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PubMed1996

The 'Health Promoting Schools' strategy: implications for nursing and allied health professionals.

In 1993, the Commonwealth government officially recommended that schools were excellent places in which to promote better health as part of the proposed National Health Strategy. The concept of Health Promoting Schools (HPS) has recently been endorsed by the Department of Education, with the result that teachers are now expected to further expand their role and responsibilities in this area. This paper outlines a survey of infant and primary school teachers in New South Wales (n = 350) which, amongst other factors, ascertained teachers' perceptions of the assistance they needed from school and community nurses in order to effectively implement the HPS strategy. Results demonstrated that teachers have a fundamental lack of understanding of child health issues and the HPS strategy, and that an overwhelming call by teachers for assistance from the nursing profession has implications not only for nurses but also for allied health agencies and the tertiary sector.

Allied Health Personnel↗
PubMed1999

Evaluating a clinical partnership model for undergraduate nursing students.

Since the transfer of nurse education to the tertiary sector in Australia there have been many challenges associated with the selection, administration and facilitation of clinical experiences for undergraduate nursing students. The School of Nursing at Australian Catholic University, McAuley Campus, planned and implemented a partnership model for clinical practice with the aim of improving current methods and overcoming some of the problems previously experienced. Evaluation of the model was conducted during the first year of implementation. An interpretive approach involving academic staff, clinical affiliates and students was used to evaluate the model. Thematic analysis of the data revealed three major themes of familiarity, acceptance and trust and supportive learning environments. It was found that students had been supported in their learning environment through the clinical affiliates commitment to teaching and learning, linkage of theory and practice and credibility as practising clinicians.

Attitude of Health Personnel↗
PubMed2000

Mental health nurses' beliefs about interventions for schizophrenia and depression: a comparison with psychiatrists and the public.

OBJECTIVE: The main objective of this paper was to investigate and compare mental health nurses' beliefs about interventions for schizophrenia and depression with those of psychiatrists and the public. Factors affecting nurses' beliefs were also investigated. METHOD: This research used methods employed in previous surveys of professional and public beliefs. A postal survey of 673 Australian mental health nurses was carried out. The survey was comprised of a vignette describing a person with either depression or schizophrenia. Participants rated whether particular medical, psychological and lifestyle interventions were helpful, harmful or neither. Factors examined included: nurses' age, sex, degree of contact with similar problems, work setting, level of highest qualification and whether their education was hospital-based or completed within the tertiary sector. RESULTS: The nurses agreed with psychiatrists (but not the public) about the interventions most likely to be helpful, such as antidepressants for depression and antipsychotic medication for schizophrenia. However, there were many differences between nurses, psychiatrists and the public. Nurses were more likely than psychiatrists to believe that certain non-standard interventions such as vitamins, minerals and visiting a naturopath would be helpful. Nurses' beliefs tended to form a bridge between the attitudes of psychiatrists and the public for some of these non-standard interventions. Age, work setting and qualifications were related to nurses' intervention beliefs. CONCLUSIONS: Mental health practitioners need to be aware of a range of beliefs within mental health services. The acknowledgement of differing belief systems is important for high quality, integrated care.

Adolescent↗
PubMed2005

A survey of UK clinical librarianship: February 2004.

AIM: This article will describe a survey carried out in February 2004, the aim of which was to summarize the form and content of clinical librarian (CL) and other similar outreach information services to UK health professionals in the acute (secondary or tertiary) sector. OBJECTIVES: (i) To survey the activities and views of UK information professionals offering information services involving the librarians' presence in the clinical setting, (ii) to develop a tool to explore critical aspects of this form of information work, (iii) to create a contacts database for UK CLs, to be made available on the Internet. METHODOLOGY: All known information specialists/librarians offering CL or similar services were surveyed. The semi-structured questionnaire was piloted. Respondents were asked to consider their activity over a period of 4 weeks. RESULTS: Twenty-six people responded to the invitation to take part and met the inclusion criteria. CONCLUSIONS: A summary of a 'typical' clinical librarian revealed by this survey is given, with a major conclusion that there is a very mixed picture of activity. Opinion on how far CLs should go in fully appraising search results is uncertain. The survey suggests reasons for this and the developments that may influence change are discussed. Recommendations for future research and development are offered.

