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PubMed2004

Culture and communication in Thai nursing: a report of an ethnographic study.

Most nurses live and work in multicultural settings. Given the need for all nurses and health-care workers to communicate--with patients, with families and with other health-care professionals--the study of the relationship between culture and communication can help to inform practice. This paper offers the findings from an ethnographic study of culture and communication, carried out in Thailand. The aim of the study was to address the question: 'in what, if any, ways do Thai cultural issues influence interpersonal communication patterns in Thai nursing and Thai nursing education?'. Data were collected from a variety of sources, including direct and indirect observation, interviews and discussions and the literature on the topic. For the interviews, the sample was a convenience and purposive one made up of clinical nurses and nurse educators (n = 14). Those data were analysed with the aid of a computerised, qualitative data analysis program. Findings reported in this paper include those relating to 'Thainess', Buddhism, the nursing profession and nurse--patient/doctor--patient relationships. The report ends with a 'portrait' of Thai nursing communication. It is suggested that understanding the cultural aspects of nursing in various contexts can help nurses, internationally.

Altruism↗
PubMed2006

Pedagogical encounters between nurses and patients in a medical ward--a field study.

BACKGROUND: Patient teaching is regarded as an important aspect of nursing care as well as an essential part of the nursing profession. In nursing practice, a distinction can be made between formal (planned) and informal (spontaneous) patient teaching. The major part of patient teaching research is within the area of formal teaching. In spite of the fact that spontaneous teaching occurs in everyday nursing practice, there is a lack of knowledge in this area. OBJECTIVES: The aim was to illuminate pedagogical dimensions in nursing situations and informal teaching. DESIGN: The study is a fieldwork study within the frames of a life-world phenomenological tradition. PARTICIPANTS AND SETTING: Fifteen registered nurses in a general medical ward of a university hospital in Sweden were followed in their daily work with patients. Twelve patients suffering from various chronic diseases were interviewed. METHODS: The observations comprised a total of 173 h on 34 separate occasions. Informal dialogues with nurses were carried through. Further, formal interviews were conducted with 12 of the observed patients. The data were analysed by means of a life-world phenomenological approach. RESULTS: Two different pedagogical encounters are presented: "Players in different field pedagogical encounters", in which there is a breakdown in the pedagogical dialogue, and "Players in same field pedagogical encounters", in which the pedagogical dialogue develops. Patients' experiences of seeking and acquiring knowledge within these two types of encounter are characterised as "worry" versus "preparedness". Patients' dignity is either threatened or supported, depending on the type of encounter. CONCLUSIONS: Health care organisations have to create a pedagogical climate where "Same field pedagogical encounters" can be created. The nurse has to view the patient as a learning person in order to help the patient to achieve "preparedness". "Preparedness" is described as a cognitive-emotive-existential state and emphasised as an important goal of patient teaching.

Adult↗
PubMed2001

Nurse-environment misfit and nursing practice.

AIM OF THE STUDY: The purpose of the following descriptive correlational study was to investigate nurses' responses to the image discrepancy between the public and nurses, and its relationships with their self-concept, job satisfaction and performance. BACKGROUND: It has been long said that nurses live in a dual structure wherein the nurse's journey toward professionalization is constrained by nursing stereotypes in a society. This duality of the nursing universe is assumed to have created a person-environment misfit which could lead to nurses' job dissatisfaction and low job performance. Nonetheless, little study has been done in this area. DESIGN/METHODS: The study was conducted in 1999 with ethical approval from an Australian University. A sample of 80 Australian registered nurses participated by completing the Porter Nursing Image Scale, Index of Work Satisfaction (IWS) and Six-Dimension Scale of Nursing Performance. Data were analysed using descriptive statistics and Pearson correlation. RESULTS: The results suggested that there is a discrepancy in the images of the nursing profession between nurses and the public, which can contribute to the nurse-environment misfit. The results also supported a negative correlation of the misfit with nurses' job satisfaction and performance. CONCLUSION: Despite the limited sample size and characteristics, this study provides evidence to encourage nurses to improve the public image of nurses, which will enhance the professionalization of nursing.

Employee Performance Appraisal↗
PubMedDate not supplied

Process, perils, and pitfalls of research in prison.

