Showing papers in "Journal of Research in Nursing in 1996"
TL;DR: It became evident that the influence of the clinical mentor and the nature of the relationship were central to students' knowledge growth and the implications for nurse education and the role of clinical staff were discussed.
Abstract: This paper is concerned with the relationship between student and clinical supervisor (known as a mentor) and its influence on nursing students' development of professional knowledge during their c...
90Â citations
TL;DR: This paper draws on the experience of the authors in conducting a number of focus group interviews while undertaking a study of perceptions of the philosophy and practice of nursing within the context of Project 2000 1.
Abstract: Focus group interviews are becoming more widely used as a data collection technique within nursing research. This paper draws on the experience of the authors in conducting a number of focus group interviews while undertaking a study of perceptions of the philosophy and practice of nursing within the context of Project 2000 1. Some of the main issues and challenges to be considered when utilising this method are examined. These include the practicalities of group size, access and sampling, as well as the fundamental issues associated with group interaction. The role of the moderator in maintaining the flow and focus of the group and in ensuring the participation of all group members is addressed, along with an examination of disclosure and validity. Finally, the issues and challenges posed by the analysis of the focus group data are considered. [NT Research 1996; 1 :2, 143-153]
55Â citations
TL;DR: Recommendations for improving sexuality-related practice include requiring multiple experiences addressing sexuality of nursing students and new staff, as well as increased research to identify more specific nursing strategies for addressing clients' sexual concerns.
Abstract: Sexuality is an important aspect of patient care, but research consistently demonstrates that nurses do not address sexuality unless the client asks specific questions. Review of research on sexuality-related practice suggests that nurses acknowledge their professional responsiblity to address sexuality with clients, but may not feel comfortable doing so. Continuing education on sexuality is of questionable value in improving practice. Recommendations for improving sexuality-related practice include requiring multiple experiences addressing sexuality of nursing students and new staff, as well as increased research to identify more specific nursing strategies for addressing clients' sexual concerns.
48Â citations
TL;DR: The authors used cognitive mapping to handle the evidence from a case study that generated a large amount of audio-recorded interview evidence, along with instructions on how the technique was used and an example of a cognitive map.
Abstract: The use of qualitative research methods generates large bodies of evidence that require analysis. This paper invites nurses to consider using 'cognitive mapping' as an expeditieus method of handling such evidence. The material draws upon personal experience of using cognitive mapping to handle the evidence from a case study that generated a large amount of audio-recorded interview evidence. An example of a 'cognitive map' is presented, along with instructions on how the technique was used.
43Â citations
TL;DR: This study set out to clarify what individualised patient care means to nurses and how they practise it as well as how it is experienced by patients.
Abstract: It is assumed that individualised patient care benefits both patients and nurses. This study set out to clarify what individualised patient care means to nurses and how they practise it as well as how it is experienced by patients. With some exceptions, individualised patient care was not practised widely in the seven wards that were used as case studies. Even in the wards where individualised patient care was more common, there were some examples of bad practice. Factors that facilitated individualised patient care were: the personal qualities of the nurses themselves; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; and effective leadership and management of nursing work [NTResearch 1996; 1: 1, 22-33]
28Â citations
TL;DR: The results demonstrated that within the domain of post-basic training needs, there is a need to employ data collection techniques which go beyond the standard wish-list approach typically adopted, and to use questionnaires which embrace some of the guiding principles of psychometric science.
Abstract: Much health service research relies on the use of questionnaires, some of which are poorly constructed and therefore have the potential for yielding unreliable databases1 . The application of the formal principles of psychometrics to questionnaire design can eliminate many of these problems. This paper reports the development of a training needs analysis tool following some of these essential parameters. The overall aim of the exercise was to identify the nature and extent of the training and education required by health visitors, practice and district nurses in a range of occupational areas, but with specific reference to research competencies. The results demonstrated that within the domain of post-basic training needs, there is a need to employ data collection techniques which go beyond the standard wish-list approach typically adopted, and to use, instead, questionnaires which embrace some of the guiding principles of psychometric science. In this way, educational provision can be more reliably inform...
26Â citations
TL;DR: A participant observation study was carried out at a secure (forensic) unit called Delphi as discussed by the authors, which was one of several set up throughout Britain following the Report of the Butler Committee.
Abstract: A participant observation study was carried out at a secure (forensic) unit called Delphi. This unit was one of several set up throughout Britain following the Report of the Butler Committee1. This particular unit announced in a series of statements that it now functioned as a therapeutic community of the kind described by Rapaport2. Given that conflict had always attended the relative weighting of custody and care within psychiatric institutions, it was decided to examine the veracity of their claim. It was anticipated that such a therapeutic undertaking would induce struggle and conflict among the staff. A feature of this study is its entree strategy and style of observations: these were designed to minimise subjects' perceptions of the vigour of the research as well as to attain as uncontaminated a picture of the unit as possible. The ethics of this strategy are reviewed. Observational data were supported by interviews plus a small panel of independent verifiers. Consistent with ethnographic studies ge...