Clinical Medicine↗
PubMed2006

[Stress in a changing society].

The objective of this study is to describe the job stress models and non-work stressors, their influence on health and magnitude in Spain. Data come from scientific publications, reports and official statistics, primarily of the last decade. Moreover, original data are provided from the analysis of the 5th Spanish Working Conditions Survey. Job stress analysis is based on two complementary models, that based on psychological demands, control and social support (Karaseks model) and another based on the effort-reward unbalance (Siegrists model). In Spain 15% of men and 22% of women have had an excessive workload that have made them feel tired in the last three months. A quarter of workers have low autonomy and 48% of men and 32% of women work in occupations that do not require special abilities, just experience. Moreover, Spain has the highest unemployment and temporary contracts rates in the 15-European Union. The entrance of women into the labour market implies difficulties in reconciling job and family life. Moreover, paid work provides women with power and economic autonomy, therefore making possible the divorce that has significantly increased in Spain as well as the lonely parents families, these being difficult and stressing situations. Additionally the higher economic autonomy and power among women is considered as one of the causes of the gender violence as well. Response to stress-related problems derived from the globalisation, the increasing importance of the tertiary sector and other social changes is insufficient either because health professionals ignore the causes of the problem and treat pharmacologically the consequences or because health consequences of these new social and economic tendencies are not taken into account in other sectors.

Adult↗
PubMed2003

Health professionals' knowledge of prevention strategies and protocol following percutaneous injury.

Prevention strategies and protocols for the management of percutaneous injuries are developed for the purpose of preventing transmission of HIV and other infections. However, implementation thereof requires health professionals to be conversant with the content of protocols and ways to prevent percutaneous injuries. The purpose of the study was to determine health professionals' knowledge of prevention strategies and protocols following percutaneous injury. The purpose was addressed within a quantitative survey design. Data were collected by means of a self-administered questionnaire. The study was conducted at a public-sector tertiary academic hospital in Gauteng. Seven units within the hospital were randomly selected for investigation. These included, trauma, intensive care, medical, surgical, maternity, theatre and paediatrics. A population of 800 health professionals worked within the sampled units. Health professionals were stratified according to the following three categories, doctors, registered and enrolled nurses and medical and nursing students. A sample size of 200 health professionals was purposively selected of which a response rate of 79.5% (n = 159) was achieved. The sample consisted of 76.7% (n = 122) registered and enrolled nurses, 13.2% (n = 21) doctors and 8.8% (n = 14) medical and nursing students; 1.3% (n = 2) did not specify their health professional category. Awareness of the existence of a protocol for percutaneous injury amounted to 96.2% (n = 153). General knowledge of the contents of the protocol reflected a different picture; only 26.4% (n = 42) of health professionals could accurately quote the procedure following a percutaneous injury as recommended by the South African Institute of Medical Research (SAIMR) protocol. The lack of knowledge of the existence of a protocol was most evident in the medical and surgical units. A total of 16.4% (n = 26) of health professionals reported having sustained a percutaneous injury. A doctor (33.3%) was more likely to sustain a percutaneous injury than a nurse (15.6%). Intensive care units reported the highest incidence of percutaneous injuries (31%; n = 9). Health professionals were unlikely to report a percutaneous injury; as only 53.8% (n = 14) reported the injury. The results of this research indicate that although knowledge of protocol and prevention strategies was inadequate these alone are insufficient to reduce the incidence of percutaneous injury.

Blood-Borne Pathogens↗
PubMed2001

The enculturation of our nursing graduates.

The transition from undergraduate nursing student to employment as a registered nurse is fraught with difficulties for a neophyte. This qualitative study used interviews and focus groups with graduate nurses from the Flinders University of South Australia in their first year of practice to ascertain their experiences as new graduates. The results reveal an enculturation of graduates not conducive to ongoing learning, consolidation of skills and application to practice. A rushed environment that was unpredictable, together with a lack of support, were recurrent themes from the graduates' perspective. Graduate nurse programs are run by institutions focused on outcomes and expenditure. There is little or no collaboration with the tertiary sector in providing appropriate programs according to graduates' needs. The graduates, as beginning practitioners, focused on not having the time to nurse holistically, an unrealistic workload, and the need for backup and continuous support on an individual basis. The wards, although possibly efficient and effective in providing health care, provided a culture where the graduates felt inadequate, rushed, overworked and unsupported, which is contrary to the aims and objectives of the graduate nurse programs. The nursing profession as a whole needs to develop a culture that is nurturing, enabling, supportive and protective of our young.

