Showing papers in "Journal of Research in Nursing in 2017"
TL;DR: The positive emotions that nurses feel as a result of compassionate and empathic practice are known as compassion satisfa... as mentioned in this paper, which are viewed as important by both nurses and patients.
Abstract: Compassion and empathy are viewed as important by both nurses and patients. The positive emotions that nurses feel as a result of compassionate and empathic practice are known as compassion satisfa...
67 citations
TL;DR: In this paper, a pilot study explored the effects of a mindfulness meditation intervention on nurses' perceived stress and compassion, using a quasi-experimental pre-test/post-test design.
Abstract: This pilot study explored the effects of a mindfulness meditation intervention on nurses’ perceived stress and compassion. A quasi-experimental pre-test/post-test design was used. Nurses (n = 90) w...
43 citations
TL;DR: Overall, directors of nursing rated their general competence and special competence better than head nurses, however, the head nurses had a stronger expertise in general competence areas, professional competence and credibility, and also in the special competence areas of substance knowledge than the directors.
Abstract: This paper describes the leadership and management competencies of head nurses and directors of nursing in social and health care In the nursing profession, studies have tended to describe the rol
40 citations
TL;DR: In this paper, the authors investigated nurse self-concept, practice environment and resilience, and how these three factors influence the retention of early career registered nurses (ECRNs), defined as RNs in the first 5 years of practice post-graduation.
Abstract: Health care systems depend on viable health professional workforces. Nurse workforce projections for Australia indicate that by 2030 the demand for nurses will exceed supply. Retaining nurses is an ongoing problem both in Australia and globally. This study investigates nurse self-concept, practice environment and resilience, and how these three factors influence the retention of early career registered nurses (ECRNs). ECRNs are defined as RNs in the first 5 years of practice post-graduation. The researchers used a cross-sectional design for the study. Survey responses were elicited from 161 ECRNs in one Australian hospital and health service using four survey instruments: The Nurse Self-Concept Questionnaire, the Practice Environment Scale of the Nursing Work Index, the Connor–Davidson Resilience Scale and the Nurse Retention Index. Study findings demonstrate correlations between ECRN retention intentions and nurse self-concept, practice environment and resilience. The significance of these factors at dif...
33 citations
TL;DR: The project conclusions highlighted the importance of effective senior-level support and organisational leadership in cultivating compassion within a healthcare organisation and the important of the integration of compassion-promoting resources within existing staff development initiatives.
Abstract: The ‘Cultivating Compassion’ project was developed in response to a research and innovation call relating to compassion training for National Health Service staff in the South East of England. The project aims included the following: the use of Appreciative Inquiry to develop, implement and evaluate a sustainable and evidence-based programme of compassion awareness training through engaging with a diverse group of health professionals and support staff; an evaluation of a ‘train the trainers’ approach; and an evaluation of ‘compassion lead’ roles and a multi-modal compassion toolkit. The project team included academics from two universities and one medical school, NHS staff from three separate organisations and service users. The participants recruited to the study included doctors, nurses, receptionists, chaplains and others working in close contact with service users from within four NHS organisations in the South East of England. The main findings from the project using thematic analysis from participant focus groups and interviews identified project enablers and inhibitors, the value of project resources, and shifts in perspectives. Project conclusions highlighted the importance of effective senior-level support and organisational leadership in cultivating compassion within a healthcare organisation and the importance of the integration of compassion-promoting resources within existing staff development initiatives.
24 citations
TL;DR: Examination of nurses’ views on the impact that mass media has on service users and how this affects nurse/service user interactions concluded that closer engagement between health journalists and nurses through ‘journalist-in-residence’ programmes could enable nurses and journalists to gain greater appreciation of their respective sets of knowledge.
Abstract: The aim of this study was to examine nurses’ views on the impact that mass media has on service users and how this affects nurse/service user interactions. Internationally, the mass media is an imp...
21 citations
TL;DR: It is suggested that teamwork in healthcare needs targeted organisational support and healthcare organisations must systematically approach and monitor the status of nursing teamwork, e.g. implement programmes to develop it as needed, particularly when faced with staffing and workload challenges.
Abstract: The purpose of this study was to re-examine data to explore connections between nurses’ perceptions of teamwork, staffing and workload, focusing on salient aspects and connections, from the nurses’...
