Biomedical subjects

M Grypdonck

Publications and source records attributed to M Grypdonck.

At least 19 recordsLinked to original sources

PubMed2002

The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study. Part 2.

In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. Following the results we described in part 1, we now focus specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The following issues will be addressed: (i) information and education; (ii) attitude of health care professionals; (iii) the patient's insight; (iv) acceptance of illness; (v) motivation; (vi) other relevant patient characteristics; and (vii) continuity of care. Finally, the implications of the findings for the development of a nursing intervention protocol will be discussed.

Attitude of Health Personnel↗

PubMed2002

The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study. Part 1.

In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. We addressed several models of symptom recognition plans and indicated how patients, healthcare professionals and other persons involved may be able to list and evaluate early warning signs systematically. We also paid attention to the role of the patient's family and to the potential effects of using early recognition and early intervention methods. In a follow-up article (part 2), we will focus more specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The results of this exploratory study will be used to design an intervention protocol for nursing staff to serve as a tool for preparing symptoms recognition plans with the individual patient and his/her social network.

Adult↗

PubMed2001

A method to develop a nursing intervention: the contribution of qualitative studies to the process.

AIM OF THE PAPER: To describe how to develop a patient-centred nursing intervention (NI). BACKGROUND: The stimulus for scrutinizing methods and techniques to develop a NI was a research project concerning the contribution of information and support to the sexual adaptation of women with gynaecological cancer. Within this project, a NI for sexual teaching (ST) was developed because the literature review revealed no tested NI for this purpose. How patients experience and perceive received information influences the usefulness and efficacy of a teaching intervention. Qualitative methods provide insight and understanding of patients' experience. Consequently, qualitative methods are appropriate to use when developing interventions that aim to influence patients' situations through the provision of information. METHOD: Previously reported approaches for developing an intervention did not match the goals and underlying premises identified for the intervention under development. An alternative method, consisting of a design phase and a testing phase, was developed. The goal of the design phase was to develop a working definition of the intervention and to formulate recommendations for carrying out the intervention. Written guidelines provided concrete examples of the topics to discuss and how to discuss them. During the design phase, a qualitative study was conducted to describe the lived-experience of the phenomenon that the information should influence, namely sexuality after treatment for gynaecological cancer. In the testing phase, a different type of qualitative study took place. The patients' experience of receiving information and the nurses' experience of providing it were investigated in order to refine the proposed intervention, to identify the results patients hope to achieve (or achieved) and to explore the underlying theoretical explanation of the intervention. During the testing phase, the feasibility and acceptability of the modified intervention were both established. CONCLUSION: Even when the starting point is advice from care-givers, an intervention can be developed that is in harmony with the patient perspective when qualitative studies are part of the process.

Adaptation, Psychological↗

PubMed1997

Effects of a nursing pain programme on patient outcomes.

The effectiveness of a continuing pain education program, directed to surgical cancer nurses, was investigated in a pretest posttest controlled intervention study. ANCOVA for repeated measures revealed that the programme resulted in a lower pain intensity of surgical colon and breast cancer patients (p = 0.02). However, no effects were found on pain duration, sleepless hours as a result of pain, state anxiety, mood disturbances, and duration of hospitalization. It is assumed that because the pain CE programme had a moderate impact on pain intensity, this had no consequences for the other outcome variables mentioned.

Affect↗

PubMed1997

Effects of a continuing education program on nurses' pain assessment practices.

Surgical nurses from five Dutch general hospitals participated in a continuing education program on pain assessment and management. A pretest-posttest controlled intervention study revealed that the program led to an increase in the quality of activities relevant to taking pain histories. Although this increase in quality was most apparent 1 month after the program, it was still observable 6 months after the program. There were, however, no effects on the number of activities relevant to taking pain histories, or on the number of nurses who used direct questioning as a method to determine pain. There may be several explanations for these results, including nurses' limited openness to new approaches, a lack of support from physicians and nurse superiors, and that program items were not translated into ward policy.

Education, Nursing, Continuing↗

PubMed1997

Nurses' perceptions of factors influencing the use of a pain program.

Factors that, according to nurse participants, influenced the application of what was learned in a pain program were explored by means of qualitative interviews. Participants indicated that the correspondence between the program and their personal view on pain management, attitudes toward the program and innovations in general, self-efficacy perceptions, and (un)familiarity and taboos with respect to program items influenced what they put into practice. In addition, participants indicated that interactions with colleagues, nursing managers, patients, and physicians affected their application of the program. Furthermore, organizational factors, such as limited time and lack of formal program implementation, were mentioned as influential.

Adult↗

PubMed1997

Being a stroke patient: a review of the literature.

