bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of competency standards for specialist critical care nurses
Authors: Dunn Sandra V. , Lawson Di , Robertson Sally , Underwood Marianne , Clark Robyn , Valentine Teresa , Walker Nicky , Wilson‐Row Christine , Crowder Kerrie , Herewane Deb 
Published: March 2003

The development of competency standards for specialist critical care nurses In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry‐to‐practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into ‘domains’ or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or ‘elements’ and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non‐critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.
Hospital noise pollution: an environmental stress model to guide research and clinical interventions
Authors: Topf Margaret 
Published: March 2003

Hospital noise pollution: an environmental stress model to guide research and clinical interventions This commentary provides an expanded environmental stress model. Conceptual relationships between ambient stressors, ambient stress, and health are detailed. A three‐part intervention, enhancement of person–environment compatibility, is specified. Details are provided on how this approach to reducing environmental pollution/hazards and sustaining these changes may be influenced by sociopolitical values, technological advances, and motivation for control over hazards. Personal variables thought to mediate the impact of environmental stress on health, including intrinsic sensitivity to specific hazards, personality, restricted capacities, other stress, culture, personal preferences, stage of life, gender, and perceived social support, are highlighted. Research results on the stress and health effects of hospital noise on patients and nurses are summarized to provide support for the model. Future directions for research are recommended. Implications of the model for nursing, including an environmental activist role in an interdisciplinary effort to plan and implement noise abatement interventions, are described.
Mental health nurses and qualitative research methods: a mutual attraction?
Authors: Cutcliffe John R. , Goward Peter 
Published: March 2003

Mental health nurses and qualitative research methods: a mutual attraction? In response to issues arising out of curriculum developments, the authors wished to examine more closely the potential reasons why psychiatric/mental health (P/MH) nurses appear to gravitate towards certain research methodologies. This paper therefore briefly examines the essential differences between qualitative and quantitative research paradigms, focusing on philosophical, epistemological and methodological issues. It then proceeds to examine some of the essential characteristics and attributes of P/MH nurses and suggests some differences in emphasis between these and other disciplines of nursing. The authors posit that psychiatric/mental health nurses are drawn to the qualitative paradigm as a result of the potential synchronicity and linkage that appears to exist between the practice of mental health nursing and qualitative research. This apparent synchronicity appears to centre around the three themes of: (a) the purposeful use of self; (b) the creation of an interpersonal relationship; and (c) the ability to accept and embrace ambiguity and uncertainty.Given this alleged synchronicity the authors argue that there are implications for nurse education and nursing research. Further it is possible that each nursing situation where the mental health nurse forms a relationship and attempts to gain an empathic sense of the individual’s world is akin to an informal phenomenological study, the product of which would be a wealth of qualitative data. However, as this would be a subconscious, implicit process, the data would remain predominantly unprocessed. The authors conclude that perhaps these data are the knowledge that expert practitioners draw upon when making intuition‐based clinical judgements.
The information needs and source preferences of women with breast cancer and their family members: a review of the literature published between 1988 and 1998
Authors: Rees Charlotte E. , Bath Peter A. 
Published: March 2003

The information needs and source preferences of women with breast cancer and their family members: a review of the literature published between 1988 and 1998 A comprehensive and critical literature review was conducted to examine the information needs and source preferences of women with breast cancer and their family members. Relevant papers published between 1988 and 1998 were reviewed and despite their having several methodological weaknesses, a number of conclusions can still be drawn. First, women with breast cancer have distinct needs for information throughout their breast cancer journeys, indicating that information needs change with time since diagnosis and with treatment‐related events. Second, family members of women with breast cancer also have substantial needs for information. Third, women with breast cancer and their family members often prefer verbal forms of information from health care professionals (HCPs), particularly around the time of diagnosis. Women with breast cancer, however, are often dissatisfied with the information they receive from HCPs. Further, the family members of women with breast cancer often perceive their information needs to be ignored by HCPs. Finally, few studies have focused specifically on the information needs and source preferences of family members of women with breast cancer. These findings have a number of implications for nursing, both for clinical practice and nursing research, and these are discussed in the review.
The nurse–patient relationship: a consideration of its discursive context
Authors: Crowe Marie 
Published: March 2003

