bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a patient‐orientated instrument to measure service quality in outpatient departments
Authors: Hiidenhovi Hannele , Laippala Pekka , Nojonen Kaija 
Published: March 2003

Development of a patient‐orientated instrument to measure service quality in outpatient departments Aims of the study. To describe three stages in the development of an instrument to measure service quality from the patients’ perspective in hospital outpatient departments. Rationale. A reliable and valid service quality instrument is a valuable tool for collecting feedback from patients when improving outpatient services. Design. A multiphase process with several versions of the questionnaire testing its validity and reliability. The first version of the questionnaire was constructed from information collected in a previous interview study of patients’ service experiences. Using this version (47 questions) information was collected in 15 outpatient departments (314 patients) and the second version of the questionnaire was developed. At this stage, a survey of employees (n=111) was included in the development process. This second version of the questionnaire (43 questions) was used to collect more data in three outpatient departments of a university hospital and in two outpatient departments of two regional hospitals on three different occasions (1416, 369 and 124 patients) within a period of 2 years. The reliability of the instrument was tested in terms of stability by using three repeated measurements, and using the Cronbach’s α coefficient as an indicator of internal consistency. Content validity was assessed by means of percentage agreement between staff and patients. Logistic regression analysis was performed to assess construct validity. Results. The final version of the questionnaire contained 12 items. Agreement between patient and staff ratings was found to be acceptable for most questions (content validity). Two measurements on different occasions yielded a similar structure (construct validity). Internal consistency was acceptable (Cronbach’s α= 0·67–0·93 in the first and 0·71–0·94 in the second survey). The variance of the α coefficients was small in the retest (stability). Conclusions. The instrument developed is general to the extent that it is suitable for assessing service quality improvement needs in individual units and for making cross‐departmental comparisons.
What do nurses and therapists think about the positioning of stroke patients?
Authors: Rowat Anne M. 
Published: March 2003

What do nurses and therapists think about the positioning of stroke patients? Background.  At present, there are a number of different positioning strategies for stroke patients, but these are mainly based on clinical experience rather than research. Prior to developing a study to evaluate the effect of positioning on outcome after stroke, it was important to establish if nurses in our hospital had given much thought to the positioning of stroke patients. Aim of the study.  This study aimed to explore whether nurses working on the stroke unit at a Scottish teaching hospital held different views on the positioning of conscious and unconscious stroke patients to nurses working on other wards with stroke patients and therapists. Methods.  Questionnaires on various aspects of patient positioning were sent to 150 nurses and 25 therapists working in five specialities where stroke patients are cared for in a large teaching hospital. Findings.  Overall, the majority of nurses and therapists (74%) believed that the best position for conscious stroke patients was sitting in a chair. Also, 80% of them believed that the best position for unconscious stroke patients was lying on the nonparetic side. There was less of a consensus between nurses and therapists working in the five specialities as to whether it was appropriate for conscious or unconscious stroke patients to lie on their paretic side, lie supine or sit propped‐up in bed in either a 30 or 70° angle. Conclusions.  The lack of consensus between nurses working in the five specialities is probably because at present there is little research to guide nursing practices for the positioning of stroke patients. Therefore, research to confirm which positions improves or hinders outcome after stroke is essential. Indeed, positioning is a simple inexpensive strategy, which could have a substantial public health impact, as stroke is so common.
Spiritual coping strategies: a review of the nursing research literature
Authors: Baldacchino Donia , Draper Peter 
Published: March 2003

