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4.
J Adv Nurs ; 75(7): 1527-1538, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30816572

RESUMEN

AIM: To explore compassion from the perceptions of individuals with personal experience of nursing care. BACKGROUND: Although compassion is considered integral to professional nursing, increasing reports of care experiences illustrating a lack of compassion have challenged this. Despite political and professional guidance to reaffirm compassion as an underpinning philosophy of contemporary nursing practice, this provides limited insight into what compassion may involve. Contemporary evidence to inform understanding of compassion predominately arises from the professional perspective. This knowledge gap supported the rationale to explore compassion from the individual perspective. DESIGN: Constructivist grounded theory, underpinned by the theoretical perspectives of symbolic interactionism and social constructionism. METHODS: Data were collected via 11 individual interviews, a focus group discussion and three additional individual interviews during 2013-2015. Initial and focused coding, constant comparative analysis, conceptual mapping, theoretical memos and diagrams supported data analysis until theoretical sufficiency was determined. FINDINGS: Inter-related data categories emerged: Self-Propensity for Compassion, Attributes for Compassion, Socialising for Compassion, Conditions for Compassion; and Humanising for Compassion (core category). CONCLUSION: Compassion is a complex phenomenon, constructed by individuals through their personal experiences of nursing care and life experiences in the social world. In this study, participants perceived that compassion was fundamentally embodied by experiences of a humanising approach to nursing care. These humanising experiences were thought to be influenced by biological, psychological and socio-contextual factors. The study provides additional insight into compassion that requires further investigation with individuals in other care contexts, nurses and healthcare professionals.


Asunto(s)
Empatía , Teoría Fundamentada , Atención de Enfermería , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad
5.
Nurs Health Sci ; 20(2): 206-213, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29349899

RESUMEN

Child home accidental injury is a global health issue, and promoting child safety is a pediatric nursing challenge worldwide. Planning child home accidental injury prevention requires understanding of factors influencing parents' behavior. Evidence suggests that participatory health promotion positively influences behavior; however, research on Thai parents is limited. This qualitative, action research study aimed to understand Thai parents' experiences of participating in a collaborative child home accidental injury prevention program and its influence on their behavior. Eight parental mother/father couples from one Thai province consented to participate, providing a wide range of data via in-depth individual interviews and self-assessment questionnaires. Thematic analysis of interview transcripts yielded three themes: collaborative learning, parental behavior change, and reflective learning extends beyond families. Participants reported that workshop participation improved their child home accidental injury-prevention behavior. The present study can inform pediatric nursing, child health-care practice, and child health policy in Thailand and beyond.


Asunto(s)
Accidentes Domésticos/prevención & control , Conducta Cooperativa , Adulto , Femenino , Investigación sobre Servicios de Salud/métodos , Humanos , Masculino , Persona de Mediana Edad , Padres/psicología , Seguridad del Paciente/normas , Investigación Cualitativa , Encuestas y Cuestionarios , Tailandia , Heridas y Traumatismos/prevención & control
6.
Nurse Educ Today ; 60: 56-61, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29045912

RESUMEN

INTRODUCTION: This study gives insight into the experiences and perceptions of one group of undergraduate nursing students as they make the transition into Higher Education and the nursing profession, during the first year, of their three-year programme. Research has shown that first year undergraduate experience is complex and challenging for any student. For undergraduate nursing students, the process of achieving additional professional practice competencies required for United Kingdom nursing registration adds additional responsibility and potentially, more pressure. Few studies have considered student nurses' lived experiences during their first year of study in any depth. STUDY AIM: This study aimed to understand how one group of undergraduate nursing students perceived their experiences of the transition into higher education and nursing profession. DESIGN: Framed within an interpretive philosophical paradigm, a hermeneutic phenomenological approach enabled the exploration of participants' lived experiences. SETTING AND PARTICIPANTS: The study took place at a Higher Education Institution approved nurse education provider in the North of England, United Kingdom (UK). Following ethical approval, ten first year student nurses from a range of different backgrounds gave informed consent to participate. METHODS: Over a one year period between 2013 and 2014 participants provided data at three points during their first year (four months, eight months and twelve months) via semi-structured, digitally recorded individual interviews (n=30) and digital recordings of critical incident accounts as they occurred (n=30). Data was transcribed verbatim, systematically thematically analysed drawing on hermeneutic phenomenological principles and verified for thematic accuracy by participants in 2015. FINDINGS: Five themes emerged from the data: uncertainty; expectations; learning to survive; seeking support; and moving forward. Findings identify that the participants had developed skills to survive however considerable variation in their experience, influenced motivation and behaviour. They developed their own skills of coping to deal with the demands of academic life and those of the practice setting. An explanatory student journey model demonstrated that developing self-efficacy was key to their successful transition through the first year of undergraduate study. CONCLUSIONS: Understanding the first year student nurse perspective and insight into their coping strategies are key to supporting a positive learning journey. Positive feedback from nurse educators, a growing sense of nursing community and motivation to succeed facilitates their internalisation of nursing identity, norms and values and an active pursuit of learning towards graduate status and becoming a nurse.


