Exploring the actual and potential role of the primary care nurse in the prevention of cancer: a mixed methods study.

The aim of this study was to investigate the actual and the potential role of the primary care nurse (PCN) in the prevention of cancer. International studies have indicated that a range of strategies can have an impact on the incidence of cancer. Due to their frequent front-line contact with the public, PCNs can play an important role in the primary prevention of cancer. Nonetheless, there is a lack of information on their actual and potential role in cancer prevention. A sequential confirmatory mixed methods approach was used. Postal questionnaires were administered to PCNs [n = 500; 225 returns (response rate 45%)] followed by semi-structured interviews (n = 15). PCNs provided high levels of cancer prevention activities, specifically focusing on smoking cessation, obesity and cervical screening. They considered that their cancer prevention role could be improved through additional practice-based training and more collaborative inter-professional working. They also identified the need for a better understanding of how to change people's attitudes and behaviours regarding cancer prevention. Evidence from this study provide important insights into the potential of the PCN to empower individuals to take responsibility for their own health and make more informed lifestyle choices.

A national survey of community psychiatric nurses and their client care activities in Ireland.

Increasingly, people with mental health problems in Ireland and in the UK are receiving mental health services in the community. The aim of this study was to identify the predominant approaches to care used by community psychiatric nurses (CPNs) and the theoretical bases of their practice. One hundred and sixteen questionnaires out of 203 sent to CPNs throughout Ireland were returned, giving a response rate of 57.1%. In addition, 33 home visits by 13 CPNs were observed. The findings showed that over 96% of the sample were in full-time employment; most (71.4%) worked a 9-5 weekday shift; 31% had a postregistration counselling qualification, and about a quarter were based in hospitals. The average caseload size was 61 and the service was predominantly a closed referral one. The main client care activities were: assessment of clients, medication management, health promotion, and client and family support. From the observations, there was no evidence of CPNs practising cognitive, behaviour therapy or family therapies to any great extent. This study provides baseline data for monitoring trends in community mental health nursing in Ireland, and for informing future policy regarding service provision and training of CPNs.

Illicit drug users in Northern Ireland: perceptions and experiences of health and social care professionals.

Over the 30 years of conflict, Northern Ireland escaped the worst excesses of illegal drug trafficking and usage. This was in large part due to the 'policing' of local community crime by paramilitaries. However, since the first 'cease-fire' in 1994 the province has witnessed a dramatic and unprecedented rise in the availability of illicit drugs. This increased availability reflects rising consumption of these drugs in the province. The aim of this study was to explore the perceptions that a sample of health and social care professionals' hold of illicit drug users in Northern Ireland. A survey methodology was used. Community settings across Northern Ireland were accessed. Focus groups and face-to-face interviews were used as data collection methods. Thirty-five health and social care professionals took part in this study. Thirty-two took part in six focus groups; three respondents underwent one-to-one interview. The participating professionals reported to have little or no education or training in the care and treatment of illicit drug users. Some stated that they would reject the offer of education and training in this area to prevent contact with illicit drug users. Many displayed strongly negative views of this client group, often expressing a preference not to care for or treat these people, preferring all their care to be given by specialists in illicit drug treatment. These findings indicate that most of the health and social care professionals who took part in this study appear unprepared and unwilling to meet the challenge of caring for illicit drug users. The findings will be of interest to service providers within and outside the UK.

Nursing skill mix substitutions and quality of care: an exploration of assumptions from the research literature.

A comprehensive search of the research literature was undertaken to explore the relationship between skill substitution and quality of care. It was possible to identify three central assumptions based upon the studies reviewed. The first suggests that a rich skill mix of mostly qualified nurses is often an ineffective and inefficient way of providing health care. The second assumption is based on research which appears to indicate that a skill mix of mostly unqualified staff is an ineffective approach to health care provision. Finally, there is a plethora of research findings which suggest that the most effective and efficient way to provide health care lies in the employment of high numbers of qualified staff. This paper examines the evidence for each of these positions and highlights the inherent limitations of the underlying studies.