Correctional facilities are fertile fields for conducting nursing research and are virtually untapped by nurse researchers. Colleagues inclined to do research in correctional facilities can make significant contributions to nursing literature. This article focuses on the process, perils, and pitfalls of research in penitentiaries. Prison populations are overlooked and largely ignored by the nursing profession. Historically, nurses have ministered to underserved populations. Incarcerated individuals meet the criteria for underserved and understudied groups. Physical and psychosocial health care problems are abundant and beg to be studied. Administrative officials and inmates were cooperative and demonstrated a willingness to contribute to research. Participation proved to be therapeutic to the inmates and was a mutually rewarding experience for this researcher.

Attitude of Health Personnel↗
PubMed1990

Quality assurance in nursing care: structure and process of nursing care.

This article has the following objectives: to state the continuity in quality assurance in nursing without developing them, to point out the changes and the trends, to comment on them and to suggest plans of action. The objectives will be attained integrating these changes into the two first steps of the evaluation: the elaboration of norms and the measuring, including structure and process and mentioning the outcome. Proposals as how to act are presented; different actors have to play their own role: the nursing profession, the nursing unit, the nursing department, the executive board of hospitals, the legal and representative authorities.

Employee Performance Appraisal↗
PubMed1995

How to make professional practice models work.

Professional practice models and shared governance have had much attention recently. They have been credited with being the answer to nurse retention, advancing the nursing profession, expanding nursing roles, and increasing autonomy for practice and work life. This article describes strategies for implementing and maintaining a professional practice model. Organizational support, nurse manager role change, unit readiness, salaried compensation, and incentives are areas that must be assessed before implementing a model. The models described are unit based and use the concepts of shared governance and group practice.

Humans↗
PubMed1978

A concept of loneliness in the elderly.

The author's concept of loneliness is described, especially as it concerns the elderly. An attempt is made to develop an understanding of the word, with its implications for guidance in the nursing profession. The nurse's defenses against her own feelings of loneliness and depression can inhibit therapeutic interactions with lonely or depressed patients. Appropriate nursing action depends upon the knowledge, correlation and use of many other concepts such as those related to dynamics of behavior, personality structure and development, or problem solving. Practical recommendations for nursing intervention are outlined. Emphasized is the necessity for the nurse to understand the concept of loneliness so that she may render effective service.

Aged↗
PubMed2002

Priorities for nursing research in Korea.

PURPOSE: To identify priorities for nursing research in Korea. METHODS: A national sample of nurses in academic and clinical settings, representing varied clinical specialties, participated in two rounds of a Delphi survey. Participants listed five most important nursing research problems rated on three dimensions: the degree of nurses' lead role, contribution to nursing profession, and nurses' contribution to health and welfare of patients and clients. A total of 29 research areas were derived from 1,013 research problems identified from the Delphi surveys, and 26 expert panel members who participated in a 1-day workshop to determine the priority of these areas. Key words of 706 research articles published in the major nursing research journals in Korea were analyzed to identify priorities. RESULTS: In the two rounds of Delphi surveys 347 of 1,047 nurses participated (31%-33% response rates respectively). To three research areas common to both Delphi survey and literature analysis were: clinical nursing practice, nursing education, and nursing research. Cultural nursing was rated the lowest in the Delphi survey but was rated third by the expert panel members. CONCLUSIONS: In the clinical practice area, research on the advanced practice nursing system was the first priority research problem followed by development of nursing interventions, clinical competency, quality and effectiveness of nursing care, and standardized nursing tasks. Research on home health care, nursing education, utilization of nursing research, and geriatric nursing were other areas of priority. Nurses around the world are encouraged to develop collaborative research projects based on common priority areas.

Delphi Technique↗
PubMedDate not supplied

Exploring boundaries in the nurse-client relationship: professional roles and responsibilities.

TOPIC: The creation and maintenance of boundaries as they pertain to the nurse-client relationship. PURPOSE: To challenge readers to reflect on their fiduciary responsibilities by identifying boundary crossings and violations. SOURCES: Review of the literature and the authors' clinical and teaching experiences. CONCLUSIONS: Although self-awareness and monitoring, debriefing, and availing oneself of supervision and education are important tools in creating and maintaining boundaries, in the final analysis, the nursing profession needs nurses who have the ability to make decisions about boundaries based on the best interests of the clients in their care.

Attitude of Health Personnel↗
PubMedDate not supplied

Nurses' willingness to manage the pain of specific groups of patients.

