Showing papers in "Journal of Research in Nursing in 2001"
TL;DR: The telephone interview was used in a study by one of the authors (EC) which explored the experience of postoperative pain, and issues relating to ethical considerations, reliability, validity, limitations and analysis are explored.
Abstract: The increasing popularity of the telephone interview as a research method may be a reflection of broader social change and technological advances, with increased use and acceptability of telecommun...
366 citations
TL;DR: The authors argue that traditional interpretations of research tend to bifurcate research knowledge and practice knowledge, with knowledge derived from practice and direct interaction with patients being perceived as knowledge that is not formally admissible by the traditional scientific model.
Abstract: Traditional interpretations of research tend to bifurcate research knowledge and practice knowledge, with knowledge derived from practice and direct interaction with patients being perceived as knowledge that is not formally admissible by the traditional scientific model. This paper proposes a research method that legitimises practice as a source of knowledge. Building upon the concepts of situational understanding and contingent knowledge, we advocate an integral research methodology, one which draws on the notion of the researcher-practitioner.Beginning with an analysis of knowledge and power we explore the contribution of reflexivity to the development of a politically and ethically engaged research process in nursing. In discussing critical reflexivity as a research method, we will outline the focus of reflexive research and the role of the reflexive researcher.Arguing against the superiority of theoretical research over practitioner research, we present a challenge to technical rationality, suggestin...
133 citations
TL;DR: In this article, it is proposed that this type of inquiry is not only a valid way of carrying out research but also a very useful means of eliciting the perspectives of patients and colleagues.
Abstract: Qualitative research is now often favoured in nursing and midwifery because it emphasises a person-centred and holistic approach. In this paper it is proposed that this type of inquiry is not only a valid way of carrying out research but also a very useful means of eliciting the perspectives of patients and colleagues. It is acknowledged that qualitative approaches are not unproblematic. In particular, there are issues of validity and reliability which should be addressed by researchers, hence a discussion of these is included. Interviewing is the most common method of collecting data within this approach and is examined here, together with its advantages, common pitfalls and problems.
49 citations
TL;DR: The BARRIERS scale may not be suitable for use in the UK without further development: a scale which includes positive as well as negative aspects of research culture, with a greater emphasis on organizational issues, may be more useful.
Abstract: The BARRIERS scale was developed in the US as a method of identifying the main barriers to research utilisation reported by nurses. However, its appropriateness for assessing such barriers in the U...
39 citations
TL;DR: It is concluded that a sensible approach by parents should involve teaching their children to drink in moderation at home and that parents should set boundaries to control and protect their children from harm associated with periodic heavy drinking.
Abstract: The topic of young people drinking, and its related problems, continues to foster concern and controversy. This review highlights some of the main psychological, social and behavioural evidence related to the formation of children's attitudes to alcohol, the acquisition of drinking habits by young people and factors associated with patterns of alcohol consumption and its consequences. Some of the implications of this evidence are highlighted, and recommendations are suggested to curb levels of heavy/inappropriate drinking among youth.Many children are hostile to alcohol consumption by adults. The onset of adolescence generally reverses such negative attitudes and drinking is widely viewed by teenagers and young adults in a positive light as a symbol of being adult and sociable. Many young people drink to intoxication as part of the process of learning how to drink. Recent studies show that rates of heavy drinking, intoxication and negative consequences among teenagers vary considerably in different countr...
35 citations
TL;DR: This paper gives an overview of the main quantitative research designs relevant to nursing and healthcare, outlines some strengths and weaknesses of the designs, provides examples to illustrate the different designs and examines some of the relevant statistical concepts.
Abstract: This paper gives an overview of the main quantitative research designs relevant to nursing and healthcare. It outlines some strengths and weaknesses of the designs, provides examples to illustrate the different designs and examines some of the relevant statistical concepts. The paper concludes with a brief discussion about the place of quantitative research in nursing.
27 citations
TL;DR: It is argued that performance measurement is not an end in itself but a means of comparing practice and the impact of changes in practice intended to secure improvement.
Abstract: This paper examines the process of benchmarking and the ways in which it can be used to secure improvement and best practice. Classic definitions are presented and their appropriateness to present-day conditions is considered. The four types of benchmarking — internal, competitive, functional and generic — are examined and the advantages and disadvantages of their use in healthcare settings presented. The benefits of considering and comparing practice in a wide range of organisations are emphasised. The paper argues that performance measurement is not an end in itself but a means of comparing practice and the impact of changes in practice intended to secure improvement.The three major stages in the benchmarking process are examined — defining what to benchmark, the collection and analysis of data and the action. The key role of the service-user for determining what to benchmark and what is best practice are highlighted. The importance of always using the benchmarking process to secure improvement is empha...