21 citations
TL;DR: A mixed methods methodological framework for CBPAR is described, which follows the action research methodological steps and captures the synergetic combination of the two approaches by integrating mixed methods into each step in the CBPAR process.
Abstract: An increased focus on patient-centred care in response to national efforts of improving the quality of health care calls for effective approaches to engaging patients and other stakeholders with research and its outcomes. Mixed methods research can provide a rigorous methodological foundation for community-based participatory action research (CBPAR) by synergistically combining qualitative stakeholder engagement methods with quantitative outcome-based oriented approaches for developing evidence-based, scientifically sound and patient-centred plans for improvement. CBPAR has long been applied in nursing research as a tool to engage patients and other stakeholders as co-researchers. When combined with mixed methods, CBPAR can assist stakeholders in developing better appreciation for a data-driven decision-making process by capitalising on the advantages of integrating quantitative and qualitative methods. This paper describes a mixed methods methodological framework for CBPAR as a means for promoting patien...
19 citations
TL;DR: The findings indicate that recently hospitalised patients and non-hospitalised individuals were in agreement about the importance of the elements of compassionate care, and patients’ ratings of their doctors’ compassionate behaviours were significantly correlated with ratings of the healthcare team.
Abstract: Compassionate care requires understanding of another’s pain or suffering, with commitment to doing something to relieve this. It is endorsed by nursing and other healthcare professionals in their c...
19 citations
TL;DR: The aim of this study was to critically analyse the impact of the ‘Leadership in Compassionate Care Programme’ and offer a conceptual model of factors that can embed compassionate care in contemporary health care environments.
Abstract: The aim of this study was to critically analyse the impact of the ‘Leadership in Compassionate Care Programme’ and offer a conceptual model of factors that can embed compassionate care in contempor...
18 citations
TL;DR: The qualitative outcomes as part of a larger feasibility study which was developed to test a Cultural Health Check toolkit designed to assist healthcare workers and organisations in the provision of safe, dignified and compassionate quality care for older people are explored.
Abstract: This paper explores the qualitative outcomes as part of a larger feasibility study which was developed to test a Cultural Health Check toolkit designed to assist healthcare workers and organisations in the provision of safe, dignified and compassionate quality care for older people. For the qualitative part of this project, 11 healthcare workers agreed to participate in a one-to-one semi-structured interview. The primary aim of the research was to identify the experiences of staff in relation to the different factors they feel contribute to the culture of the organisation. These data were analysed using Attride-Stirling thematic analysis. The data were coded and four global themes were evident: professional practice, support, workforce and service delivery. Professional practice included organisational themes of quality, communication and collaboration and how these impact on a health worker’s ability to carry out their role and the impact on the delivery of compassionate quality care. Support included or...
TL;DR: It is now almost universally accepted in the United Kingdom and beyond that the nurse’s role is first and foremost to be ‘compassionate’, and although the concept of compassion is self-evidently important in nursing, to give it exclusive primacy is potentially dangerous on two counts.
Abstract: Nursing is universally valued but rarely well defined. Debate about the primacy of compassion versus clinical expertise is an age-old conversation that shows no sign of abating, and the issues were reignited in the United Kingdom and beyond by the Mid Staffordshire NHS Foundation Trust Public Inquiry report (2013), known as the Francis report, which claimed amongst other things that ‘it is clear that the nursing issues found in Stafford are not confined to that hospital but are found throughout the country’ (Mid Staffordshire NHS Foundation Trust Public Inquiry report, 2013: 1499). Even though Francis provides no evidence to support this claim of widespread nursing ‘issues’ he recommended an increased focus in nurse education on the ‘practical requirements’ for delivering compassionate care, including working as a healthcare assistant prior to nurse training, and I have previously argued that this is illogical (Maxwell, 2013). The response to the inquiry by England’s Chief Nursing Officer was to produce a national strategy entitled ‘Compassion in Practice’ (Cummings and Bennet, 2012), and although this document includes competence amongst its ‘6Cs’, it does not explore what this means and it is compassion which retains the headline. Despite the lack of empirical evidence, and in the wake of an appalling scandal, it is now almost universally accepted in the United Kingdom and beyond that the nurse’s role is first and foremost to be ‘compassionate’. Whilst the concept of compassion is self-evidently important in nursing, to give it exclusive primacy is potentially dangerous on two counts. First, the meaning of ‘compassion’ is poorly defined in nursing scholarship (Schantz, 2007), leading to a blurring of the boundaries between compassionate care as a skilled professional activity and compassion as a value or an innate moral characteristic, and this might confirm the stereotype that nurses are born and do not need to be educated. Second, it may diminish the other key skills and behaviours that distinguish professional nursing from lay and family nursing. Defining nursing primarily as caring and compassionate immediately invokes the gendered assumptions that traditionally female communion (relational) work is less skilled than traditionally male agency (task) work, and this is borne out by the introduction in England of the ‘practical’ training for compassion given to healthcare assistants and
TL;DR: Examples of modern nursing workforce challenges are contrasted with situations faced by Nightingale and nurses are urged to engage politically in order to regain control of their environment and the art of nursing.
