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1.
Background
Paper based simulated patients are widely used to analyse nurses’ clinical judgements. However, developments in the physical simulation of clinical environments offer exciting, but relatively underexploited, opportunities for exploring nurses’ judgements. Critical event risk assessment is an element of acute care practice which lends itself well to simulation and in which more clinical experience is often assumed to lead to better quality judgements.Objectives
To model nurses’ judgements of critical event risk using physical and paper simulation and to examine whether improving fidelity via physical clinical simulation impacts on the apparent benefits of clinical experience on nurses’ judgement performance.Design
A comparative clinical judgement analysis.Setting
A university in Northern England.Methods
Sixty-three nursing students and 34 experienced nurses made dichotomous risk assessment judgements (“at risk” or “not at risk”) in response to 25 paper and physical simulated scenarios. These were randomly generated from a dataset of real patient case records. Clinical outcomes (the judgement criteria) for a ‘correct’ judgement were derived from the same case records. Logistic regression models were constructed to derive statistics for each nurse representing various measures of judgement performance: achievement (ra), consistency (Rs) and clinical information use (G). These statistics were known as Lens Model statistics (from the psychological theory of Brunswik's Lens Model of judgement). Performance measures for novice and experienced nurses were compared.Results
No significant differences in judgemental achievement (ra) between experienced nurses and students were observed in either paper or high fidelity clinical simulations. Similarly, there were no significant differences in the nurses’ abilities to correctly match the ways they synthesised clinical information with the optimum synthesis required by the task (policy matching) (G). When faced with “paper patients” experienced nurses exercised more cognitive control/consistency (Rs) than students (P = 0.04). However, this heightened control in experienced nurses was absent when those same nurses made judgements in the higher fidelity clinical simulation environment.Conclusion
Clinical experience made no difference to nurses’ judgement achievement (accuracy) in either the lower fidelity paper scenarios or the higher fidelity setting of the clinical simulation unit. The significant impact of clinical experience on judgement consistency was negated by the increases in fidelity offered through clinical simulation. 相似文献2.
3.
Betsie G.I. van Gaal Lisette Schoonhoven Joke A.J. Mintjes George F. Borm Theo van Achterberg 《International journal of nursing studies》2010,47(9):1117-1125
Background
Patients in hospitals and nursing homes are at risk for the development of often preventable adverse events. Guidelines for the prevention of many types of adverse events are available, however compliance with these guidelines appears to be lacking. As a result many patients do not receive appropriate care. We developed a patient safety program that allows organisations to implement multiple guidelines simultaneously and therefore facilitates guideline use to improve patient safety. This program was developed for three frequently occurring nursing care related adverse events: pressure ulcers, urinary tract infections and falls. For the implementation of this program we developed educational activities for nurses as a main implementation strategy.Objectives
The aim of this study is to describe the effect of interactive and tailored education on the knowledge levels of nurses.Design
A cluster randomised trial was conducted between September 2006 and July 2008.Settings
Ten hospital wards and ten nursing home wards participated in this study. Prior to baseline, randomisation of the wards to an intervention or control group was stratified for centre and type of ward.Participants
All nurses from participating wards.Methods
A knowledge test measured nurses’ knowledge on the prevention of pressure ulcers, urinary tract infections and falls, during baseline en follow-up. The results were analysed for hospitals and nursing homes separately.Results
After correction for baseline, the mean difference between the intervention and the control group on hospital nurses’ knowledge on the prevention of the three adverse events was 0.19 points on a zero to ten scale (95% CI: −0.03 to 0.42), in favour of the intervention group. There was a statistically significant effect on knowledge of pressure ulcers, with an improved mean mark of 0.45 points (95% CI: 0.10-0.81). For the other two topics there was no statistically significant effect. Nursing home nurses’ knowledge did neither improve (0 points, CI: −0.35 to 0.35) overall, nor for the separate subjects.Conclusion
The educational intervention improved hospital nurses’ knowledge on the prevention of pressure ulcers only. More research on long term improvement of knowledge is needed.Trial registration
ClinicalTrials.gov ID [NCT00365430]. 相似文献4.
5.
