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Showing papers in "Journal of Research in Nursing in 2008"


Journal ArticleDOI
TL;DR: This paper explored memoing in the context of qualitative research methodologies and explored several techniques for employing memo writing to enhance the research experience and outcomes, including data exploration, continuity of conception and contemplation, and communication.
Abstract: This paper explores memoing in the context of qualitative research methodologies. The functions of memos in the research process are discussed and a number of techniques for employing memo writing to enhance the research experience and outcomes are examined. Memoing is often discussed in the literature as a technique employed in grounded theory research, yet there is limited exploration of the value of memo writing in qualitative methodologies generally. Memoing serves to assist the researcher in making conceptual leaps from raw data to those abstractions that explain research phenomena in the context in which it is examined. Memos can be effectively employed by both the novice and experienced researcher as a procedural and analytical strategy throughout the research process. Data exploration is enhanced, continuity of conception and contemplation is enabled and communication is facilitated through the use of memoing. While guidelines exist to aid in the production and use of memos, memoing remains a flex...

965 citations


Journal ArticleDOI
TL;DR: In this article, the authors consider the theory and practice developments of the nursing profession, whilst also responding to broader social and historical process that prevends in the profession and the wider society.
Abstract: Responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prev...

118 citations


Journal ArticleDOI
TL;DR: It is argued that the role and status of care homes needs to be raised, and that a relationship-centred approach to care adopted, which acknowledges the importance of attending to the needs of all those who live in, work in, or visit care homes.
Abstract: Care homes play a vital role in the provision of support for the frailest members of our society, and given the demographic trends their role will continue for the foreseeable future. However, there remain enduring concerns about the quality of care such homes provide. Training and education for staff are often seen as the key to raising standards and as such are widely promoted. This paper presents a conceptual review and synthesis of the literature on the role of education and training in initiating and supporting change in care homes. A systematic method to the identification of sources was adopted, and a rigorous three-stage approach to analysis applied. The review identifies the barriers and facilitators to change and concludes that education is a necessary but not a sufficient condition for success. Rather it is argued that the role and status of care homes needs to be raised, and that a relationship-centred approach to care adopted, which acknowledges the importance of attending to the need...

98 citations


Journal ArticleDOI
Susanne Darra1
TL;DR: In this paper, the authors explored the practice of insider research in a study carried out as part of a research training fellowship, and explored the effects of research on the effect of insider knowledge on the research process.
Abstract: This paper relates to research practice and in particular, it explores the practice of insider research in a study carried out as part of a research training fellowship. The effects of research on ...

69 citations


Journal ArticleDOI
TL;DR: In this article, the authors examine the current social and political conditions under which scientific knowledge appears to be "true" and argue that this apparent neutrality is dangerous because it masks the methods by which power silently operates to inscribe rigid norms and to ensure political dominance.
Abstract: Drawing on the philosophy of Michel Foucault and Gilles Deleuze, this paper interrogates the constitution of ‘evidence’ that defines the evidence-based movement in the health sciences. What are the current social and political conditions under which scientific knowledge appears to be ‘true’? Foucault describes these conditions as state ‘science’, a regime that privileges economic modes of governance and efficiency. Today, the Cochrane taxonomy and research database is increasingly endorsed by government and public health policy makers. Although this ‘evidence-based’ paradigm ostensibly promotes the noble ideal of ‘true knowledge’ free from political bias, in reality, this apparent neutrality is dangerous because it masks the methods by which power silently operates to inscribe rigid norms and to ensure political dominance. Through the practice of critique, this paper begins to expose and to politicise the workings of this power, ultimately suggesting that scholars are in a privileged position to o...

