Sunday, February 22, 2009

KEYWORDS
primary health care • workforce issues • nursing
kemp l.a., harris e. & comino e.j. (2005) Journal of Advanced Nursing49(3), 307–314
Changes in community nursing in Australia: 1995–2000

ABSTRACT

Aim. This paper reports a study whose aim was to examine the congruence between community nurses' perceptions and the realities of changes in their work.

Background. There have been increasing challenges to the delivery of community nursing services in Australia over the past decade. Acute care sector changes and the recent focus on health promotion, prevention, early identification and intervention adds pressure and creates tensions for community nurses, which are well-documented in the literature. There is, however, a lack of empirical evidence of actual changes in community nurses' workloads and the focus of their work. Validation of nurses' perceptions would enable them to have a stronger voice in the future development of community health care.

Methods. Four sources of data were used: community health client administrative data 1995–2000; occasions of service data 1995–2000; staffing numbers 1998–2001; and interviews with 14 community nurses in late 2001.

Results. Documentary evidence shows that there has been a large increase in the number of adult clients, and all clients are increasingly receiving a shorter, more intensive, clinically focussed service and are then discharged from care, rather than receiving a lower intensity service over a longer period of time. Staffing numbers have not increased to match this higher acuity and intensity. These changes were echoed by the nurses, who reported that expanded acute care roles were impacting on their workload and resulting in a loss of holistic primary health care focus. There has been a lack of leadership and proactive planning by community nurses in response to these changes.

Conclusion. Community health care in Australia is shifting from primary to short-term clinical care. Greater opportunities for community nurses to engage proactively in defining and promoting their role in the health care system are needed in order to ensure an appropriate balance of acute clinical and holistic primary health care in the community.


Submitted for publication 14 November 2003 Accepted for publication 19 April 2004

taken from: http://www3.interscience.wiley.com/journal/118698503/abstract

M. JONES 1 sen(m) rmn msc, J. BENNETT 2 bsc(hons) phd rn rm, R. GRAY 3 rn bsc(hons) msc phd, P. ARYA 4 & B. LUCAS 5 ma mbbs mrc psych
1 Nurse Consultant, Hillingdon Primary Care Trust and Buckinghamshire and Chilterns University, Riverside Centre, Uxbridge, 2 Workforce Development Manager, The Sainsbury Centre For Mental Health, London, 3 Senior Lecturer, Institute of Psychiatry, De Crespigny Park, Camberwell, London, 4 Specialist Registrar in Psychiatry, Hillingdon Primary Care Trust, Riverside Centre, Uxbridge, and 5 Consultant Psychiatrist, Hillingdon Primary Care Trust, Ruislip Manor, UK
Correspondence to M. Jones
Hillingdon Primary Care Trust and Buckinghamshire and Chilterns University
Riverside Centre
Uxbridge
UB8 3NN
UK
E-mail: Martin.jones@thh.nhs.uk
Copyright 2006 Blackwell Publishing Ltd
KEYWORDS
akathisia • nurse consultant • nurse prescribing

JONES M., BENNETT J., GRAY R., ARYA P. & LUCAS B. (2006) Journal of Psychiatric and Mental Health Nursing13, 26–32
Pharmacological management of akathisia in combination with psychological interventions by a mental health nurse consultant

ABSTRACT

The article describes the management of akathisia by a mental health nurse (MHN) prescriber, working in partnership with the patient. A single-case design was used to evaluate this. It highlights three features: first, MHN can safely prescribe psychiatric medication in combination with concordance therapy. Second, the value base underpinning prescribing practice is partnership, honesty and choice for the patient. Finally, the pharmacological mechanism of antipsychotic medication, which contributes towards akathisia, requires further analysis.


Accepted for publication: 22 June 2005

Niels Buus
The University of Southern Denmark and The Centre for Innovation in Nursing Education in the County of Aarhus, Aarhus N, Denmark
Correspondence: Niels Buus, The University of Southern Denmark and The Centre for Innovation in Nursing Education in the County of Aarhus, Olof Palmes Alle 17, 1, 8200 Aarhus N, Denmark.
E-mail: <n_buus@hotmail.com>
Copyright © 2005 Blackwell Publishing Ltd
KEYWORDS
discourse analysis • edit and review • methodological research • serial publications • social sciences

BUUS N. Nursing Inquiry 2005; 12: 27–33

Nursing scholars appropriating new methods: the use of discourse analysis in scholarly nursing journals 1996–2003

ABSTRACT

Nursing scholars appropriate the analysis of discourse. 'Discourse analysis' covers a wide spectrum of approaches to analysing meaning and language and there is no widely accepted definition of either a concept or an analysis of discourse. A sample of the discourse analyses indexed in the CINAHL database was analysed in order to identify what notions of discourse and discourse analysis are preferred by nursing scholars. The results showed that nursing scholars prefer approaches to discourse that resemble mainstream qualitative research avoiding social life and interaction. Explanations for these findings are briefly outlined.


