Search PubMed⌕ Search

Biomedical subjects

P Nolan

Publications and source records attributed to P Nolan.

At least 37 records · Page 2Linked to original sources
PubMed2001

In search of the history of Irish psychiatric nursing.

Based on a paper given at the Cinderella Services conference at South Bank University, London, in April 2001, this paper explores the origins and development of the asylum system in Ireland, and traces the relationship between the politics and practice of mental health care. The role of the attendants is illuminated in so far as the limited primary source material allows. Although some aspects of the history of Irish mental health services have been subject to scholarship, psychiatric nursing is an area that has not. In particular, very little attention has been paid to the role that attendants and asylum nurses played in the Irish asylum system, especially during the late nineteenth and early twentieth centuries. The government constructed an extensive network of asylums and workhouses to deal with the growing numbers of mentally disordered and impoverished people. Irish asylum nurses tended to come from rural stock, and have agricultural skills; they were able to communicate with patients in either English or Gaelic. They were encouraged to impart to patients skills that would permit them to find employment or contribute to the upkeep of the asylum.

History, 18th Century↗
PubMed2000

Evaluation of 11th rib extrapleural-retroperitoneal approach to the thoracolumbar junction. Technical note.

OBJECT: The 11th rib extrapleural-retroperitoneal approach offers an alternative means for access to the thoracolumbar junction. It provides excellent operative exposure without the need to transgress the diaphragm, resulting in less morbidity and reduced risk of pulmonary complications. This approach, however, has been dismissed by many surgeons offering the unsubstantiated criticism that it affords limited access. Thus far, only technical descriptions of the operative procedure are available in the literature, without documentation of the clinical outcomes of these patients. In the current study the authors describe the 11th rib extrapleural-retroperitoneal approach to the thoracolumbar junction, and they evaluate the associated early and late morbidity in these patients. METHODS: From September 1996 to August 1999, the authors collected prospective data of consecutive patients who underwent surgery for a variety of pathological conditions of the thoracolumbar junction via this approach. In 26 consecutive patients requiring an anterior spinal procedure, lesions located between T-10 and T-11 were studied and followed for a mean period of 17 months (range 1-36 months). There were 13 men and 13 women whose mean age was 47 years (range 16-80 years), with the following pathological entities: trauma (13 cases), neoplasm (six cases), infection (two cases), and deformity (five cases). There were no cases of neurological deterioration. There were no significant pulmonary complications, and only one patient required insertion of a postoperative chest tube. CONCLUSIONS: The 11th rib extrapleural-retroperitoneal approach was successfully used to treat patients with a variety of lesions in the thoracolumbar junction and was associated with little morbidity. The authors believe that previous criticism suggesting that this approach provides only limited access is unsubstantiated.

Adolescent↗
PubMed2000

Men in nursing: ambivalence in care, gender and masculinity.

This paper briefly reviews some aspects of the history of men in nursing and suggests that for centuries men have been at the forefront of caring work, and that it was in the mid-nineteenth century when shifts in the nature of masculinity and femininity occurred, spearheaded by Florence Nightingale, which resulted in nursing becoming feminised. Drawing on techniques of oral history, this paper presents the experiences of two men who pioneered the return of men into nursing, and how their work changed in the course of their working lives. Both men saw a shift away from institutional hierarchies towards a more patient centred model, which accompanied comparable developments in their own thinking in different fields of nursing. There were differences in the work they did and how they constructed their pasts, yet there were also similarities in the way they developed their philosophy of caring for patients.

Historiography↗
PubMed1999

Practice nurses' perceptions of services for clients with psychological problems in primary care.