50 citations


Journal ArticleDOI
TL;DR: The CIT as mentioned in this paper is a qualitative, systematic, open-ended technique for educating descriptive data from participants as well as being an effective naturalistic tool for focusing participants' on a specific event.
Abstract: The CIT is a practical and efficient methodology that encourages participants to tell their story; with happenings that are memorable events in participants' lives. It is a form of story-telling, as participants share their singular experience as a story to the researcher. It is a qualitative, systematic, open-ended technique for educing descriptive data from participants as well as being an effective naturalistic tool for focusing participants' on a specific event. The CIT is a user-friendly instrument that can foster reflection and promote personal expression. The development of the CIT to generate indicators of specific happenings relative to research questions demonstrates the technique's suppleness and emphasises the capability of this methodology in nursing research. As nurses learn more about this methodology and its application to the study of nurses and nursing care, they will begin to comprehend how simple and effortless this technique is to use. The CIT can be developed to conform to any area o...

49 citations


Journal ArticleDOI
TL;DR: In this paper, a systematic review was undertaken to gain insight into the uptake and designs of practice-based action research in health care development, focusing on the use of action research for health care.
Abstract: Action research (AR) is promoted for health care development. A systematic review was undertaken to gain insight into the uptake and designs of practice-based AR. Empirical research papers from 200...

42 citations


Journal ArticleDOI
TL;DR: In this paper, a focus group was used to enable a cohort of women to describe their personal experiences of motherhood in the context of problematic substance use and street-based prostitution.
Abstract: This study aimed to enable a cohort of women to describe their personal experiences of motherhood in the context of problematic substance use and street-based prostitution. The study also aimed to describe the impact upon women of separation from their children. Findings that emerged from focus group data were organised into four over-arching themes: children and motherhood, personal accounts of drug use and street-based prostitution, risks to women and their children and supportive/unsupportive factors in the women’s lives. Each theme consisted of many categories that illustrated the impact of dependent drug use and involvement in prostitution on the lives of the women and their children. This article describes the theme of children and motherhood. Involvement in street-based prostitution is extremely risky, frequently characterised by calculated risk taking, with consequences for both the woman and her children. Parental responsibilities and lifestyle contribute to stress, which is typically com...

36 citations


Journal ArticleDOI
TL;DR: The role of social support and individual coping strategies (problem-focused, emotion-focused) in the moderation of the relationship between health care-related occupational stress and health was examined, indicating that neither of the coping strategies was influential, whereas social support levels were either detrimental or beneficial based on the reported level of job stress.
Abstract: The role of social support and individual coping strategies (problem-focused, emotion-focused) in the moderation of the relationship between health care-related occupational stress and health was e...

34 citations


Journal ArticleDOI
Pam Smith1
TL;DR: Research since the 1960s has shown how high standards of morale in hospitals had a positive impact on nurses and patients, and the importance of good morale among staff and the positive effects it has on patients.
Abstract: Compassion and smiles have been placed very firmly on the NHS agenda (Department of Health Press Release 18.06.08; John Carvel’s Guardian article 18.06.08: ‘Nurses to be rated on how compassionate and smiley they are’). Press release and article stressed the importance of nurses’ compassion and smiles to ensure patients receive good care, which in turn may aid their recovery. Although such statements are portrayed as news, research since the 1960s has shown similar trends. Revans’ (1964) research reported how high standards of morale in hospitals had a positive impact on nurses and patients. Good communication between all grades of staff was a key finding. One indicator of good communication identified in the research was the frequency with which the ward sister had contact with student nurses. In those hospitals with high morale, recruitment and retention were good while student nurse attrition, sickness rates and absenteeism were low. Patient stays were also shorter. Revans concluded that staff well-being was closely associated with that of patients. This association has been confirmed in subsequent studies and in my own research in the 1980s sisters were described as critical because of the influence they were seen to have on ‘how the students work and on the way they feel, their morale’. Patients were reported to be aware if there was a tense atmosphere on a ward, which filtered down to them and made them feel ‘unhappy whereas on other wards they’re much more relaxed’. As one patient observed ‘if staff work well with sister then the atmosphere of the ward is well’ (Smith, 1992; p. 79–80). Recent research by Borrill and West (2003) continues to report the importance of good morale among staff and the positive effects it has on patients. One of the key findings for Borrill, et al. (2003) was effective team working and the importance of good working relationships between all professional groupings. Significantly those hospitals with effective staff management, including appraisals and a higher percentage of staff working in teams showed lower patient mortality. But the components of quality care have always been elusive. Attempts to define quality of nursing care was evident in ‘The Proper Study of the Nurse’, which was commissioned by the Royal College of Nursing and supported by the then Ministry of Health. A comprehensive programme of research was set up comprising a series of studies undertaken from 1966 to 1975 to look at the nurse’s role in a variety of specialities. The programme was led by Mcfarlane (1970), who later became one of the first Professors of Nursing in the United Kingdom. One study to look at the care Journal of Research in Nursing ©2008 SAGE PUBLICATIONS Los Angeles, London, New Delhi and Singapore VOL 13 (5) 367–370 DOI: 10.1177/ 1744987108096012 GU E S T E D I TOR I A L

