实习护生对从事传染病事业态度的质性研究

目的:深入了解和研究在传染病医院实习的护生在实习前后对从事传染病事业的态度转变。方法:以质性研究Edmund Husserl观点构成的现象学方法为指导,采用个人访谈法,深入访问在某"三甲"传染病医院实习即将结束的8名实习护生。结果:实习护生对从事传染病事业的态度包括:恐惧和矛盾心理,逐渐接受,不能理论联系实际,需要支持,愿意从事传染病护理事业。结论:通过在传染病医院的临床实习,可减轻实习护生对传染病的恐惧心理,增加对传染病的认知,转变实习前对从事传染病护理事业的态度。     

Community neonatal nursing work

BACKGROUND: A neonatal community nursing service may help families to cope with the early transfer of small, vulnerable infants to home. The previous literature has relied on self-reports to explore this kind of work. AIM: This paper reports a study exploring the work of a community neonatal nursing team in order to describe the strategies and interventions used to support families of preterm infants. METHOD: A qualitative case study design was adopted. Data were collected using fieldwork observations, semi-structured interviews and documentary analysis with a team of four community neonatal nurses. A nursing model of transition was explored as a possible framework for practice. FINDINGS: Thematic data analysis yielded two broad themes: Working with Mothers and Working with Others. Subcategories of Working with Mothers consisted of Baby Well; Mum Happy; Keeping in Touch and One of the Family. Working with Others focussed on multidisciplinary liaison activities. DISCUSSION: The complexity of nursing work was interdependent with maternal caregiving and dependent upon effective liaison with other health care professionals. The nursing model of transition requires further development to offer a sufficiently coherent practice model to direct neonatal nursing care delivery.     

护士工作家庭增益体验的质性研究

目的探讨护士对工作家庭增益的认知与体验,为护士全面认知工作与家庭的关系提供参考。方法采用半结构式深入访谈的方法进行质性研究,访谈17名护士。结果通过资料分析和整理提炼出2个方面的主题,对工作-家庭增益体验:包括收入稳定、就医方便、照顾家庭便利、持家有道、善于沟通交流、提升家庭地位及收获积极心态;对家庭-工作增益体验:包括安心工作、共享生活习惯与经验、培育同理心。结论护士感知到的既有工作-家庭增益,也有家庭-工作增益。管理者应加强对护士家庭-工作增益的研究,倡导护士工作家庭增益的正向理念,引导护士客观理性地看待护理职业并切实感受其职业获益,实现工作家庭互惠互益的愿景。     

Nursing students' expectations regarding effective clinical education: A qualitative study

This study aimed to describe the expectations of Bachelor of Science nursing students regarding what constitutes an effective clinical education. In this study, a semistructured interview process was utilized with 17 nursing students studying in sophomore, junior and senior years in training units of hospitals affiliated with Tehran University of Medical Sciences. Content analysis was employed to analyse the data. Data analysis led to identification of three main themes: (i) appropriate communication and interaction between instructors and students; (ii) incorporation of both theory and practice in clinical education, with two subthemes, one being the presence of the instructor as a factor for reducing the gap between theory and practice and the other being evaluation based on appropriate criteria; and (iii) having specialized instructors, with a specific emphasis on the instructor's knowledge and motivation as important factors in learning. The findings reveal the significant role of mentors in providing effective educational and clinical experiences. Therefore, mentors must strive to develop their knowledge and clinical behaviours according to students' needs in clinical settings.     

Nursing profession and nurses' contribution to nursing education as seen through students' eyes: A qualitative study

The behavior of clinical instructors, as observed by students, deeply influences their professional development. When instructors behave unprofessionally, they risk undermining the professional growth students gain from their clinical placement experience. Clinical instructors need to be aware of how their behavior can affect the students' learning process and the contributions they make to clinical nursing education. A qualitative study was performed to describe the nursing profession as perceived by students who observed their clinical instructors' behaviors during the clinical experience. In‐depth interviews of nursing students were conducted until data saturation was attained. Sixteen interviews were analyzed using an inductive content analysis methodology. The nursing profession was described by the participants through five themes as follows: the helping relationship, technical role, professional growth, working group, and contradictions and conflicts. Several examples of unprofessional behaviors on the part of the clinical instructors were reported by the respondents. The nursing profession, as perceived by nursing students, does not always reflect their expectations and their ideas related to professionalism. Universities and schools of nursing should ascertain that clinical instructors are prepared to educate students. Faculty should clearly state to students what they can expect from the clinical experience, namely, preparing students to face real working environments that do not always reflect educational philosophies.     