Over a third of people presenting in primary care in the United Kingdom (UK) have a mental health problem causing some degree of disruption in their lives. Approximately 90% of these are treated and managed by primary care staff without any support from mental health services. Following the White Paper published by the UK Department of Health in 1997 (Department of Health, 1997. The New NHS--Modern and Dependable, HMSO, London), the influence of primary care both in the commissioning and provision of mental health services is likely to increase. By far the largest professional group currently involved in mental health in primary care are practice nurses. Although their numbers have increased dramatically during this decade, little is known of the work they do or of their perceptions of it. The present questionnaire-based study sought to elicit the types of mental health problems encountered by practice nurses in primary care, the interventions they provide and the skills they utilise. The data indicates that practice nurses care for people with a wide variety of mental health problems ranging from mild to severe. Many feel unprepared for this type of work and are reluctant to get too involved with clients in case they uncover problems they are not able to cope with. Lack of access to appropriate educational support is identified as the main problem currently faced by practice nurses alongside poor inter-professional relationships with mental health personnel. This paper discusses ways of meeting the needs of practice nurses and of improving collaboration in primary care settings.

England↗
PubMed1999

A comparative study of the perceptions of British mental health nurses and psychiatrists of their work environment.

This comparative study of the perceptions of mental health nurses and psychiatrists about aspects of their work environment was undertaken in the West Midlands in England. The aim of the study was to ascertain the extent to which the environment in which mental health professionals' work impacts on their own mental and physical well-being. Seventy-four psychiatrists and 301 mental health nurses responded to a postal questionnaire. Analysis of data indicated that significant differences exist between nurses and psychiatrists in their working conditions, their physical working environment, their sources of support with a work-related problem, and the effects of their work on their own mental and physical health. The main recommendation derived from this study was to improve communication between mental health professionals and their managers by giving more structured feedback and guidance about one's work performance. This may help to alleviate the mental strain many mental health professionals experience in their work.

Adaptation, Psychological↗
PubMed1999

The language of mental health nursing reports: firing paper bullets?

A great deal of the caring work of nursing is accomplished and mediated through language. This paper attempts to characterize some of this language in quantitative and stylistic terms in an attempt to characterize the genre of nursing report language. Nursing students (n = 26) and graduate nurses (n = 3) viewed a videotape of a person being interviewed by a psychiatrist and produced written reports. These showed a large proportion of words relating to the person and to feelings and needs, compared to existing databases of the English language in general. The language produced by the participants also contained many modal or modifying words and is similar to spoken rather than written English in terms of the proportion of lexical content. There was much diversity in their descriptions and the vocabulary used to refer to the client. Graduate nurses showed more scepticism of the evidence provided by the video and advocated more investigation and questioning of the client. The use of standard forms and techniques of expression suggests that these reports were assembled on a language production line. Finally, we advocate a more systematic approach to educating nursing students about the power of the language they use.

England↗
PubMed1999

Individual and organizational well-being in psychiatric nursing: a cross-cultural study.

Although health care systems around the world are undergoing rapid changes, there is an absence of comparative studies of how these changes affect nurses' well-being and work life. The purpose of this study was (i) to identify and describe possible differences between the psycho-social work environments of English and Swedish mental health nurses, and (ii) to attempt to explain these differences. 1016 psychiatric nurses from Stockholm (Sweden) and Birmingham (England) responded to a postal questionnaire on their psycho-social work environment and feelings of professional fulfillment, mental energy and work-related exhaustion. The study was given ethical clearance in Stockholm and Birmingham. Results indicated that while the English nurses rated their organizational well-being more favourably, Swedish psychiatric nurses reported greater individual well-being than their counterparts. Multiple regression analyses indicated that self-esteem was important for explaining mental energy and work-related exhaustion, but less so for explaining professional fulfillment, which was predicted primarily by organizational factors. When controlling for self-esteem, which was higher amongst the Swedish nurses, the differences in professional fulfillment and mental health were no longer significant. Reasons for the differences in self-esteem and experiences of the workplace are discussed. Low response rate may have contributed to a selection bias.

Adult↗
PubMed1999

Violence in mental health care: the experiences of mental health nurses and psychiatrists.