Accepted for publication 20 April 2004

taken from: http://www3.interscience.wiley.com/journal/118709767/abstract

Barry W. Rovner a1, Pearl S. German a2, Jeremy Broadhead a3, Richard K. Morriss a4, Larry J. Brant a5, Jane Blaustein a1 and Marshal F. Folstein a1
a1 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
a2 Department of Health Policy and Management, John Hopkins University School of Public Health and Hygiene, Baltimore, Maryland
a3 Maudsley Hospital, London, England
a4 University of Leeds, Leeds, England
a5 Gerontology Research Center, Francis Scott Key Medical Center
Abstract

The prevalence of psychiatric disorders among new admissions to nursing homes is unknown. Such data are needed to estimate the psychiatric needs of this population. We report the prevalence of specific psychiatric disorders in 454 consecutive new nursing home admissions who were evaluated by psychiatrists and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised. Eighty percent had a psychiatric disorder. The commonest were dementia syndromes (67.4%) and affective disorders (10%). Also, 40% of demented patients had additional psychiatric syndromes such as delusions or depression, and these patients constituted a distinct subgroup that predicted frequent use of restraints and neuroleptics, and the greatest consumption of nursing time. These data demonstrate that the majority of nursing home residents have psychiatric disorders on admission, and that their management is often quite restrictive. Research is now needed to determine the best methods of treatment for nursing home patients with mental disorders.

Footnotes

1 First Place Winner of the 1989 IPA Research Awards (sponsored by Bayer AG)

taken from: http://journals.cambridge.org/action/displayAbstract

Thursday, February 19, 2009

Sexuality: A Critical Component of Quality of Life in Chronic Disease

Margaret C. Wilmoth PhD, MSS, RN

aSchool of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA


Available online 12 November 2007.

Nursing is a science and an art. The science aspect of including sexuality in nursing practice requires knowledge about “normal” sexual functioning, an understanding of the pathophysiology and pharmacotherapies that may cause changes in sexuality, and knowledge about assessing and treating sexual difficulties. The art of including sexuality into nursing practice comes from awareness of one's beliefs and values, and comfort in talking about sexuality. The nurse will find that most patients will be pleased that he/she has taken the time to broach this important concern with them. This article provides an overview of the relationship among sexuality, chronic disease, and quality of life. Two frameworks are suggested that are useful in operationalizing sexuality in nursing practice.

taken from: http://www.sciencedirect.com/science

Clinical Nurse Specialist:Volume 19(5)September/October 2005pp 255-259

Nursing Attitudes and Beliefs Toward Human Sexuality: Collaborative Research Promoting Evidence-Based Practice

[FEATURE ARTICLES]

REYNOLDS, KATHLEEN E. MSN, RN APRN-BC; MAGNAN, MORRIS A. PhD, RN

From the Karmanos Cancer Hospital, Detroit Medical Center, Detroit, MI (Ms Reynolds); and School of Nursing, Oakland University, Rochester, MI and College of Nursing, Wayne State University, Detroit, MI (Dr Magnan).

Corresponding author: Morris A. Magnan, PhD, RN (e-mail: mamagnan@wayne.edu).

Abstract

Purpose and Objectives: The purpose of this study was to use a collaborative process between Advanced Practice Nurses and a nurse researcher to identify barriers to incorporating sexuality assessment and counseling into nursing practice.

Design/Approach: This article provides an historical account of the collaborative group processes leading to the development and testing of the Sexuality Attitudes and Beliefs Survey (SABS).

Background/Rationale: Nurses often are called upon to talk to patients about their sexuality and sexual concerns. Many nurses believe that sexuality assessment, evaluation, and counseling is a part of their professional role, however, nurses do not necessarily integrate this awareness into their patient care. Discomfort, embarrassment, or strongly held attitudes about the nurse's role in discussing sexuality with patients can act as barriers to responding to these patient concerns.

