Showing papers in "Journal of Research in Nursing in 2013"
TL;DR: Based on this review and meta-analyses, MBCT is an effective intervention for patients with three or more previous episodes of major depression.
Abstract: ObjectiveMindfulness-based cognitive therapy (MBCT) is a programme developed to prevent depression relapse, but has been applied for other disorders. Our objective was to systematically review and meta-analyse the evidence on the effectiveness and safety of MBCT for the treatment of mental disorders.MethodsSearches were completed in CENTRAL, MEDLINE, EMBASE, LILACS, PsychINFO, and PsycEXTRA in March 2011 using a search strategy with the terms ‘mindfulness-based cognitive therapy’, ‘mindfulness’, and ‘randomised controlled trials’ without time restrictions. Selection criteria of having a randomised controlled trial design, including patients diagnosed with mental disorders, using MBCT according to the authors who developed MBCT and providing outcomes that included changes in mental health were used to assess 608 reports. Two reviewers applied the pre-determined selection criteria and extracted the data into structured tables. Meta-analyses and sensitivity analyses were completed.ResultsEleven studies were ...
64 citations
TL;DR: An insider view from a potential target population of healthcare providers regarding their perceived educational needs is provided and the results point the way forward to practical and achievable ways of increasing and improving knowledge about dementia, and enhancing skills in caring for people who are cognitively impaired, among general hospital staff.
Abstract: Aims and objectives: This UK study aimed to generate new ideas about training strategies for healthcare staff caring for people with dementia in the acute hospital setting.Background: A review of related literature exposed topical debate regarding current educational deficits, yet revealed few examples of the implementation of training initiatives for practising healthcare professionals.Design: A descriptive qualitative approach was used.Methods: Data were generated using two focus groups comprised of Staff Nurses (four) and Healthcare Assistants (three) working in a mixed gender acute elderly care unit in the North of England. Dialogues explored individuals’ experiences of delivering care to people with dementia hospitalised with physical illnesses and, usefully, their thoughts about learning in the workplace.Results: Four broad categories emerged from transcript-based analysis: learning about dementia; learning about the person; learning from each other; learning from specialists. Specific recommendatio...
49 citations
TL;DR: Examination of stress experiences and coping strategies of nurse managers in an acute care setting indicates that coping mechanisms lessened the work stressors experienced by managers, but it was not always evident managers felt confident in their ability to cope effectively.
Abstract: Competing demands and a nursing shortage have contributed to a managerial workforce that is overworked and a health care environment that is under constant tension. The short supply and high turnov...
48 citations
TL;DR: In this article, the authors provide an explanatory explanation of experiences at stroke onset and delay seeking medical assistance for ischemic stroke symptoms is common worldwide, yet existing literature does not provide an adequate understanding of experiences during stroke onset.
Abstract: Delay seeking medical assistance for ischemic stroke symptoms is common worldwide, yet existing literature does not provide an adequate understanding of experiences at stroke onset. An explanatory ...
39 citations
TL;DR: The unstructured and flexible approach, and variety of data collection methods, utilised in the study enhanced its accuracy, truthfulness and reduced the subjectivity of children's responses.
Abstract: The purpose of this paper is to describe, and reflect upon, a number of methods deployed to facilitate sick children to have a voice within an acute health care setting. Using an ethnographic approach to investigate the nature of communication between children and health professionals, multiple modes of data collection were employed to engage children's interest, motivation and facilitate child empowerment in the process. The simultaneous use of semi-participant observations, informal interviews and participatory activities ensured that the diverse abilities, interests and preferences of children were acknowledged. Multiple data sources permitted the portrayal of a comprehensive picture which we believe enhanced the trustworthiness of the data. However, as with all data collection methods, researchers need to be critically aware of strengths and weaknesses and these will be reflected upon. Ultimately, it was crucial to use participatory activities in context and have continuous dialogue with the participa...