Effective pain management remains a challenge for the nursing profession. While nurses' knowledge of appropriate pain strategies has improved considerably, additional research needs to be conducted into the influence of factors other than knowledge on the management of pain. This study examined the willingness of nurses (n = 157) and nursing students (n = 265) to spend time and energy managing the pain of different groups of patients, when told that all patients had the same degree of pain. The willingness of nurses to spend time and energy in managing patients' pain was used as a proxy for preconceived notions relative to particular groups of patients. A pattern emerged that suggested that nurses' and nursing students' willingness to spend time and energy managing patients' pain in influenced by their perceptions of different groups of patients.

Adult↗
PubMedDate not supplied

Graduate nurses' experiences of interactions with professional nursing staff during transition to the professional role.

As new members of the nursing profession, graduate nurses (GNs), in their transition to the professional role, have a variety of experiences with registered nurses. These experiences give rise to diverse thoughts and emotional responses that may have a significant impact on nurses' own professional development and socialization to the professional role. Literature documenting GNs' perceptions and feelings regarding their orientation to the professional role is scarce. This study involved 16 nurses' descriptions of their own experiences, thoughts, and feelings that arose from interactions with nurse colleagues during their first year of professional nursing practice. There was a lack of consistency regarding the way in which GNs were assisted in this important transitional teaching and learning experience. Understanding GNs' perceptions of the process of transition to the professional role holds tremendous value for nursing education. This understanding could serve as a guide in the development of positive and appropriate orientation strategies as we strive to imbue nursing graduates with the professional values, attitudes, and behaviors that are essential in achieving outcomes reflective of quality patient care.

Adaptation, Psychological↗
PubMed1998

Nursing informatics education for advanced nursing practice.

This paper describes how nursing informatics content will be integrated into the education of Advanced Nursing Practitioners at Masters level. Changes in health care, especially the need to deliver evidence based nursing care and the growing amount of health data, information and knowledge, require well educated Advanced Nurse Practitioners to lead the nursing profession. The nursing informatics content for this level of nursing education is described and compared with national and international curriculum guidelines, including Nightingale work.

Curriculum↗
PubMed1999

[Demystifying the desire for control].

Demystifying the desire for control. Humans are constantly striving for various forms of control: to master a role or new responsibility, or to control their weight. The desire for control, therefore, is fundamental to the nursing profession because nurses are responsible for helping individuals maintain, regain or attain optimal health. Analysis of much of the literature reveals the lack of consensus on the terminology and definition of the desire for control. To remedy this shortcoming and clarify this key concept in nursing, the authors analysed this concept with the method described by Wilson, often used in nursing. The authors describe the background, characteristics and consequences of this concept. Identifying these factors should give nurses an opportunity to observe this concept in practice and to understand certain behaviors. Our view of reality shapes how we deliver care. Demystifying this concept will also open the field to research.

Humans↗
PubMed1975

Psychiatric nursing: a view from within.

There are several recurrent themes that reflect the concerns of nurses who seek entry into graduate programs in psychiatric nursing. Four of the themes that will be presented are an emphasis on mental health, a desire to seek varied points to entry into health care, increased interaction with other health workers and participation in social change. The themes are interrelated and reflect a view of nursing responsibilities and an awareness of the needs for a comprehensive approach to health care. These views are typical of a range of concerns within the nursing profession. Although nursing comprises the largest number of prepared health care workers, nursing is a marginal group within the system. There is considerable discussion of a need for revision of health care systems and of need to utilize manpower resources most effectively. System change is a difficult process and one can only speculate about the outcomes. It is difficult to predict whether the beliefs and values of nurses and nursing a marginal group, can be shared within the health care system.

Career Mobility↗
PubMed2002

Knowledge and practice of breast cancer screening amongst public health nurses in Singapore.