33 citations


Journal ArticleDOI
TL;DR: Bridging emerged as the centre-stage storyline in adjusting to life with late-stage Parkinson’s disease and this consisted of three temporal stages, namely: 1) building on the past; 2) bridging the present and 3) broaching the future.
Abstract: Studies reporting the lived experience of late-stage Parkinson’s disease are sparse Using constructivist grounded theory and centre-stage storyline generation as the methodological approach, this study reports on 69 interviews with 13 people with late-stage Parkinson’s disease and their family carers who were recruited from the caseload of two specialist Parkinson’s disease nurses working in North Wales and one consultant geriatrician The interviews were conducted longitudinally between June 2007 and April 2008, and all participants were diagnosed with late-stage idiopathic Parkinson’s disease using Brain Bank clinical criteria All interviews and the subsequent sharing, modification and testing of the results of data analysis were conducted in the person’s home and with their participation as partners in the research process From this process, bridging emerged as the centre-stage storyline in adjusting to life with late-stage Parkinson’s disease, and this consisted of three temporal stages, na

Journal ArticleDOI
TL;DR: One of these subcategories, walking with another, is examined, relating the ways in which experienced rural nurses walk with another by firstly keeping things in perspective for new or novice rural nurses, and secondly using a particular form of language called nurse chat.
Abstract: The aim of this constructivist grounded theory study was to explore rural nurses' experiences of mentoring. Mentoring is often proposed as a solution to the problem of nursing workforce shortages. The global problem of workforce for nurses can be defined using the parameters of recruitment and retention rates, `problems' with which result in staff shortages, particularly of experienced nurses. Constructivist grounded theory has its foundations in relativism and an appreciation of the multiple truths and realities of subjectivism. Seven Australian rural nurses were interviewed. To ensure data saturation of particular categories and the fit of tentative theoretical conceptualisations, two participants were interviewed twice with no new codes identified from the subsequent interviews. Cultivating and growing new or novice rural nurses was the core category which conceptualised a two-part process consisting of getting to know a stranger and walking with another. Supportive relationships such as mentoring were found to be an existing, integral part of experienced rural nurses' practice — initiated by living and working in the same community. In this grounded theory, cultivating and growing is conceptualised as the core category. A two-part process was identified — getting to know a stranger and walking with another. This paper examines one of these subcategories, walking with another, relating the ways in which experienced rural nurses walk with another by firstly keeping things in perspective for new or novice rural nurses, and secondly using a particular form of language called nurse chat. For experienced rural nurses, mentoring in this way delivers a number of different outcomes with various nurses. Because it is a part of the experienced rural nurse's practice on an ongoing basis, individual mentoring relationships do not provide an end in relation to this nurse's experiences of mentoring, rather they are part of an ongoing experience. Creating supportive environments that include developing relationships such as mentoring is a potential solution to local staffing needs that does not require intensive resources. Experienced nurses engaged in clinical practice have the potential to cultivate and grow new or novice nurses — many already do so. Recognising their role and providing support as well as development opportunities will bring about a cycle of mentoring within the workplace.