37 citations
TL;DR: In the current climate of constrained finances there is a risk that the allocation of resources is directed to current explicit dimensions to the detriment of others, which may be a reduction in health care quality, rather than improvement.
Abstract: Aims:The aim of this study was to determine whether the widely adopted Institute of Medicine’s dimensions of quality capture the current meaning of quality in health care literature.Design:An integrative review was utilised as there has been a multitude of published papers defining quality in relation to health care, therefore collective analysis may provide new insight and understanding.Method:Papers offering a definition or conceptual understanding of quality in relation to health care were identified by searching relevant databases. Papers were excluded according to predefined criteria. An integrative review was conducted and the Institute of Medicine’s dimensions were used as a framework for data extraction and analysis.Findings:The review identified two important additional dimensions of quality; namely caring and navigating the health care system and argues that they require recognition as dimensions in their own right.Conclusion:In the current climate of constrained finances there is a risk that th...
32 citations
TL;DR: In this article, the use of an emic-etic ethnographical technique in a grounded theory study of how New Zealand practice nurses use information was used to heighten theoretical sensitivity in this study.
Abstract: This paper draws lessons from the use of an emic–etic ethnographical technique in a grounded theory study of how New Zealand practice nurses use information. The technique was used to heighten theoretical sensitivity in this study. As a nurse practitioner, I (the lead author) could not step out of my emic perspective to provide an etic perspective of my own general practice. From my emic embodied subjectivity I constructed my work environment to fit with best practice. Conversely, in four other general practices, my lack of personal connection protected an etic
sense of disembodiment. New insights into mental models guiding the emic and etic roles of ethnography are suggested. Emic and etic perspectives, along with embodied and disembodied feelings, are not binary opposites but rather sit along a philosophical continuum. Their position on this continuum depends on the role and relationships of the researcher(s) in the social and cultural context of the area of inquiry.
29 citations
TL;DR: The qualitative differences in the complexity of how young children, aged 3–5 years, demonstrated the way they engaged in care procedures involving venepuncture are described.
Abstract: A fear of medical examination and of pain in care procedures is common among children Young children are particularly sensitive to the way a procedure is carried out The children will engage and
26 citations
TL;DR: Mothers' knowledge and practices of managing minor illnesses of children under the age of five and the association between socio-demographic variables of the mothers and their knowledge and Practices of managingMinor illnesses are explored.
Abstract: Assessing mothers’ knowledge and practices in managing minor illness is very important in order to ensure safe and effective ways of managing minor illnesses and decrease complications and hospital
23 citations
TL;DR: Two key themes which capture the perspectives of older South Asian study participants towards end-of-life care discussions are revealed, which relate to beliefs and experiences about the delegation of decision-making to family members and avoidance as a cultural norm.
Abstract: The National End-of-life Care Strategy for England identifies that a lack of open discussion about death and dying can be a barrier to achieving good quality end-of-life care. South Asians constitute the single largest ethnic minority group in the United Kingdom, yet little is known about their attitudes and expectations towards the discussion of death and dying. In this study, set in East London, five focus groups and 29 in-depth, semi-structured interviews were conducted with a total of 55 older adults aged between 52 and 78 years. Participants from six South Asian ethnic groups were recruited from 11 local community organisations. A constructivist grounded theory approach was used to analyse the data. Findings revealed two key themes which capture the perspectives of older South Asian study participants towards end-of-life care discussions. The theme ‘avoidance as a cultural norm’ relates to the relative absence of discussions around death and dying experienced by participants. Participants neither expected to have discussions about their own death and dying within their family, nor to assume any involvement in decision-making. The second theme ‘avoidance as protection’ relates to beliefs and experiences about the delegation of decision-making to family members. Future research should explore the perspectives of second-generation adult children towards end-of-life care discussions.
23 citations
TL;DR: There are several priorities for moving a neonatal palliative care model of care forwards, which include legislation that supports access to care such as development and funding support of perinatal hospices, continuity of care, caregiver support, research and in particular education for the health care professionals caring for dying babies and their families.