Education, Nursing, Baccalaureate↗
PubMed1998

The Mental Health Nursing Clinical Confidence Scale: a tool for measuring undergraduate learning on mental health clinical placements.

A significant proportion of the undergraduate preparation of student nurses in the tertiary sector involves the opportunity for experience in a variety of clinical placements. The majority of nursing students in Australian universities spend time in mental health settings. This compulsory clinical experience provides the opportunity for the application of nursing theory and the development of clinical confidence. Whereas there have been attempts to quantify the attainment of confidence to perform skills in general nursing settings, there has been little attention to this issue in mental health settings. The Mental Health Nursing Clinical Confidence Scale was developed as part of a larger study aimed at investigating the impact of mental health clinical placements on undergraduate nurses' attitudes and clinical confidence. Students were surveyed using the scale before and after a mental health nursing placement. The scale revealed robust psychometric properties. Significant changes in the self-reported confidence levels of students were found at the completion of the clinical placement. A number of key factors impacted on student confidence levels both before the clinical and after the placement. The 20 item scale will be a useful instrument in future evaluations of the effectiveness of student learning in mental health settings.

Adolescent↗
PubMed1987

[Asylum in Switzerland. Some aspects of refugee migration].

"Switzerland is the European country which, after Sweden, has received the highest number of refugees (30,000) in proportion to its population. Asylum seekers have increased considerably since 1979. They are coming mostly from Third World, politically unsettled countries. The essay presents the results of a survey conducted in Geneva on a sample of 549 asylum seekers assisted by public welfare agencies from 1974 to 1983. These refugees belong to the younger age bracket of the active population. About half of them have completed their secondary or tertiary education. But their professional, social and cultural adjustment poses some problems. The vast majority of them, in fact, are employed in unqualified occupations in the tertiary sectors." (SUMMARY IN ENG)

Acculturation↗
PubMedDate not supplied

[Epidemiology of pain in Gabon].

The authors report on a prospective survey which took place from January 1999 to December 2000 - the epidemiology of pain in Gabon - to determine its distribution in the population. Ninety-eight women and eighty-four men aged 17 to 80 years old (mean age: 50) who consulted at the pain clinic were included in the study, a majority of the patients being aged between 21 and 60 years. Lower back pains and gonalgias secondary to osteo-arthritis or arthritis were more common in the North of the country, where the patients represented 57.7% of the sample, these two previous localisations along with cephalagias accounting for 52.7% of the motives for the visits. Thoracic and abdominal pains common in both men and women in the South were psychological. Patients working in the tertiary sector represented 45.3% of the patients, those of the secondary sector 24.4%, and those of the primary 20.3%. The non-steroidal anti-inflammatory analgesics (NSAI) associated with WHO grade 1 and 2 analgesics were effective in 50% of cases, some of whom also needed steroidal articular infiltration. Psychological pains were soothed by amitriptyline. A specific training of doctors and paramedics in pain treatment is necessary to improve care and assistance in this area.

Adolescent↗
PubMed2004

[Medico-legal conditions of recognition and compensation of occupational asthma in Sénégal].

The aims of this study were to appreciate how frequent asthma was named in the legal list of worker's compensation, state hazards and occupations involved and appreciate conditions required for a legal recognition of the disease. The study consisted of a review of the legal list of occupational diseases of all tables where asthma was stated. Medical, technical and administrative criteria allowing compensation were looked for. Asthma was listed in 12 among the 67 tables; causal substances listed were known as sensitizers and included mainly organic and metallic compounds. Numerous occupations were concerned in all primary, secondary and tertiary sectors. Medical conditions refered to "all asthma confirmed by functionally respiratory tests or regenerated by a new exposure". Time length of declaration was seven days. Variety of occupations concerned and numerous substances involved should invite to look for occupations in all patients with asthma. Physicians should be aware of theses legal conditions in order to recognize better occupational asthma and ease it legal compensation.