24Â citations
TL;DR: The paper asserts that while not without its challenges, the experiment can make a valuable contribution when evaluating the causal relationship between continuing professional nurse education and practice and explores the relationship between research methods and the development of knowledge.
Abstract: An increasing number of studies are evaluating the effects of continuing nurse education on practice Researchers investigating this relationship have traditionally adopted qualitative non-experime
20Â citations
TL;DR: The debate which currently surrounds the possibilities of evaluating clinical supervision is identified, along with a brief summary of some, and arguments are made for a broad methodological approach to evaluatingclinical supervision.
Abstract: The subject of evaluating clinical supervision for nurses and health visitors in the United Kingdom is considered in this paper. Some of the methodological problems and possible solutions are debated. A multi-site project funded by the Department of Health is described. The paper seeks to identify the debate which currently surrounds the possibilities of evaluating clinical supervision. Research methods and tools are presented, along with a brief summary of some, and an assessment is made of their potential value. The dilemmas of evaluation on a 'grand scale' are considered and arguments are made for a broad methodological approach to evaluating clinical supervision. [NT Research 1996; 1: 2, 96-101]
20Â citations
TL;DR: Arguing that professional development and regulation must be understood within the context of state control, the paper questions whether nurse prescribing represents a genuine development in nursing roles or is merely an act of tacit delegation by a medical profession which is itself subject to loss of autonomy.
Abstract: In October 1994 nurse prescribing was launched for the first time in Britain in eight community demonstration sites. Using nurse prescribing as an illustration, this paper aims to explore the regulation of nursing and the influence of medicine on the expansion of the nurse's role. Arguing that professional development and regulation must be understood within the context of state control, the paper questions whether nurse prescribing represents a genuine development in nursing roles or is merely an act of tacit delegation by a medical profession which is itself subject to loss of autonomy. Recognising historical renegotiation in divisions of health-care labour, sections on the introduction of nurse prescribing; changing professional boundaries; and regulation in nursing, medicine and pharmacy, are used to critique nurse prescribing as an example of growing nursing professionalisation.
18Â citations
TL;DR: Black insulation tapes in two different grid configurations were laid out in an attempt to prevent patients with Alzheimer's disease ambulating through exit doors, and it was found that the use of a horizontal grid reduced exit door contact up to 97% for four of these patients with a diagnosis of Alzheimer's Disease.
Abstract: The ambulation of demented patients into potentiafiy dangerous areas or away from areas where they can be monitored is a problem for the care-providers of such patients in psychiatric settings for ...
TL;DR: The level of mouth care provided by nurses for patients with cancer in Scottish hospices and in the community within Scotland is determined, and the value of a training pack in oral disease and oral care is assessed.
Abstract: Oral disease is common in patients with cancer and mouth care is an important element of palliative care. Responsibility for provision of this care usually falls to nursing staff. This study aimed to determine the level of mouth care provided by nurses for patients with cancer in Scottish hospices and in the community within Scotland, and to assess the value of a training pack in oral disease and oral care. Fifteen hospices, 52 Macmillan nurses and 112 district nurses were invited to participate. Responses to an initial questionnaire confirmed the important role of nurses in providing mouth care, but highlighted significant deficiencies in training, particularly for district nurses, and a lack of formal protocols in this area. There was little interaction with professional dental staff. Training packs, including clinical photographs and simple mouth care protocols were sent to 15 hospices, 20 Macmillan nurses and 45 district nurses. A follow-up questionnaire six weeks later showed that the packs had been ...
TL;DR: A collaborative approach between education and practice is proposed, using a network of 'link practitioners' to ensure continuous awareness and dissemination of research.
Abstract: Current initiatives in the central production of rigorous reviews of the evidence for effectiveness in health care require efficient mechanisms for dissemination to individual practitioners. Nursing needs to ensure that sources of information about 'effectiveness' are routinely accessed, and that the skills to find, evaluate and utilise systematic reviews are available to improve care delivery and develop practice. A collaborative approach between education and practice is proposed, using a network of 'link practitioners' to ensure continuous awareness and dissemination of research. Working together to access the best currently available evidence for practice reduces duplication, shares costs, and ensures that the benefits of combined collaborative participation are greater than the individual contribution of each participating organisation. [NT Research 1: 2, 113-118]
TL;DR: A critical review of the data collection processes involved in the compilation of a community profile for one area within the context of the NHS reforms is provided, identifying appropriate data sources and evaluating them for accessibility, practical use and reliability and validity.
Abstract: This paper presents the methodological approach and findings of one facet of a larger study. The main study, which had a health visiting focus, was concerned with an in-depth investigation of the v...