Asunto(s)
Adaptación Psicológica , Hermenéutica , Estudiantes de Enfermería/psicología , Adulto , Actitud del Personal de Salud , Bachillerato en Enfermería , Inglaterra , Femenino , Humanos , Aprendizaje , Masculino , Investigación Cualitativa , Autoeficacia
7.
Health Soc Care Community ; 24(5): 639-48, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-25944423

RESUMEN

The contribution of women to the achievement of global public health targets cannot be underestimated. It is well evidenced that within families, women are a key influence on the health and well-being of their children and partners. However, geographical differences in women's health inequalities persist and research focusing specifically on women's perceptions of locality factors influencing their own health and well-being is scarce. This paper presents an interpretive, qualitative research study undertaken in 2011 with a group of women living in one locality in the North East of England in the United Kingdom which aimed to better understand their health and well-being perceptions and locality influences on it. Fifteen women participated in two focus groups and six individual, semi-structured interviews. Thematic analysis yielded four key themes: health and well-being perceptions; mental resilience; low income and choice; and influence of place. The influence of women's geographical location in relation to amenities and services and loneliness were recurring factors in the discussion, each influencing lifestyle. It was evident that women in their local context were themselves assets through which their own physical and mental health could be improved. However, women's perceptions of protective factors and their influences on health and well-being varied. Connecting with women in the context of their immediate living circumstances and understanding their perceptions as individuals are important first steps in the process of gaining consensus and mobilising their assets to collectively build healthy local communities.


Asunto(s)
Estilo de Vida , Soledad , Salud de la Mujer , Inglaterra , Femenino , Humanos , Reino Unido
8.
Nurse Educ Today ; 35(1): 50-6, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24933402

RESUMEN

The provision of inter professional learning (IPL) within undergraduate programmes is now well established within many Higher Education Institutions (HEIs). IPL aims to better equip nurses and other health professionals with effective collaborative working skills and knowledge to improve the quality of patient care. Although there is still ambiguity in relation to the optimum timing and method for delivering IPL, effective facilitation is seen as essential. This paper reports on a grounded theory study of university educators' perceptions of the knowledge and skills needed for their role adequacy as IPL facilitators. Data was collected using semi structured interviews with nine participants who were theoretically sampled from a range of professional backgrounds, with varied experiences of education and involvement in facilitating IPL. Constant comparative analysis was used to generate four data categories: creating and sustaining an IPL group culture through transformational IPL leadership (core category), readiness for IPL facilitation, drawing on past interprofessional learning and working experiences and role modelling an interprofessional approach. The grounded theory generated from this study, although propositional, suggests that role adequacy for IPL facilitation is dependent on facilitator engagement in a process of 'transformational interprofessional learning leadership' to create and sustain a group culture.