Abstract: The purpose of this paper is to move beyond the rhetoric of espousing the importance and timeliness of palliative care for the neonatal population, and to explore how what is known can influence health and social policy. A recent Commonwealth of Australia Senate enquiry into palliative care raised concerns about the current lack of specialist perinatal and neonatal palliative care in Australia. Inherent to the difficulties of moving a neonatal palliative care model forwards are the identified barriers to palliative care practice in the clinical setting, which have been well defined. To inform policy, it is imperative that health professionals in the neonatal discipline are knowledgeable about legislative priorities and the public concerns regarding palliative care for neonates. This paper argues that there are several priorities for moving this model of care forwards, which include legislation that supports access to care such as development and funding support of perinatal hospices, continuity of care, caregiver support, research and in particular education for the health care professionals caring for dying babies and their families. To achieve this, we need to set national research priorities that reflect a truly collaborative partnership. It is time to move beyond the rhetoric.
TL;DR: This paper presented an animated model that illustrates and facilitates an understanding of how the various techniques inherent in the Grounded Theory (GT) method converge to enable data categorisation and the formation of substantive theory.
Abstract: As a qualitative research method, Grounded Theory (GT) has had a significant impact on nursing research and has made a major contribution to the development of nursing knowledge. Despite this, conflicting opinions in the literature about methodological issues have contributed to the confusion about how this type of research is best conducted. The purpose of this paper is to present an animated model that illustrates and facilitates an understanding of how the various techniques inherent in the GT method converge to enable data categorisation and the formation of substantive theory. It will explain the key tenets of the research process underpinning GT and provides a guide for navigating the research process. It is hoped that this will facilitate understanding and promote the use of this methodology in nursing when it is appropriate to the research question being posed.
TL;DR: The authors argue that the identities and practices of those working in prison care are significantly shaped by organisational and societal discourses and that these generate rigidities and defensive mechanisms that limit the development of practice.
Abstract: Those caring for prisoners are subject to the influences of the dominant custodial discourses of security and risk management that prevail in a prison environment. The conflicting caring and custodial roles adopted by nurses working in prisons and by prison officers constitute the foundation for further exploration of prisoner care in the wider healthcare literature. In this discussion paper, we argue that the identities and practices of those working in prison care are significantly shaped by organisational and societal discourses and that these generate rigidities and defensive mechanisms that limit the development of practice. We argue that a greater emphasis on mindfulness in professional development and clinical supervision may be helpful in enabling prison workers involved in caring roles to enter a professional dialogue characterised by openness, inclusion and engagement. This, we argue, would facilitate the development of newer and richer understandings of practice and to a revitalisation of profe...
TL;DR: Findings provide evidence of the poor care that women receive during labour and birth in Jordan, where women seem to be processed as objects to give birth in a technological manner.
Abstract: Background: Bir th memories about their childbir th experience are powerful factors influencingwomen’s future fer tility and exploring bir th memories is impor tant. Bir th memories of women inJordan have never been reported previously.Objective: To explore the childbir th memories of women in Jordan.Design: An explorator y descriptive study was conducted to collect quantitative and qualitativedata on 160 first-time mothers giving bir th in Nor thern Jordan’s Bade’ a Hospital. Data werecollected using three open-ended questions up to six weeks after the bir th. Major themesemerging from the analysis were subject to manifest and latent content analysis to quantifyqualitative data where appropriate .Results: All women were married and their age ranged from 17 to 37 years. About two-thirds(64.5%) had school education and 35.5% had graduate education. The majority (72.5%) werehousewives. The major themes to emerge from the data were negative childbir th memories,women being processed, dehumanised bir th, vivid recall, halo effect, the joy of becoming amother and praise for the suppor t of Allah.Conclusion: Findings provide evidence of the poor care that women receive during labour andbir th. Women seem to be processed as objects to give bir th in a technological manner. They are treated more like machines devoid of feeling than independent women requiring information, childbirth education or suppor tive ‘one to one’ care . Childbir th care was based on a medical model where the bir th process is institutionalised, managed and controlled by the use of birth technology. There was no evidence of holistic care provided for women, and little consideration of their psychological, environmental or family relationships.