19 citations
TL;DR: It is argued that action research has the potential simultaneously to contribute to the development of knowledge as well as to facilitate and evaluate change.
Abstract: This paper discusses the main challenges posed by action research. These include issues related to definition, researcher role, collaboration, ethics and resources. We argue that action research has the potential simultaneously to contribute to the development of knowledge as well as to facilitate and evaluate change. The central tenets of action research are described and we use our research on the development of communities of practice as a means of illustrating these elements. We conclude that while the lack of precise definition may have led to suspicion about the robustness and scientific merit of action research, different and imaginative ways of employing it as an approach are proving that it is both a legitimate and highly contemporary research design for the exploration of health and social care issues and the development of practice.
18 citations
TL;DR: The concept of eudaemonia has been used in the context of research and practice in nursing as mentioned in this paper, with particular attention being given to issues of reliability and validity of quality of life.
Abstract: This paper gives an overview of the concept of the quality of life as it is related to research and practice in nursing. The paper begins with an account of the concept's history, tracing attempts to measure quality of life to the post-war social indicators movement. This section also discusses problems with the concept's definition. Quantitative approaches to health-related quality of life are then described, with particular attention being given to issues of reliability and validity. The third section addresses qualitative approaches to the quality of life. The emphasis here is to outline a way of thinking about the quality of life that has the potential to inform practice. The approach described is based on the philosophical notion of eudaemonia, or human flourishing. In summary, this paper gives an overview of quantitative (statistical) and qualitative (philosophical) approaches to the quality of life and applies these to research and practice in nursing and allied disciplines.
17 citations
TL;DR: The evidence of ethnic minority under-recruitment and possible explanations for it is examined, exploring the relationship between stated institutional policy on equality of opportunity, student choice of institution, and new data on the way the selection process operates in nursing course admissions are explored.
Abstract: This paper reviews the literature on the recruitment of minority ethnic students to pre-registration nursing courses and goes on to examine the evidence of ethnic minority under-recruitment and possible explanations for it, exploring the relationship between stated institutional policy on equality of opportunity, student choice of institution, and new data on the way the selection process operates in nursing course admissions.While the perception of the institutions' policy towards minority ethnic students may affect the numbers applying, recent research shows that 6.7% of applicants were from minority ethnic groups (who make up 6% of the general population), but that only 3% went on to become students, a fact that could not be explained fully on the grounds of entry qualification or choice of nursing specialty at the time of application.New data on recruitment of minority ethnic students to pre-registration nursing courses at Leicestershire in 1998/99 indicate that black and other minority ethnic student...
16 citations
TL;DR: Developing valid models of empowerment and disempowerment relevant to staff/patient interaction as a means of generating a greater understanding of how these concepts are expressed in healthcare is aimed at.
Abstract: This study aimed to develop valid models of empowerment and disempowerment relevant to staff/patient interaction as a means of generating a greater understanding of how these concepts are expressed...
TL;DR: This project was designed as a scoping exercise to assess the current state of the evidence base to support the development, delivery and evaluation of cancer nursing services in the United Kingdom.
Abstract: The rate of evolution of cancer nursing in the UK has been remarkable over the past 20 years. Legislative changes and reform have provided the impetus for a range of developments in practice, research and education, and the push to achieve evidence-based practice has also driven the profession. There is a collective aspiration that all patients with cancer should expect to be supported by a cancer nursing service that is skilled, caring and competent. Demonstrating the value of nursing in terms of its effects on patients has never been so important. This project, commissioned by the Department of Health, was designed as a scoping exercise to assess the current state of the evidence base to support the development, delivery and evaluation of cancer nursing services in the United Kingdom. Three distinct elements were implemented concurrently to achieve this. The first was a review of UK literature centred around aspects of developing, delivering and evaluating cancer nursing and cancer nurses. The second was the development of a research directory profiling recently completed, currently under way and planned UK research concerned with cancer nursing and cancer nurses. The final element was a review of the organisation of cancer nursing services in England. This paper will report on the first two elements. The results of the third element will be published separately.
TL;DR: Quality of life data from the SF-36 questionnaire are presented from 260 previously sedentary participants randomly selected from a large GP practice and after 12 months, only 61% of participants in the health walks group were still classified as sedentary.