Asthma↗
PubMed2005

Clinical-academic partnerships research: converting the rhetoric into reality.

An increasing recognition of the importance of research-based practice to the nursing profession has led to a number of strategies designed to increase the utilization and conduct of nursing research. The transfer of nursing education from hospitals to universities occurred partly in response to the identified theory-practice gap. Subsequently, a significant investment in joint clinical-academic positions and clinical professorial positions has been made with the intention of bridging the gap between the tertiary sector and the clinical field. Anecdotal evidence suggests that neither strategy has achieved the desired degree of success. The available literature suggests that nurses do not tend to become involved in the conduct of research, nor do they readily utilise research findings in their practice. It is hypothesized in this paper that this reflects the strong cultural differences between the clinical and academic worlds in nursing. The aim of this paper is to discuss the impact of these cultural differences and describe specific principals that could contribute to significant cultural change and the bridging of the academic-clinician divide.

Attitude of Health Personnel↗
PubMedDate not supplied

A clinical learning milieu: nurse clinicians' attitudes to tertiary education and teaching.

A target population of 742 registered nurses (RNs) who had direct contact or potential for direct contact with college nursing students were surveyed regarding their attitudes to the transfer of undergraduate nurse education to the tertiary sector, and to helping teach/supervise students. The RNs were located at 19 of 21 hospitals providing clinical experience for students of one college during semester one in 1989; 490 (66%) returned completed questionnaires. These bedside nurse clinicians were clearly divided on whether the transfer would ultimately benefit the nursing profession. Despite this, nearly all preferred to work in a hospital providing clinical experience for college students; they saw teaching as an essential part of the RN's role and gained satisfaction from it.

Attitude of Health Personnel↗
PubMedDate not supplied

[Epidemiologic approaches, in school health education programs with particular attention to dentistry].

At the request of the Cultural Union of the Upper Aniene Valley, the social-health workers dealing with school medicine of the Teaching District of Affile (Rome) have tried to define the programming lines for a health education intervention in the elementary schools of the district. The basic requisites of the intervention were pinpointed as: effectiveness, in terms of improvement of health conditions; short-term results; cognitive-transformative methodology having a spiral progression (cognitive, decision-making, implementative and of verification). The departure point of the intervention was the cognitive study on the social-health situation of the school population based on an analysis of the individual data contained in the medical files compiled by the school doctor, standardised and filled out with the pupils' social and family data. Out of 257 children, 212 were examined, namely 82.4% of the school population. The first social-anamnestic data on pupils' families was in respect of parents' level of education, giving the following results: 65% with elementary schooling only, 11% semi-illiterate and 10.5% diploma- or degree-holders. In respect of parents' working activities, on the other hand, a clear difference emerged: compared with 50.4% of worker or artisan fathers and about 33.3% engaged in the tertiary sector, almost all the mothers were still home-based (90.9% housewives). Another interesting fact emerged from the cards, namely that only 69% of the boys and girls have undergone the full cycle of antidiphtheria-antitetanus vaccinations, and only 80% of antipolio vaccinations. As regards pupils pathological anamnesis, cases of hospitalisation were for the following causes: 5.7% fractures and/or burns, followed by intestinal infections (4.5%). Whereas, as regards current pathology the high incidence of a cariogenic pathology emerged, with such high values as to indicate, in the field of prevention and health education, oral hygiene as the priority intervention to be undertaken in respect of the pupils included in the teaching district. The stages of the planned intervention were fixed as follows: -campaign to make teachers and families, considered as the primary educators, aware of this health problem; -meetings with pupils for the purpose of informing them in a simple way of the problem of caries and of discussing together behaviours liable to ensure greater dental hygiene; -involvement of the school and local administrative authorities for the implementation of any measures aimed at favouring the improvement of the behavioural and eating habits of the boys and girls (access for all to school canteens, free dental examinations, etc.).(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗
PubMedDate not supplied

[Shift-work and housekeeping interference].

