bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of ‘Project 2000’ educational reforms on the occupational socialization of nurses: an exploratory study
Authors: Philpin Susan M. 
Published: March 2003

The impact of ‘Project 2000’ educational reforms on the occupational socialization of nurses: an exploratory study There is much in both nursing and sociological literature concerning the socialization of students into health care professions. In the case of nursing, concern has been expressed at the disparity between the values espoused by the educational establishment and those in the clinical areas. This study aimed to explore the changes in nursing occupational socialization since the implementation of recent educational reforms. Ethical approval was obtained from the local Research and Ethics Committee. The sample (n = 18) was drawn from qualified nurses working in a range of departments within three Welsh hospitals, half had undergone traditional training and half had received Project 2000 education. Data collection and analysis techniques were based on a grounded theory approach; this approach was deemed appropriate in that it allows the possibility of developing fresh perspectives on the subject without being too constrained by earlier studies. A strongly emerging theme from the data was that the nature of nursing socialization was related to the work contexts in which it was experienced; in particular respondents offered sharply contrasting accounts of nursing culture in ‘acute’ and ‘chronic’ areas of health work. The process of socialization was found to be harsher in acute areas with numerous instances of negative sanctions used to ensure compliance to ward culture, whilst in chronic areas occupational socialization was a more satisfactory process and nurses experienced less dissonance between ward and educational establishments. The size of this study mitigates against any firm conclusions; however, the early indications suggest that it would be a fruitful area for further research with a wider sample group drawn from diverse areas. This exploratory study suggests that the location of nursing work, in terms of whether it is in acute or chronic areas, is a determining factor in the experience of contemporary occupational socialization of nurses.
A systematic review of the relationships between written manual nursing care planning, record keeping and patient outcomes
Authors: Moloney Rhona , Maggs Christopher 
Published: March 2003

A systematic review of the relationships between written manual nursing care planning, record keeping and patient outcomes A systematic review of research literature published in English between 1987 and 1997 was carried out to test the hypothesis that care planning and/or record keeping in nursing practice has no measurable effect on patient outcomes. The study was limited to research applicable to acute in‐patient care and to non‐information technology based recording. A search strategy was agreed with the steering group and search terms refined as the study progressed. Using the guidelines from the University of York National Health Service Centre for Reviews and Dissemination ( NHS Centre for Reviews 1995), a data extraction proforma was constructed. An initial search revealed ≈300 possible abstracts for discussion. Further analysis limited this to 43 studies, of which 30 were rejected as having too little information. Of the remaining 13 studies, none was sufficiently robust to be included in the review. The hypothesis can be neither accepted nor rejected. This has important consequences for nursing practice and management and for research. A multi‐centre rigorous study is recommended.
Early parental interactions with and perceptions of multiple birth infants
Authors: Holditch‐Davis Diane , Roberts Dia , Sandelowski Margarete 
Published: March 2003

Early parental interactions with and perceptions of multiple birth infants The perceptions and interactions of mothers and fathers of seven sets of twins and one set of triplets were compared to those of parents of 49 singleton infants. Couples were typically interviewed together three times during the pregnancy and at 1 week and 3 months post‐partum. Two‐weekly observations of mother–father–infant interactions were conducted after the first postnatal interview. Three major themes were apparent in the interviews — the positive and negative specialness for multiple births, difficulties involved in managing more than one infant, and attachment issues — that were also evident during the observations. Although there were few differences in care‐giving and interactive behaviours between the multiple birth and singleton parents, the logistics of caring for more than one infant dictated that multiple birth infants were left alone more and looked at, talked to and held less often. Couples used different strategies to care for their infants, varying in both the extent to which they interacted preferentially with the infants and in the relative involvement of the mother, father and others.
The integration of comprehensive psychiatric/mental health care into the primary health system: diagnosis and treatment
Authors: Sokhela Nobesuthu Effie 
Published: March 2003