AIM OF STUDY: The study aimed to examine the knowledge and practice of breast cancer screening amongst Public Health nurses who are patient educators. METHOD: A self-administered questionnaire was sent to all 447 nurses in the Public Health Service to assess their knowledge and practice of breast cancer screening. Response rate was 96.4%. Knowledge scores ranged from 0-17 with one point given to a correct knowledge question, zero for wrong answer. RESULTS: Median knowledge score was nine and 58.3% of nurses scored > or = 9. Statistically significant factors influencing knowledge scores were related to the nursing profession, namely nursing qualifications, current nursing post and current workplace. 76.2% of Nursing Officers/Higher Nursing Officers and 74.5% of midwives had knowledge scores > or = 9 compared with 57.3% of staff nurses and 40.8% of assistant nurses (p < 0.01). 60.1% of nurses who were taught breast-self examination scored > or = 9 (p < 0.05). As for practice, 93.7% of nurses did breast-self-examination, 54.1% had clinical breast examination in the past one year and 50.2% had mammogram done. On multivariate analysis, significant factors affecting practice of clinical breast examination were marital status (Prevalence Rate Ratio 1.94, 95% Confidence Interval 1.20-3.15), doctor's gender (PRR 1.35, CI 1.04-1.75) and those affecting mammogram were age group (PRR 1.78, CI 1.27-2.48), marital status (PRR 1.63, CI 1.03-2.59), history of breast disease (PRR 1.51, CI 1.06-2.16). CONCLUSIONS: The majority of nurses had certain misconceptions in the knowledge of breast cancer and breast cancer screening. A higher proportion of nurses in the Family Health Service had higher knowledge scores than other nurses in the Public Health Service. Most of the nurses did breast-self-examination. Having ever married and the availability of a female doctor influenced the nurses attending clinical breast examination. Nurses who were > or = 50 years old, ever married and those with a positive history of breast disease were more likely to have mammography done.

Adult↗
PubMed2002

Don't underestimate the power of culture.

Integrating a client's health care beliefs into the plan of care is the first step in providing culturally congruent care. Since caring is largely defined within a cultural context, knowing how clients wish to be cared for, and knowing about their culture, is paramount for the nursing profession. Transcultural nursing, a specialized area within nursing, embraces the power of culture. Transcultural nurses recognize and utilize the role of culture in the provision of culturally congruent care. By the year 2060, non-Hispanic whites are projected to comprise about half of the U.S. population (49.4%). In the year 2000, an estimated 12% of registered nurses were from an identified minority group. Therefore, it is not surprising that the culture of nursing in the United States continues to reflect the predominant values of the non-Hispanic white or Anglo-American culture. Ethnocentrism and cultural imposition must be avoided. Three major health belief systems (biomedical, naturalistic, and magico-religious) are presented with emphasis on their influential power with respect to health care practices. Underestimating the power of culture may be harmful to the health of the client.

Attitude to Health↗
PubMedDate not supplied

[Occupational stress and assessment of human resources in health: from assessment to the changing process].

Health professionals are at risk for occupational stress, as confirmed by diverse sources including the Italian legislative decree, D.L. 626/94, the Health Promoting Hospital of the World Health Organization, and the Ottawa Charter. The aim of this study was to analyze quantitatively and qualitatively the principal sources of stress in the work environment and the resources, both individual and organizational, that health professionals feel they possess to cope with it. The instruments utilized for the first quantitative phase were: the Maslach Burn out Inventory, the Job Content Questionnaire, Coping Inventory for Stressful Situation and Team Climate Inventory. The study population consisted of 224 subjects belonging to the nursing profession (nurses-in-charge of ward, specialized and general nurses), working in the community and in hospital. The results show medium levels of burn out, and coping strategies that are primarily oriented towards a direct solution of the stressful situation. Vision is a critical aspect, ie. a clear perception of institutional choices and goals is lacking. The administration and analysis of the questionnaires was followed by a second phase in which, by means of the focus group methodology, the results were qualitatively analyzed and the health professionals stimulated to an active and pro-positive approach in the search for solutions to the critical situations.

Adult↗
PubMed2006

Nursing clinical developments units--A strategy to promote the relationship between practice and academia.

Bridging the theory-practice gap has historically been acknowledged as a priority for the nursing profession. Enhancing nurses' attitudes regarding the relevance of theory to practice has been considered as crucial in order that the relationship between theory and practice becomes strong and complimentary. A review of the literature suggests that strategies such as joint clinical and academic positions have not had a significant impact in this respect. Nursing Clinical Development Units (NCDUs) were introduced in the United Kingdom as an initiative to promote the recognition and utilisation of research findings as an inherent component of nursing practice. However, there is limited literature addressing the impact of NCDUs on relationships between academia and the clinical field. The aim of this paper is to present the findings of a qualitative evaluation conducted with participants (n=14) of an NCDU program in Victoria, Australia. The findings suggest that this initiative can significantly enhance relationships with, and attitudes towards, academia.

Community Mental Health Services↗