The nurse–patient relationship: a consideration of its discursive context This paper is a theoretical exploration of the discursive context that shapes the nurse–patient relationship. It represents a feminist poststructural consideration of the broader institutional and social context that influences the dynamics of that relationship. The characteristics of that relationship can be regarded as performances of subjectivity shaped by managerial, medical and nursing discourses. Both nurse and patient signify particular discursively constituted meanings to each other which shape the relationship. It is proposed that the discourses which inform how each should respond to the other encourage the utilization of disciplinary tactics by the nurse which relay to the patient what is expected of him/her. An effect of these disciplinary procedures is to rein in the caring potential of nursing practices. However, nursing’s relationship with women’s work and the social history of caring may provide it with a discursive context that recognizes the social significance of this work.
‘You feel helpless, that’s exactly it’: parents’ and young people’s control beliefs about bed‐wetting and the implications for practice
Authors: Morison  , Tappin  , Staines  
Published: March 2003

‘You feel helpless, that’s exactly it’: parents’ and young people’s control beliefs about bed‐wetting and the implications for practice Young people wet the bed when they fail to wake up to a full bladder. The causes of bed‐wetting are far from certain and this uncertainty is reflected in the diversity of treatments on offer and the lack of any guarantee that treatment will work in a particular case. Most young people are sad and ashamed about the bed‐wetting and want it to stop, but they vary widely in their belief in their own capacity to influence the situation, and in their optimism about what the future holds. The problem can persist into adolescence or even adulthood, with far reaching social and emotional consequences, both for the young people and their families. In an ethnographic study involving 19 families ‘perceived helplessness’ emerged as a key issue permeating the whole system and often activating a downward spiral, leading to abdication of effort and responsibility by the young people themselves, by their parents and sometimes by health care professionals. Informed by the insights gained from this study and an extensive review of the literature on perceived control the Family Perspectives on Bed Wetting Questionnaire has been developed to explore family members’ feelings, degree of concern and dimensions of perceived control relating to: effort, ability, luck, important others and the unknown. This questionnaire was used as a basis for structured interviews with family members in a longitudinal survey, involving 40 families attending one of nine community‐based, nurse‐led enuresis clinics in Greater Glasgow. It was found that only 38% of the young people were entering into treatment with the belief that they had the ability to be dry at night. This became self‐fulfilling, with only 33% achieving initial success of 14 consecutive dry nights in a 16‐week period (chi‐squared test, P=0·029). Seventy per cent of young people felt that luck was important, while most parents felt that luck had little part to play. Implications for practice include the need to assess the families’ readiness to engage in treatment, to create opportunities for effective control and to encourage realistic expectations.
A phenomenological study of early nursing experiences in Hong Kong
Authors: Wong Frances Kam Yuet , Lee Wai Man 
Published: March 2003

A phenomenological study of early nursing experiences in Hong Kong The experience of primary professional socialization is crucial for neophytes to learn to become a nurse. These early nursing encounters may also have long‐term effects on professional development of individual nurses. However, research into the early experiences of nurses has been poorly documented. This study endeavours to reveal the early lived nursing experience amongst a group of nurses in Hong Kong. This study adopts a phenomenological approach which involves the thematic analysis of the critical incidents provided by 77 subjects. Findings revealed that incidents associated with death and dying, and clinical learning embracing interpersonal relations and professional development, were the most memorable events. Nurses were in general not equipped adequately to communicate with the dying and the grieving relatives. The subjects disclosed that positive clinical encounters confirmed their value of nursing work and motivated them to stay in the profession. Conversely, the negative experiences made them seriously consider leaving nursing. A number of implications for nursing education have been drawn from the research findings.
‘Scraps’: hidden nursing information and its influence on the delivery of care
Authors: Hardey Michael , Payne Sheila , Coleman Peter 
Published: March 2003