Journal ArticleDOI
TL;DR: The findings clearly highlight the value of COAT in enabling partnerships to be developed between carers and practitioners, which recognise the expertise of both parties and challenge providers to invest sufficient time and ‘ear-marked’ resources for family care support.
Abstract: Given that the majority of frail older people living at home are cared for by family members, ensuring appropriate and sensitive support services for family carers is a major policy priority globally. Such assessment of the needs and situation of individual carers is a crucial first step towards ensuring that they receive flexible, quality support services. However, existing assessment practice is still inadequate in many countries. This paper describes a negotiated approach to carer assessment, the Carers Outcome Agreement Tool (COAT) and briefly considers its development with carers and practitioners in an Anglo-Swedish development project (2003–2005) and subsequent implementation within five municipalities in Sweden (2006–2008). A participatory research design was adopted in both projects building on the AldreVast Sjuharad model, which is a user-focused approach to research and development. This paper provides a short summary of the COAT development before presenting the qualitative findings from the Swedish implementation project (2006–2008), which emerged from focus group interviews with COAT practitioners and telephone follow-up interviews with carers who had a first and second COAT assessment. The findings clearly highlight the value of COAT in enabling partnerships to be developed between carers and practitioners, which recognise the expertise of both parties. They also challenge providers to invest sufficient time and ‘ear-marked' resources for family care support so that COAT becomes an integral part of a comprehensive long-term carer strategy, which feeds directly into local developments in service delivery and organisation.

Journal ArticleDOI
TL;DR: The RICH-ER (Responsive, Intersectoral-Interdisciplinary, Child Health- Education and Research) model as discussed by the authors is an alternative model of health care practice for children at risk because of their social, cultural and material circumstances.
Abstract: This paper builds upon insights from a programme of research on culture and health that is informed by critical theoretical perspectives. The evidence generated through this research programme is drawn upon to critically examine the assumptions about the prevailing understandings of the links between culture, health, and health inequalities and to illustrate the need for new paradigms of practice. Using the case of children at risk because of their social, cultural, and material circumstances, the tenets of an alternative model of health care practice, the RICH-ER (Responsive, Intersectoral-Interdisciplinary, Child Health – Education and Research) model was introduced and studied.

Journal ArticleDOI
TL;DR: It is argued that contextual moral judgements can enhance ethical decisions in the field and further that rigid adherence to formal bio-medical ethical guidance can lead to inappropriate ethical actions.
Abstract: During an ethnographic study of an Acute Medical Admissions Unit, informed consent was not obtained from some patient informants despite research proposals to various research committees stating that it would The ethical judgement was made that not to seek informed consent was in the best interests of patients who were very ill or distressed and that to insist on informed consent would have been potentially harmful to these patients Drawing on my experiences of collecting data whilst holding the dual roles of researcher and nurse, I argue that contextual moral judgements can enhance ethical decisions in the field and further that rigid adherence to formal bio-medical ethical guidance can lead to inappropriate ethical actions Importantly, the ethnographer must be able to articulate arguments that reflect the contextual nature of ethical decision-making to powerful gatekeepers, such as research committees If this does not happen then challenges to the dominance of deontological-rationalist ethic

Journal ArticleDOI
TL;DR: The objective was to assess the attitude of Iranian clinical nurses and nurse educators towards nursing research and found that the majority of nurses are still not convinced of the importance of research to nursing practice and to the nursing profession.
Abstract: Research utilisation poses significant challenges for the nursing profession in Iran. Nurses' attitudes toward research and their motivation to engage in research utilisation have repeatedly been identified as potential barriers. Yet little is known about the attitudes of Iranian nurses' regarding research. Therefore, there is a need for a study that focuses particularly on Iranian nurses' attitudes toward research utilisation. The objective was to assess the attitude of Iranian clinical nurses and nurse educators towards nursing research. A self-administered questionnaire based on a cross-sectional survey conducted on 410 respondents from 15 educational hospitals and nursing schools affiliated to Tehran Medical Sciences University, Iran. According to the self-report, nurses generally held positive attitudes toward research. Education, professional role and research activities had a statistically significant relationship with their research attitudes. Although the attitudes towards research were positive,...