Violence against mental health service personnel is a serious workplace problem and one that appears to be increasing. This study aimed to ascertain the extent and nature of violence against mental health nurses and psychiatrists, and to identify what support, if any, they received following exposure to violence. Mental health staff working within five West Midlands Trusts in the United Kingdom were surveyed using a postal questionnaire to investigate the extent and nature of violence they encountered in their daily work. There was an overall response rate of 47%, which included a response rate for psychiatrists of 60% (n=74) and for mental health nurses of 45% (n=301). Though both groups experienced violence at work, nurses were found: to have been exposed to violence significantly more during their career; to have been a victim of violence within the previous 12 months of the survey; and to have suffered a violent incident involving physical contact. Whilst a higher proportion of nurses than psychiatrists received some support following a violent incident, a large proportion of both groups did not receive any, although most felt in need of it. The implications of this study for training and management are discussed.

Adult↗
PubMed1999

Annie Altschul's legacy to 20th century British mental health nursing.

Being knowledgeable about, learning from and building upon one's history is the hallmark of an enlightened and progressive profession. This includes an appreciation of the work of those who contributed to moulding the profession into what it currently is. Mental health nursing has not distinguished itself by respect for its former leaders. In this paper, the life and times of one of the most outstanding mental health nurses of the century, Professor Annie Altschul, are recalled and examined. She sought constantly to establish what should be the essence of mental health nursing and what its role should be in the alleviation of human suffering. As an outsider herself, she identified strongly with those marginalized by society. Always a spokesperson for the centrality of nursing in patient care, she saw nurses as those best placed to provide holistic care to patients whilst other professionals specialized in their biomedical, social and financial needs. Long after her retirement, Altschul remains active in supervising and examining postgraduate nursing students. She is still a voice in the mental health debate, someone whose opinions are sought and valued.

Faculty, Nursing↗
PubMed1999

General practitioners' perceptions of community psychiatric nurses in primary care.

The management of and responsibility for the care of people with mental health problems in the community is increasingly being assumed by general practitioners (GPs) and primary care personnel. As primary care groups (PCGs) evolve, so must their expertise in managing people with a wide range of mental health problems. It is expected that all mental health professionals will participate in this development, although it is likely that community psychiatric nurses (CPNs) will be the largest professional group involved, with a significant part to play in the shaping, management and delivery of mental health services. To date, there has been little research into how CPNs are perceived by other primary health care professionals. This study seeks to provide an insight into how GPs assess the contribution of CPNs in primary care. Overall, the results of the study suggest that GPs view CPNs favourably and consider that they have an important role to play. Greater involvement in primary care raises issues about the education and preparation of CPNs, their professional development and supervision needs.

Attitude of Health Personnel↗
PubMed1999

The Effects of Guided Imagery andMusic Therapy on Reported Change in Normal Adults.

This study explores the main changes gained from Guided Imagery and Music (GIM) therapy as described by former clients. It also explores whether gains are integrated into the clients' lives and if those changes stabilize over periods of time after finishing GIM therapy. Questionnaires were sent to GIM therapists who forwarded them to former GIM clients. Twenty-five former GIM clients returned questionnaires directly to the researcher. Results show that the main gains reported by former clients of GIM therapy are (a) getting more in touch with one's emotions, (b) gaining insights into some problems, (c) spiritual growth, (d) increased relaxation, and (e) discovering new parts of oneself. Results also show that GIM therapy might be helpful for clients with symptoms of anxiety and/or fear, and for clients who want to increase their self-esteem. Changes gained during GIM therapy appear to stabilize over a period of time after finishing GIM therapy. They improved after termination of therapy, especially in the mental and transpersonal areas.

Journal Article↗
PubMed1999

Feelings of professional fulfilment and exhaustion in mental health personnel: the importance of organisational and individual factors.