Setting: A Midwestern urban healthcare facility, affiliated with a university served as the setting.

Sample: Thirty-five nurses working outpatient and inpatient settings in oncology and HIV/AIDS.

Method: Instrument development and voluntary survey.

Outcomes: The collaborative initiative developed and piloted an instrument to measure nurses' attitudes and beliefs about human sexuality. Results of the pilot study suggest that what nurses believe patients expect from them, time availability, and confidence in one's ability to address issues related to human sexuality present significant barriers to incorporating sexuality assessment and counseling into nursing practice.

Conclusion: Successful collaboration among clinicians and researchers required administrative support as well as a individual commitment and is a model that can be adapted to other settings and for other projects.

Implications for Practice: This study highlights the benefits of collaboration between clinicians and researchers to support evidenced based practice. The findings from this study will be used to develop strategies for removing barriers to sexuality assessment by nurses.

© 2005 Lippincott Williams & Wilkins, Inc.

taken from: http://www.cns-journal.com/pt/re/clnnursespec/abstract

ISSUES AND INNOVATIONS IN NURSING PRACTICE

Spirituality and family nursing: spiritual assessment and interventions for families
Ruth A. Tanyi MSN RN FNP-C APRN-BC
Doctoral Student in Public Health: Preventive Care, Loma Linda, California, USA
Correspondence to Ruth A. Tanyi,
Family Nurse Practitioner,
Prevention,
Lifestyle and Wellness Services,
PO Box 1185,
Loma Linda,
CA 92354,
USA.
E-mail: rtanyi@yahoo.com
Copyright 2006 The Author. Journal compilation 2006 Blackwell Publishing Ltd
KEYWORDS
family health • nursing • spiritual assessment • spirituality
tanyi r.a. (2006) Journal of Advanced Nursing53(3), 287–294
Spirituality and family nursing: spiritual assessment and interventions for families

ABSTRACT

Aim. The aim of this paper is to propose a guideline for spiritual assessment and interventions explicitly for families, while considering each family member's unique spirituality.

Background. Spirituality's positive effect is pervasive in health care and in the lives of many families; therefore, there is a need to integrate spiritual assessment and interventions in total family care.

Discussion. The majority of published guidelines on spiritual assessment and interventions are designed predominantly for individuals. They fail to differentiate between individual and family spirituality or offer only brief discussions on family spirituality. Such guidelines are potentially problematic. They may lead nurses to focus only on individual spirituality and neglect to discern family unit spirituality or recognize the presence of conflicts in spiritual perspectives within the family. While other disciplines such as social work and family therapy have several guidelines/strategies to assess family spirituality, there is a dearth of such guidelines in the family health nursing and spirituality literature, in spite of the rhetoric about incorporating spirituality as part of total family assessment. As a beginning solution, guidelines are proposed for spiritual assessment and interventions for the family as a unit, and the category of spiritual interpretation to represent diagnosis is introduced. Case studies exemplify how to integrate the guideline, and illustrate elements that may favour specific interpretations which would guide the interventions.

Conclusion. As nurses continually strive to assist families with their health needs, they must also attend to their spiritual needs, as one cannot truly assess a family without assessing its spirituality.


Accepted for publication 5 April 2005

taken from: http://www3.interscience.wiley.com/journal/118563247/abstract

FamiLy LiFe

Journal of Family Nursing, Vol. 11, No. 4, 371-387 (2005)
DOI: 10.1177/1074840705281781

Nursing Science and Chronic Illness: Articulating Suffering and Possibility in Family Life
Catherine A. Chesla, R.N., D.N.Sc., F.A.A.N.

University of California, San Francisco

Families living with a member who has a chronic illness vacillate between hope and despair, suffering and possibility. How this living "between" evolves in families and how family relations are affected has received insufficient attention. As nurses we can learn families’ experiences of suffering and situated possibility through family narratives about and reflections on the everyday. Articulating this experience in thick, alive, complex, and practical texts promises to enhance our understanding, our practice with families, and our own lived possibilities.