TL;DR: The findings suggest that educators should provide more information during nurses’ education to focus on the moral duty to provide safe care.
Abstract: Nurses are the healthcare providers who are well positioned to strengthen patient safety through providing safe care in clinical practice. The purpose of this study was to explore and describe the ...
TL;DR: The findings indicate that in advanced cancer there is a need to monitorize patients with low levels of perceived social support and enhance their social support resources, particularly in men.
Abstract: Background: Cancer patients who perceived themselves as having adequate social support resources fare better and make adaptation easier than patients who perceive their support as inadequate. Besid...
TL;DR: Assessment of anxiety-related computer literacy rates of a few nursing students in Jordan indicated that there was a significantly negative relationship between computer anxieties andComputer literacy rates, implying the need for frequent use of computers in various educational and training activities.
Abstract: The learning environment extends beyond the classroom, in a way, necessitating integration of computer literacy with education, establishing e-learning culture within future nursing education and f...
TL;DR: Service user involvement is a rarity in the evaluation of psycho-social interventions, despite its use being mandated by the National Institute for Health and Clinical Excellence and evidenced as effective in other areas of mental health (Leader, 1998).
Abstract: BackgroundThe efficacy of interventions and treatments for self-harm is well researched. Previous reviews of the literature have highlighted the lack of definitively effective interventions for sel...
TL;DR: In this article, the authors explored the perceived impact of advanced practice nurses in promoting evidence-based practice amongst frontline nurses, and a collective instrumental case study was conducted to evaluate the impact of such nurses.
Abstract: The aim of this study was to explore the perceived impact of advanced practice nurses in promoting evidence-based practice amongst frontline nurses. A collective instrumental case study was underta...
TL;DR: For individuals with RA, the impact of the disease on their ability to maintain normal life is important, and as such it is vital that healthcare professionals have a better understanding of the perceptions and experiences that individuals have living with RA.
Abstract: The purpose of this study was to examine men’s and women’s experiences living with rheumatoid arthritis (RA). Using semi-structured, in-depth telephone interviews, nine women and seven men who were...
TL;DR: In this article, the authors explored how people with moderate to most severe COPD predominantly cope with breathlessness during daily living and identified four predominant coping types: Overrater, Challenger, Underrater and Leveller.
Abstract: Coping with breathlessness is a complex and multidimensional challenge for people with chronic obstructive pulmonary disease (COPD) and involves interacting physiological, cognitive, affective, and psychosocial dimensions. The aim of this study was to explore how people with moderate to most severe COPD predominantly cope with breathlessness during daily living. We chose a multi-modal grounded theory design that holds the opportunity to combine qualitative and quantitative data to capture and explain the multidimensional coping behaviour among people with COPD. The participants’ main concern in coping with breathlessness appeared to be an endless striving to economise on resources in an effort to preserve their integrity. In this integrity-preserving process, four predominant coping types emerged and were labelled: ‘Overrater’, ‘Challenger’, ‘Underrater’, and ‘Leveller’. Each coping type comprised distinctive physiological, cognitive, affective and psychosocial features constituting coping-type-specific i...
TL;DR: This paper explains how a group of mental health service users and carers formed a Research Development Group in Wales and describes how the group was established and funded as part of the United Kingdom Clinical Research Networks.
Abstract: It is claimed that the involvement of mental health service users in research remains fragmented, and expertise in involving service users is still developing. This paper explains how a group of mental health service users and carers formed a Research Development Group in Wales. This is a process paper which describes how the group was established and funded as part of the United Kingdom Clinical Research Networks. It explores the rationale for a Mental Health Service User and Carer Partnership Research Development Group and the challenges experienced in setting up the group, including activities such as a current research project. This project involves collaboration between group members and nurses from a local National Health Service Trust, which is helping to build research capacity. This project is used to illustrate the issues raised, and we provide critical reflections of this process. The power balances that posed challenges to a group of this type are explored and ways to overcome them are suggest...