TL;DR: The paper describes aspects of the main part of a research project on the implementation and development of lecturer-practitioner roles in nursing, which constituted a detailed exploration of the post over a number of years in one setting.
Abstract: The paper describes aspects of the main part of a research project on the implementation and development of lecturer-practitioner roles in nursing, which constituted a detailed exploration of the post over a number of years in one setting. The long-term nature of the study and the challenges it posed for the researcher are discussed, especially those concerning the role of the researcher, and the considerations entailed in using a participant observation approach. Problems encountered and strategies adopted are presented, in order to provide insight into the use of this research methodology in nursing and health care [NT Research 1996; 1: 1, 38-43]
TL;DR: Findings suggest that hostility to them as a group because of their preparation route to become midwives is replaced by an acceptance of their role in developing the professional ideology and hegemony.
Abstract: Pre-registration midwifery education prepares as midwives those who are not already qualified as nurses. It replaces and develops the 'direct entry' system and links midwifery to higher education through joint validation and award. This report covers the early experiences of the first group of midwives who qualified by this route and explores their views about their courses, their professional work relationships and experiences in practice. Findings suggest that hostility to them as a group because of their preparation route to become midwives is replaced by an acceptance of their role in developing the professional ideology and hegemony. In practice, most are confident with clients although there is some evidence that they need greater experience and support in working with sick neonates. The respondents suggest improved attention to the issue of shared learning and experiences, especially as these concern experiences in non-midwifery nursing areas [NT Research 1996; 1 : 1, 68-78]
TL;DR: A possible causal relationship over time between the estimated level of physical help given and the measured level of difficulty with feeding according to the Edinburgh Feeding Evaluation in Dementia scale is indicated.
Abstract: The relationship between the level of physical help given by nurses and the level of difficulty with feeding in elderly patients with dementia was investigated by means of structural equation model...
TL;DR: In this article, the authors examine both the shared and distinctive ethical features which are pertinent to different methodologies and conclude that an unquestioning following of the often stated ethical maxims is neither appropriate nor desirable with different research designs.
Abstract: The issues of ethics in research are often portrayed as taken for granted and the same regardless of the research approach adopted. A critique of the considerations within different methodologies shows that while there tends to be a cornmonality of principles, their translation into practice is diverse. In addition, it can be argued that an unquestioning following of the often stated ethical maxims is neither necessarily appropriate nor desirable with different research designs. This paper examines both the shared and distinctive ethical features which are pertinent to different methodologies. If focuses especially on the key facets of the hitherto dominance of the medical model in research and its implications, the challenge to research orientations where there is a need for the researcher to control the research situation, concerns about deception in research and the call for anonymity and confidentiality. Conclusions are drawn which aim to put into perspective the 'received wisdom' of adherence to 'acc...
TL;DR: This paper explores the impact of a nursing development unit (NDU) upon the practitioners who work there by exploring the process this initiates through the conceptual lens of role transition' and 'emotional labour'.
Abstract: This paper explores the impact of a nursing development unit (NDU) upon the practitioners who work there. The ideas proposed are generated from research and evaluation undertaken in three different NDUs: critical care; care of the older person with mental health problems; and primary health care. A model is proposed which seeks to explain some of the more complex issues encountered by practitioners who rise to the challenge of being in an NDU. By exploring the process this initiates through the conceptual lens of role transition' and 'emotional labour', it is hoped to illuminate critical issues for consideration when managing the pace of change and when evaluating the outcome of the initiative.
TL;DR: This exploratory two-stage study sought to reveal the prevailing circumstance of teaching, support, supervision and role modelling for students in clinical areas, within the context of Project 2000 courses, in three centres in England.
Abstract: This exploratory two-stage study, funded for two years by the English National Board for Nursing, Midwifery and Health Visiting, sought to reveal the prevailing circumstance of teaching, support, supervision and role modelling for students in clinical areas, within the context of Project 2000 courses, in three centres in England. Evidential data collection methods were developed which included personal interviews, non-participant observation and the scrutiny of documents. Findings revealed confusion and misunderstanding between students, practitioners and tutors about clinical supervision arrangements and competing explanations were reported. Further controlled research is required to assess and cost the comparative impact clinical supervision may make to student learning experience and to the well-being and skill base of qualified nurses, and the effect of both on the quality of patient care. [NT Research 1996; 1:2, 102-111]
TL;DR: Two strategies adopted to scrutinise nursing research are explored: nursing research ethics committees in higher education and in health service settings (trusts or hospitals) and alternatives are discussed.
Abstract: Uncertainty exists in the strategies adopted to ensure nursing research is ethical. Currently available codes and guidelines demonstrate some limitations. Local research ethics committees (LRECs) a...
TL;DR: There is limited information on the scale and cause of abuse of older people in residential care and nursing homes, but it is reasonable to assume a significant level of abuse, given the regularity of proven abuse and investigation.