Pisanti R van der Doef M Maes S Lazzari D Bertini M 《International journal of nursing studies》2011,48(7):829-837
Background
Among health care workers, nursing has been identified as particularly stressful. Several studies have shown cross-national differences in nurses’ levels of occupational stress and burnout.Objectives
The purpose of the study was to compare job characteristics, organizational conditions, and strain reactions in Italian (N = 609) and Dutch (N = 873) nurses. It was also examined how and to what extent various job characteristics and organizational conditions explain occupational and general strain.Design
The study was a cross-sectional questionnaire survey.Method
Based on the Job Demand-Control-Support Model and the Tripod accident causation model, respectively job characteristics and organizational conditions were assessed as independent variables. Strain was operationalized in terms of job satisfaction, burnout, and psychosomatic complaints.Results
Italian nurses perceived their job characteristics, organizational conditions, and well-being as more unfavourable than their Dutch colleagues. Hierarchical regression analyses showed that high job demands, low skill discretion, and low social support from supervisor were the most consistent predictors of occupational and general strain across samples. Organizational conditions added significantly to the prediction of job satisfaction and burnout. Furthermore, lack of personnel was a stronger predictor of burnout in the Italian nurses than in the Dutch nurses.Conclusions
The study provides cross-national confirmation of the impact of job characteristics and organizational conditions on nurses’ well-being. Differences in job characteristics partially explain the observed cross-national differences in distress/well-being. Furthermore, some evidence for crossnational differential effects of job characteristics and organizational conditions on well-being was found. 相似文献6.
Chanyeong Kwak Bok Yae Chung Cho Eun-Jung 《International journal of nursing studies》2010,47(10):1292-1298
Background
The International Hospital Outcomes Study found that organizational/managerial support for nursing has a pronounced effect on nurses’ job dissatisfaction, burnout and quality of care. However, these findings have not been validated in non-Western countries using the same study method and instrument.Objectives
The objectives of this study were to: (a) examine associations between job satisfaction and burnout, organizational support and quality of care reported by South Korean nurses, (b) identify the best predictors of job satisfaction among South Korean nurses through multivariate modeling and (c) compare findings of this study with those from the International Hospital Outcomes Study.Research method
This replication study used a cross-sectional survey design. The Pennsylvania Registered Nurse Survey used in the International Hospital Outcomes Study (IHOS) was administered to 496 registered nurses working at 23 acute hospitals in South Korea. A statistical model of job satisfaction was developed using logistic regression.Results
Job dissatisfaction was positively correlated to total burnout scores (r = .42, p < .001) and lack of organizational support (r = .36, p < .001). Multivariate analysis found that job satisfaction was significantly associated at the level of 0.05 with total burnout scores, amount of organizational support and satisfaction with nurse identity, with odds ratios of .92 (p < .001), 1.04 (p < .01) and 11.93 (p < .001), respectively. Korean nurses reported low quality of care in their practice setting and were less confident in their patients’ ability of self-management after discharge. Yet despite a high patient-to-nurse ratio (22 patients per nurse), Korean nurses had a higher job satisfaction rate (68.8%) and lower burnout scores (35.7) than their counterparts in the International Hospital Outcomes Study.Conclusion
The high patient-to-nurse ratio allows South Korean nurses to focus on more technical tasks that give less stress and have higher job satisfaction because of it. However, this also leads to the South Korean nurses having less confidence in their patient's ability to take care of themselves upon discharge. South Korean nurses should also be given opportunity to advance themselves professionally and be recognized for their abilities while being given more responsibility for the clinical decision making in their patient's care. 相似文献7.
Background
The Magnet Recognition Program in the USA has been based on 14 hospital characteristics that were common in hospitals that were “magnets” for professional nurses. While the program has expanded to other countries, no research has explored how the concept translates to other cultures and healthcare systems, nor have multilevel approaches been used.Objective
The primary aim of this study was to explore the presence of Magnet Hospital attributes in hospitals in two European countries. In addition, the relationship between Magnet Hospital attributes and nurses’ job satisfaction was examined at both the nurse and the hospital level.Design
A secondary data analysis with cross-sectional design was conducted. A multilevel approach was taken to account for the hospital effect due to the nested nature of the data.Settings
Nurses practicing in acute care hospitals in Germany (16) and Belgium (15) were examined. Hospitals that had less than five respondents were excluded.Participants
Survey responses from 2303 registered nurses (RNs) from Belgium and 2646 RNs from Germany were included. Non-RN providers, RNs with administrative positions, and those working in non-inpatient areas were excluded. The final sample was 3182 staff nurses working in acute care hospitals.Methods
Magnet Hospital attributes that might be represented in NEXT survey items were reviewed by an expert panel before psychometric testing. Only six Magnet Forces could be measured. Latent constructs of these forces and job satisfaction were established. The measurement models and structural regression models were estimated using multilevel modeling in Mplus 4.21.Results
Six Magnet Forces were validated by two-level confirmatory factor analyses, with good fit to the data as demonstrated by the fit indices. All six Magnet Forces significantly predicted job satisfaction at the nurse level, with personnel policies having the strongest effect (b = 0.96). At the hospital level, management style had the strongest effect (b = 0.84) in predicting job satisfaction, followed by professional development, interdisciplinary relationship, and autonomy.Conclusions
Magnet Hospital attributes are evident in hospitals in two European countries and were found to be associated with job satisfaction. Further multilevel research should explore these attributes particularly at the nursing unit-level where work environment is experienced. 相似文献8.