Abstract: Nightingale conceived of the art of nursing as the ability of the nurse to positively influence a patient’s environment to foster healing. By this definition, the art of nursing is at risk. Rather ...
TL;DR: In this paper, a forensic advanced practice nurse with her own private practice specialises in the treatment of convicted sexual offenders who have been court-ordered to undergo sex offender treatment, and her treatment methodology is based on empirically validated best practices.
Abstract: I am a forensic advanced practice nurse with my own private practice. I specialise in the treatment of convicted sexual offenders who have been court-ordered to undergo sex offender treatment. This perspective is a reflection of over 30 years of working with these patients. More specifically, it is about my discovery that, without care and compassion for the men I work with, good outcomes are less likely, for both my patients and myself. It is about my struggle to maintain my own sense of humanity and compassion towards sexually violent men. It is also about the challenges I have faced trying to convince others on the treatment team that this approach gives our patients a better chance of developing their own sense of compassion. My treatment methodology is based on empirically validated best practices. However, a common trait in people who engage in cruel or callous behaviour is a lack of empathy. Empathy is the foundation upon which care and compassion for others is developed. I spend a good deal of time helping my patients develop concern for others, which begins with my being a role model of compassion and human caring. My approach requires being clear about my intentions, and developing self-care to manage the stress and possible burnout from working with this difficult patient population. Embodying lovingkindness and compassion towards self prevents stress and burnout.
TL;DR: In this article, questions of sexuality and intellectual disability have now moved beyond the institutional era, and contemporary sexual health interventions have gradually been reconfigured in terms of social part-of-speech.
Abstract: Questions of sexuality and intellectual disability have now moved beyond the institutional era, and contemporary sexual health interventions have gradually been reconfigured in terms of social part...
TL;DR: Qualitative thematic analysis resulted in five themes, three of which were the focus of this paper: general values, fundamental nursing and nursing values, which included respect and dignity being important.
Abstract: Nursing students are the future of nursing, and are situated between the expectation of the public (that the public will receive compassionate care) and the profession (that the profession will continue to develop technically to meet the needs of the changing healthcare economy). Research has focused on the factors affecting registered nurses' values in care. However, less is known regarding the factors that shape nursing students' values, attitudes/and perceptions of compassionate care. Six focus group discussions with 23 adult branch nursing students (years 1–3) from a UK university were conducted to ascertain the nursing students' understanding of personal and professional values, factors influencing these values, and whether they felt these values influenced the way they provided compassionate care. Qualitative thematic analysis resulted in five themes, three of which were the focus of this paper: general values, fundamental nursing and nursing values. Participants considered a range of influencers of their general values, and demonstrated a transparency between their personal and professional values, with respect and dignity being important. Fundamental nursing was complex to consider but was considered to orientate around the provision of care in a compassionate way.
TL;DR: This paper explored the ways in which student nurses use self-authored poems to think about important aspects of nursing practice and found that students use metaphor to explore emotional and relational aspects of practice and the technique of self-distancing when describing difficult and angering events.
Abstract: The aim of this study was to explore the ways in which student nurses use self -authored poems to think about important aspects of nursing practice. Being a nurse can be rewarding in that it affords opportunities to care for and communicate with others. However, it can also yield challenges, and nurses are often faced with practice filled with uncertainty, grief and loss. Our findings suggest that students can use poetry writing to meaningfully explore nursing practice, engage with critical thinking, and consider the feelings of others. Of particular note was the ways in which students use metaphor to explore emotional and relational aspects of practice and the technique of self-distancing when describing difficult and angering events. The work has implications for nurse education and practice. Proactively encouraging students to adopt particular ways of expressive writing might be beneficial for student health and wellbeing. Such an approach has the potential to improve quality care provision and support the emotional health of student nurses, which might lead to a reduction in compassion fatigue, stress and attrition.