The integration of comprehensive psychiatric/mental health care into the primary health system: diagnosis and treatment This research study was funded by the Health Systems Trust in Cape Town through the University of Natal in Durban. Objectives The objectives of this study were to teach primary health care nurses to diagnose and treat common psychiatric conditions, to refer those patients whom they cannot handle, and to evaluate the implementation of these functions in their primary health care practice. Methods Twenty nurses from six clinics in one province of South Africa were trained, and implementation was studied. History taking, diagnosis, pharmacological treatment and referral were studied through record reviews. Record reviews were done by two independent psychiatrists, who achieved an inter‐rater reliability of 0·68. Results Record reviews showed that at the end of the project nurses could take substantially complete psychiatric histories in 89% cases, five axis diagnoses were correct in 63% of cases, and when STAT medication was prescribed it was appropriate in 92% of cases. Appropriate long‐term medication was prescribed in 60% of cases. Ethical issues Permission was obtained from the provincial office, the Municipal Offices and participating clinics. Informed consent was obtained by the registered nurses from all participating clients. Limitations The sample for the clinics was not representative of all clinics in the Eastern Cape but a representation of rural‐urban settings sampled from 20 clinics in a region. The sample of consumers was convenient and may not represent the client population in each clinic. For this reason the findings may not be a true reflection of the entire region, and generalization of the findings should be made at the utmost discretion of the reader.
Validation of the structure of the perceived meanings of cancer pain inventory
Authors: Chen Mei‐Ling 
Published: March 2003

Validation of the structure of the perceived meanings of cancer pain inventory This study examined the structure of a newly developed instrument measuring the meaning of cancer pain for Taiwanese patients. The Perceived Meanings of Cancer Pain Inventory (PMCPI) was developed based on Lazarus’s cognitive theory of emotion and on findings from qualitative interviews. The 27‐item PMCPI contains six scales: loss, threat, challenge, blame‐others, blame‐self, and spiritual awareness. Two hundred cancer patients from three hospitals in northern Taiwan who were experiencing pain were included in the study. A series of confirmatory factor analyses were conducted to test the fit of specified measurement models. The results indicated that only the loss, threat, challenge and spiritual awareness scales possessed good construct validity, while blame‐other and blame‐self failed to show a satisfactory fit with the data. Correlation coefficients among the scales were also estimated. Parallel‐item testing demonstrated that the items of each valid scale had the same factor loading and error variance.
Establishing the credibility of qualitative research findings: the plot thickens
Authors: Cutcliffe John R. , McKenna Hugh P. 
Published: March 2003

Establishing the credibility of qualitative research findings: the plot thickensQualitative research is increasingly recognized and valued and its unique place in nursing research is highlighted by many. Despite this, some nurse researchers continue to raise epistemological issues about the problems of objectivity and the validity of qualitative research findings. This paper explores the issues relating to the representativeness or credibility of qualitative research findings. It therefore critiques the existing distinct philosophical and methodological positions concerning the trustworthiness of qualitative research findings, which are described as follows: quantitative studies should be judged using the same criteria and terminology as quanitative studies; it is impossible, in a meaningful way, for any criteria to be used to judge qualitative studies; qualitative studies should be judged using criteria that are developed for and fit the qualitative paradigm; and the credibility of qualitative research findings could be established by testing out the emerging theory by means of conducting a deductive quantitative study. The authors conclude by providing some guidelines for establishing the credibility of qualitative research findings.
Nurses’ perceptions: issues that arise in caring for patients with diabetes
Authors: McDonald Patricia E. , Tilley Barbara C. , Havstad Suzanne L. 
Published: March 2003

Nurses’ perceptions: issues that arise in caring for patients with diabetes Nurses’ perceptions in caring for persons with diabetes have been little studied. To address this gap in the literature, a sample of nurses from a large Mid‐western health care system were surveyed on nurses’ perceptions of: (i) problems encountered in the care of patients with diabetes; (ii) problems encountered by patients and/or family member(s) in diabetes management; and (iii) nurses’ suggested solutions. A randomly selected list of 200 registered nurses obtained from the health system’s Department of Human Resources included inpatient, outpatient, emergency department, medical centre and home health care nurses. The sample was stratified to include 25% inpatient and 75% outpatient nurses. Of the 200 surveys mailed, 136 were returned (68% response rate). Twenty‐four per cent of the 136 nurses reported they did not provide care for patients with diabetes. Of 103 nurses providing care to patients with diabetes, 98% were female, 91% were Caucasian, 76% were between the ages of 30 and 49 years, 57% worked in outpatient settings, 35% worked in primary care, and 42% had a bachelor’s degree or higher. Of those with practice guidelines, 84% found the practice guidelines helpful. These nurses also perceived that they, as nurses, needed more education to improve their care of diabetes patients; few nurses believed it was within the scope of their practice to change treatment regimens. The perception of most nurse respondents was that acceptance of diabetes, knowledge deficits and non‐compliance were primary patient problems in the management of diabetes. Nurses’ perceptions of solutions to the problems centred on education of nurses and patients, and reinforcement of the importance of follow‐up care.
Quality of life in women with symptomatic HIV/AIDS
Authors: Sarna Linda , van Servellen Gwen , Padilla Geraldine , Brecht Mary‐Lynn 
Published: March 2003