Spiritual coping strategies: a review of the nursing research literature Aims of the paper.  This paper reviews some of the limited nursing research‐based literature, orientated towards the use of spiritual coping strategies in illness. This review aims at identifying those spiritual coping strategies used by the believers and nonbelievers followed by implications for holistic nursing care. Literature search.  The CINAHL AND MEDLINE CD Rom databases were searched, identifying literature published from 1975 onwards which amounted to 187 articles. The majority of the literature traced were found anecdotal with only few studies investigating directly spiritual coping strategies. Following scrutiny of the available articles, only five research studies explored directly the spiritual coping strategies used in various illness, four of which were conducted in USA and one in UK. Because of the small scale research studies, generalization of the findings of this review is limited to the samples used. Theoretical background.
Research suggests that spiritual coping strategies, involving relationship with self, others, Ultimate other/God or nature were found to help individuals to cope with their ailments. This may be because of finding meaning, purpose and hope, which may nurture individuals in their suffering. Spirituality is oftenly referred by literature as being synonymous with religiosity. Thus the use of spiritual coping strategies is restricted to individuals who hold religious beliefs. However, the definition of spirituality indicates that this concept is broader than religiosity. The theories on stress‐coping (Folkman & Lazarus 1984) and the numinous experience (Otto 1950) outline the rationale for the use of these strategies which are applicable to both the believers and nonbelievers. Implications.  This review suggests that the onset of illness may render the individual, being a believer or nonbeliever to realize the lack of control over his/her life. However the use of spiritual coping strategies may enhance self‐empowerment, leading to finding meaning and purpose in illness. This implies that holistic care incorporates facilitation of various spiritual coping strategies to safeguard the wholeness and integrity of the patients.
The quality of perioperative care: development of a tool for the perceptions of patients
Authors: Leinonen Tuija , Leino‐Kilpi Helena , Ståhlberg Marja‐Riitta , Lertola Kalle 
Published: March 2003

The quality of perioperative care: development of a tool for the perceptions of patients Aim of the study. To find out how surgical hospital patients (n=874) perceived the quality of perioperative care they received in an operating department and in the recovery room. Background. Patients’ perceptions of the perioperative care have not been included systematically in the improvement of the care. Accordingly, there is no standardized, valid, and reliable instrument or system in common use that we could use for the evaluation. The nursing care in operating departments has an important role in modern health care, and therefore more research concerning perioperative care quality is needed urgently and the development of the measurement tool is urgent. Method. The data were collected using a structured questionnaire in five operating departments in southern Finland during 1998. Results. Physical activities (such as pain management and temperature maintenance) were rated as excellent, as were staff characteristics and the physical and social environment. The most critical comments were made with regard to supporting patient initiative, encouragement and educational activities. Patients stated they would have liked more information and it was felt that they should have been encouraged to ask more questions about unclear matters. Some of the patients said they had only very limited influence over their own care. The patients were very pleased with their care in the recovery room. There were only minor differences between the views of patients from different departments. Conclusions. Overall the quality of care was considered extremely good, but comparisons of different quality categories did reveal some problems. Although it has already proved to be a useful tool, the questionnaire needs to be developed and tested further.
Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment
Authors: Sapountzi‐Krepia Despina S. , Valavanis John , Panteleakis George P. , Zangana Dimitra T. , Vlachojiannis Pantelis C. , Sapkas George S. 
Published: March 2003

Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment Aims. To explore the impact of bracing on the perceptions of body image, happiness and satisfaction of adolescents with scoliosis. Design. The study was designed as compare of 134 girls and 16 boys who wore a Boston type brace for scoliosis treatment and a control group of 99 healthy girls and 51 healthy boys. All them were secondary school pupils living in Athens Greece and were interviewed. A semi‐structured schedule included general questions, and the Piers–Harris scale was used. Data were analysed using the SPSS/PC+ software, and descriptive statistics, factor analysis and the non‐parametric Mann–Whitney U‐test. Statistical significance was set at P=0·05 or less. Results. The scoliosis group had a poorer perception of body image in comparison to the control group (P=0·048), while boys with scoliosis (P=0·030) had a better perception of body image than girls with scoliosis. Girls with scoliosis had a statistically significant difference (P=0·0388) in perception of happiness and satisfaction, in comparison with girls in the control group. Cohabitation with the mother seemed to be negatively correlated with body image, happiness and satisfaction perceptions because adolescents with scoliosis who were not living with their mother had a better body image perception (P=0·027) as well as better perceptions of happiness and satisfaction (P=0·047). Nevertheless, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings and problems with health professionals, while 90% of them declared that they wanted to have more opportunities to do this. Conclusion. Adolescents with scoliosis face problems during bracing and they need to be supported by health care professionals.
The quality of nursing home care: do the opinions of family members change after implementation of emotion‐oriented care?
Authors: Finnema Evelyn , De Lange Jacomine , Dröes Rose‐Marie , Ribbe Miel , Van Tilburg Willem 
Published: March 2003