Asunto(s)
Docentes , Personal de Salud/educación , Relaciones Interprofesionales , Aprendizaje , Rol Profesional , Conducta Cooperativa , Inglaterra , Teoría Fundamentada , Humanos
9.
Nurse Educ Pract ; 14(4): 410-6, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24480095

RESUMEN

Action learning sets (ALS) are used widely for organisational and workforce development, including in nursing (Anderson and Thorpe, 2004; Pounder, 2009; Young et al., 2010). In the United Kingdom, a multi-faceted educational Pilot programme for new nurses and midwives was implemented to accelerate their clinical practice and leadership development (NHS Education Scotland, 2010). Action Learning Sets were provided for peer support and personal development. The Realistic Evaluation study reported in this paper explored issues of context, mechanism and outcome (Pawson and Tilley, 1997) influencing the action learning experiences of: programme participants (recently qualified nurses and midwives, from different practice settings); and programme supporters. A range of data were collected via: online questionnaires from 66 participants and 29 supporters; three focus groups, each comprising between eight and 10 programme participants; and one focus group with three action learning facilitators. The qualitative data pertaining to the ALS are presented in this paper. Thematic data analysis of context, mechanism and outcome configurations, generated five themes: creating and sustaining a collective learning environment; challenging constructively; collective support; the role of feedback; and effectiveness of ALS. Study outcomes suggest nursing and midwifery action learning should (a) be facilitated positively to improve participants' experience; (b) be renamed to avoid learning methodology confusion; and (c) be outcome focused to evidence impact on practice.


Asunto(s)
Competencia Clínica , Educación Continua en Enfermería/métodos , Partería/educación , Aprendizaje Basado en Problemas/métodos , Adulto , Femenino , Grupos Focales , Humanos , Masculino , Investigación en Educación de Enfermería , Proyectos Piloto , Embarazo , Escocia , Adulto Joven
10.
Nurse Educ Today ; 34(2): 218-24, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23871210

RESUMEN

A culture of continuous service improvement underpins safe, efficient and cost-effective health and social care. This paper reports a qualitative research study of assessment material from one cohort of final year pre-registration health and social care students' interprofessional service improvement learning experience. Initially introduced to the theory of service improvement, students were linked with an interprofessional buddy group, and subsequently planned and implemented, if possible, a small scale service improvement project within a practice placement setting. Assessment was by oral project presentation and written reflection on learning. Summative assessment materials from 150 students were subjected to content analysis to identify: service user triggers for service improvement; ideas to address the identified area for improvement; and perceptions of service improvement learning. Triggers for service improvements included service user disempowerment, poor communication, gaps in service provision, poor transitions, lack of information, lack of role clarity and role duplication, and differed between professions. Ideas for improvement included both the implementation of evidence based best practice protocols in a local context and also innovative approaches to problem solving. Students described both intrapersonal and interprofessional learning as a result of engaging with service improvement theory and practice. Service improvement learning in an interprofessional context has positive learning outcomes for health and social care students. Students can identify improvement opportunities that may otherwise go undetected. Engaging positively in interprofessional service improvement learning as a student is an important rehearsal for life as a qualified practitioner. It can help students to develop an ability to challenge unsafe practice elegantly, thereby acting as advocates for the people in their care. Universities can play a key support role by working collaboratively with service organisations; role modelling effective interprofessional working; and supporting research to measure the impact of education on practice.


Asunto(s)
Personal de Salud/educación , Relaciones Interprofesionales , Seguridad del Paciente , Mejoramiento de la Calidad , Estudiantes del Área de la Salud , Inglaterra , Investigación sobre Servicios de Salud , Humanos , Aprendizaje
11.
J Adv Nurs ; 68(7): 1526-37, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22211526

RESUMEN

AIMS: This article reports the study of a group of United Kingdom health visitors' interactions with their changing practice context, focusing on role identity and influences on its stability. BACKGROUND: United Kingdom policies have urged health visitors to refocus their role as key public health nurses. Reduced role identity clarity precipitated the emergence of different models of health visiting public health work. An inconsistent role standard can lead to role identity fragmentation and conflict across a group. It may precipitate individual role crisis, affecting optimum role performance. METHODS: Seventeen health visitors in two United Kingdom community healthcare organizations participated in a grounded theory study, incorporating constant comparative analysis. Direct observations and individual interviews were undertaken between 2002 and 2008. RESULTS/FINDINGS: Four interlinked categories emerged: professional role identity (core category); professional role in action; interprofessional working; and local micro-systems for practice; each influencing participants' sense of identity and self-worth. The Role Identity Equilibrium Process explains interactive processes occurring at different levels of participants' practice. CONCLUSION: Re-establishing equilibrium and consistency in health visiting identity is a priority. This study's findings have significance for other nurses and health professionals working in complex systems, affected by role change and challenges to role identity.