Quality of life in women with symptomatic HIV/AIDSDespite the increasing incidence of cases of human immune deficiency virus (HIV) infection and of acquired immune deficiency syndrome (AIDS) in women, there is a serious lack of information about those women’s quality of life (QoL). The purpose of this exploratory descriptive study was to describe QoL using an HIV‐specific instrument (the HOPES) every 2 months over a 4‐month period in a convenience sample of 44 women with symptomatic HIV/AIDS. Changes in physical, psychological, social, sexual dimensions, and overall QoL were evaluated along with the frequency of the most prevalent distressing items. The mean scores of the global QoL, physical and psycho‐social summary scales were significantly different over the 4‐month data collection period: quality of life improved. The most prevalent disruptions were in the psycho‐social domain, including financial problems, worry about the family, distress about losing others from HIV, and worry about disease progression. The most prevalent physical disruptions included reduction in energy, difficulties with daily activities and frequent pain. Married women appeared to be more vulnerable to disruptions in QoL over time. In addition to the use of conventional disease‐specific parameters for the ongoing follow‐up of women with HIV/AIDS, the systematic use of a QoL assessment can provide a focused approach to monitoring problems and targeting interventions. Such an approach is especially important for nurses who assist women living with the symptoms of HIV/AIDS.
The attitudes and attributions of student nurses: do they alter according to a person’s diagnosis or sexuality and what is the effect of nurse training?
Authors: Stewart David 
Published: March 2003

The attitudes and attributions of student nurses: do they alter according to a person’s diagnosis or sexuality and what is the effect of nurse training?The threat of an AIDS (acquired immune deficiency syndrome) epidemic in the early 1980s saw the emergence of strong negative attitudes from both the public and health care professionals alike. Certain ‘high risk’ groups in society, who were considered as susceptible to the disease, homosexuals and intravenous drug users in particular, became the victims of prejudice and discrimination. More recent research has indicated a possible shift to a more positive orientation, although the findings are far from conclusive. In this current study, the Prejudicial Evaluation and Social Interaction Scale (PESIS) was administered to four separate cohorts of student nurses approximately a year apart in training (n=192). Each cohort was divided into four groups, each one completing the PESIS after reading a version of a vignette that described either a person with AIDS or leukaemia, and who was either homosexual or heterosexual. The design therefore allowed for within‐group and between‐group comparisons. Overall the results showed that the student nurses held positive attitudes although they reported a significantly greater prejudice towards AIDS. No significant differences were found for sexual orientation. Additionally significantly greater levels of blame and responsibility were associated with the person with AIDS, but again there was no effect for sexual orientation. The findings suggest that a slightly more negative attitude continues to be associated with a diagnosis of AIDS but no longer with homosexuality. No effect across cohorts was noted either, student nurses being as positive at the beginning of training as at the end. Some of the limitations of PESIS and the difficulties of attitude assessment in general are discussed and future areas of research are identified.
Geographical mobility, children and career progress in British professional nursing
Authors: Ratcliffe Phil 
Published: March 2003

Geographical mobility, children and career progress in British professional nursingPrevious explanations for the proportional over‐representation of men at all levels of the British professional nursing hierarchy above the basic grade are flawed as they use a gender‐based framework of explanation. This study presents an empirical test of a non‐essentialist explanation which examines geographical mobility as a criterion of exclusion from promotions which has a disproportionately positive effect on the promotion prospects of men. The study uses a national sample survey of 400 male and 400 female nurses. Data are␣collected on career histories and associated life events. Data are modelled as␣survival data using a form of the Cox proportional hazard model with residual␣heterogeneity to examine explanatory variables which affect the hazard of promotion. Geographical mobility, children, decade of qualification, employer moves, part time work and private sector working are all significant explanatory variables (P < 0·05) for the hazard of promotion. Gender is not a␣significant variable in its own right but two variables exhibit significant interactions with gender. Children negatively affect the career progress of men and women but women’s career progress is affected most. Significantly, the effects of children are not due to career breaks or to part time working. Gender essentialist explanations have been shown to be inadequate. Institutional genderism through the process of gender differential application of apparently individualist criteria of exclusion has been exposed. There is now a requirement for policy makers and employers to review procedures in order to avoid these forms of structural institutional genderism and discriminatory practices in employment.
Methodological issues in the development and use of instruments to assess patient nutritional status or the level of risk of nutritional compromise
Authors: Lyne Patricia A. , Prowse Morag A. 
Published: March 2003

