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  • 1
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 33 (2001), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A descriptive study of meaning of illness in chronic renal disease Aim. To explore the subjective meaning of illness in a sample of renal patients. Background. Patients’ illness representations, such as the meaning they attach to illness, may affect their coping and adaptation. Improved understanding in this area may therefore benefit patient care. Meaning of illness has not previously been explored in renal disease. Design and methods. Cross-sectional survey (n=405) in a single regional renal unit in the North of England. Ethical approval was obtained and patients gave written consent. The instrument used was an eight-item schema, based on the work of Lipowski (1970, Psychiatry in Medicine1, 91–102). Field notes regarding rationale for choice were recorded concurrently, then content analysed to enable identification of themes. The chi-square test (significance level P 〈 0·05) was used to analyse differences in selected meaning in older and younger patients; males and females; and patient groups (predialysis, haemodialysis and transplant). Findings. ‘Challenge’ was selected by most patients (n=253, 62·5%), with similar results in all three patient groups. Slightly more older than younger patients selected ‘challenge’, although the difference was not statistically significant and older patients more commonly had a fatalistic interpretation of the option. More men selected ‘challenge’ than women. Those selecting ‘challenge’ and ‘value’ appeared to have a more positive outlook than other patients. Conclusions. Patients had identifiable meanings for their illness, and these may be associated with their response to renal disease. The schema appeared to be comprehensive, but is in need of further refinement. Consideration of the possible influence of social desirability is necessary.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Patient and carer needs following a cancer-related hospital admission: the importance of referral to the district nursing service Background. Despite 30 years of research attention, discharge planning and district nurse (DN) referral remain problematic and few cancer-related publications exist. With shorter hospitalizations, discharged cancer patients and their carers may experience unmet needs for assessment, information and support. Although DN referral might enable patient/carer needs to be met, the DN role lacks clarity. Aim. To investigate the needs of people with cancer, and their lay carers during discharge from hospital to home, and identify the role of DNs in meeting these needs. Method. In this qualitative study, 71 pre- and postdischarge interviews were performed with cancer patients and (where possible) their carers. Predischarge interviews focused on expectations and postdischarge interviews on experiences of discharge and aftercare. Interview tapes were transcribed and analysed thematically. Results. Interviewees anticipated few aftercare needs during predischarge interviews but described met and unmet needs during postdischarge interviews. Unmet needs of those referred and not referred to the district nursing service were similar. Patients and carers had unmet needs for psychological support related to nutrition. Carers, especially those not resident with and not related to patients, had informational needs. Even very elderly, ill and isolated patients felt that other people had greater needs than their own and many thought that DNs only performed physical tasks. Conclusion. All cancer patients discharged from hospital might be referred to a DN for ongoing assessment of needs. However, to ensure optimal results, the DN role needs to be clarified and public perceptions altered. Further research on psychological aspects of nutrition and the needs of carers not resident with/not related to patients is necessary.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 29 (1999), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Skills competency in nurse education: nurse managers' perceptions of diploma level preparation This paper reports on part of a national study conducted between 1994 and 1996, the overall aim of which was to examine the `fitness for purpose' of the Project 2000 nursing education reforms. The study used multiple methods of data collection, including an individual and group interview study of nurse managers (n = 132) and a national survey of Project 2000 diplomates and traditionally prepared registered nurses (n = 5417). Findings in relation to the managers' expectations and experiences of diplomates are presented. This includes views on the level of skills achievement and skills acquisition of diploma level education. The qualities of the diplomates are discussed and this includes those areas where the skills of the diplomates are felt to achieve what is required of the role. Also included is an exploration of those skills which the managers felt fell short of expectations. Managers raised the long-standing concerns of clinical skills and competencies and discussed these in relation to the changing health care environment and the relative roles of other health care workers. The conclusions highlight the need to identify what could be seen as the `core skills' required of a registered nurse and the need to explore the environment in which the diplomate takes up first appointment.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 31 (2000), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The importance of ‘knowing the patient’: community nurses’ constructions of quality in providing palliative care This paper reports findings from a study conducted in one community health care trust where 62 members of the district nursing team (grades B–H) were interviewed. An adaptation of the critical incident technique was used to determine factors which contributed or detracted from high quality care for a number of key areas including palliative care. The centrality of knowing the patient and his/her family emerged as an essential antecedent to the provision of high quality palliative care. Factors enabling the formation of positive relationships were given prominence in descriptions of ideal care. Strategies used to achieve this included establishing early contact with the patient and family, ensuring continuity of care, spending time with the patient and providing more than the physical aspects of care. The characteristics described by the community nurses are similar to those advocated in ‘new nursing’ which identifies the uniqueness of patient needs, and where the nurse–patient relationship is objectified as the vehicle through which therapeutic nursing can be delivered. The link with ‘new nursing’ emerges at an interesting time for community nurses. The past decade has seen many changes in the way that community nursing services are configured. The work of the district nursing service has been redefined, making the ideals of new nursing, for example holism, less achievable than they were a decade ago. This study reiterates the view that palliative care is one aspect of district nursing work that is universally valued as it lends itself to being an exemplar of excellence in terms of the potential for realizing the ideals of nursing practice. This is of increasing importance in the context of changes that militate against this ideal.