Asunto(s)
Actitud del Personal de Salud , Enfermería en Salud Comunitaria/organización & administración , Rol Profesional/psicología , Enfermería en Salud Pública/organización & administración , Adulto , Preescolar , Enfermería en Salud Comunitaria/tendencias , Política de Salud , Humanos , Relaciones Interprofesionales , Investigación Metodológica en Enfermería , Innovación Organizacional , Pautas de la Práctica en Enfermería/tendencias , Autonomía Profesional , Enfermería en Salud Pública/tendencias , Investigación Cualitativa , Autoimagen , Reino Unido
12.
Nurse Educ Pract ; 11(4): 239-44, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21185233

RESUMEN

One of the challenges of contemporary health care is the need for health and social care professionals to work differently to meet the complex needs of patients/clients. However it cannot be assumed that these professionals have been prepared with the skills and confidence to collaborate effectively, outside of traditional professional boundaries. Interprofessional education (IPE) is well established as an effective learning and teaching approach to prepare practitioners for collaborative practice at the point of qualification (DOH 2001; Hale 2003; Morison et al., 2003; Department of Health 2006; Hammick et al., 2007). The phenomenological study reported in this paper sought to follow up a group of newly qualified adult nurses at six months post-qualification. These nurses had undertaken a pre-registration curriculum in which classroom-based interprofessional learning was well embedded and formally assessed within their three year programme. Data from eight in depth interviews were analysed and five key themes were emerged: common understanding of IPE; teaching and learning; understanding of professional roles; stereotypes; influence of the practice environment. The outcome of the study suggested IPE should be as practice focused as possible to improve its relevance to nursing practice. This study contributed to the development of an innovative curriculum which provides the opportunity for nurses to integrate IPE theory within their collaborative working practice.


Asunto(s)
Conducta Cooperativa , Educación en Enfermería , Relaciones Interprofesionales , Humanos , Entrevistas como Asunto , Reino Unido
13.
Drug Alcohol Rev ; 22(2): 175-80, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12850904

RESUMEN

Fixed and symptom-triggered taper methods during in-patient benzodiazepine withdrawal treatment were compared using a randomized controlled design. Forty-four benzodiazepine users seeking in-patient withdrawal treatment at two substance use treatment clinics in Adelaide, Australia were recruited. Measurements included the Severity of Dependence Scale and the SF-36. A scale comprising six items from the Clinical Institute Withdrawal Assessment Scale--Benzodiazepines (CIWA-B) was used to measure withdrawal symptoms. Participants were randomized to receive a fixed diazepam tapering regime or diazepam only in response to withdrawal symptoms (symptom-triggered group). Results showed that there were no significant differences between treatment groups in terms of withdrawal severity, duration of in-patient treatment, amount of diazepam administered, treatment attrition and benzodiazepine use at follow-up. Both groups showed a reduction in benzodiazepine dosage of 86% over the first 8 days which was maintained at 1 month post-discharge. Although there were improvements in some subscales of the SF-36 between baseline and follow-up, values were significantly below age-matched norms at both time-points. This study showed that benzodiazepine users entering treatment have relatively poor health and that symptom-triggered taper methods incorporating flexible dosing and flexible treatment duration are as effective as fixed dose taper methods for in-patient benzodiazepine withdrawal treatment.


Asunto(s)
Benzodiazepinas/efectos adversos , Diazepam/uso terapéutico , Moduladores del GABA/uso terapéutico , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Síndrome de Abstinencia a Sustancias/rehabilitación , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Proyectos Piloto , Índice de Severidad de la Enfermedad , Centros de Tratamiento de Abuso de Sustancias , Síndrome de Abstinencia a Sustancias/diagnóstico , Encuestas y Cuestionarios
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