Key Words: chronic illness • family research • suffering • narrative • qualitative research

taken from: http://jfn.sagepub.com/cgi/content/abstract/11/4/371

WOMEN AND CHILDREN
Child in hospital: family experiences and expectations of how nurses can promote family health
Hanna Hopia MNSc, RN, Patricia S Tomlinson PhD, RN, Eija Paavilainen PhD, RN and Päivi Åstedt-Kurki PhD, RN
Researcher, Doctoral Student, Department of Nursing Science, University of Tampere, Tampere, FinlandProfessor Emeritus, Maternal, Child, Family Scholar, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USAActing Professor, Department of Nursing Science, University of Tampere/Etelä-Pohjanmaa Hospital District, Tampere, FinlandProfessor, Department Head, Department of Nursing Science, University of Tampere/Pirkanmaa Hospital District, Research Unit, Tampere, Finland
Correspondence to Hanna Hopia
Pyssymiehenkatu 49
40630 Jyväskylä
Finland
Telephone: + 358 14 254 754
E-mail: hanna.hopia@jypoly.fi
Copyright 2005 Blackwell Publishing Ltd
KEYWORDS
chronically ill child • family health • family nursing • family nursing interventions • grounded theory • hospitalized child
hopia h, tomlinson ps, paavilainen e & åstedt-kurki p (2005) Journal of Clinical Nursing 14, 212–222
Child in hospital: family experiences and expectations of how nurses can promote family health

ABSTRACT

Aims and objectives. This study set out to explore, from the family's point of view, ways in which nursing staff can promote family health during the child's hospital stay.

Background. Having a child in hospital is a major source of stress and anxiety for the whole family. Earlier studies have described parental coping strategies, ways to strengthen those strategies and to support parental participation in child care, but no one has studied the promotion of family health during the child's hospitalization from the family's point of view.

Design. Interviews were conducted in 2002 with 29 families who had a child with a chronic illness which were receiving or had received treatment on the paediatric wards of two Finnish hospitals.

Methods. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Data collection and analysis phases proceeded simultaneously.

Results. Five domains were distinguished in the promotion of family health: (1) reinforcing parenthood, (2) looking after the child's welfare, (3) sharing the emotional burden, (4) supporting everyday coping and (5) creating a confidential care relationship.

Conclusions. The results strengthen the knowledge base of family nursing by showing how nursing staff can promote family health during the child's hospital stay.

Relevance to clinical practice. The results have a number of practical applications for nursing, both for clinical practice and research. The results can be used in paediatric hospital wards caring for chronically ill children and their families. The five domains of family health promotion described here should be tested in other paediatric wards and in other geographical locations.


Submitted for publication: 3 December 2003 Accepted for publication: 22 July 2004

taken from: http://www3.interscience.wiley.com/journal/118662230/abstract

Policies and Practices for Maternal Support Options during Childbirth and Breastfeeding Initiation After Cesarean in Southeastern Hospitals
Hila J. Spear a
a Hila J. Spear, RN, PhD, IBCLC, is a professor of nursing and director of graduate studies in the Department of Nursing at Liberty University, Lynchburg, VA.
Address for correspondence: Hila J. Spear, RN, PhD, IBCLC, Department of Nursing, Liberty University, 1971 University Boulevard, Lynchburg, VA 24502. E-mail: hspear@liberty.edu.
Copyright 2006, AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
KEYWORDS
breastfeeding • cesarean • childbirth • policy • support

ABSTRACT

Objective: To describe policies, practices, and associated rationales of hospital obstetric units regarding mothers' support person options during childbirth and to explore practices concerning support of breastfeeding initiation after cesarean delivery.

Design: Descriptive telephone survey.

Setting: Hospitals in the southeastern region of the United States.

Participants: Convenience sample of 154 obstetric nurse manager and nurse representatives employed by the participating hospitals.

Main Outcome Measures: Types of policies regarding mothers' support person options during childbirth and immediate postpartum stage, initiation of breastfeeding after cesarean birth, and attitudes about policies.

Results: All hospitals allowed two or more support persons during vaginal births, 89% permitted only one support person during nonemergent cesareans, and 58.0% of the nurse representatives believed that mothers should be allowed a second support person. Less than one third (31.2%) of the hospitals considered a mother's request to breastfeed in the operating room, and most (78.6%) allowed mothers to breastfeed in the recovery room.

