Search PubMed⌕ Search

Biomedical subjects

C M Begley

Publications and source records attributed to C M Begley.

17 recordsLinked to original sources
PubMed2006

Iatrogenic sexual dysfunction and the protective withholding of information: in whose best interest?

In recent years a growing body of evidence has highlighted the impact of neuroleptics and antidepressants on sexual function. Research from a service user's perspective suggested that service users are dissatisfied with the information that they received on drugs, and would like more education, in particular, on the side effects of medication that impact on sexual function. This paper reports some of the findings of a grounded theory study that explored how psychiatric nurses responded to issues of sexuality in practice. Emphasis within the paper is given to how nursing staff addressed the side effects of drugs that impact on sexual function. Findings suggested that nurse addressed the issue of prescribed medication and sexual function in practice, using a 'Veiling Sexualities Cycle', which had three subcategories: 'Hanging the Veil', 'Lifting the Veil' and 'Re-veiling'. In the light of contemporary mental health policy, findings from the study are discussed and recommendations for practice and education made.

Attitude of Health Personnel↗
PubMed2006

Sexual health education for people with mental health problems: what can we learn from the literature?

Research into sexual risk behaviour among people with 'severe' mental health problems suggested that they are likely to engage in high-risk sexual behaviour, for a number of reasons, putting them at risk of sexually transmitted diseases. The aim of this review is to describe approaches, content and outcomes of sexual health education programmes, developed and implemented for people with mental health problems. A literature review from 1980 to 2005 was carried out using the electronic databases CINAHL, PsycINFO, British Nursing Index, Pubmed and Medline, and the Cochrane library was also searched. The literature search was confined to papers written in English. The keywords 'sexuality', 'sexual health education', 'sexual health promotion', 'HIV', 'sexually transmitted disease' were combined with 'mental illness', 'chronic mental illness''severe mental illness''persistent mental illness''psychiatry', 'mental disorder', 'education interventions' and 'evaluation'. A vast amount of literature was recovered on sexual risk behaviour in people with severe mental health problems, and sexual dysfunction as a result of prescribed medication. As the focus of the review was on sexual health education, this literature was omitted. Although the literature on sexual health education for people experiencing mental health problems was sparse, 14 studies were located that either described or evaluated sexual health education programmes. Most sex education programmes focused on topics such as HIV and other sexually transmitted diseases, negotiating safe sex and skill development in condom use. Findings suggested that the people who attended benefited from sexual health education programmes, facilitated in a sensitive and supportive manner. Education tended to produce a reduction in sexual risk behaviour as opposed to complete cessation. Nevertheless, it is appropriate to consider integrating such education with service provision. The results of the review provide guidance to service providers and mental health nurses wishing to develop and evaluate sexual health education programmes for service users. Areas for future research are also identified.

Attitude to Health↗
PubMed2005

Neuroleptic medication and sexuality: the forgotten aspect of education and care.

Discussing issues of sexuality is a challenging and difficult issue for many health care workers. When it comes to sexuality and people with mental health problems there seems to be a dual taboo. Mental health nurses are ideal members of the health care team to talk to service users about issues as sensitive as sexuality and the side effects of medication that impact on sexual health. However, in both clinical practice and the nursing literature, the side effects of medications that impact on sexual function are often ignored and unspoken about. This paper examines the impact of both conventional and atypical neuroleptic medication on sexual function and discusses the probable causes of such effects. The possible reasons why health care professionals are reluctant to discuss side effects impacting on sexual health with service users are explored and emphasis is placed on the need for mental health nurses to respond to requests from service users for more education and discussion in the area of sexuality and sexual health.

Antipsychotic Agents↗
PubMed2001

'Giving midwifery care: student midwives' views of their working role.

OBJECTIVE: to explore the opinions, feelings and views of student midwives of their education as they progressed through their two-year programme in Ireland, with the intention of interpreting and understanding the working and learning world of the participants so that future students might be assisted to improve their educational experiences. DESIGN: using quantitative and qualitative methods. A phenomenological approach was used to guide the qualitative section of the study reported here. SETTING: all seven midwifery schools in Southern Ireland. PARTICIPANTS: all students in the first intake of 1995 in every midwifery school in Ireland (n = 125). DATA COLLECTION: individual and group interviews, diary-keeping and questionnaires. KEY CONCLUSIONS: the findings presented here illustrate the students' views of their working role. The environment appeared to be one of work, rather than learning, and the students' status that of junior employee rather than 'learner' They perceived themselves as 'thrown in the deep end' without much support or guidance from qualified staff. They were frightened, unsure of themselves and suffered from role conflict and loss of status. There appeared to be an acute shortage of staff and the care given was seen to be the basic minimum, fulfilling women's physical needs but ignoring their emotional ones. The care given appeared to be planned according to routine and economic necessity rather than for sound midwifery, medical or social reasons. IMPLICATIONS FOR PRACTICE: the education of students needs to focus on the development of autonomous practice and the use of routines and non-research based care should be phased out. Students need to be assisted, with support from educated mentors, to plan care in a holistic way that will enable them to develop their midwifery skills in the future.