‘Scraps’: hidden nursing information and its influence on the delivery of care What nurses commonly describe as ‘scraps’ are defined as the personalized recordings of information that is routinely made on any available piece of paper (hence scraps) or in small notebooks. The use of scraps is common in practice and has been noted in research from across the globe. Drawing on an empirical study it is argued that scraps are a unique combination of personal and professional knowledge that informs the delivery of care. The overall aim of the study was to discover how nurses define and communicate information about patients and the delivery of care to each other on an elderly care unit. The processes by which information was constructed and the organizational structure and interactions that influenced this were also identified. The research design was an ethnographic one that involved: observations of formal nursing end of shift reports (23 handovers) and informal interactions between nurses (146 hours); interviews (n + 34) with registered nurses, student nurses and nursing auxiliaries; and analysis of written records. Data were collected from five acute elderly care wards at a district general hospital in the south of England. A grounded theory analysis was undertaken which revealed that scraps may have a significant role in the communication of information and the delivery of care. Therefore a categorization of scraps within three main themes was undertaken. First, the analysis revealed the processes involved in the construction of scraps. Second, the content and role of scraps in influencing the delivery of care was exposed. Finally, the potentially confidential nature of scraps and consequent problems of storage and disposal was recognized. The findings are discussed in relation to a suggested model of the interrelationship between paperwork, scraps, handovers and the delivery of nursing care. It is concluded that scraps are significant in facilitating nursing care and that this should be recognized in research, education and practice.
Developing the research capacity of departments of nursing and midwifery based in higher education: a review of the literature
Authors: Cooke Alison , Green Barbara 
Published: March 2003

Developing the research capacity of departments of nursing and midwifery based in higher education: a review of the literature The purpose of this literature review is to identify those factors which might affect the research capacity of departments of nursing based in higher education, and to make recommendations based upon the findings to enable departments to develop their capacity to undertake research. There is a dearth of published research which directly addresses this issue and therefore publications were reviewed which related to: the impact on nurse educators of the integration of nursing into higher education; nurse educators’ attitudes towards research and their research role; analysis of the results of the 1992 and 1996 Research Assessment Exercises and commentaries on them; developing research within nursing generally; and factors affecting research productivity within nursing and related disciplines. The papers were analysed according to the following themes: academic qualifications; research skills; time available for research; motivation to undertake research; a culture of research; subject specialization; subject areas for research; research quality; and a nursing research council. The conclusions are first, that whilst there is a dearth of literature which relates directly to research capacity development in academic departments of nursing, there is much advice which can be drawn upon. Second, the article concludes that the factors affecting research capacity development are numerous and complex and it is not something which can only take place at the departmental level. There are also issues which require consideration nationally, as well as factors which depend upon the individual academic, and these impact upon the research capacity of academic departments of nursing. The factors are summarized at the end of the paper in the conclusions and recommendations.
The expression of sexuality in people with psychosis: breaking the taboos
Authors: McCann Eddie 
Published: March 2003

The expression of sexuality in people with psychosis: breaking the taboos While mental health professionals should recognize that people suffering from schizophrenia have sexual and relationship requirements, there appears to be a failure to address adequately the subject of human sexuality, particularly in the area of psychosocial rehabilitation. The broad aim of this small study was to identify the sexual and relationship needs of people being cared for in hospital and preparing for a return to community living. The objectives of the study were to discover the clients’ sexual expressions in the past and present, and to try to elicit hopes and aspirations for the future. An attempt was made to uncover some of the obstacles to the expression of sexuality and explore some of the clients’ subjective experiences of the issues. The number of respondents was 11 from a possible 15. Data were collected through: a questionnaire on demographic characteristics; an adapted version of a questionnaire investigating the determinant factors of sexual behaviour through life; and a semi‐structured interview devised to elicit subjective experiences regarding sexual expression. The findings show that people with psychotic illness are prepared to discuss issues relating to sex and relationship matters. No interviews had to be prematurely terminated. No exacerbations of symptoms were noted. All of the respondents showed an openness to discuss a range of intimate feelings. Most respondents seemed hopeful about the opportunity to form intimate and fulfilling relationships in the future. A drive towards more rigorous holistic nursing assessments and appropriate psychosocial responses is proposed.
Path analysis of efficacy expectations and exercise behaviour in older adults
Authors: Resnick Barbara , Palmer Mary H. , Jenkins Louise S. , Spellbring Ann Marie 
Published: March 2003