Abstract: This study describes results from a double blind randomised controlled trial which examined the efficacy of a primary care-based exercise promotion programme (the Health Walks Scheme). Quality of life data from the SF-36 questionnaire are presented from 260 previously sedentary participants randomly selected from a large GP practice (data are available for 72% at the 12-month follow-up). After 12 months, only 61% of participants in the health walks group were still classified as sedentary, compared with 73% in the control group who were simply given advice regarding exercise (p=0.05). There were no significant changes in the dimensions of the SF-36 questionnaire at 12 months. Those people who actually completed a health walk showed larger improvements in dimensions of the SF-36 (although these were also not significant). The appropriateness of quality of life outcome measures in health promotion trials is discussed in the light of the findings.
TL;DR: The study indicated that the pathway concept was adaptable to this mental health setting and that benefits had been derived, and recommended recommendations relate to local evaluation of the integrated care pathway pilot and wider research considerations.
Abstract: This qualitative study set out to discover a multidisciplinary team's impressions of an integrated care pathway pilot. Specific aims were: to explore participants' beliefs about the effectiveness and limitations of the pilot and its impact on practice, and to use the findings to develop recommendations for the future of integrated care pathways within the clinical area. The research setting was an in-patient dementia assessment service, forming part of the mental health directorate of an NHS trust in the east of England. Data were generated through semi-structured interviews with a purposive sample of the multidisciplinary team, based on the premise that a qualitative approach develops an insider view of the team's experiences, beliefs and perceptions. Theoretical analysis was conducted, based on the analytical framework described, and facilitated through the use of QSR.NUD.IST IV content analysis software. Four categories emerged, which focused on: the clinical impact of the pathway; team performance; pa...
TL;DR: This paper discusses and analyses the STEP partnership model and the issues emerging for academic and service coalitions, which were formed for the purpose of implementing evidence-based practice in nine clinical centres.
Abstract: Partnership working is central to the rubric of contemporary health policy. This paper discusses and analyses the STEP partnership model and the issues emerging for academic and service coalitions,...
TL;DR: The current research evidence is described, and recommendations are made for healthcare policy changes to accommodate the needs of this population of older people.
Abstract: Demographic trends suggest that substance misuse is increasing significantly in the general population and is becoming the most prevalent psychiatric disorder. As the current younger generation age...
TL;DR: In ESRF studies from data using the SF-36 questionnaire it has been shown that it is the physical functional component of health that is most affected by the patient's condition, with co-morbidity having a significant impact.
Abstract: End-stage renal failure (ESRF) is a life-threatening condition and survival can be maintained only with renal replacement therapy. Furthermore, the complications of ESRF, its treatment and co-existing diseases have been found to have a significant impact on the physical health of patients. It is well documented that the health status of the renal patient population is worse than that of the general healthy population; for this reason the assessment of quality of life of ESRF patients has received considerable attention. During the 1990s, the focus of health assessment moved away from the disease itself towards health status and wellbeing. The widespread use of the 36-item short-form (SF-36) questionnaire has promoted this. In ESRF studies from data using the SF-36 questionnaire it has been shown that it is the physical functional component of health that is most affected by the patient's condition, with co-morbidity having a significant impact. There is growing consensus that health-related quality of life is more than just an assessment of health status. Rather, it is the relative importance given by the individuals themselves to the impact of the disease on their life. While this approach is emerging, some of the tools which have been developed to measure individualised quality of life require further scientific validation for use with the ESRF population.
TL;DR: There was agreement that regular professional meetings and ward hand-overs provide a natural and effective dissemination route and the use of link nurses, and regular study days, both of which provide cascade learning, work well.
Abstract: Nineteen F and G grade nurses, one practice development nurse, two physiotherapists and two occupational therapists working in 11 community hospitals in Leicestershire and Rutland were interviewed about their use of clinical guidelines and their attitude towards them. They were asked questions about sources of clinical guidelines, and a simple gap analysis was carried out.The interviewees were able to identify clinical guidelines that were used locally, and human and organisational resources of guidelines: resource rooms, practice development nurses, link nurses and study days.The use of link nurses, and regular study days, both of which provide cascade learning, work well. Furthermore, in the opinion of the ward nurses, the practice development nurse has a useful role in making nurses aware of guidelines.Generally, the responses about the use of clinical guidelines were positive, although some reservations were noted. There was agreement that regular professional meetings and ward hand-overs provide a na...
TL;DR: Evidence is needed of the benefits of interactive learning so as to withstand arguments from employers that common studies are sufficient to facilitate flexible deployment of the workforce and from educational institutions who wish to use them to economise on scarce resources.