Adult↗
PubMed2001

'Knowing your place': student midwives' views of relationships in midwifery in Ireland.

OBJECTIVE: to explore the feelings and views of student midwives of their education as they progressed through their two-year programme in Ireland, with the intention of interpreting and understanding the working and learning world of the participants so that future students might be assisted to improve their educational experiences. DESIGN: phenomenology, using the technique of triangulation in a number of ways. SETTING: all seven midwifery schools in Southern Ireland. PARTICIPANTS: all students in the first intake of 1995 in every midwifery school in Ireland (n=125). DATA COLLECTION: individual and group interviews, diary-keeping and questionnaires. KEY CONCLUSIONS: the findings presented in this paper illustrate the students' views of their relationships with qualified midwives and obstetricians. IMPLICATIONS FOR PRACTICE: an attitude of respect for all students needs to be fostered in hospitals educating midwives if we are to produce caring midwives in the future. The new, extended programme of midwifery education in Ireland should include an emphasis on communication skills and conflict management. A re-organisation of the hierarchical structures evident in midwifery management would lead to an improvement in the experiences of students and childbearing women alike.

Adult↗
PubMed2000

The fluid dynamic and shear environment in the NASA/JSC rotating-wall perfused-vessel bioreactor.

The rotating-wall perfused-vessel (RWPV) bioreactor, used for both microgravity and Earth-based cell science experiments, is characterized in terms of the fluid dynamic and fluid shear stress environment. A numerical model of the flow field is developed and verified with laser Doppler velocimeter measurements. The effects of changes in operating conditions, including rotation rates and fluid perfusion rates, are investigated with the numerical model. The operating conditions typically used for ground-based experiments (equal rotation of the inner and outer cylinders) leads to flow patterns with relatively poor mass distribution characteristics. Approximately 50% of the inlet-perfused fluid bypasses the bulk of the fluid volume and flows to the perfusion exit. For operating conditions typical in microgravity, small differential rotation rates between the inner and outer cylinders lead to greatly improved flow distribution patterns and very low fluid shear stress levels over a large percentage of the fluid volume. Differences in flow patterns for the different operating conditions are explored. Large differences in the hydrodynamic environments for operating conditions typical of true microgravity and ground-based "microgravity simulations" are demonstrated.

Bioreactors↗
PubMed1999

A study of student midwives' experiences during their two-year education programme.

OBJECTIVE: To explore the opinions, feelings and views of student midwives of their education as they progressed through their two-year programme in Ireland, with the intention of interpreting and understanding the working and learning world of the participants so that future students might be assisted to improve their educational experiences. DESIGN: Triangulation, using quantitative and qualitative methods. A phenomenological approach was used to guide the qualitative section of the study. SETTING: All seven midwifery schools in Southern Ireland. PARTICIPANTS: All students in the first intake of 1995 in every midwifery school (n = 125). DATA COLLECTION: Individual and group interviews, diary-keeping and questionnaires. The design and conduct of the study are described in this paper and the findings will be presented at a later date.

Adult↗
PubMed1999

Student midwives' views of 'learning to be a midwife' in Ireland.

OBJECTIVE: To explore the opinions, feelings and views of student midwives of their education as they progressed through their two-year programme in Ireland, with the intention of interpreting and understanding the working and learning world of the participants so that future students might be assisted to improve their educational experiences. DESIGN: Quantitative and qualitative methods. A phenomenological approach was used to guide the qualitative section of the study. SETTING: All seven midwifery schools in Southern Ireland. PARTICIPANTS: All students in the first intake of 1995 in every midwifery school in Ireland (n = 125). DATA COLLECTION: Individual and group interviews, diary-keeping and questionnaires. KEY CONCLUSIONS: The findings presented in this paper illustrate the students' views of their education. Students perceived themselves as part of the workforce and believed that their educational needs were denied. They were given little clinical teaching and guidance and were not assisted to learn the skills of decision-making or judgement. Much of their learning took place by trial and error. The 13 weeks allocated for theoretical input in the midwifery education programme in Southern Ireland is far too short and many students thought that time was wasted. Relationships with the teaching staff were good, although some authoritarian attitudes were evident and teaching did not appear to be student-focused. IMPLICATIONS FOR PRACTICE: Theoretical teaching needs to be broadened and thought given to the integration of theory and practice. Clinical teaching is a necessity throughout the two-year programme and opportunities to teach while giving care should be identified and utilised. The use of prepared mentors, sufficient support staff and longer allocations to each area are recommended.

Education, Nursing, Graduate↗
PubMed1996

Triangulation of communication skills in qualitative research instruments.

