Biomedical subjects

M Nolan

Publications and source records attributed to M Nolan.

At least 145 records · Page 8Linked to original sources

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Ageing and quality of life. 2: Understanding successful ageing.

Older people are being maintained in their own homes for longer periods and at increasing levels of frailty since the widespread introduction of community care policies across Europe. In order to sustain a good quality of life such individuals are more reliant on support from both informal (family) and formal sources. If appropriate assistance is to be provided then there is a need for a better understanding of how older people maintain their self-esteem. This article provides additional empirical support for the processes of accommodation and immunization and illustrates how knowledge of these concepts is important to the development of improved services for older people.

Activities of Daily Living↗

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Single-case experimental designs. 1: Using idiographic research.

The single-case experimental design is an example of idiographic research which involves establishing causality. The reasons for using idiographic research in nursing are discussed and important differences between nomothetic and idiographic designs are highlighted in this article. Single-case experimental designs are recommended in situations where both true experimental and quasi-experimental designs are difficult or impossible to use for practical or ethical reasons. Single-case experimental designs are ideal for nursing care situations because they study individual cases, making it possible to give individualized nursing care while simultaneously studying the outcomes of specific patients.

Humans↗

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Causality and control: key to the experiment.

The main aim of the experimental approach in research is to discover causal relationships between variables. This article describes the concept of causality and discusses common and important aspects and factors related to causality, manipulation and control. The four principles which underpin the inference of causality in experiments are highlighted and the role of 'control' in achieving the aim of experimental studies is discussed. Some methods of control such as manipulation, randomization, matching subjects, and holding extraneous variables constant are considered. Experimental designs are underpinned by these concepts. Indication is given of the threats to internal validity, which will be discussed in detail in the next article in this series.

Causality↗

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Causality and control: threats to internal validity.

The essence of experimental research is to establish causal relationships between variables and this requires internal validity. An experiment is said to have internal validity when extraneous variables have been controlled. However, there are many threats to internal validity. This article considers 13 of them, providing examples which clarify and help to identify under what conditions these threats may occur. The threats discussed are history, maturation, testing, instrumentation, statistical regression, selection mortality, interactions with selection ambiguity about the direction of causal influence, diffusion of imitation of treatments, compensatory equalization of treatments, compensatory rivalry by respondents receiving less desirable treatments and resentful demoralization of respondents receiving less desirable treatments.

Bias↗

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The basic experimental design.

This article considers the three characteristics of the basic experiment (random assignment of subjects, manipulation of relevant variables and control of irrelevant variables) and describes the two most common experimental designs: the pre-test/post-test design and the post/test only design. The necessity of controlling for subject and situational variables is highlighted and the challenge researchers face when using experimental approaches in other than laboratory situations are addressed briefly.

Controlled Clinical Trials as Topic↗

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Self-directed and student-centred learning in nurse education: 1.

This article, the first of two, considers the factors precipitating the widespread adoption of self-directed and student-centered learning in nurse education. It argues that these concepts have been accepted in a relatively uncritical fashion and that the theoretical rationale for their use has yet to be fully tested empirically. The results of a study of the expectations of Project 2000 students suggest that adult learners may not necessarily want the freedom afforded by self-directed approaches, but may prefer a more structural and ordered model.

Adult↗

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Self-directed and student-centred learning in nurse education: 2.

Based on a study of student nurses' expectations at the start of their Project 2000 training, this article, the second of two, argues for the need to develop a new approach to self-directed learning. Termed the cooperative model, it places emphasis on tutors providing initial direction and leadership so that students can gradually develop the skills needed to become self-directed. This requires the use of pedagogical approaches which recognize the value of didactic as well as experiential teaching strategies. The characteristics of the cooperative model, which is located within the continuum of self-directed learning suggested by D'A Slevin and Lavery (1991), are outlined.

Education, Nursing, Baccalaureate↗

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Single-case experimental designs. 2: Common examples.

This article describes and discusses some commonly used single-case experimental designs, including reversal and non-reversal designs. The A-B-A-B design is recommended for use when reversal designs can be used and when the patient's treatment phase needs to be maintained. The B-A-B design is used in situations when studying an intervention or treatment which is already in progress. The A-B1-A-B2-A-Bn design is useful when the aim of the researcher is to study the effects of different levels of a specific independent variable. Two types of non-reversal multiple baseline designs are discussed here.

Data Interpretation, Statistical↗

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Rehabilitation: realizing the potential nursing contribution.

This article highlights the present renewed interest in the subject of rehabilitation and describes the nursing role as it is portrayed in the literature. It is argued that the focus of rehabilitation is too narrow, concentrating mainly on the physical aspects of care, and that the nursing contribution is under developed. The article is the first in a series which will subsequently consider rehabilitation in multiple sclerosis, arthritis, spinal injury, myocardial infarction and stroke. The series will conclude with suggestions as to how rehabilitation in general, and nursing in particular, can respond more adequately to the needs of chronically ill and disabled people and their family carers.

Humans↗

PubMedDate not supplied

Rehabilitation in multiple sclerosis: the potential nursing contribution.

This article, the second in a series focusing on aspects of rehabilitation, considers the potential nursing role in relation to multiple sclerosis (MS). It begins with a brief description of the experience of MS as recounted by the individuals affected, which is then contrasted with current interventions which focus primarily on physical aspects of care. A number of areas of potential improvement are outlined, together with suggestions for a more comprehensive nursing role.

