resources, during a critical period in nurses’ careers. Three groups of nurses participated who were undertaking, or had recently completed, the first Project 2000 course at a university in the south of England. Participants were given an open‐ended questionnaire and asked to describe potential difficulties, and the coping resources they anticipated using, in a subsequent 6‐month period. Following analysis of the descriptors a structured questionnaire was developed to measure actually experienced difficulties and coping resources that were reported; this was completed by the three groups 6 months after the initial phase of the study. Both student and staff nurse groups reported fewer stressors and more resources than they had predicted. Students anticipated difficulties with competence but actually reported financial difficulties. They experienced support from mentors although this was not anticipated. Newly qualified staff nurses experienced fewer difficulties with meeting personal expectations of the role than they had anticipated. They reported more use of emotion‐focused coping and less professional support than the student groups. The results are discussed in relation to training needs.
New pharmacological treatments for Alzheimer’s disease: implications for dementia care nursing
Authors: Adams Trevor , Page Sean 
Published: March 2003

New pharmacological treatments for Alzheimer’s disease: implications for dementia care nursing This paper addresses developments regarding new pharmacological treatments for people with Alzheimer’s disease such as Donepezil and Rivastigmine. Following a brief discussion of the experience of people in the early stages of Alzheimer’s disease, the pharmacology associated with these new treatments is outlined. The implications of these treatments for nurses working with this client‐group are fully discussed within the context of assessment, treatment and cessation. It is argued that nurses have an important contribution in the management of these treatments and recommends that descriptive and evaluative research should be undertaken relating to this new specialist area of nursing care.
A review of health professional attitudes and patient perceptions on ‘inappropriate’ accident and emergency attendances. The implications for current minor injury service provision in England and Wales
Authors: Sanders Julie 
Published: March 2003

A review of health professional attitudes and patient perceptions on ‘inappropriate’ accident and emergency attendances. The implications for current minor injury service provision in England and Wales Increasing attendances in accident and emergency (A and E) departments in the United Kingdom have been attributed to a greater number of patients presenting with minor injuries. A and E staff believe this type of patient is suitable for primary care, and is ‘inappropriate’ for A and E management. Thus, A and E staff find ‘inappropriate’ attenders time‐consuming and unrewarding, and are less motivated to help them, whilst ‘inappropriate’ patients believe they have attended the appropriate service for their medical needs and expectations. This review examines research into health professional and patient attitudes towards ‘inappropriate’ attendances in accident and emergency. It identifies a discrepancy between health professional and patient perspectives regarding ‘inappropriate’ attendances. However, the change in accident and emergency services with the development of minor injury units and nurse practitioners within A and E to treat minor injury patients away from the mainstream A and E service, appears to be based on the professional attitude of what constitutes an appropriate A and E attendance, and not on the patients’ perspective. As negative attitude formation towards ‘inappropriate’ A and E attendances has occurred, there is concern that such attitudes could remain or develop again in the new units. Patients are generally not medically trained and may experience difficulty in ascertaining the severity of their own condition and attending the ‘appropriate’ service, as defined by trained professionals. This is exacerbated by the unclear boundaries and roles of minor injury units, nurse practitioners and general practitioners in minor injury care. Therefore research is required into current attendances in minor injury units, A and E departments and general practice, in order to develop clear roles and boundaries for these services. More importantly, research is warranted into the attitudes of all minor injury care providers towards attending patients, and into patient perceptions of the services offered.
An exploration of the epistemological intricacies of using qualitative data to develop a quantitative measure of user views of health care
Authors: Coyle Joanne , Williams Brian 
Published: March 2003

An exploration of the epistemological intricacies of using qualitative data to develop a quantitative measure of user views of health care Nurse researchers are increasingly combining qualitative and quantitative methods in order to understand more fully the world of research subjects. Qualitative data are often used to explore the subjective meanings behind survey responses and to develop quantitative measures and scales. Insights from qualitative data help researchers to design instruments which are more sensitive to respondents’ meanings and interpretations. The aim of this paper is to highlight the epistemological and methodological complexities involved in this enterprise through drawing on our own experience of developing an instrument to examine person‐centredness in health care from a qualitative study of dissatisfaction. The intricacies of this project relate to: epistemological continuity and inconsistency; research roles; reflexivity; confirmation; and completeness. Through discussing the literature around integrating methods, we suggest that researchers could be assisted in their attempts to develop conceptually sound quantitative measures by extending the concept of reflexivity (used in qualitative research) to the quantitative components of mixed method studies. This would aid conceptual clarity by making explicit the social, cultural, and political construction of knowledge, and would also encourage researchers to reflect upon the ethical and political consequences of their research.
Reflection: nursing’s practice and education panacea?
Authors: Burton  
Published: March 2003