Triangulation is a credible and useful method of conducting research which can result in an increase in both quality and quantity of data gathered. The five documented types of triangulation (data, investigator, theoretical, methodological, unit of analysis) do not completely answer all the needs of nurse researchers, particularly in the field of qualitative research. Using more than one method of data collection from within the same research tradition (within-method triangulation) is an accepted and effective technique. Extending the concept of triangulation to include the development of research tools leads to the proposal that the conscious use of two or three types of communication within each qualitative research instrument would improve its effectiveness over a tool which used only one type. This application of 'triangulation of communication skills' is considered within each of the major qualitative research tools, and the benefits outlined. The implications for nursing research and nurse researchers of consciously using non-verbal cues to supplement verbal information are described. It is suggested that using triangulation of communication skills in this way may improve the validity of data obtained and, if clearly documented, increase the credibility of the findings. In particular, when conducting qualitative interviews, the expert use of triangulation of communication skills will enhance the quality and quantity of data gathered. To this end, novice researchers need education and practice in using communication skills to best effect, in order to ensure the validity and completeness of their findings.

Clinical Competence↗
PubMed1996

Using triangulation in nursing research.

Triangulation is proposed by many nurse researchers as a means of solving the quantitative/qualitative debate and integrating the two approaches. While this view is accurate, it does not take into account the possible complexity and usefulness of triangulation, nor does it fully recognize the two goals of triangulation: confirmation and completeness of data. In this paper the five types of triangulation (data, investigator, theoretical, methodological, and unit of analysis) are described and the advantages and disadvantages of using this method are discussed. It is argued that the view that triangulation is merely the combination of different methods of investigation is a narrow one, and it is recommended that nurse researchers increase their utilization of the four less frequently used types of triangulation: data, investigator, theoretical and unit of analysis. When using triangulation of methods, researchers should also consider whether the use of within-method triangulation would be beneficial to their study. Sequential use of quantitative and qualitative methods to develop and refine tools of enquiry may also be more effective for certain studies than the more usual simultaneous use. The 'triangulation state of mind', the conscious employment of multiple data sources and methods to cross-check and validate findings continuously, should permeate all studies and lead to the goal of confirmation. Above all, triangulation must be chosen deliberately, for the correct reasons, and an adequate description of the rationale, planning and implementation of procedures should be given in reports, to give credence to this emerging method of research.

Bias↗
PubMed1996

Selecting a database for literature searches in nursing: MEDLINE or CINAHL?

This study compares the usefulness of the MEDLINE and CINAHL databases for students on post-registration nursing courses. We searched for nine topics, using title words only. Identical searches of the two databases retrieved 1162 references, of which 88% were in MEDLINE, 33% in CINAHL and 20% in both sources. The relevance of the references was assessed by student reviewers. The positive predictive value of CINAHL (70%) was higher than that of MEDLINE (54%), but MEDLINE produced more than twice as many relevant references as CINAHL. The sensitivity of MEDLINE was 85% (95% CI 82-88%), and that of CINAHL was 41% (95% CI 37-45%). To assess the ease of obtaining the references, we developed an index of accessibility, based on the holdings of a number of Irish and British libraries. Overall, 47% of relevant references were available in the students' own library, and 64% could be obtained within 48 hours. There was no difference between the two databases overall, but when two topics relating specifically to the organization of nursing were excluded, references found in MEDLINE were significantly more accessible. We recommend that MEDLINE should be regarded as the first choice of bibliographic database for any subject other than one related strictly to the organization of nursing.

Choice Behavior↗
PubMed1990

A comparison of 'active' and 'physiological' management of the third stage of labour.

A randomised, controlled trial of 1429 women was carried out to compare 'active' management of the third stage of labour, using i.v. Ergometrine 0.5 mg, with a method of 'physiological' management, in women at 'low risk' to haemorrhage. In the "active" management group a higher incidence of the following complications was found:- manual removal of placenta (p less than 0.0005), problems such as nausea (p less than 0.0005), vomiting (p less than 0.0005), and severe after-birth pains (p less than 0.02), hypertension (p less than 0.0001) and secondary postpartum haemorrhage (p less than 0.02). The incidence of postpartum haemorrhage (blood loss greater than 500 ml) and postnatal haemoglobins less than 10 gm/100 were higher in the 'physiological' group (p less than 0.0005, p less than 0.002). No difference was found in the need for blood transfusion in either group. The routine use of i.v. Ergometrine 0.5 mg during the third stage of labour in women at 'low risk' to haemorrhage does not appear to be necessary and has many adverse effects. Further studies comparing different methods of 'physiological' management are recommended in order to reduce to a minimum the incidence of postpartum haemorrhage and anaemia.

Adolescent↗
PubMed1990

The effect of ergometrine on breast feeding.

A randomised, controlled trial of 1429 women was carried out to compare 'active' management of the third stage of labour, using i.v. Ergometrine 0.5 mgs, with a method of 'physiological' management, in women at 'low risk' to haemorrhage. A separate sub-study, with 168 women in each of the two groups, examined the possible effects of Ergometrine on serum prolactin levels and the duration of breast feeding. No difference was found in peak (post-suckling) serum prolactin levels taken from 126 women between 48 and 72 hours postnatal. Further studies with larger sample sizes would give a more dependable result. Women who did not receive the drug Ergometrine were more likely to continue breast feeding for longer than four weeks than those who did (p less than 0.05). It is recommended that this drug should not be given routinely to women intending to breast feed.

Breast Feeding↗