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Information and support needs of women with primary relatives with breast cancer: development of the Information and Support Needs Questionnaire Aims of the study. The aim was to develop and pilot test a newly developed measure, The Information and Support Needs Questionnaire (ISNQ), for use with women with primary relatives with breast cancer. Background/rationale. Breast cancer is a major risk to the health of women in the United Kingdom (UK). Increasingly, research is documenting women’s needs for information and support, particularly at the time of diagnosis. However, to date there is little understanding of the information and support needs of women who have a family history of breast cancer. Contributing to the dearth of understanding of female relatives’ needs is the lack of valid and reliable instruments for use in descriptive and intervention research with this population. Design/methods. The ISNQ and survey items documenting family history, sources of information and support for breast cancer risk, breast self-care practices, and other variables were pilot tested for the acceptability of the measures, appropriateness of the data collection methods, initial psychometric properties of the ISNQ, and time and financial costs of administration. Data were collected from 39 women living in the North-west of England who had primary relatives with breast cancer using mailed questionnaires and follow-up telephone interviews. Findings. The items on the ISNQ were reported to be clear, acceptable to women and to yield relevant data. The psychometric properties of the new measure were satisfactory with a high reliability coefficient alpha. Descriptive findings indicate that women had moderate to high needs for information and support, but reported that these needs were not well met. Conclusions. The results of this pilot are guiding the development of a larger study in which the information and support needs of women with a family history of breast cancer are explored.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 32 (2000), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Protecting children: intuition and awareness in the work of health visitors This paper is based upon an ethnographic study of a group of health visitors engaged in child protection work. The purpose of this paper is to explore the meanings individual health visitors attach to events concerned with identifying children who may be at risk of harm from child abuse, and also the idiosyncratic nature of health visiting in this complex but everyday social situation. The paper focuses on understanding the importance of a particular form of knowledge which the health visitors referred to as ‘intuitive awareness’.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 32 (2000), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Community nurses’ perceptions of patient ‘compliance’ in wound care: a discourse analysis As part of an interview study of community nurses’ perceptions of their work, 62 staff working within the district nursing service in one English National Health Service Trust (grades B–H) were asked to recount occasions when they had been involved in wound care and to discuss the ways in which working with patients who required such care could be either enhanced or made difficult. A large number of respondents expressed the view that non-compliance could pose serious problems for the management of wounds. Data relating to compliance are presented here and are interpreted in the light of discourse analysis, an approach which permits the researcher to focus on the meanings underlying the communications of research participants and to interpret those meanings in the light of social and cultural mores and influences. The authors found that non-compliance could be explained by nurses in a number of different ways. These ranged from passive resistance, which could be due to ignorance or lack of motivation, through overt refusal, to deliberate interference in order to prolong treatment. It also seeks to outline some of the factors that appear to motivate the nurses’ desire to achieve compliance.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 31 (2000), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Wound care in the community setting: clinical decision making in context Sixty-two community nurses in northern England of grades B and D to H were interviewed by a team of four researchers. The interviews were semi-structured, and were tape-recorded, fully transcribed and content analysed. They were conducted as part of a larger study, the aim of which was to examine community nurses’ perceptions of quality in nursing care. One of the main themes the work focused on was decision-making as an element of quality. Data relating to wound care were considered from the perspective of the insights they offered into clinical decision-making. Data were interpreted in the light of a literature review in which a distinction had been made between theories which represented clinical decision-making as a linear or staged process and those which represented it as intuitive. Within the former category, three sub-categories were suggested: theorists could be divided into ‘pragmatists’, ‘systematisers’ and those who advocated ‘diagnostic reasoning’. The interpretation of the data suggested that the clinical decisions made by community nurses in the area of wound care appeared largely intuitive, yet were also closely related to ‘diagnostic reasoning’. They were furthermore based on a range of sources of information and justified by a number of different types of rationale.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of advanced nursing 6 (1981), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This paper attempts to explain some general issues in evaluation and evaluative research in the health care field with specific reference to nursing. The evaluation process and nursing process are contrasted and methods used in evaluative research discussed. The case is made for more emphasis to be placed on the evaluation phase of the nursing process and process-outcome evaluation is advocated as a means of encouraging progress in the hitherto neglected area of evaluative research in nursing.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of advanced nursing 24 (1996), S. 0 
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A national study was conducted in England over a three-year period (1991–1994) to explore the changing role of the nurse teacher The study used multiple methods of data collection, including a modified Delphi survey and a series of telephone interviews A wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers) were included in the sample This paper presents findings relating to the changes in the role of the nurse teacher following the formation of links with higher education Some of the issues discussed include the difficulties related to academic status and the relationships between nurse teachers and other lecturers in higher education, changes in teaching styles and the place of student nurses with higher education The implications for nurse teachers which stem from a closer association with higher education are explored
    Type of Medium: Electronic Resource
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