BACKGROUND: Mental health personnel are at high risk for mental illness, burnout and suicide. Previous studies of this group of professionals have indicated the importance of organisational factors in explaining burnout, or exhaustion, and work satisfaction. This study looks more systematically at the contribution of organisational and individual factors to work-related exhaustion and to professional fulfillment, an expanded version of job satisfaction. METHODS: A cross-sectional study of 1, 051 psychiatrists and mental health nurses in the city of Stockholm was carried out by postal questionnaire with a previously validated instrument. Multiple and logistic regressions were used to identify predictors of exhaustion and professional fulfillment. RESULTS: Organisational characteristics were found to be more important than individual characteristics in predicting exhaustion and professional fulfillment in mental health professionals. CONCLUSIONS: The results indicate that the psychosocial work environment and well-being of mental health professionals can be improved by concentrating on organisational factors such as efficiency, personal development and goal quality.

Adult↗
PubMed1998

The role of lateral cephalometric radiography and fluoroscopy in assessing mandibular advancement in sleep-related disorders.

Mandibular advancement splints are successful in managing obstructive sleep apnoea (OSA) in selected subjects. For these to be effective, some improvement in the dimensions of the oropharyngeal airway must occur. Twenty subjects with proven obstructive sleep apnoea were examined using lateral cephalometric radiography and a fluoroscopic technique. Cephalograms were analysed, and assessed for both skeletal and soft tissue abnormalities known to be present in OSA subjects. On the basis of these, a prediction was made as to whether the subject's oropharyngeal airway would increase during mandibular protrusion. From the fluoroscopic sequences, the narrowest antero-posterior dimensions of the post-palatal and post-lingual airways were recorded as the mandible moved from the intercuspal position into maximal protrusion. The changes in airway size were noted and these were compared with the predictions made from the static films. In nine subjects, fluoroscopy indicated that the airway opened well during mandibular protrusion, seven did not improve and in four the changes were minimal. Post-palatally the mean airway increase was 2.6 mm, whilst behind the tongue a mean improvement of 3.1 mm was seen. In all but two instances, the cephalometric prediction agreed exactly with the outcome demonstrated by fluoroscopy. All subjects whose airways clearly increased were correctly identified by the cephalogram alone. Cephalometric features associated with a good airway response to protrusion were a reduced lower facial height, low maxillomandibular planes angle and a high hyoid position, accompanied by a normal anteroposterior relationship of the jaws, relatively normal mandibular body length and soft palate area. The more abnormal the skeletal and soft tissue dimensions, the poorer the prognosis. Thus, whilst a single radiograph could indicate whether a positive mandibular response to protrusion could be expected, where doubt existed, a fluoroscopic analysis could provide a useful adjunct to diagnosis.

Adult↗
PubMed1998

Predictors of a healthy workplace for Swedish and English psychiatrists.

BACKGROUND: Few studies have attempted to analyse the organisational aspects of the workplace that may affect the well-being of psychiatrists and even fewer have offered insights into what a positive workplace might look like. This study provides an outline of such a workplace, with reference to individual and organisational factors. In addition, a comparison is made between two European cities to check for cultural differences. METHOD: Three hundred and eighty psychiatrists from Stockholm and Birmingham responded to a previously tested questionnaire on their work environment. RESULTS: Predictors of a positive workplace for psychiatrists were: high self-esteem, satisfactory support with work-related problems, lower perceived workload, positive view of leadership, low work-related exhaustion and having a sense of participation in the organisation. There were few cultural differences. CONCLUSIONS: Measures should be taken to improve leadership skills for managers, to offer more support for work-related problems, and to allow psychiatrists to participate more in the organisation.

Anxiety↗
PubMed1998

Competencies drive decision making.

Staff nurses, using the Nursing Interventions Classification, selected the core competencies, performance criteria and interventions relevant to their practice. A performance-based approach highlights performance outcomes and previous experience. A preceptor and self-directed learning activities help apply the knowledge in the work setting.

Clinical Competence↗