The quality of nursing home care: do the opinions of family members change after implementation of emotion‐oriented care? Objective. The present study focuses on opinions on the quality of nursing home care of family members of nursing home residents with dementia. Furthermore, we examined whether family members’ appreciation of the care increased as a result of the implementation of emotion‐oriented care. Design. Randomized clinical trial. Instrument. An 18‐item questionnaire was developed. The following subjects were addressed: communication activities between staff and family members; satisfaction regarding contacts with staff; the extent to which family members can participate in care; the contact that family members experience with the person with dementia, and opinions about the way in which nursing staff treat residents. Results. Most family members already had a positive opinion on the nursing home care prior to the implementation of emotion‐oriented care. The most positive assessment concerned the way in which nursing staff treated residents. The lowest scores concerned communication activities between ward staff and family members. Comparison of the first and end measurements showed that in general opinions on the quality of care did not change. Study limitations. A large number of incomplete questionnaires made it impossible to conduct factor analysis on the classification of the questions in various sections and therefore allowed us only to make statements at the item level. Conclusions. For the most part family members had a positive opinion on the nursing home care. In general, implementation of emotion‐oriented care did not lead to a more positive assessment. Despite the generally accepted notion that involving family members in care is important, family members were regularly treated as outsiders. This demonstrates that there is room for improvement in the communication by nursing home staff with family members (e.g. more frequent contacts and information about the illness).
Caring in nursing: a different interpretation
Authors: Sumner Jane 
Published: March 2003

Caring in nursing: a different interpretationAim. To applyHabermas’ (1995)Theory of Moral Consciousness and Communicative Action to the nurse–patient relationship, offering a different interpretation to the nurse–patient relationship that iscaring in nursing.Rationale. Many authors have described the nurse–patient relationship, but Habermas’ theory synthesizes the components into a complex matrix that iscaring in nursing.Findings. The theory offers three claims to normative validity: the claim to truth which is the factual objective knowledge; the claim to truthfulness which refers to the intrasubjective self; and the claim to right which is the intersubjective interaction. The validity claims explain the patient’s personal and illness self, the nurse’s personal and professional self, and the interaction/discourse. The interaction is situation specific, and is identified as moral because dialogue/discourse requires a ‘considerateness’ of each for the other. ‘Considerateness’ in discourse requires certain rules, including that each participant has an equal voice, be followed in order for the Principle of Universalization to occur. Habermas draws onKohlberg’s (1981), andSelman’s (1980)work to develop three levels of moral maturity of communication. These are preconventional, conventional, and postconventional. Initial moral maturity is egocentric, subjective, and obedient to authority. Maturity develops with recognition of other and reciprocity. At the postconventional level there is mutuality and the ability for abstract reasoning. There is a third person objectivity combining speaker and addressee/listener perspectives. Norms are not just accepted, they are reasoned through. This leads to justification of the norm, which is then accepted as valid. When the three validity claims are met and there is genuine ‘considerateness’ in the interaction there is communicative action. The reverse is strategic action, where the communication is coercive. When there is communicative action both patient and nurse are validated with a sense of fulfillment or <physis>.Conclusion. Habermas’ (1995)theory offers a new paradigm for caring in nursing.
John Heron’s six‐category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom
Authors: Sloan Graham , Watson Hazel 
Published: March 2003

John Heron’s six‐category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom Aims. This paper provides a critique of how Heron’s six‐category intervention analysis framework has been adopted by nursing in the United Kingdom (UK) as a theoretical framework in nursing research and model for clinical supervision. From this, its merits as an analytic framework and model for clinical supervision in nursing are discussed. Background. Heron’s six‐category intervention analysis has been acknowledged as a means by which nursing could develop its therapeutic integrity. It has also been used as a theoretical framework in nursing research focusing on nurses’ perceptions of their interpersonal style. More recently descriptions of this framework have been proposed as a structure for clinical supervision. However, its use as a theoretical framework to underpin research investigating the interpersonal skills of nurses and as a model of clinical supervision must firstly be scrutinized. Findings. Returning to Heron’s original description and comparing this with its current adoption in the UK, misconceptions of this framework can be identified. Its value as an analytic tool investigating interpersonal relations in nursing has still to be evaluated. Furthermore, nursing’s emphasis on certain intervention categories has undermined the potential potency of this framework and its contribution as a model for clinical supervision in nursing. Conclusion. We argue that Heron’s six‐category intervention analysis as a framework to investigate the interpersonal competence of nurses, particularly mental health nurses, requires investigation. This, in turn, would provide an opportunity to challenge the framework’s theoretical standpoint. In addition to its value as an analytic tool, all six categories of Heron’s framework have equal relevance to its contribution in nursing as a supervision model.
Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynaecology nurses
Authors: Jolley Sue 
Published: March 2003

Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynaecology nurses Aim. This study was designed to investigate the teenage sexual health service provided by gynaecology nurses at Queen’s Medical Centre, Nottingham, United Kingdom (UK), by assessing their knowledge, activities and perceptions in relation to teenage sexual health. Background. Part of a gynaecology nurse’s work is caring for teenagers with sexual health problems, including unwanted pregnancies and sexually transmitted infections (STIs). Given the current national focus in the UK on improving teenage sexual health, there is clearly a role for gynaecology nurses to play, but this is rarely referred to in published literature and appears to be poorly defined. Method. A cross sectional survey of all gynaecology nurses at Queen’s Medical Centre was carried out, followed by semi‐structured interviews with a small random subsample. Findings. Results indicated that, although 65% of nurses had worked on the gynaecology unit for more than 5 years, there was poor knowledge, an inconsistent pattern of nursing interventions and negative perceptions of the service offered. A majority of the nurses (87%) had not received any specific training in how to nurse teenagers with sexual health problems and 65% considered that the quality of sexual health service offered to teenagers was poor. Unexpected findings included poor general knowledge of local teenage sexual health services, the emotional effect on some nurses caring for young teenagers undergoing medical terminations of pregnancy (ToP), and the complete lack of training and protocols for taking a sexual history. Conclusions. The nurses felt that the teenage sexual health service provided could be improved by better staff training, better information for teenagers and better organization. Recommendations have been made as a result of the study but the staff will need management support to ensure that changes are effective. Generalizations cannot be drawn from a study in one hospital but the results could reflect the low profile given to the teenage sexual health aspect of gynaecology nurses’ work in the UK.
Well‐being of intensive care nurses (WEBIC): a job analytic approach
Authors: Le Blanc Pascale M. , De Jonge Jan , De Rijk Angelique E. , Schaufeli Wilmar B. 
Published: March 2003

Well‐being of intensive care nurses (WEBIC): a job analytic approach Aims of the study. This paper presents the results of a validation study of the so‐called well‐being of intensive care nurses (WEBIC)‐questionnaire that is designed to perform a detailed job analysis of intensive care unit (ICU) nurses’ jobs. Background. The WEBIC‐questionnaire is based on modern sociotechnical systems theory, and distinguishes four integrated task categories: (1) operational, (2) organizing, (3) preparatory, and (4) supportive tasks. For each task, the WEBIC assesses (1) how demanding this task is, and (2) how satisfying the performance of this task is. Using the WEBIC, information is gathered about ICU nurses’ qualitative workload, and typical job‐related risks for ICU nurses’ well‐being at work can be mapped. Methods. A cross‐sectional survey on work and well‐being of almost 2000 ICU‐nurses in 13 different European areas was conducted. Exploratory factor analyses were performed to study the validity of the factorial structure of the WEBIC‐questionnaire. The construct validity of the WEBIC‐questionnaire was studied by performing hierarchical multiple regression analyses of the WEBIC‐factors on two types of job‐related well‐being, i.e. burnout and general job satisfaction. Results. Results of the exploratory factor analyses showed that the hypothesized four‐factor structure of the WEBIC is confirmed by our data. Internal consistencies of the different factors varied from 0·77 to 0·91. Intensive care unit nurses’ most central (operational) tasks turned out to pose the greatest demands, but also seemed to drive their satisfaction. With respect to the relationships between the four WEBIC‐factors, and burnout and general job satisfaction, it was found that, especially for the satisfying tasks, significant relationships with these outcomes were found. Conclusion. The reliability and construct validity of the WEBIC‐questionnaire can be considered satisfactory. Furthermore, the questionnaire provides a systematical and detailed coverage of ICU nurses’ tasks. In relation to this, the questionnaire is not only useful for scientific purposes but also for practical use.