Journal ArticleDOI
TL;DR: The results of this study indicate that it is more likely to be the organisational barriers within the health service or changes in expectations that are continuing to slow the career progress of female nurses.
Abstract: This paper investigates the assumption that men have a greater opportunity for career success in the nursing profession than women. This study investigates, through the use of a questionnaire, the attitudes and future expectations of male and female individuals attending interviews to enter a pre-registration nursing course. The results from the questionnaires were analysed using both descriptive and inferential methods of analysis, and the findings were discussed in relation to the existing research. In only two of the items, significant differences were found between male and female nursing applicants' attitudes and expectations towards their future careers. The results of this study indicate that it is unlikely to be the individual differences between males and females that determine their career progress, and instead it is more likely to be the organisational barriers within the health service or changes in expectations that are continuing to slow the career progress of female nurses. The results from...

Journal ArticleDOI
TL;DR: Managerial interventions that would create supportive work environments are needed to encourage nurses to stay longer at their jobs, including using participative management and supportive leadership, decreasing workload and employing nurses who work on a full-time basis.
Abstract: This paper aimed at studying variables of hospitals' organizational climates and nurses' intent to stay and determine predictors of the two concepts. A survey using a convenience sampling technique was used to collect data. A total of 362 nurses from three types of hospitals were recruited. Farly's Nursing Practice Environment Scale (NPES) was used to assess the organizational climates at Jordanian hospitals (Farly and Nyberg, 1990). McCain's Behavioral Commitment Scale (McCloskey, 1990) was used to measure nurses' intent to stay. Stepwise regression analyses were used to indicate predictors of hospitals' organizational climates and nurses' intent to stay.Quality of care and professionalism were major variables influenced hospitals' organizational climates. Nurses reported that they plan to keep their jobs for at least two or three years. Nurses' intent to stay, time commitment, types of hospitals and average daily census were predictors of hospitals' organizational climates. Predictors of nurses' intent ...

Journal ArticleDOI
TL;DR: It is an interesting contradiction that in writings that lay open to public scrutiny the political biases inherent within their work as researchers, and essentially argue against dominant discourse, the authors invariably find ourselves repeating the very thing that they argue against.
Abstract: This interesting paper immediately captured my attention for several reasons. As an academic activist, I recognise and applaud the sprit of revolution that is at the heart of decentralising traditional regimes of knowledge and power. I also have a certain resonance with the stance taken by the authors and with the arguments articulated. As an paper it reads rather like a treatise, a manifesto, not only for the role of critique in exposing and politicising dominant discourses, in this case those that misrepresent and distort the construction of evidence in healthcare practices, but also, in my reading, it embodies the concept of ‘writing as doing’. That is to say that the writing itself is to some extent an example of what it is attempting to argue for (and/or against). Simply stated the medium is the method. It is an example of the value of critique. I find it an interesting contradiction that in writings that lay open to public scrutiny the political biases inherent within our work as researchers, and essentially argue against dominant discourse, we invariably find ourselves repeating the very thing that we argue against. And so I found myself asking if I felt this paper (or the writing) to be coercive? Is there an element of ‘fundamentalism’ in the way in which the arguments are presented, and in actuality, does that matter, perhaps it is a conscious and deliberate intention of the writing. To Act, that is. I certainly felt galvanised by the content and felt a stir to action. Of course, the words are open to interpretation and individual critique, as the authors rightly point out. We, as readers, are working with our own interpretations of the authors’ constructs. And this, I feel, is the essence of the paper. This is all we can ever do; construct and reconstruct our interpretations of the world. It is how knowledge is created, generated, revised, adapted, developed, challenged and decentralised and so on. For it can never just be; an episteme by its very definition is a transient partial view and a dynamic fluid one at that. Journal of Research in Nursing ©2008 SAGE PUBLICATIONS Los Angeles, London, New Delhi and Singapore VOL 13 (4) 281 DOI: 10.1177/ 1744987108093531 R E V I EW

Journal ArticleDOI
TL;DR: The correlation of total scores of nurses' career commitment and job performance indicated a significant and positive relationship.
Abstract: Few studies explore the concepts of nurses' career commitment and job performance This study aimed to address this by using a survey method A convenient sample of 640 registered nurses was obtain