TL;DR: Duoethnography is a method of dialogical reflection that combines different voices and juxtaposing worldviews in order to glean fresh perspectives on wider social or professional issues.
Abstract: Duoethnography is a method of dialogical reflection that combines different voices and juxtaposing worldviews in order to glean fresh perspectives on wider social or professional issues. In this pa...
TL;DR: Conclusions from this research highlight the value of feedback focused on emotions and understanding experiences of patients, relatives and staff, and how the activity of feedback can be effectively supported.
Abstract: There is an emergent recognition in healthcare that people need to be at the heart of services, and experiences of care matter; these should therefore be recognised and enhance practice.The aims of this research were to evaluate an NHS development programme, Valuing Feedback. The programme focused on supporting compassionate care practice by enabling NHS staff to listen, learn and respond to feedback enabling the development of practice.Findings identified that participants had a heightened awareness of the power and importance of feedback to support practice change. An enhanced understanding of using the feedback tools, Emotional Touchpoints and Envision Cards, was evident and working with these tools during the programme supported local implementation. Participants identified learning and changes to their practice resulting from feedback, specifically development in their own practice and service change. Participants identified that listening to positive and negative feedback based on emotional experien...
TL;DR: The aim of this study is to describe the research team’s systematic process in designing a dissemination strategy for a completed research study and provide key insights and practical advice for researchers looking for innovative ways to disseminate their findings within the lay and scientific communities.
Abstract: Research results hold value for many stakeholders, including researchers, patient populations, advocacy organisations and community groups. The aim of this study is to describe our research team’s ...
TL;DR: This research can be used to inform the measurement of compassionate communication and promote standardisation nationally and recommendations include pilot testing to further investigate the construct of non-verbal compassionate communication in an acute healthcare context.
Abstract: The National Health Service is committed to measuring the quality of nursing care through adopting a number of indicators which are not nationally standardised. Compassionate communication is one i...
TL;DR: The approach that one large NHS Trust has taken to developing a framework for clinical academic careers in nursing is outlined and the internal and external resources that are drawn upon to support the implementation of the framework are outlined.
Abstract: The drive to establish clinical academic careers in nursing in the United Kingdom has gained momentum in recent years, spearheaded by opportunities presented by the Higher Education England/National Institute for Health Research integrated clinical academic pathway. However, embedding clinical academic careers within a healthcare organisation is challenging. This paper outlines the approach that one large NHS Trust has taken to developing a framework for clinical academic careers in nursing. The internal and external resources that are drawn upon to support the implementation of the framework are outlined and some of the practical challenges of making the framework a reality are discussed. The development, implementation and sustainability of the framework are dependent on professional, managerial and research leadership together with close collaboration between the healthcare organisation and higher education institutions.
TL;DR: Most women viewed screening for alcohol in pregnancy positively, although its acceptability in the small number of women who continue to drink is unclear, and confusion over what level of alcohol is safe and using screening as an opportunity for education and support emerged as key themes from free-text responses.
Abstract: Providing antenatal and postnatal support for women who drink alcohol in pregnancy is only possible if those at risk can be identified. However, screening will only be helpful if women feel comfort...
TL;DR: In order to provide adequate and qualified nursing services, nurses should be allowed the option to specialise after graduation and should be employed in their fields of expertise.
Abstract: Nurses have experienced various difficulties due to the lack of nursing specialisation. This study was conducted in order to determine opinions and suggestions of nurses on nursing specialisation. ...
TL;DR: In this paper, the medium of found poetry is incorporated into a doctoral program for nurses, educators and allied health and social care professionals at the start of their various doctoral journeys, which advocates a narrative practice approach to issues of researcher identity and reflexivity.
Abstract: This paper describes how the medium of ‘found poetry’ is incorporated into a doctoral programme for nurses, educators and allied health and social care professionals at the start of their various doctoral journeys. It advocates a narrative practice approach to issues of researcher identity and reflexivity. ‘Finding’ the poems begins with the creation of collages as representational anchors for students to talk about themselves, their professional practice, their hopes and expectations of the doctoral experience, and their research ideas. (Re)presenting their transcribed talk as poetry involves culling and playing with words, phrases and segments, making changes in spacing, lines and rhythm to arrive at an evocative distillation (Butler-Kisber, 2002). This process enables each person to bring stories and/or fragments of experience into critical engagement with others. Poetic thinking functions pedagogically, helping students find a critical voice to enliven and hone their reflexive writing in relation to t...