Abstract: There is limited information on the scale and cause of abuse of older people in residential care and nursing homes. It is reasonable to assume a significant level of abuse, given the regularity of ...
TL;DR: A study was carried out to compare two medical wards which had been operating a 12-hour shift for more than one year with two medical ward which had carried on with a conventional shift system over the same period of time, finding no significant differences between the shift patterns.
Abstract: Despite the increasing use of and discussion about 12-hour shifts, little work has been carried out in the United Kingdom to assess its impact. A study was carried out to compare two medical wards which had been operating a 12-hour shift for more than one year with two medical wards which had carried on with a conventional shift system over the same period of time. Staff questionnaires, interviews, patient interviews, documentation review, and analysis of a number of organizational issues were undertaken to evaluate the effect of the shift pattern worked. Viewing this shift pattern from a variety of perspectives indicates that there were no significant differences between the shift patterns with regard to staff perception, patient perception, documentation and organisational issues. However, some aspects of the 12-hour shift produced more favourable responses from the staff: less fatigue was reported by those working the 12-hour shift and documentation was more complete on these wards. However, the length...
TL;DR: This paper identifies general guidelines that researchers can adopt for effective recruitment strategies and emphasises that recruitment is an important element of the research process and deserves careful attention in the initial planning phases of a study to ensure its completion.
Abstract: There is a well established theoretical base for many of the methodological aspects of nursing research1,2,3. Researchers have explored measurement tools, design of studies, methods of data collection and analysis, but the question of recruitment of participants to a research project remains a neglected area despite the profound influence it can have on the success or failure of that project. A research project into the management of challenging behaviour in children with learning disabilities (being conducted at Hull University) provides a case study as a means of exploring and illustrating the potential problems of recruitment. This paper then identifies general guidelines that researchers can adopt for effective recruitment strategies. The conclusions drawn emphasise that recruitment is an important element of the research process and deserves careful attention in the initial planning phases of a study to ensure its completion.
TL;DR: This review discusses the main effects of the change in shifts on nurses and patients alike and focuses on studies since 1980 and on studies carried out in the United Kingdom.
Abstract: The requirement to ensure that practice is evidence-based, means that all aspects of the structure, process and outcome of nursing care need to be subjected to critical review. This report attempts...
TL;DR: The status of individualised care is examined, the nature and context of forensic/psychiatric care is described and its relationship with findings of two decades ago is described.
Abstract: The nursing process was introduced to develop the contribution of nursing and adopt a more systematic approach to care delivery. Few in-depth studies have yet described its true impact and level of implementation. The study reported in this article examines the status of individualised care and makes comparisons with nursing care in other locations. It also describes the nature and context of forensic/psychiatric care and its relationship with findings of two decades ago [NT Research 1996; 1: 1, 13-21 ]
TL;DR: An argument for a stronger level of practitioner involvement in the needs assessment process at both individual and community level is presented.
Abstract: The NHS and Community Care Act 1990 heralded a change from service-led to needs-led assessment. A recently published research study concerned with assessment of need for district nursing 1 enquired into the needs assessment process from the practitioners' perspective. This paper draws on interview data from district nurses and GPs in exploring the role of the district nurse in identifying need for district nursing care at individual and community levels. Direct district nurse involvement in the identification of need for their care was found to be limited. The paper presents an argument for a stronger level of practitioner involvement in the needs assessment process at both individual and community level.
TL;DR: The authors evaluate the evidence on both sides and propose a way forward on the value of quantitative versus qualitative research.
Abstract: How can nurse researchers reconcile the conflicting arguments on the value of quantitative versus qualitative research? The authors evaluate the evidence on both sides and propose a way forward
TL;DR: The many research publications now written by practitioners is evidence that nursing practice is increasingly using knowledge based on research as mentioned in this paper. There is a need, therefore, for nurses to acquire knowledge from these publications.
Abstract: The many research publications now written by practitioners is evidence that nursing practice is increasingly using knowledge based on research. There is a need, therefore, for nurses to acquire th...
TL;DR: The study aimed to establish the current situation in relation to the availability of appropriately educated nurses providing cancer care to patients in Scotland and to present results from a national survey of directors of nursing in Scotland.
Abstract: The care of patients with cancer, from diagnosis to terminal care, demands the support of a multidisciplinary team in both hospital and community settings. To deliver effective care, all professional groups involved in the care of such patients require a high degree of specialist knowledge. This knowledge can be acquired only through the integration of education and clinical practice. While there have been significant advances in the management of cancer and in the palliation of symptoms this does not appear to have been reflected in the provision of nurse education in cancer care in Scotland. This paper presents results from a national survey of directors of nursing in Scotland. The study aimed to establish the current situation in relation to the availability of appropriately educated nurses providing cancer care to patients in Scotland.