Journal ArticleDOI
TL;DR: In this paper, the role of gatekeepers, engagement with elites, and the use of the telephone interview method in this context are examined, and strategies to help researchers design and implement telephone interview studies successfully to maximise access to the views and experiences of ''hard to reach groups', such as elites, while minimising the associated disruption.
Abstract: Elite groups are interesting as they frequently are powerful (in terms of position, knowledge and influence) and enjoy considerable authority. It is important, therefore, to involve them in research concerned with understanding social contexts and processes. This is particularly pertinent in healthcare, where considerable strategic development and change are features of everyday practice that may be guided or perceived as being guided, by elites. This paper evolved from a study investigating the availability and role of nurses whose remit involved leading nursing research and development within acute NHS Trusts in two health regions in Southern England. The study design included telephone interviews with Directors of Nursing Services during which time the researchers engaged in a reflective analysis of their experiences of conducting research with an `elite' group. Important issues identified were the role of gatekeepers, engagement with elites and the use of the telephone interview method in this context. The paper examines these issues and makes a case for involving executive nurses in further research. The paper also offers strategies to help researchers design and implement telephone interview studies successfully to maximise access to the views and experiences of `hard to reach groups', such as elites, while minimising the associated disruption.

Journal ArticleDOI
TL;DR: To give minority ethnic groups the opportunity to voice their opinions on nursing care and to inform future nurse education, six community groups, some of mixed ethnicity and some of specific ethnic identity, were included in the study.
Abstract: :During the last two decades, there has been a growing emphasis on the delivery of health care to meet the needs of minority ethnic patients, but there is less emphasis on the views of the patients themselves. This paper aimed to give minority ethnic groups the opportunity to voice their opinions on nursing care and to inform future nurse education. Focus groups were used to collect data. Six community groups, some of mixed ethnicity and some of specific ethnic identity, were included in the study. Data were analysed using a thematic approach and three themes were identified as representing the views of the participants. Participants identified that knowledge of cultural and religious practices were essential for nurses in order for them to understand the basis of their beliefs and practices. They also highlighted how the actions and behaviour of nurses either confirmed or ignored their specific requirements. They also recognised the inherent communication problems for those who had difficulty in ...

Journal ArticleDOI
TL;DR: It is incumbent upon primary health care nurses to recognize and take account of the lay explanations of health illness that patients/families hold, and failure to do so may compromise effective care-giving.
Abstract: In the United Kingdom, as in other developed nations, there has been an increased research focus on ethnicity and the mediation of ethnicity on health and illness experience. This paper examines how lay understandings may affect chronic disease management and the steps primary care nurses may take to optimize care delivery for patients/families, using the example of hypertension in the African-Caribbean community. A focused ethnographic approach was adopted for this study. Data were first collected using focus group interviews (2), semi-structured interviews (21), and vignette interviews (5). Data were analyzed with the assistance of Atlas/ti qualitative analysis software using the principles developed by Roper and Shapira. Findings are presented using Kleinman’s seminal work as a theoretical framework: a) the aetiology or cause of the condition, b) the timing and mode of onset, c) the patho-physiological processes involved, d) the natural history and severity of the illness, e) the appropriate tr...

Journal ArticleDOI
TL;DR: In this article, an example of the autoethnographic approach to research by examining the life of the author is given, where the author considers her creative identity as a female nurse and life long lea...
Abstract: This paper gives an example of the autoethnographic approach to research by examining the life of the author. The account considers her creative identity as a female nurse and life long lea...

Journal ArticleDOI
TL;DR: Despite the challenges of reaching out to the decentralised HHC workforce, adequate response to a detailed health survey is possible, using appropriate techniques and with the close cooperation of employers and labour unions.
Abstract: Home health care (HHC) is growing rapidly and yet health and safety conditions of HHC clinicians are poorly understood. Study of this workforce presents unique challenges because it is decentralised, often part-time and mobile. As part of a larger project on sharps injuries and blood exposures in HHC, this paper addresses the challenges of recruiting a large cohort of HHC nurses and aides and describes novel cross-sectional survey methodology. Recruitment was conducted with cooperation from eight HHC agencies and two labour unions. Intensive personal contacts and a financial incentive ($25) were employed. Some groups of HHC clinicians could be contacted only by mail, while others were contacted during a promotional “mini-fair” at their agency. A total of 1772, 18-page health and safety surveys were distributed and 1225 usable surveys were collected. This 69% overall response rate is better than that in many recent health surveys. Survey returns were highest (67—91%) where promotional events were held. The...

