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PubMed2006

Accessibility and equity of health and social care services: exploring the views and experiences of Bangladeshi carers in South Wales, UK.

There is a paucity of information regarding the extent and nature of caring provided by minority ethnic communities. The proportion of older people from these communities will dramatically increase in the next 20 years, which will be accompanied by increasing health and social care needs and an increased demand for carers. A qualitative, exploratory study was conducted to identify the health and social care needs of informal carers, who were caring for a dependent adult from a Bangladeshi community in South Wales, UK. This paper focuses on Bangladeshi carers' access to formal support services provided by the statutory, private and voluntary sectors to assist them with their caring responsibilities. The findings are based on data collected using face-to-face, focused interviews with 20 Bangladeshi carers. Purposive and snowball sampling were used to recruit the sample. The data were analysed using thematic content analysis. The dimensions of accessibility and equity of quality of care were drawn upon to aid understanding of the findings. Bangladeshi carers faced a number of barriers in accessing health and social service provision, which impeded uptake of these services. Additionally, there was evidence of inequity in service provision. Recommendations for improving the accessibility of health and social care services are proposed, which may assist in promoting more equitable services for carers from the Bangladeshi community.

Adolescent↗
PubMed1981

Perspectives on attitudes to nursing in Australian nursing students.

At a hospital school of nursing in Australia, a pilot study was carried out on first year students' images of nursing and work values. Students were found to accept most items on the College of Nursing (Australia) Inventory as characteristics of nursing and as work values. Background factors had minimal effect on their attitudes to nursing and work values, although age, type of secondary school attended, and religion had minor effects. Responsibility for decisions, individuality, job security, maintaining personal identity, and flexibility, were more highly rated as work values than as characteristics of nursing. No difference between students with and without previous psychiatric nursing training was found on the attitude scales. Limitations of the study and suggestions for further research are discussed.

Attitude↗
PubMed1983

A personal construct theory approach to the socialization of nursing trainees in two British general hospitals.

Student and pupil nurses (64), from an initial sample of 117, completed repertory grids questionnaires and interviews on the first day of training, at 4 and 18 months. Measures of identification attraction and ideal/actual congruence were derived from the grids. Trainees were found to become more identified with and attracted to medical roles during training and less identified with and attracted to lower-status non-medical roles such as factory worker. Ideal/actual congruence with medical roles other than trainee also increased. Some measures derived from the grids related to trainee 'wastage' and to satisfaction with the hospital.

Adult↗
PubMed1991

Researching needs in district nursing.

This paper describes the first stage of a research project aimed at understanding the needs of clients (and their carers) of district nursing services. The project applies a pluralistic research design, combining qualitative and quantitative methods. Through the use of an ethnographic approach, concepts of needs are generated which are related to how clients and carers perceive themselves and the role of the district nurse. The study attempts to formulate needs within a contextual framework against which an activity analysis of district nurses' work (stage 2) can be evaluated.

Clinical Competence↗
PubMed2006

Dimensions of hospital nurses' quality of working life.

AIM: This paper is a report of a study describing the quality of working life of nurses in Taiwan. The purpose of the study was to gather data on which to base a questionnaire to be used in further research. BACKGROUND: Nurses often complain of overwork and underpay. Problems persist with nurses' job satisfaction, stress, organizational commitment and intent to leave. 'Quality of working life' is a system of analysing how people experience work: it relates to job satisfaction, intent to leave, turnover rate, personality and work stress. However, reliable information on hospital nurses' quality of working life is limited. METHOD: A descriptive study was carried out with a convenience sample. A total of 16 focus groups in one medical centre and five regional hospitals informed a quality of working life framework. Each group had three to five participants who were Registered Nurses in medical or surgical wards with at least 2 years' nursing experience, and who held a position below assistant nurse manager. The data were collected in 2000. FINDINGS: A total of 56 nurses' quality of working life categories were identified and fitted into six dimensions: socio-economic relevance, demography, organizational aspects, work aspects, human relation aspects and self-actualization. In this paper, we focus on issues emphasized by focus group participants. These were managing shift work within the demands of family life; accommodation; support resources; and nurses' clinical ladder system and salary system. CONCLUSIONS: Further research is needed with other groups of nurses in a wider variety of settings in order to examine strengths and weaknesses in the total healthcare work environment and to develop appropriate strategies for nurses' quality of working life.

Adaptation, Psychological↗
PubMed2006

Cultural attribution of mental health suffering in Chinese societies: the views of Chinese patients with mental illness and their caregivers.

AIMS AND OBJECTIVES: This study examined the cultural attribution of distress in the Chinese, the special role of the family in distress and the specific emotional reactions within distress dictated by culture. METHODS: This phenomenological study illustrated the narrative representation of the experiences of suffering by the Chinese patients with mental illness. Twenty-eight Chinese-Australian patients and their caregivers were interviewed together in their homes. They were invited to talk about the stories of the patients' experiences of suffering from mental illness. The interviews were recorded and transcribed to be further analysed according to the principles of narrative analysis. RESULTS: The results of case narration indicated that (1) because of the influence of Confucian ideals, interpersonal harmony was the key element of maintaining the Chinese patients' mental health, (2) Chinese patients' failure to fulfil cultural expectations of appropriate behaviours as family members contributed to disturbance of interpersonal relationships and (3) Chinese patients' failure to fulfil their familial obligations contributes to their diminished self-worth and increased sense of guilt and shame. CONCLUSIONS: The findings of the present study suggest that Chinese people's well-being is significantly determined by a harmonious relationship with others in the social and cultural context. Psychotherapy emphasizing an individual's growth and autonomy may ignore the importance of maintaining interpersonal harmony in Chinese culture. The results of this study contribute to the essential knowledge about culturally sensitive nursing practices. An understanding of patient suffering that is shaped by traditional cultural values helps nurses communicate empathy in a culturally sensitive manner to facilitate the therapeutic relationship and clinical outcomes.