Conclusions: Overall, maternal support policies, practices, and nurse representatives' attitudes were mother and family friendly, particularly related to vaginal births. Though breastfeeding initiation after cesarean birth was encouraging, support person options during nonemergent cesarean births and related rationales warrant further examination. JOGNN, 35, 634-643; 2006. DOI: 10.1111/J.1552-6909.2006.00078.x


Accepted: March 2006

taken from:http://www3.interscience.wiley.com/journal/118588403/abstract

INTEGRATIVE LITERATURE REVIEWS AND META-ANALYSES

Risk assessment scales for pressure ulcer prevention: a systematic review
Pedro L. Pancorbo-Hidalgo PhD RN, Francisco Pedro Garcia-Fernandez RN, Isabel Ma Lopez-Medina PhD Student RN and Carmen Alvarez-Nieto PhD RN
Professor of Medical-Surgical Nursing, School of Nursing, University of Jaén, Jaén, SpainManager of Training, Research and Quality Unit, University Hospital of Jaén, Jaén, SpainProfessor of Medical-Surgical Nursing, School of Nursing, University of Jaén, Jaén, SpainProfessor of Mother and Childhood Nursing, School of Nursing, University of Jaén, Jaén, Spain
Correspondence to Pedro L. Pancorbo-Hidalgo,
School of Nursing,
University of Jaén,
Las Lagunillas s/n 23071,
Jaén,
Spain.
E-mail: pancorbo@ujaen.es
Copyright 2006 Blackwell Publishing Ltd
KEYWORDS
meta-analysis • nursing • pressure ulcers • risk assessment scales • risk factors • systematic review
pancorbo-hidalgo p.l., garcia-fernandez f.p., lopez-medina i.m. & alvarez-nieto c. (2006) Journal of Advanced Nursing54(1), 94–110
Risk assessment scales for pressure ulcer prevention: a systematic review

ABSTRACT

Aim. This paper reports a systematic review conducted to determine the effectiveness of the use of risk assessment scales for pressure ulcer prevention in clinical practice, degree of validation of risk assessment scales, and effectiveness of risk assessment scales as indicators of risk of developing a pressure ulcer.

Background. Pressure ulcers are an important health problem. The best strategy to avoid them is prevention. There are several risk assessment scales for pressure ulcer prevention which complement nurses' clinical judgement. However, some of these have not undergone proper validation.

Method. A systematic bibliographical review was conducted, based on a search of 14 databases in four languages using the keywords pressure ulcer or pressure sore or decubitus ulcer and risk assessment. Reports of clinical trials or prospective studies of validation were included in the review.

Findings. Thirty-three studies were included in the review, three on clinical effectiveness and the rest on scale validation. There is no decrease in pressure ulcer incidence was found which might be attributed to use of an assessment scale. However, the use of scales increases the intensity and effectiveness of prevention interventions. The Braden Scale shows optimal validation and the best sensitivity/specificity balance (57·1%/67·5%, respectively); its score is a good pressure ulcer risk predictor (odds ratio = 4·08, CI 95% = 2·56–6·48). The Norton Scale has reasonable scores for sensitivity (46·8%), specificity (61·8%) and risk prediction (OR = 2·16, CI 95% = 1·03–4·54). The Waterlow Scale offers a high sensitivity score (82·4%), but low specificity (27·4%); with a good risk prediction score (OR = 2·05, CI 95% = 1·11–3·76). Nurses' clinical judgement (only considered in three studies) gives moderate scores for sensitivity (50·6%) and specificity (60·1%), but is not a good pressure ulcer risk predictor (OR = 1·69, CI 95% = 0·76–3·75).

Conclusion. There is no evidence that the use of risk assessment scales decreases pressure ulcer incidence. The Braden Scale offers the best balance between sensitivity and specificity and the best risk estimate. Both the Braden and Norton Scales are more accurate than nurses' clinical judgement in predicting pressure ulcer risk.


Accepted for publication 17 January 2005

taken from: http://www3.interscience.wiley.com/journal/118563322/abstract

LabouR Pain

Labour pain experience and intensity: A Jordanian perspective

Abushaikha, Lubna RN PhD; Oweis, Arwa RN DNS

Assistant Professor, Department of Maternal-Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan (Abushaikha)

Assistant Professor, Department of Maternal-Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan (Oweis)

Correspondence: Lubna Abushaikha, Assistant Professor, Faculty of Nursing, Department of Maternal-Child Health, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. Email: lub2001@just.edu.jo