Path analysis of efficacy expectations and exercise behaviour in older adults The benefits of regular exercise for older adults are well documented and include improvements in physical, functional, as well as psychological, health. The purpose of this descriptive study was to test a theoretically and empirically based model describing the factors that influence exercise behaviour of older adults in the United States of America. The hypothesized model suggested that age, gender, and mental and physical health have an effect on self‐efficacy and outcome expectations, and that all these variables influence exercise behaviour. Exercise behaviour was hypothesized to have a reciprocal relationship with self‐efficacy expectations and mental and physical health. The convenience sample was 187 older adults living in a continuing care retirement community (CCRC) in Baltimore, Maryland. A one‐time health interview was conducted which included a measure of self‐efficacy and outcome expectations related to exercise, a measure of health status (SF‐12), and gathering of information from participants about their actual exercise behaviour. Of the 187, 71 (38%) reported participating in 20 minutes of continuous aerobic exercise at least three times per week over the previous 3 months. Six hypothesized paths were significant. The model fitted the data and accounted for 32% of the variance in exercise behaviour. Interventions that focus on strengthening self‐efficacy and outcome expectations can improve exercise behaviour in older adults.
An investigation into the use of serum albumin in pressure sore prediction
Authors: Anthony Denis , Reynolds Tim , Russell Linda 
Published: March 2003

An investigation into the use of serum albumin, in pressure sore prediction Objectives To ascertain the relevance of serum albumin and serum sodium as predictors of pressure sores in addition to the Waterlow score. Design Observational study of patients at risk of developing decubitus ulcers. Setting Staffordshire, in the midlands of the United Kingdom. Participants 773 elderly hospital in‐patients of a district general hospital. Measurements Waterlow scores and serum albumin and sodium. Development of a pressure sore. Results Logistic regression analysis of serum albumin, serum sodium and the Waterlow score showed the Waterlow score and serum albumin were significant predictors of pressure sores. Conclusions Serum albumin may, in this patient group (in‐patients over 64 years of age), be a useful predictor of pressure sore occurrence, though further work is needed to establish whether this is the case. Risk assessment of pressure sores can possibly be improved by adding serum albumin to one of the pre‐existing tools such as the Waterlow score.
The psychometric properties of the Miller Behavioural Style Scale with adult daughters of women with early breast cancer: a literature review and empirical study
Authors: Rees Charlotte E. , Bath Peter A. 
Published: March 2003

The psychometric properties of the Miller Behavioural Style Scale with adult daughters of women with early breast cancer: a literature review and empirical study Several researchers have suggested that the information‐seeking behaviours of patients need to be taken into consideration when assessing their information needs. This study reviews published evidence of the psychometric properties of the Miller Behavioural Style Scale, a tool commonly used to identify the information‐seeking behaviours of individuals under threat, and examines its reliability and validity with adult daughters of women with early breast cancer. Ninety‐seven adult daughters completed the MBSS and a 30‐item, self‐administered questionnaire, a tool designed to explore the information needs of adult daughters of women with breast cancer. The internal consistency of the monitoring and blunting sub‐scales of the MBSS was α=0·65 and 0·41 respectively. The blunting sub‐scale fell substantially below acceptable limits and was discarded from subsequent analyses. The monitoring sub‐scale possessed good test–retest reliability (n=17) with a 5‐week time interval (r=0·71, P < 0·005), as measured using a Pearson’s correlation coefficient. Furthermore, the majority (73·4%) of monitoring items possessed moderate or substantial test–retest reliability, as indicated by kappa coefficients. Finally, the monitoring sub‐scale possessed good construct validity, both discriminant and convergent validity, as measured by the univariate associations between monitoring behaviour and selected items from the information questionnaire and a demographic questionnaire. In conclusion, adequate support exists for the psychometric properties of the monitoring sub‐scale of the MBSS and its use with adult daughters of women with early breast cancer in future research. These findings have a number of implications for nursing research and these are discussed in this paper.