临床一线哺乳期护士返岗后职业压力源的质性研究

目的 探索临床一线哺乳期护士返岗后的职业压力来源，为护理管理者制定针对性的管理对策提供依据。方法 采用质性研究中的现象学研究方法，从人文关怀的视角对某三级甲等综合性医院的25名临床一线哺乳期返岗护士采用半结构式个人访谈法进行访谈,对访谈资料采用Colaizzi7步分析法进行分析。结果 临床一线哺乳期护士返岗后的职业压力来源可归纳为4个主题：超负荷的工作量、母乳喂养、烦躁和焦虑的心理状态、工作方向感缺失。结论 护理管理者应重视临床一线哺乳期返岗护士的职业压力，给予人性化的管理，并采取相应的措施缓解其职业压力，提高其工作效率和生活质量。     

Unmet expectations: why nursing home staff leave care work

Background.  The shortages of healthcare professionals have been a common topic in care of older people.
Aim and objectives.  The aim of the present study was to illuminate what caused the nursing home caregivers to decide to leave their employment.
Design.  A two-year intervention study was performed in three nursing homes in Sweden.
Method.  This qualitative interview study was conducted with 18 caregivers who decided to leave their employment during the first year. Content analysis was the method used to analyse the interviews.
Result.  The caregivers' decisions to leave their work in care of older people could be encompassed in one main category: 'Unmet Expectations'. Their experiences were lack of encouragement and trust and professional development. Feelings of insecurity, different opinions on the care delivered, being disregarded and betrayed followed as did thoughts of leaving work and pursing other opportunities.
Conclusion.  The main findings indicated that organizational work pressure with information about pending financial cutbacks caused the caregivers to leave the nursing homes.
Relevance to clinical practice.  The study's results show the value of meeting the needs of caregivers, as caregivers consider that they meet the needs of the older people. Optimal use of caregivers' skills, experiences, competence and respect for their aspirations is also likely to result in cost-efficient care.     

Factors affecting the integration of immigrant nurses into the nursing workforce: A double hermeneutic study

Background

Variations in nursing practice and communication difficulties pose a challenge for the successful integration into the workforce of immigrant nurses. Evidence for this is found in cultural clashes, interpersonal conflicts, communication problems, prejudiced attitudes and discrimination towards immigrant nurses. While the evidence shows that integrating immigrant nurses into the nursing workforce is shaped by factors that are socially constructed, studies that examine social structures affecting workforce integration are sparse.

Objectives

The aim of this study was to examine interplaying relationships between social structures and nurses’ actions that either enabled or inhibited workforce integration in hospital settings.

Design

Giddens’ Structuration Theory with double hermeneutic methodology was used to interpret 24 immigrant and 20 senior nurses’ perceptions of factors affecting workforce integration.

Results

Four themes were identified from the data. These were: (1) employer-sponsored visa as a constraint on adaptation, (2) two-way learning and adaptation in multicultural teams, (3) unacknowledged experiences and expertise as barriers to integration, and (4) unquestioned sub-group norms as barriers for group cohesion. The themes presented a critical perspective that unsuitable social structures (policies and resources) constrained nurses’ performance in workforce integration in the context of nurse immigration. The direction of structural changes needed to improve workforce integration is illustrated throughout the discussions of policies and resources required for workforce integration at national and organisational levels, conditions for positive group interactions and group cohesion in organisations.

Conclusion

Our study reveals inadequate rules and resources used to recruit, classify and utilise immigrant nurses at national and healthcare organisational levels can become structural constraints on their adaptation to professional nursing practice and integration into the workforce in a host country. Learning from each other in multicultural teams and positive intergroup interaction in promoting intercultural understanding are enablers contributing to immigrant nurses’ adaptation and workforce integration.     

Nursing values in China: The expectations of registered nurses

The purpose of this study was to identify the essential professional values of Chinese nurses and their manifestations in the current health-care environment. Data were collected from 29 nurse experts by semi-structured individual interviews or focus groups in Beijing and Shanghai, China. Thematic analysis was used to analyze the data. Seven themes were identified: altruism, caring, trustworthiness, dignity, responsibility for the development of the profession, autonomy, and justice. On the whole, these values were in accordance with the codes of the International Council of Nurses and the Chinese Nursing Association. Additionally, culture and socioeconomic trends were found to have an influence on nurses' understanding and explanation of professional values. The findings of this study provided insight into Chinese nurses' professional values and might contribute to the future development of a culturally sensitive scale to measure nursing values in China.     