Accepted for publication July 2004
Abstract

In this descriptive study, 100 low-risk participants who delivered vaginally were recruited from the postpartum unit of a major hospital in the city of Amman. Three instruments, the Numeric Pain Intensity Scale (NPIS), a pain assessment questionnaire and a demographic questionnaire were used to assess labour experiences and labour pain intensity levels. The majority of Jordanian parturients did not receive pain relief. Eighty-one women reported pain intensity levels of ≥ 8 on the NPIS (ranging from 0-10). The mean pain intensity level during the second stage of labour was 8.83. A significant difference in age was found between primiparas and multiparas. Jordanian parturients reported painful labour experiences; therefore, re-evaluation of current maternity nursing and midwifery practices and roles regarding labour pain management are warranted. The roles of supporter and educator among maternity nurses and midwives in Jordan also need to improve considerably.

taken from: http://pt.wkhealth.com/pt/re/ijnp/abstract

RAISING THE AWARENESS OF PRIMARY CARE PROVIDERS ABOUT POSTPARTUM DEPRESSION

Authors: M. Cynthia Logsdon a; Katherine Wisner b; Diane M. Billings c; Brian Shanahan d
Affiliations: a University of Louisville, Louisville, Kentucky, USA

b University of Pittsburgh, Pittsburgh, Pennsylvania, USA

c Indiana University, School of Nursing, Indianapolis, Indiana, USA

d CEO, MediSpin, Inc, New York, New York, USA

Abstract

About 13% of women experience depression in the first year after childbirth. Postpartum depression has deleterious effects on the woman's relationships, her functional status, and her ability to care for her infant. Primary care providers have the most contact with postpartum women, but may be unable or unwilling to screen, treat, and/or refer the women. Thus, many women with postpartum depression are not receiving mental health services. The purpose of this article is to describe methods to raise the awareness of primary care providers about postpartum depression, thereby eliminating a major barrier to mental health treatments of postpartum women.

taken from: http://www.informaworld.com/smpp/content~content=a727132068~db=all

METHODOLOGICAL ISSUES IN NURSING RESEARCH
Measuring postpartum stress
Chich-Hsiu Hung PhD RN
Associate Professor, College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan
Correspondence to Chich-Hsiu Hung,
College of Nursing,
Kaohsiung Medical University,
No. 100,
Shih-Chuan 1st Road,
Kaohsiung City 80708,
Taiwan.
E-mail: chhung@kmu.edu.tw
Copyright 2005 Blackwell Publishing Ltd
KEYWORDS
maternal role • midwifery • social support • exploratory common factor analysis • measurement • Hung Postpartum Stress Scale
hung c.-h. (2005) Journal of Advanced Nursing50(4), 417–424
Measuring postpartum stress

ABSTRACT

Aims. This paper reports a study whose purpose was to revalidate the Hung Postpartum Stress Scale by expanding and revising its contexts to reflect the social changes that have occurred in Taiwan over the last two decades.

Background. Existing measures of general stress, which have also been used to assess postpartum stress, fail to measure women's specific childbearing stressors during the postpartum period. The Hung Postpartum Stress Scale was initially developed 11 years ago by Hung and associates to measure stress in the early postpartum period as it occurred in the Taiwanese social milieu of the time. However, revalidation was needed because of rapid changes in the Taiwanese social system.

Methods. Employing a non-experimental, quantitative research design and a proportional stratified quota sampling of hospitals by birth rate, the revised instrument was completed by 861 postpartum women selected from clinics and hospitals in Taiwan.

Results. An exploratory common factor analysis indicated the structure validity of three dimensions of postpartum stress: concerns about maternity role attainment, concerns about negative body changes, and concerns about lack of social support. With regard to generalizability of the factors across delivery type, education level, and income status subgroups within the population, high coefficients of congruence were shown. Moreover, the internal consistency reliabilities for the total Hung Postpartum Stress Scale and its three dimensions across the full sample and within pertinent sub-samples showed that it is a reliable tool for measuring postpartum stress.

Conclusions. A series of analyses supported the validity and reliability of the revised Hung Postpartum Stress Scale. Additional research is recommended using confirmatory factor analysis to determine the stability of the factor structure identified in the present study.