Journal ArticleDOI
TL;DR: Nursing researchers aspiring to phenomenological approaches are faced with difficult dilemmas relating to which phenomenology to follow, and whether the many hours required to do that work and gain that knowledge is a legitimate use of the time of hard-pressed nursing researchers is questioned.
Abstract: As someone who has long advocated the importance of theory to research, I am not entirely comfortable with the argument I am going to make here. Please take it, if not as devil’s advocacy, then as deliberately contentious conjecture. What I wish to suggest is that many nurses have wasted a great deal of time and effort wrestling needlessly and often fruitlessly with various arcane versions of phenomenology in their attempts to understand them and to decide which is most suitable for their research. Should they follow Husserl or Heidegger? Jaspers or Merleau-Ponty? Schutz or Gadamer? Should their phenomenology be of the descriptive kind, or the interpretive, or even the dialogic variety? When they have decided which path to follow, how much should they worry about keeping to the letter of the phenomenological law? Can they have confidence in secondary (or even more attenuated) information from methods texts and research papers, or do they need to go to the original philosophers to gain their theoretical grounding? Mark my words, there is a considerable difference as demonstrated in John Paley’s critiques of purported uses of Husserlian (1997) and Heideggerian (1998) phenomenology in the nursing literature, which showed they had often strayed very far from the original theory. Not that going back to the philosophical things in themselves is a very appetising antidote to the disease of misinterpretation, as anyone who has attempted to digest the likes of Heidegger’s (1962:185) Being and Time will attest. I am afraid the snappy title belies what lies within: let us take a random sentence to illustrate the problem: ‘With equal primordiality the understanding projects Dasein’s Being both upon its for-the-sake-of-which and upon significance, as the worldhood of its current world’. Now, I am not saying this is nonsense, but I am saying that it takes a lot of work and a lot of background knowledge to make sense of it, and I am questioning whether the many hours required to do that work and gain that knowledge is a legitimate use of the time of hard-pressed nursing researchers. To sum up the argument thus far, nursing researchers aspiring to phenomenological approaches are faced with difficult dilemmas relating to which phenomenology Journal of Research in Nursing ©2008 SAGE PUBLICATIONS Los Angeles, London, New Delhi and Singapore VOL 13 (4) 267–268 DOI: 10.1177/ 1744987108094400 BOARD ED I TOR I A L

Journal ArticleDOI
TL;DR: It is highly relevant to note that in the recent White Paper proposals are made to strengthen continuing professional development, amongst other measures aimed at improving performance in general, as well as eliminating poor performance more effectively than in the past.
Abstract: The government document A First Class Service – Quality in the New NHS (Department of Health, 1998) stated that one of the key strategies for achieving quality was the introduction of clinical governance, and as Scott noted (above) this would require a fundamental change in culture. Sadly, while there has been a significant change in culture it has had little to do with quality, as recent media coverage in the South of England, and numerous anecdotes testify. It is important to remember, when despairing over such displays of the most blatant abrogation of standards, that there are people doing fine work in the NHS, but it is also important to scrutinise carefully that which has put management and nursing in a very bad light, and to consider how this might have been avoided. What are the lessons to be learned? One wonders why qualified nurses with an accountability to both their profession and to the State struggle on when conditions for patients are so appalling? A misguided notion of not letting people down? A fear of whistle-blowing? Whatever the reasons – and no doubt they are as varied as the staff involved – the highly exposed weakness of nursing need to be examined. It is highly relevant to note that in the recent White Paper (Secretary of State for Health, 2007) proposals are made to strengthen continuing professional development, amongst other measures aimed at improving performance in general, as well as eliminating poor performance more effectively than in the past.These proposals must be welcomed and concur with the views of Scott (1999: 173) who stated that for clinical governance to be successful:

Journal ArticleDOI
TL;DR: Factors such as the lack of exposure to positive role models and limited opportunities to gain an insight into the work of nurses suggest that South Asian people might be less likely to consider nursing as a career than their white counterparts.
Abstract: This paper presents a knowledge review, undertaken to identify potential barriers affecting the recruitment of British South Asian people into the nursing profession The review identified eleven studies, which explored attitudes and levels of knowledge towards nursing within the British South Asian population Many of these studies, although providing useful insights, have methodological limitations Studies highlighted perceptions among the South Asian population of nursing as a low status and stressful occupation with unsociable working hours and low pay Nursing members of the opposite sex was not acceptable to some individuals on religious grounds Others, however, had no problem with this The review highlights both similarities and differences in attitudes towards nursing amongst the British South Asian population and the majority white population Factors such as the lack of exposure to positive role models and limited opportunities to gain an insight into the work of nurses suggest that S

Journal ArticleDOI
TL;DR: From this study is that the HCAs and MAs carry out quite demanding work tasks and particularly the MAs are responsible for qualified patient care, which raises questions about their formal education and competence.
Abstract: To describe the work and the everyday activities of health care assistants (HCAs) and mental attendants (MAs) in acute hospital care. Several caring duties have been delegated from registered nurses to HCAs and MAs the last decade. Their tasks can either be rather demanding and qualified or be quite unqualified. Both a qualitative and quantitative design was used. Data collection comprised diaries written by 26 HCAs and MAs in 10 wards during a week in April 2006. Content analysis was used for data analysis. The study shows that the participants on average spend half of their working time on direct care (bedside). The HCAs in the geriatric wards spend more time on bedside than all the others. There can be several explanations as to the difference between wards. The MAs appear to have more authority and influence on psychiatric care in contrast to the HCAs. From this study is that the HCAs and MAs carry out quite demanding work tasks and particularly the MAs are responsible for qualified patient care, whic...

Journal ArticleDOI
TL;DR: Using focus groups from identified local groups in Leicester the author has been able to portray some of the important areas of care that are often not adequately dealt with in a very personal way.
Abstract: Undoubtedly, the care of ethnic minority groups within health care is important for nurse educators to address, in order to prepare students to give what is described by Ramsden (2005, p. 17) as culturally safe care. Using focus groups from identified local groups in Leicester the author has been able to portray some of the important areas of care that are often not adequately dealt with in a very personal way. This particular paper reports on one aspect of the outcome of a study funded by the Charles Frears Charitable trust. With this limitation, it is perhaps more difficult to comment on its importance in adding to the literature on education for culturally competent practice. It does not suggest other aspects of the study that may be forthcoming in future publications. The study uses a qualitative approach; the methodology is easy to understand, and the focus on three themes appears to have been carefully identified. The section where the participants comment on their needs in relation to dress was particularly interesting. There are so many factors that control dress code in any culture. It is often a generational concept as much as anything, but clearly in this case, it is seen as purely culturally based. We do not of course know the age range of the participants. As with much research of this type, one wonders on what basis the individual comments were chosen for inclusion in the paper. In the conclusion, reference is made to the need for ‘a working knowledge’ of cultural and religious beliefs and that knowledge must be combined with understanding and respect. The challenge lies in how to facilitate the students’ learning to enable them to provide such care. McGee (1994, p. 790) describes the ‘key to culturally sensitive care lying in enabling nurses to examine their own prejudices towards and stereotypes about’ minority ethnic groups. It is this reflective approach that is not directly referred to in this paper and which is seen to be important. The use of a developmental model (Bennett, 1993, p.29) has proved helpful in indicating students’ ability to move along a continuum that takes them from a point of ethnocentrism to one of ethnorelativism. The affective elements of providing culturally competent care are difficult to learn (Andrews and Boyle, 1999, p. 8). Nursing theorists have identified a number of concepts that lead to cultural competence and the affective element is usually mentioned as the first step. Campinha-Bacote Journal of Research in Nursing ©2008 SAGE PUBLICATIONS Los Angeles, London, New Delhi and Singapore VOL 13 (2) 111–112 DOI: 10.1177/ 1744987108088658 R E V I EW