Abstract: While moves towards transdisciplinary education programmes for health and social care professionals are undoubtedly in evidence, the explicit objectives are often unclear and, in numerous studies, ...
TL;DR: The findings suggested that the role of staff nurses working in the community differed from that in hospital and that the roles requires a broad range of skills, highlighting the need for flexibility and adaptability in the skills of community staff nurses.
Abstract: Although staff nurses comprise a large and important group within the community nursing workforce, there is some confusion surrounding their role and the skills required by them. This study explored the views of a range of different community nurses (n=68) working in one inner-city community trust regarding the skills and learning needs of community staff nurses. The sample comprised community staff nurses (n=28); health visitors (n=15); district nurses (n=19), and nurse managers (n=6) within one trust. The study used three data collection methods: semi-structured interviews, focus groups and a postal questionnaire, with the data from each being triangulated. The findings suggested that the role of staff nurses working in the community differed from that in hospital and that the role requires a broad range of skills. The study therefore highlighted the need for flexibility and adaptability in the skills of community staff nurses.
TL;DR: Rosenfield's (1992) taxonomy of cross-disciplinary research is presented as a model to explain the development of the nurse and health economist approach and a commitment to the goal of transdisciplinarity in research is suggested.
Abstract: Nurses, it is argued, should participate in interdisciplinary research, yet there is little written about working in an interdisciplinary environment in research This paper sets out some reflections on the experience of a nurse and a health economist working together on a series of studies A number of difficulties are identified as themes running through the experience of interdisciplinary research: evaluating complex interventions, disruption of normal academic and scientific life, competition between disciplines and teams, finding a common language and learning to work together, finding the common ground and mutual self-interest, and learning to respect other perspectives and disciplines Rosenfield's (1992) taxonomy of cross-disciplinary research is presented as a model to explain the development of our own approach A commitment to the goal of transdisciplinarity in research is suggested
TL;DR: It is argued that the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) already sets a framework to which researchers, as well as nurses, must adhere.
Abstract: The Royal College of Nursing (RCN, 1998) guidelines on research ethics are a laudable attempt to establish ethical principles for nursing research, but more relevant for protecting patients, clients and colleagues is the concept of a personal morality for nurses undertaking research. This paper examines the pros and cons of establishing ethical codes in research, and argues that the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) already sets a framework to which researchers, as well as nurses, must adhere.
TL;DR: It is indicated that only a small percentage of patients undergoing surgery actually receive a pre-operative visit and when visits are carried out their content does not reflect the evidence of effectiveness in the research literature.
Abstract: A telephone survey was completed involving senior nurses from all NHS theatre units in Wales that carry out routine scheduled surgery (n=19).The survey examined whether these units had pre-operative visiting regimes, constraints and barriers to pre-operative visits and the nature, content, timing and staffing of any visits that were undertaken. A purposive sample of respondents from the telephone survey (n=6) was interviewed further and a content analysis of the transcribed interviews completed.The results indicate that only a small percentage of patients undergoing surgery actually receive a pre-operative visit. When visits are carried out their content does not reflect the evidence of effectiveness in the research literature. The reasons for this apparent non-utilisation of research evidence are explored in the paper and recommendations are made as to how this situation could be altered.
TL;DR: In this paper, the authors identified the approaches to studying preferred by student nurses, determined whether these changed during the Diploma of Higher Education in Nursing (DipHE Nursing), and which approaches were associated with greater academic achievement.
Abstract: This research identified the approaches to studying preferred by student nurses, determined whether these changed during the Diploma of Higher Education in Nursing (DipHE Nursing), and which approaches to studying were associated with greater academic achievement. Two cohorts of student nurses were sampled. Cohort 1 (n=40) completed the 44-item Revised Approaches to Studying Inventory RASI (Tait and Entwistle, 1996) at the end of the course and was interviewed. Cohort 2 (n=76) completed the RASI twice, once at the beginning of the course and again following the first year.
In keeping with research reported elsewhere (Swannell, 1992; Richardson, 1995; Devlin, 1996; Solomonides, 1996), an association between age and preference for the deep approach to studying was observed. It was also found that student nurses changed their approaches to studying during the course to favour the deep approach. This occurred as the theory became relevant to their concepts of nursing. As those students who preferred the deep approach attained higher assessment grades than those who preferred the surface approach, the paper recommends strategies to encourage the deep approach to studying from the outset of the course.