TL;DR: One method of coping with a long-term condition is normalcy: psychologologically normalcy as discussed by the authors, which can lead to a spiral of losses including social capital, mobility, physical health and self-worth.
Abstract: Living with chronic illness can lead to a spiral of losses including social capital, mobility, physical health and self-worth. One method of coping with a long-term condition is normalcy: psycholog...
TL;DR: While governing body nurses claim an authority located in clinical and managerial expertise, this is contested by members of the clinical commissioning group and external stakeholders irrespective of whether it is aligned with clinical knowledge and practice or with new forms of management.
Abstract: Clinical commissioning groups were set up under the Health & Social Care Act (2012) in England to commission healthcare services for local communities Governing body nurses provide nursing leadership to commissioning services on clinical commissioning groups Little is known about how nurses function on clinical commissioning groups We conducted observations of seven formal meetings, three informal observation sessions and seven interviews from January 2015 to July 2015 in two clinical commissioning groups in the South of England Implicit in the governing body nurse role is the enduring and contested assumption that nurses embody the values of caring, perception and compassion This assumption undermines the authority of nurses in multidisciplinary teams where authority is traditionally clinically based Emerging roles within clinical commissioning groups are not based on clinical expertise, but on well-established new public management concepts which promote governance over clinically-based authority
TL;DR: Education can effectively increase paediatric clinicians’ confidence in and attitudes towards providing pain and symptom management for children with severe illness, and further training is needed to promote interdisciplinary healthcare team work to improve the effectiveness of pain and symptoms management.
Abstract: Pain and symptom management is the most important area of paediatric palliative care, but clinicians often receive little training in this area. Our research evaluated the effectiveness of pain and symptom management training among paediatric professionals. A quasi-experimental pretest–posttest study was used. Fifty-three paediatric nurses and 18 paediatricians participated in this study for a response rate of 80%. Results showed significant main effects of training on confidence levels (p < 0.001), and attitude scores (p < 0.001) among paediatric clinicians in a variety of areas, with no differences in scores between paediatricians and nurses. This suggests that education can effectively increase paediatric clinicians’ confidence in and attitudes towards providing pain and symptom management for children with severe illness. Further training is needed to promote interdisciplinary healthcare team work to improve the effectiveness of pain and symptom management.
TL;DR: It is demonstrated that PW does not necessarily ‘release time to care’ in every instance and that many factors influence this, but it does show encouraging signs that it may engage ward-based teams, thus creating some of the conditions and capacity in which compassion and quality can flourish.
Abstract: Recent concerns about the poor quality of healthcare and diminishing compassion within patient care have prompted many healthcare organisations to adopt ‘compassion’ and ‘care’ into their value and...
TL;DR: The focus of this edition of the Journal of Research in Nursing (JRN) is on compassion in practice as mentioned in this paper, where the authors provide readers with plenty of food for thought about compassion, in its broadest sense, at organisational, professional and individual levels.
Abstract: The focus of this edition of Journal of Research in Nursing (JRN) is on compassion in practice. Hardly a day goes by where there is not a reference somewhere in the media, in all of its forms, that indicates a growing sense that there is a deficit of compassion, whether that be at the societal, organisational, professional or individual level. The reasons for this are complex, multivariate and interconnected. Whilst our focus is on health and social care and the nursing contribution in particular, the evidence of this so called ‘compassion deficit’ is much wider than that, reaching deep into society. This edition of JRN brings readers plenty of food for thought about compassion, in its broadest sense, at organisational, professional and individual levels but these deliberations need to be considered within the context of the societal obligations and relationships that we all practise within. For instance, at the societal level, consider, just one example where people’s propensity for compassion is sometimes questionable – the attitudes towards and treatment of refugees seeking asylum. In this situation there are far-reaching consequences of political action and inaction, including the seismic ramifications of both of these on public health and wellbeing (Walsh, 2015) – in this situation the way nurses use compassion makes a considerable difference. Considering the plight of refugees and reflecting on the attitudes and behaviours of people towards the most vulnerable in society provides a powerful insight