Reflection: nursing’s practice and education panacea? Nurses are now directed to ‘reflect effectively and practice reflectively’. When there is scant evidence to support the use of reflection, why does the United Kingdom Central Council, English National Board for Nursing Midwifery and Health Visiting and institutes of nurse education insist that nurses, at all levels of experience, reflect? Before developing the debate in relation to the robustness or otherwise of the concept of ‘reflection’ and its application to practice, a discussion as to what constitutes nursing knowledge, followed by an examination of the main theories related to adult learning, is presented. The paper develops to encompass a critical examination of both theoretical and applied perspectives on reflection. Conceptual issues and assumptions related to reflection are explored. Key areas considered are whether the practice of reflection facilitates the improvement of one’s knowledge, helps to generate theory and results in one becoming a more critical practitioner with resulting benefits for patients. It will be argued that reflective theory and practice has not yet been adequately tested and that there is a pressing need for evidence to demonstrate irrefutably the effectiveness of reflection on nursing practice, particularly with respect to patient outcomes.
Coping with type‐2 diabetes: the role of sense of coherence compared with active management
Authors: Sandén‐Eriksson Birgitta 
Published: March 2003

Coping with type‐2 diabetes: the role of sense of coherence compared with active management Changes in lifestyle, particularly in dietary and exercise habits, are necessary for the majority of patients with type‐2 diabetes but are difficult to carry out. However, Antonovsky describes a salutogenic health perspective grounded in patients’ developing what he terms ‘a sense of coherence’ (SOC). Can a strong SOC help diabetes patients to control the disease? The aim of this study was to analyse the relationship between SOC and treatment results measured as glucolysed haemoglobine (HbA1c) in patients with type‐2 diabetes. The aim was further to test the relationship between treatment results and an index of patients’ participation in active management and emotional state. Eighty‐eight patients answered a questionnaire containing 13 statements about sense of coherence (SOC‐13), questions about self‐assessed health, diabetes activity such as self‐management of diet, exercise and self‐control of blood sugar and emotional acceptance. There was no direct relationship between SOC‐13 and treatment results measured as HbA1c but there was a positive correlation between SOC‐13, self‐assessed health and HbA1c (P < 0·02). Self‐assessed health was seen as a mediating factor. The better patients’ estimation of their own health, the higher were SOC‐13 scores and the lower HbA1c. There was also a strong positive correlation between low levels of HbA1c and high levels of an index of active management and emotional acceptance of diabetes (P < 0·001).
Reactions of nurses and therapists in mainstream health services to contact with people who have learning disabilities
Authors: McConkey Roy , Truesdale Marie 
Published: March 2003

Reactions of nurses and therapists in mainstream health services to contact with people who have learning disabilities Government policy in the United Kingdom is to make the National Health Service accessible to all citizens, including those who hitherto may have relied on specialist services. It is recognized that the attitudes of health professionals can be a major influence in making this happen. To date there has been a paucity of research studies involving nurses and therapists, two of the largest groupings of health care workers. The present study contrasted the reactions of nurses and therapists to their contact with people who have learning disabilities, with those of staff working in specialist services for this client group, and with students who are not involved in health services. Over 1000 respondents — mainly university students on undergraduate or post‐graduate courses — completed a written questionnaire. Although nurses and therapists had significantly less contact with people who had learning disabilities during their work than did staff in specialist services, there were no differences in terms of contact in personal life. In both instances their contacts were higher than those reported for non‐healthcare students. However both nurses and therapists were significantly less confident in working with a patient who had learning disabilities as opposed to one with physical disabilities. By contrast, willingness for social contacts did not vary across the four groups although respondents with previous personal contact were significantly more willing for this than those with no prior contact. The results confirm that the form of contact is a more salient variable on staff attitudes than contact per se. Hence, changed reactions are more likely to come about from successful contacts in a work rather than social environment. The implications are discussed for initial and post‐qualifying training courses, especially for suitable placement experiences. Suggestions are made for future research that focuses on increasing the expertise and confidence of nurses and therapists in working with patients who have learning disabilities.
Children’s community nursing services: models of care delivery. A review of the United Kingdom literature
Authors: Eaton Nicola 
Published: March 2003

Children’s community nursing services: models of care delivery. A review of the United Kingdom literature Children’s community nursing (CCN) services in the United Kingdom (UK) have slowly become recognized as an important component in the care of sick children. However, as yet not every child has access to a CCN scheme should the need arise. In the literature there are many descriptions of CCN schemes set up in various parts of the United Kingdom based on a variety of models. This article describes six models of CCN and discusses the main components considered important when implementing or evaluating those models. Components include qualifications of the members of the team, communication between members of the multidisciplinary team, clinical responsibility, resources, willingness and ability of parents to provide care, and accessibility of services. The benefits and limitations of the models are also considered.