TL;DR: If nurses and other healthcare professionals are to respond to substance misusers, there need to be new models of care from those that have traditionally guided the work of generic healthcare professionals.
Abstract: Drug, alcohol and tobacco misuse (generically known as substance misuse) is a universal phenomenon that affects all levels of society Increasing drug use generally has caused a host of social, behavioural, psychological and physical problems among populations Substance use and misuse impinges on the five key areas for health promotion outlined in the Health of the Nation document (DoH, 1992): coronary heart disease and stroke, prevention of accidents, cancer, sexual health, mental health The widespread misuse of psychoactive substances in the general population demands a healthcare workforce that can offer nursing interventions; is capable of providing effective preventive strategies; can offer counselling; and is qualified to give specialist care when necessary to substance misusers and their familiesThe care of substance misusers is not the domain of any one profession or organisation, although professionals in both primary healthcare and hospital settings are usually the first point of contact for
TL;DR: Using a series of data collected over the past four years, the paper demonstrates how practice has been standardised and developed across the regional children's hospital and community services by exploring the Acute Pain benchmark.
Abstract: The principles and processes of the North West Regional Clinical Practice Benchmarking Group are explained. Using a series of data collected over the past four years, the paper demonstrates how practice has been standardised and developed across the regional children's hospital and community services. This is undertaken by exploring the Acute Pain benchmark. The group is currently undergoing an external evaluation and many issues raised in the preliminary draft of the evaluation are explored.
TL;DR: The analysis suggests that patients often lack a sense of agency in the face of disease- and treatment-related events, and that many do not believe they possess the relevant knowledge or authority to act positively in these circumstances.
Abstract: It has been suggested that cancer in the elderly is badly treated and that criteria other than chronological age should form the basis for treatment decisions. A study was conducted to discover whether there were age-related differences in the treatment received by a sample of older people with colorectal cancer, and to determine whether any differences were related to patterns of functional status. It was recognised that involvement in treatment decisions may be influenced by contextual factors, therefore additional qualitative data were collected from patients themselves. Responses to semi-structured questions from 337 patients aged 58-95 years were analysed in the light of previous research, which suggests that only a minority want to share equally in medical decision-making with clinicians. Our aim was to determine whether a similar pattern was apparent in patients' responses, and to develop understanding of the determinants of involvement in treatment decision-making. The analysis suggests that patients often lack a sense of agency in the face of disease- and treatment-related events, and that many do not believe they possess the relevant knowledge or authority to act positively in these circumstances. Concerns remain about the losses involved in taking a dependent approach and about the extent to which resisting dependency is possible.
TL;DR: Conditions when either of the two sampling methods, partial interval recording and momentary time sampling, may be reasonably selected are outlined, however, continuous sampling may be preferable for observing complex behaviours involving at least two participants.
Abstract: Observational methods are under-utilised in nursing research, but have a number of benefits. This paper outlines two approaches to collecting observational data, namely continuous sampling and time...
TL;DR: The need for clarity in classifying nursing practice is highlighted and a potential solution through the WISECARE project is presented, which utilised state of the art information technology to develop an information tool which allowed a systematic approach to nursing practice through the classification of patient problems.
Abstract: Currently, the vast majority of nursing practice is not assessed in any quantifiable manner, making it difficult to demonstrate explicitly the value of nursing to cancer care. This results from the lack of any meaningful or universal system or language that makes visible what nurses 'do'. As a consequence, nursing is often deemed invisible in terms of its importance in healthcare. A model for classifying nursing care may therefore address this situation, making nursing visible not just to policymakers but also to patients. This paper highlights the need for clarity in classifying nursing practice and presents a potential solution through the Workflow Information Systems for European Nursing Care (WISECARE) project. WISECARE was an EC-funded project which utilised state of the art information technology to develop an information tool which allowed a systematic approach to nursing practice through the classification of patient problems.
TL;DR: As part of the UKCC Nursing in Secure Environments project, all pre-registration programme providers for mental health and learning disability were contacted and invited to complete a questionnaire concerning their involvement with, and preparation of, nurses for working in these settings.
Abstract: As part of the UKCC Nursing in Secure Environments project, all pre-registration programme providers for mental health and learning disability were contacted and invited to complete a questionnaire concerning their involvement with, and preparation of, nurses for working in these settings. Details are provided of the analysis of these questionnaires, along with parallel data captured from the project's focus groups and from focused interviews which provided a commentary of the practitioners' views concerning the adequacy of pre-registration preparation for work in these specialised environments.