The meaning and consequences of tuberculosis among Somali people in the United Kingdom

Aim. To ascertain the socio‐cultural meaning and consequences of tuberculosis among people of Somali origin living in the UK. Background. In countries where treatment has not been readily available, tuberculosis has become highly stigmatized. Research in Somalia has documented the stigma and social isolation associated with tuberculosis which acts as a powerful deterrent to sufferers acknowledging their illness. The Somali community in the UK is diverse and dynamic: little is known about how tuberculosis is understood, or how stigma is articulated and experienced post‐migration. Design. A focused ethnography was undertaken. Method. A total of 48 individual interviews were undertaken in 2008–2009 with community leaders, Somali community members and tuberculosis patients to explore the social meaning of tuberculosis and perceived consequences of the disease. Eight focus groups were undertaken involving 56 participants. Vignettes concerning tuberculosis were used to prompt discussion of community norms and socio‐cultural constructions of tuberculosis. Data were analysed using the ‘Framework’ approach. Findings. Most participants were familiar with tuberculosis, its characteristics and treatment. However, many participants held misconceptions about how the disease spread and its prognosis. Tuberculosis was perceived as a stigmatizing disease. Somalis with tuberculosis were considered likely to experience felt and enacted stigma with fear of discrimination in the form of social isolation influencing the extent to which people with tuberculosis disclosed their condition. Conclusion. Nurses should understand the socio‐cultural meaning and consequences of tuberculosis for Somalis to educate the community through public health initiatives and support patients and their families.     

合同制护士付出-获得不平衡与离职意愿的相关研究

目的探讨合同制护士付出-获得不平衡与离职意愿的相关性，寻找导致合同制护士离职的原因，以稳定护理队伍。方法选择某三级甲等医院的338名合同制护士，采用付出一获得不平衡量表和离职意愿量表进行问卷调查。结果合同制护士付出-获得不平衡现状不理想，其中处于付出一获得不平衡状态的比例为79．88％，超负荷状态的比例为85．2l％。合同制护士付出一获得不平衡与离职意愿呈正相关（P〈0．01），付出-获得不平衡是导致合同制护士离职的主要因素之一。结论为减少人员流失，降低离职意愿，护理管理者可提高合同制护士福利待遇，给予一定的职业发展空间，多渠道纠正护士付出-获得不平衡状态，从而稳定护理队伍。     

The effectiveness of simulation activities on the cognitive abilities of undergraduate third‐year nursing students: a randomised control trial

Aims and objectives. To provide evidence on the effectiveness of simulation activities on the clinical decision‐making abilities of undergraduate nursing students. Based on previous research, it was hypothesised that the higher the cognitive score, the greater the ability a nursing student would have to make informed valid decisions in their clinical practice. Background. Globally, simulation is being espoused as an education method that increases the competence of health professionals. At present, there is very little evidence to support current investment in time and resources. Methods. Following ethical approval, fifty‐eight third‐year undergraduate nursing students were randomised in a pretest–post‐test group‐parallel controlled trial. The learning environment preferences (LEP) inventory was used to test cognitive abilities in order to refute the null hypothesis that activities in computer‐based simulated learning environments have a negative effect on cognitive abilities when compared with activities in skills laboratory simulated learning environments. Results. There was no significant difference in cognitive development following two cycles of simulation activities. Therefore, it is reasonable to assume that two simulation tasks, either computer‐based or laboratory‐based, have no effect on an undergraduate student’s ability to make clinical decisions in practice. However, there was a significant finding for non‐English first‐language students, which requires further investigation. Conclusions. More longitudinal studies that quantify the education effects of simulation on the cognitive, affective and psychomotor attributes of health science students and professionals from both English‐speaking and non‐English‐speaking backgrounds are urgently required. It is also recommended that to achieve increased participant numbers and prevent non‐participation owing to absenteeism, further studies need to be imbedded directly into curricula. Relevance to clinical practice. This investigation confirms the effect of simulation activities on real‐life clinical practice, and the comparative learning benefits with traditional clinical practice and university education remain unknown.     

35岁以上护士心理状况的调查分析

目的调查35岁以上护士（以下简称大龄护士）心理状况,为制订改善大龄护士心理状况的干预措施提供理论依据。方法采用自行设计的调查问卷对408名大龄护士的心理状况进行调查。结果 236名（57.84%）大龄护士心理状况为优良水平,128名（31.37%）为中等水平,44名（10.78%）为差水平。排在前4位主要心理问题分别为焦虑（48.29%）,自责（46.08%）,体力不支（43.38%）和强迫心理（30.64%）。结论护理管理者要加强大龄护士心理素质训练,减少职业给其所致的压力源,为其创造良好的工作环境和条件,使大龄护士能克服不良心理情绪,提升积极乐观工作态度,从而提高护理质量。     

心内科护士对冠心病健康教育效果评价认识的质性研究

目的了解心内科护士对冠心病健康教育效果评价的认识及体验。方法对11所三级甲等医院的23位心内科护士及护士长进行深度访谈，并运用现象学资料分析法分析访谈资料。结果23例受访者均认为有必要且已经实施了冠心病健康教育效果评价，并提出应构建冠心病健康教育效果评价量表的建议：构建冠心病健康教育效果评价量表，增加护理人员数量。结论我国应借鉴国外经验，选择合理的效果评价指标和评价实施者，以构建简单、适用、科学的冠心病健康教育效果评价量表，为健康教育效果评价提供量化依据。