Adaptation, Psychological↗
PubMed2004

Giving voice to the burden of blame: a feminist study of mothers' experiences of mother blaming.

Mother blaming has been identified as a pervasive and serious problem and it is known that the professional literature has strong and entrenched mother-blaming messages. Using a feminist approach, this paper explores mother blaming as it has been experienced by a group of mothers themselves. Analysis of narrative exposes mother blaming as a burden that complicates the already-complex responsibilities that comprise mothering. Health providers are among those identified by women as being particularly likely to attribute problems with (even grown) children to maternal fault. Implications for practice and research are drawn from the findings of this paper.

Adolescent↗
PubMed2004

Re-reading nursing and re-writing practice: towards an empirically based reformulation of the nursing mandate.

This article examines field studies of nursing work published in the English language between 1993 and 2003 as the first step towards an empirically based reformulation of the nursing mandate. A decade of ethnographic research reveals that, contrary to contemporary theories which promote an image of nursing work centred on individualised unmediated caring relationships, in real-life practice the core nursing contribution is that of the healthcare mediator. Eight bundles of activity that comprise this intermediary role are described utilising evidence from the literature. The mismatch between nursing's culture and ideals and the structure and constraints of the work setting is a chronic source of practitioner dissatisfaction. It is argued that the profession has little to gain by pursuing an agenda of holistic patient care centred on emotional intimacy and that an alternative occupational mandate focused on the healthcare mediator function might make for more humane health services and a more viable professional future.

Anthropology, Cultural↗
PubMed2006

Reducing the isolation of young adults living with a mental illness in rural Australia.

Research on mental health issues in rural Australia has been insufficient to date to guide nurses' clinical practice. This study explored young adults' experience of living with a mental illness in rural Western Australia using the grounded theory approach. Nine young adults, aged 18-30 years, identified isolation as their main concern. Isolation was brought about by society excluding participants because they had a mental illness and because of their behaviour. This isolation was further increased by the general population's lack of knowledge and understanding of what it is like to live with a mental illness. Based on the findings of this study, measures of how nurses can help reduce these young adults' isolation in a rural area are suggested.

Adaptation, Psychological↗
PubMed2004

Men's experiences of having lower urinary tract symptoms: factors relating to bother.

OBJECTIVE: To gain an understanding of men's experiences of having lower urinary tract symptoms (LUTS) and of bother, a principle determinant of whether a patient has an intervention for LUTS. PATIENTS AND METHODS: Data were collected on 75 patients with LUTS presenting to a urology outpatient clinic. Men completed a questionnaire asking about their symptoms, bother, mood and perceptions about LUTS. RESULTS: Most participants scored within the normal range for anxiety and depression, and expressed a moderate level of distress. They were to some extent bothered by their symptoms. Most men perceived LUTS as a long-term problem but felt unable to control their symptoms. The results suggest that bother reflects men's overall distress with having LUTS. Bother appears to be related to symptom severity, self perception, social limitation and the impact of LUTS. Embarrassment and social anxiety relate strongly to bother. CONCLUSION: Several psychological factors relate to bother; it may be possible to reduce bother using a brief psychological intervention.

Adult↗
PubMed1983

Inferences of mental illness from noninvolvement.

These studies continue the exploration of variables related to a person's use of the mental illness categorization. The central concern in the present studies was the effect of perceived variation in a target person's level of involvement in a social situation. While a low level of involvement, as portrayed in videotaped scenarios, prompts attribution of mental illness, other features of implicit personality theories also relate to greater or lesser attribution of mental illness. Those participants who gave evidence of having attributed lower levels of involvement, regardless of filmed information, also attributed higher levels of mental illness. Social workers, compared to general population participants, attributed higher levels of mental illness at all levels of target involvement. We discuss the implications of these findings for dissemination and assignment of the mentally ill role.

Attitude of Health Personnel↗
PubMed1993

Accuracy in interpersonal expectations: a reflection-construction analysis of current and classic research.

Research and theory on interpersonal expectations have been dominated by a strong social constructivist perspective arguing that expectancies are often inaccurate and a major force in the creation of social reality. The reflection-construction model is an attempt to examine these strong claims conceptually and empirically. This model assumes that social perception includes both constructivist phenomena and accuracy. When this model is used as a framework for interpreting research on teacher expectations and on the role of stereotypes in person perception, it shows that interpersonal expectancies are often accurate, and usually lead only to relatively small biases and self-fulfilling prophecies. The model also is used to interpret research on expectancies that has provided some of the foundations for the strong constructivist perspective. This reflection-construction analysis shows that even those studies strongly suggest that people's expectations generally will be highly accurate.

Black or African American↗