Accepted for publication 5 July 2004

taken from: http://www3.interscience.wiley.com/journal/118698635/abstract

ISSUES AND INNOVATIONS IN NURSING PRACTICE
Nurse–patient relationships in palliative care
Esther Mok BA MA PhD RN RM and Pui Chi Chiu BSc MSc RN
Associate Professor, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, ChinaPalliative Nurse, Haven of Hope Hospital, Hong Kong, China
Correspondence to Esther Mok,
School of Nursing,
The Hong Kong Polytechnic University,
Hung Hom,
Kowloon,
Hong Kong,
China.
E-mail: hsemok@inet.polyu.edu.hk
Copyright 2004 Blackwell Publishing Ltd
KEYWORDS
nurse–patient relationship • palliative care • nurses' qualities • trust
mok e. & chiu p.c. (2004) Journal of Advanced Nursing48(5), 475–483
Nurse–patient relationships in palliative care

ABSTRACT

Aim. The aim of this paper is to report a study exploring aspects of nurse–patient relationships in the context of palliative care.

Background. Although there are numerous studies addressing nurse–patient relationships, little research has focused on these in the context of palliative are. Furthermore, no previous study has examined the relationship in the Chinese context.

Methods. Qualitative data were collected from 10 hospice nurses and 10 terminally ill patients by means of open ended unstructured interviews. Respondents were asked to reflect on practices and incidents that would allow an understanding of the meaning of nurse–patient relationships in palliative care.

Results. Four major categories emerged from the perspectives of patients and nurses: (1) forming a relationship of trust; (2) being part of the family; (3) refilling with fuel along the journey of living and dying; and (4) enriched experiences. Responses revealed that a relationship of trust is formed, and that nurses are not only regarded as health professionals, but also become part of the family or a good friend. Nurses who develop trusting relationships demonstrate a holistic approach to caring, show their understanding of patients' suffering, are aware of their unvoiced needs, provide comfort without actually being asked, and are reliable, proficient, competent and dedicated in their care.

Conclusion. Trust, the achievement of the goals of patients and nurses, caring and reciprocity are important elements of nurse–patient relationships in palliative care. Such relationships not only improve patients' physical and emotional state, but also facilitate their adjustment to their illness, ease pain and can ultimately lead to a good death experience. It is nurses' personal qualities and skills, which are embedded in these relationships, that constitute excellence in nursing care. Nurses also derive satisfaction and are enriched through the relationships.


Submitted for publication 17 February 2003 Accepted for publication 26 February 2004

taken from: http://www3.interscience.wiley.com/journal/

Issues In Clinical Nursing
Nurse–patient communication: an exploration of patients' experiences
Catherine McCabe MSc, RGN, BNS, RNT
Lecturer in Nursing, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
Correspondence to Catherine McCabe Lecturer in Nursing Trinity Centre for Health Sciences St James's Hospital Dublin 8
Ireland
E-mail: camccabe@tcd.ie
Copyright 2004 Blackwell Publishing Ltd
KEYWORDS
communication • empathy • nurse–patient communication • patient satisfaction • phenomenology • socialization
mccabe c. (2004) Journal of Clinical Nursing13, 41–49
Nurse–patient communication: an exploration of patients' experiences

ABSTRACT

Background. Patient-centred communication is a basic component of nursing and facilitates the development of a positive nurse-patient relationship which, along with other organizational factors, results in the delivery of quality nursing care. Nurses are frequently described in the literature as poor communicators, however, very few studies have examined patients' experiences of how nurses communicate.

Aims and objectives. The aim of the study was to explore and produce statements relating to patients' experiences of how nurses communicate.

Design. A qualitative perspective using an hermeneutic phenomenological approach was considered to be the most appropriate methodology for this study.

Methods. Using purposeful sampling, eight patients in a general teaching hospital in the Republic of Ireland were interviewed. Data were collected using unstructured interviews. Data analysis was a reflective process and the findings were presented through the description and interpretation of themes and sub-themes.

Results. Following data analysis four themes emerged. These were, 'lack of communication', 'attending', empathy' and 'friendly nurses'.

Conclusions. The findings of this study indicate that, in contrast to the literature that suggests that nurses are not good at communicating with patients, nurses can communicate well with patients when they use a patient-centred approach. However, health care organizations do not appear to value or recognize the importance of nurses using a patient-centred approach when communicating with patients to ensure the delivery of quality patient care.

Relevance to clinical practice. The implication of these findings for clinical practice is that the task-centred approach to patient care that is associated with nursing in the past, appears to be alive and well. If health care management want to ensure that patients receive quality nursing care, they will need to consider patient-centred communication to be essential to encourage and support nurses to communicate in this manner.


Submitted for publication: 20 November 2002 Accepted for publication: 13 May 2003

taken from:http://www3.interscience.wiley.com/journal/

 

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