A model of professional nurse caring: nursing students' experience

Research into caring from the perspective of nursing students is poorly documented. This paper presents a study which described the construct of caring as experienced by students in pre-registration programmes at two universities in New South Wales, Australia. Qualitative data were collected using a questionnaire and semi-structured interviews. From the analysis of the data a model of professional nurse caring from the student's perspective was created. In this model, compassion, as the core of caring is actualized in the students' nursing of patients by communicating, providing comfort, being competent, being committed, having conscience, being confident and being courageous. Communication is not only an actualization of this caring but constitutes an important medium for the expression of caring actions.     

Working experiences of Iranian retired nurses: A content analysis study

Understanding the experiences of retired nurses can be useful in increasing self‐confidence, motivation to work and work enthusiasm among nurses. The purpose of this study was to explore the work experiences of Iranian retired nurses. A qualitative design was conducted using a content analysis approach. Purposive sampling was used to choose the study participants. Semi‐structured interviews were held to collect the perspectives of 20 retired nurses (10 female and 10 male). Two main themes emerged in the data analysis: ‘work problems and unpleasant experiences in a sense’ with subthemes ‘exhausting work’, ‘insufficient salary’, ‘inappropriate relation’ and ‘unsuitable social position’; and ‘job satisfaction and pleasant experiences in a sense’ with subthemes ‘divine satisfaction and religious belief’, ‘satisfaction of patients and their companions’ and ‘love of nursing profession and relaxation experience’. The findings indicate the challenges that nurses face after retirement. These experiences will help nurse managers to adopt appropriate measures to support nurses after retirement.     

Feeding nursing home patients with severe dementia: a qualitative study

AIM: To describe the nature of problems nurses face when feeding nursing home patients with severe dementia, and how they deal with these problems. BACKGROUND: In our study on starting or withholding artificial nutrition and hydration for nursing home patients with dementia, we found that many problems in feeding arose (long) before any decision was made about artificial feeding, namely from the first moment a patient needed help with meals. Because 'ordinary feeding' was experienced as a daily recurring problem for nurses, we decided to investigate this within the study. METHODS: Participant observation by two researchers in two Dutch nursing homes. FINDINGS: Nurses interpreted the aversive behaviour of patients differently, and a link between interpretation and responses (stop or continue feeding) was observed. Differences in interpretation with regard to the same patient were observed in nurses in five of the seven units. Only in three units did nurses discuss their different interpretations in an attempt to find out why a patient avoided food and fluids and how to deal with these problems. CONCLUSIONS: Nurses' interpretations of aversive behaviour of patients differ. No definite conclusions can be drawn about the causes of the aversive behaviour observed, because they cannot be verified. We recommend that interpretations of the behaviour of particular patients should be discussed by nurses with physicians, other disciplines and the patient's family to obtain more insight into all its possible causes and to determine together the most likely interpretation and appropriate way in which to deal with the aversive behaviour. This would give nurses more confidence and improve the quality and continuity of care provided. To structure the search for possible causes of aversive behaviour, we developed a framework of causes of aversive behaviour and domains of functioning.     

Managing equality and cultural diversity in the health workforce

Aims. This article offers practical strategies to managers and others for supporting overseas trained nurses and managing cultural diversity in the health workforce. Background. Widespread nursing shortages have led managers to recruit nurses from overseas, mainly from developing countries. This paper draws on evidence from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study reported elsewhere in this issue, which indicates that overseas trained nurses encountered widespread discriminatory practices including an overuse of complaints and grievances against them. The researchers also found that the overseas trained nurses responded to their experiences by using various personal strategies to resist or re‐negotiate and overcome such discriminatory practices. Methods. A research workshop was held in June 2005 at the midpoint of the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study. Twenty‐five participants attended the workshop. They were the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study researchers, advisory group members, including the author of this paper and other researchers in the field of migration. The overall aim of the workshop was to share emerging research data from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals and related studies. The final session of the workshop on which this paper is based, was facilitated by the author, with the specific aim of asking the participants to discuss and determine the challenges to managers when managing a culturally diverse workforce. The discussion yielded four main themes collated by the author from which a framework of strategies to facilitate equality and cultural diversity management of the healthcare workers may be developed. The four themes are: assumptions and expectations; education and training to include cultural sensitivity, equality and human rights; performance management; and transparent human resource management processes. Conclusion. Managing a racially and culturally diverse workforce is complex and challenging for managers. There are no ready‐made tools to show them how to do so. Achieving effective management of a culturally diverse workforce comes from an intrinsic motivation to develop the cultural competence to engage with them. Implications for practice. This article, together with others in this special issue, provides a springboard for moving this agenda on. It offers managers a framework of themes, which they can draw on to develop their own best practice for managing racial equality and cultural diversity in the health workforce.