TL;DR: The multi-modal grounded theory approach, which encompasses videos of daily life activity, interviews, medical history, demographics, self-rated sensation of breathlessness, and physiological measurements, has the potential to generate new knowledge and may become an important methodological contribution towards understanding the multidimensionality of coping with breathlessness.
Abstract: Conventional methods have not yet succeeded in capturing the complexity of how people with chronic obstructive pulmonary disease (COPD) cope with breathlessness during daily living. We used a multi...
TL;DR: Findings show support for the effectiveness of a brief eating disorder training on primary care providers’ reported knowledge and skills for addressing eating disorders in their practice and underscore the importance of providing information on how they can more adequately screen and intervene with eating disorders, as part of primary care to their patients.
Abstract: Objective: To investigate the longitudinal effectiveness of a brief eating disorder training on primary care providers’ self-perceived knowledge, skills and attitudes regarding eating disorder scre...
TL;DR: The SSPAQ is a cohesive measure of sexual self-perception, and findings suggest each subscale can be used independently for measures of sexual anxiety, sexual depression,Sexual self-efficacy, and sexual satisfaction, and may be useful in research and clinical settings.
Abstract: The psychological impact of a cardiac event includes anxiety and depression, poor sexual quality, and diminished sexual satisfaction. Few measures capture psychosexual recovery following a cardiac ...
TL;DR: Safety organising behaviours may provide additional insights into the black box of organisational contextual factors that may be implicated in perceptions of patient safety culture among nurses.
Abstract: The cultivation of patient safety cultures is critical for the sustainability of positive patient outcomes. At the core of safety cultures are the safety organising behaviours of its workers. Yet, ...
TL;DR: Differences between psychological interventions however are small and unstable when reviewed in meta-analyses suggesting that for most people adding complexity to treatment does not result in improved outcomes.
Abstract: Depression is one of the most prevalent health disorders globally and causes significant distress and cost to the sufferer and society Psychological therapy for depression has been recommended ove
TL;DR: The study confirms the need for robust funding and effective marketing of new research roles to permit security for professionals’ long-term career prospects and mainstream such roles in the future.
Abstract: This paper reports part of a larger qualitative study and focuses on exploring the educator role in shaping clinical academic careers for nurses and allied health professionals. Using a purposive sampling technique, 30key participants from four universities were recruited with 7 or 8 from each institution. Individual interviews were undertaken between October 2005 and January 2007 and data were managed, analysed and coded thematically using the data analysis software NVivo. The findings illustrate participants’ commitment to sustain a positive research culture within their departments. They identify the need for a more systematic approach to target able students and introduce creative ideas to engage their interest in research and raise its profile as a viable career option. Whilst participants offer exemplars of flexible employment models to support those in clinical research, the study confirms the need for robust funding and effective marketing of new research roles to permit security for professionals’ long-term career prospects and mainstream such roles in the future. In conclusion, educationalists see themselves as having a key role working with practice colleagues to prepare and support the new clinical academic workforce to help them achieve their successful engagement.
TL;DR: The findings suggest that health policy priorities stimulate the areas in which advanced practice roles in ophthalmic nursing emerge, and it appears that the distinct systems of regulation have minimal effect on role development.
Abstract: This paper compares the results of studies of ophthalmic advanced practice in two similar but distinct health economies and integrates the effects of the setting, health policy and professional reg...
TL;DR: In this article, the authors investigated gender differences in quality of life and coping patterns after discharge for patients with burns in China, using a cross-sectional survey research design and p...
Abstract: The purpose of this study was to investigate gender differences in quality of life and coping patterns after discharge for patients with burns in China. Cross-sectional survey research design and p...