Humans↗

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Arthritis and rehabilitation: developments in the nurse's role.

This article is the third in a series concerned with the nurse's role in rehabilitation dealing with both individuals and their family carers facing the challenges posed by a number of chronic conditions. This article focuses on arthritis. Following the format of earlier articles attention is first turned to patients' experiences of arthritis. This is then followed by consideration of a range of psychosocial interventions. It is suggested that the nurse's role in arthritis care is reasonably well established; however, further developments, particularly in the community, are briefly explored.

Arthritis↗

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Developing nursing's future role: a challenge for the millennium: 1.

Over the past decade health care in general and nursing in particular have experienced a period of unprecedented change resulting from a variety of factors including demography, advances in technology and the introduction of differing service delivery systems. For nursing this has created a number of tensions, especially between professional aspirations and the demands of a new managerial culture. Many nurses have found themselves torn between the push towards the ideal of individualized holistic care and the reality of resource constrained environments. The new White Paper 'The New NHS: Modern, Dependable' (Secretary of State for Health, 1997) heralds a move away from the 'short termism' of the internal market towards a partnership model of integrated care. It also reaffirms the Government's commitment to further develop the role of the nurse. This article, the first of two, considers the challenges nurses face in responding to a managerial agenda while simultaneously maintaining the development of the nursing profession. The opportunities afforded by the recent White Paper are identified and the need to address a number of current tensions are highlighted. Developments at the Northern General Hospital in Sheffield are briefly described, with the results of a major survey being presented in the second article.

Delivery of Health Care, Integrated↗

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Developing nursing's future role. 2: Nurses' job satisfaction and morale.

This, the second of two articles, presents the results of a recent survey of nurses' job satisfaction and morale undertaken at the Northern General Hospital NHS Trust, Sheffield. The survey was conducted in order to provide a benchmark against which to gauge progress towards creating a work environment in which nurses are able to exercise maximum autonomy within a supportive and enabling culture. The results mirror recent national reports which highlight the increasing tension between workload pressures and the desire to provide holistic patient care. A number of factors were identified which suggest the need for remedial action across a range of fronts. Such factors are briefly described, together with the action taken to date to address the issues raised.

England↗

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Rehabilitation following spinal injury: the nursing response.

Spinal cord injury is one of the most unexpected and devastating of events that typically affects young people, often males. Thus it stands in stark contrast to both multiple sclerosis and arthritis, the conditions considered in the previous two articles of this series. The differences do not end here as spinal injury is relatively stable once the initial phase has passed, whereas both multiple sclerosis and arthritis are progressive. However, despite this variation the literature suggests that rehabilitation in all three conditions raises similar concerns. This article focuses on these concerns and how nurses can respond to them.

Humans↗

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Evidence-based care: can we overcome the barriers?

Evidence-based care has become the new mantra within the NHS, despite the fact that the concept of applying research to practice has been promoted for several decades. However, literature on the subject suggests that formidable obstacles remain to the integration of research into care delivery. This article describes a study which used Funk et al's (1991a,b) Barriers Scale with a population of nurses in a large teaching hospital in the UK. This scale was specifically developed to identify barriers to the introduction of research into practice, and modified for a UK context. The results suggest that a complex array of barriers exist but that foremost among these is the nature of the organizations within which nurses work. Comparisons are made with data from the USA, and the need to create time for nurses to implement change, and to empower them to do so, is stressed.

Attitude of Health Personnel↗

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Educating nursing home staff in the reduction of pressure sores.

Care-related work within continuing care settings is often perceived as being of low status and requiring little skill. In reality, however, creating a positive long-term care environment requires imagination and creativity. Education and training are a key element in any effort to improve the quality of care in nursing homes and similar settings, yet recent evidence suggests that opportunities for continuing education and training for staff in such environments are limited. This article considers the context of continuing education for nurses and care assistants employed in nursing homes, and uses a pilot evaluation of an educational package aimed at reducing the incidence of pressure sores as a case example to raise important issues. The difficulties in providing sufficient opportunities for education are highlighted and the need to embed any educational programme within a well-developed staff support structure is stressed.

Health Personnel↗

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Cardiac rehabilitation following myocardial infarction.

Coronary heart disease is the major cause of death in the UK, but cardiac rehabilitation programmes have tended to develop in an ad hoc and unsystematic way. This article considers some of the deficits in current practice and suggests ways in which nurses can contribute more fully to care in this area. The need for better training and the necessity to develop skills in psychological care are highlighted. The authors also emphasize the importance of giving greater attention to a number of areas such as family involvement, sexuality and gender issues, and community follow-up.

Family↗

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Nursing's knowledge base: does it have to be unique?

An International Seminar held at the University College of Health Sciences, Jonkoping, Sweden, in May 1996, was the stimulus for this article. The purpose of the seminar was to consider the contribution that nursing theory has made to the development of the profession and to identify ways in which this contribution could be enhanced. This article briefly traces the emergence of nursing theory and argues that despite its relatively short history, theory has failed fully to inform practice and is increasingly seen as irrelevant. It is suggested that two trends--the abstract and esoteric nature of much nursing theory and the desire to create a unique' body of nursing knowledge--must be countered before theory can establish its value. It is argued that these are manifestations of professional and academic insecurity which nursing must overcome before it can reach maturity.

Diffusion of Innovation↗