Methodological issues in the development and use of instruments to assess patient nutritional status or the level of risk of nutritional compromise This paper presents the results of an appraisal of the evidence for the effectiveness of methods of nutritional assessment currently in use by nurses and from this develops concepts which may be applied to many areas of nursing practice. The paper first shows how the approach to nutritional assessment by nurses has changed over time, producing the present search for methods which are relatively quick and easy to use. It then describes the limited nature of the evidence of effectiveness of these methods and considers the reasons for this situation. It suggests that the difficulty of validation is an important factor and describes the three most common approaches to validation, showing how problems arise from lack of clarity in the definition of terms and the assumption of a simple relationship between the level of risk of nutritional compromise and actual nutritional status. In conclusion, it is suggested that these difficulties illustrate principles applicable to many areas of nursing care, and a definition of ‘segments’ of care processes, each with well‐defined purposes and outcome measures, is proposed. Such an approach will help to demonstrate the complexity and value of nursing activity.
Practice development: ambiguity in research and practice
Authors: Clarke Charlotte , Procter Susan 
Published: March 2003

Practice development: ambiguity in research and practice Practice development activity occupies an ambiguous position in relation to both clinical practice and research. In practice, it is seen at times as an added extra to normal work despite arguably being an inherent part of professional practice. In research, it fails to demonstrate the rigour of being generalisable because of its explicit location in a specific care environment. The study reported in this paper explored the implications of this ambiguity for practitioners who seek to develop health care practice. Ten focus groups were held with health care researchers and practitioners concerning the processes of developing practice in the North East of England. The results demonstrate how people manage themselves and the uncertainty that surrounds the use of research in clinical practice. The paper argues for an appreciation of reflexive forms of research, such as action and practitioner research, which do not disassociate research and practice and in which practitioners have a role in knowledge creation as well as knowledge implementation.
An investigation of the components of best nursing practice in the care of acutely ill hospitalized older patients with coincidental dementia: a multi‐method design
Authors: Tolson Debbie , Smith Margaret , Knight Paul 
Published: March 2003

An investigation of the components of best nursing practice in the care of acutely ill hospitalized older patients with coincidental dementia: a multi‐method design The main aim of this study was to examine, from the consumer’s perspective, the components of best nursing practice in the care of acutely ill hospitalized elderly people who coincidentally suffered from dementia. Due to the complexity of the problem under investigation a triangulated design was formulated. This design comprised survey methodology, audit and critical incident technique. Data derived from each of these approaches were analysed first in isolation and subsequently combined at a conceptual level. The sample comprised 213 people aged 65 years and older, who were consecutive admissions from two acute medical and two acute care of elderly people wards. Sixty‐six per cent of these individuals were found to suffer from cognitive impairment, 40% experiencing severe problems. The documentary survey revealed that patients with normal or severely abnormal cognitive functioning were more likely to have this noted than those with mild–moderate levels of impairment. No evidence of formal assessment was located and only 15% of these patients had items included in their nursing care plans associated with their chronic confusion. A sub‐sample of 41 chronically confused people and their main hospital visitor were invited to participate in critical incident interviews. These conversations led to the identification of four major themes which reflected the most valued aspects of the nursing care which had been received or observed. The relationship between documentary care scores and the proportion of positive descriptions of care within each of the four themes was explored. The findings indicate that acute nursing care is deemed only to be at its best when it is delivered in tandem with dementia care. Discrete areas for practice development are identified and standards to guide nursing care are proposed. In addition to the practice development issues raised by the work, the methodological lessons further advance the practice of multi‐method research.
Factors related to nurse communication with elderly people
Authors: Caris‐Verhallen Wilma M.C.M. , De Gruijter Ingrid M. , Kerkstra Ada , Bensing Jozien M. 
Published: March 2003

Factors related to nurse communication with elderly people This study explores variables that might influence nurses’ communication with elderly patients. Three groups of variables arise from the literature that seem to affect the quality or quantity of nurse–patient communication: variables related to nurses, to patients, and to the setting in which nursing care takes place. The study was conducted in two different care settings: a home for elderly people and a home care organization. In a sample of 181 video‐taped nursing encounters, involving 47 nurses and 109 patients a study was made of nurse–patient communication. In addition, relevant data related to patients, nurses and situation were gathered by questionnaires and were combined with the results of observations of videotaped nurse–patient interactions. It was found that the educational level of nurses was related most strongly to the way nurses communicate with their elderly patients. Patient characteristics such as age, gender and subjective state of health appeared to play a minor role in the way nurses communicate.