The purpose of this paper is to review the research literature on the patient's experience of stroke. Four qualitative studies on how patients experience stroke were identified. The findings of these studies show that the stroke patient often has clear goals for himself in relation to functional abilities, against which he measures all success and forward progress in his rehabilitation. Even though the stroke patient accepts a lower level of functional ability, he is not willing to accept the rehabilitation professionals' prediction of his ultimate functional level if it is lower than his own goal. Furthermore, stroke patients see recovery as a return to the existence they had lived before the stroke, which is different from the health care providers' view. To the health care provider, recovery is measured in terms of isolated and discrete return of movement, whereas in the eyes of the patients, recovery is a return to previously valued activities. Further, studies on psychosocial function after stroke were reviewed. Recent studies show that the psychological impact of the stroke experience is immense and that stroke patients experience stress on a variety of levels. Also, depression exists in a large portion of the stroke population. The impact of stroke also influences the patient's social existence, as studies have shown that stroke patients do manifest diminished social function. However, the reviewed studies are not without limitations. Further studies, with a qualitative design, are needed to throw light on the patient's experience of being ill with stroke, and the process of his recovery.

Aphasia↗

PubMed1997

Nursing students' responses to ethical dilemmas in nursing practice.

In literature as well as in nursing practice a growing concern about nurses' ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students' ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg's definition of morality was refined by adding a care perspective. The results show that the majority of students can be located in the fourth moral stage according to Kohlberg's theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions.

Adolescent↗

PubMed1997

[Importance of qualitative research for nursing and nursing science].

Qualitative research has an important place in nursing science and is becoming increasingly recognized. Qualitative research in nursing mainly deals with the lived experiences of patients and nurses. In the field of chronic illness, qualitative research has brought to the open some of the processes chronically ill patients undergo and what it means living with chronic illness. In addition, new insights were gained about the processes involved in receiving and in giving care. Qualitative research about chronic illness provided nurses with understanding of the lived experience of patients. This understanding is essential for good nursing care. However, qualitative research is not the only method and for some aspects of nursing not the adequate one. Qualitative and quantitative research are complementary.

Adaptation, Psychological↗

PubMed1997

Development, reliability, and validity testing of the Ethical Behavior Test: a measure for nurses' ethical behavior.

The need for reliable and valid measures for ethical behavior of nurses has encouraged the authors to develop a new instrument to measure students' ethical behavior in daily nursing dilemmas. Characteristic of the instrument presented is the inclusion of two fundamental components of ethical behavior: (1) ethical reasoning (and the resulting decision), and (2) the actual implementation of the ethical decision. As for many instruments, Kohlberg's theory of moral development has been used as the conceptual framework. However, Kohlberg's abstract justice orientation was refined by a care perspective and representative nursing dilemmas were used to make the instrument conceptually more appropriate for measuring nurses' ethical behavior. The analysis of the psychometric properties of the instrument has provided several relevant indications for the reliability and validity of the ethical reasoning and implementation scores. The revealed inconsistencies in the Ethical Behavior Test could be satisfactorily interpreted in terms of Kohlberg's theory and related empirical research findings, supporting the reliability of the ethical behavior scores. The content validity rests upon the careful development of the instrument resulting in an optimal mix of dilemmas, arguments and care situations to reveal nurses' ethical behavior and in a substantial degree of correspondence between the concept and operationalization. The congruency between the patterns of ethical behavior and Kohlberg's theoretical insights about ethical reasoning and practice support the construct validity of the instrument.

Adult↗

PubMed1996

Effects of a pain programme on nurses' psychosocial, physical and relaxation interventions.

The effectiveness of a continuing education programme on pain assessment and management was investigated in 106 surgical cancer nurses. It was found that the programme led to a more positive attitude towards physical and relaxation interventions (such as the use of relaxation, distraction and massage techniques). In addition, an increase in the duration and quality of psychosocial interventions (provision of information, emotional support, and promotion of autonomy) was established. Furthermore, the programme resulted in an increase in the quality of physical and relaxation interventions. However, the programme did not lead to more positive attitudes towards psychosocial interventions, or to increases in the numbers of psychosocial, physical and relaxation interventions.

Adult↗

PubMed1996

The relationship between education and ethical behavior of nursing students.

Based on the cognitive theory of moral development of Kohlberg, refined by the addition of the dimension "ethics of care" and the educational theory of Janssen, the relationship of education and ethical behavior of nursing students was examined. Ethical behavior referred not only to the ethical reasoning of students but also to the relationship between this reasoning and their behavior. This study examined the responses of 2,624 nursing students to five ethical nursing dilemmas included in the Ethical Behavior Test by relating them to four educational variables: students' level of education, level of enrollment, school, and students' perceptions of the educational process. A significant relationship between education and ethical behavior was found.

Adolescent↗

PubMed1993