In Italy, within the last ten years, an increasing number of women have been involved on shift and night-work not only in the tertiary sector, but also in the industrial one. This has been made possible by the promulgation of Law 903/1977, concerning parity in treatment of both men and women in questions of employment. The work agreements for women night-work have gradually increased over the period 1980-1986 passing from 194 in 1980 to 357 in 1986, with approximately 10000 more women involved each year. The sectors mostly involved in these last years have been the textile, food and mechanical ones. The present study reports the major problems complained by the women shiftworkers as concerns their difficulties in family and social life, and refers the case of a group of women abruptly introduced to night work in a food industry, where they had been previously engaged only on day-work for many years. During the first year of night-work the absenteeism among this group tripled (29.8 days per year on average) with respect to the previous years. The impact on shift and night-work appeared to have been the most disruptive of the whole condition of this group of women, with negative effects on their personal, family and working life. High absenteeism, increasing psychosomatic complaints, worsening of the subjective health status, sleep disturbances, difficulties in family relationships were the main consequences. The women with heavier family commitments, namely those married with children, showed the worst effects.

Adult↗
PubMedDate not supplied

[Man and work: a compatible system? Problems of health and disease associated with work].

Man and work: a compatible system? Problems of health and disease associated with work. Here, a short review of the main characteristics of the modern work organisation and of its influences on worker's health is reported. In spite of the great improvement that has occurred in the environment and in the relationships between employers and employees, many conflicts and tensions are still present, about ecological, insurance and economical problems, often on an international ground. In addition work organisation is mostly perceived as unable to satisfy personal needs, attitudes and values. That is true even in industrialised countries, where 60-70% of active population is engaged in office job. While the expansion of tertiary sector has greatly contributed to the decrease of occupational diseases, sick leave, due to non-specific symptoms and complaints related to prevalent chronic degenerative diseases, has increased. The frequently observed relationship between such disorders, mostly with a strong phycophysiological component, has produced the designation of "job related diseases". Tackling these together with the traditional occupational health problems implies a revision of methods and contents of occupational medicine and its connection with related preventive and clinical disciplines. The international debate on the issue may offer useful suggestions for the Italian situation.

Humans↗
PubMed2000

Reconciling pedagogy and health sciences to promote indigenous health.

OBJECTIVES: To increase knowledge and skills regarding Indigenous learning styles. To raise awareness within the tertiary education sector that Aboriginal students learn differently and that Indigenous cultures and pedagogy have validity and strength. To examine pedagogical strategies that assist both tertiary students capacity for learning and university lecturers' delivery and evaluation of teaching and learning strategies. METHODS: A qualitative, ethnographic framework using personal observations, field and classroom experience, interviews and review of literature in the fields of education, public health and Indigenous cultural perspectives. RESULTS: Aboriginal people are the receivers of services and programs that will be delivered, in the majority of cases, by university-educated, non-Aboriginal, professional health care providers. Indigenous students face specific challenges in obtaining an effective education for working in the Aboriginal and wider community in the field of public health; the challenges relate to culture, health paradigms and community. CONCLUSION: Lecturers in health and human science courses for Aboriginal students need to both examine and appreciate the cultural constraints on learning faced by their students within the context of mainstream curriculum, and to build on the large pool of knowledge and learning styles that Aboriginal society bequeaths to Aboriginal students. IMPLICATIONS: Academics can apply the cultural differences and knowledge base of the Indigenous community as a force to promote health through learning.

Anthropology, Cultural↗
PubMed1995

Expenditure on health research in South Africa, 1991/1992.

OBJECTIVE: To determine expenditure on health research in South Africa in 1991/1992. DESIGN: Data from the financial statements of large statutory councils conducting research in South Africa, as well as other relevant reports, particularly the Department of National Education's (NATED) survey of research institutions, were analysed. RESULTS: A total of R198.7 million was spent on health research in 1991/1992, 56.1% by the tertiary education sector and 20.7% by the Medical Research Council. Only 1.1% of expenditure on health was spent on research. Less than 9% of health research expenditure by tertiary educational institutions is classified within the category of 'comprehensive medicine' (which includes community health, epidemiology and nutrition), whereas 82% of expenditure by autonomous government institutions is so classified. CONCLUSIONS: Given that expenditure on health research in South Africa is relatively low by international standards, an increase in expenditure by both the public and private sectors should be considered. Given the scarcity of research resources, there should be adequate planning, co-ordination, and particularly prioritisation of resource allocations, so that research can be directed towards addressing the country's health needs.

Health Expenditures↗