B.I.J.M. van der Heijden A. Kümmerling E. van der Schoot H.M. Hasselhorn 《International journal of nursing studies》2010,47(4):434-445
Objectives
This study examined the importance of one's social work environment in the light of prevention of premature leave from the nursing profession. A research model with social support (from direct supervisor and close colleagues) as predictor and intention to leave as the dependent variable has been tested, while controlling for job satisfaction and age. Moreover, we have studied the impact of nurses’ age upon the prevalence of social support from both parties.Participants
Data were obtained from 17,524 registered female nurses working in hospitals throughout Europe (Belgium, Germany, Finland, France, Italy, The Netherlands, Poland, and Slovakia).Results
Our findings indicated that a lack of job satisfaction is an important risk factor in the light of nurses’ turnover as for most countries the intention to leave cannot be buffered by social support from one's close colleagues. However, in general, social support from one's direct superior appeared to contribute negatively to the intention to leave the profession, over and above job satisfaction and age. As regards age effects, in line with our expectation, we have found a significant negative relationship between age and social support from close colleagues, while the hypothesis regarding the relationship between age and supervisory support could not be confirmed.Conclusions
Given its importance in the light of preventing premature leave, we advocate not to neglect the possible positive effects of social support from important key figures like nurses’ direct supervisor and close colleagues. It is necessary for health care institutions to carefully pay attention to finding opportunities to obtain more social support for all staff members. In Section 5, limitations and practical implications of this study are dealt with. 相似文献9.
Anastasia A. Mallidou Greta G. Cummings Carole A. Estabrooks Phyllis B. Giovannetti 《International journal of nursing studies》2011,48(1):81-93
Background
Hospital organizational culture is widely held to matter to the delivery of services, their effectiveness, and system performance in general. However, little empirical evidence exists to support that culture affects provider and patient outcomes; even less evidence exists to support how this occurs.Objectives
To explore causal relationships and mechanisms between nursing specialty subcultures and selected patient outcomes (i.e., quality of care, adverse patient events).Method
Martin's differentiation perspective of culture (nested subcultures within organizations) was used as a theoretical framework to develop and test a model. Hospital nurse subcultures were identified as being reflected in formal practices (i.e., satisfactory salary, continuing education, quality assurance program, preceptorship), informal practices (i.e., autonomy, control over practice, nurse-physician relationships), and content themes (i.e., emotional exhaustion). A series of structural equation models were assessed using LISREL on a large nurse survey database representing four specialties (i.e., medical, surgical, intensive care, emergency) in acute care hospitals in Alberta, Canada.Results
Nursing specialty subcultures differentially influenced patient outcomes. Specifically, quality of care (a) was affected by nurses’ control over practice, (b) was better in intensive care than in medical specialty, and (c) was related to lower adverse patient events; nurses in intensive care and emergency specialties reported fewer adverse events than did their counterparts in medical specialties.Conclusions
Understanding the meaning of subcultures in clinical settings would influence nurses and administrators efforts to implement clinical change and affect outcomes. More research is needed on nested subcultures within healthcare organizations for better understanding differentiated subspecialty effects on complexity of care and outcomes in hospitals. 相似文献10.
Background
Low competence levels among nursing staff have been associated with lower quality of older people care. However, interventions to improve staff competence have not always been evaluated for their impact on the quality of older people care. An educational intervention in the form of a workplace “toolbox” was shown to have positive effects on nursing staff competence and work satisfaction, but had no effects on care recipients’ or their family members’ ratings of quality of care. It was therefore of interest to investigate whether the intervention had any effect on nursing staff ratings of quality of care.Objectives
The aim of the study was to evaluate the possible effects of an educational “toolbox” intervention on nursing staff ratings of quality of care.Design
A prospective, non-randomized, controlled intervention.Participants and settings
Nursing staff in two municipal older people care organizations in Sweden.Methods
Practical instruments and educational materials for improving staff competence and work practices were collated in a workplace “toolbox” and introduced in the intervention organization in February of 2003. Nursing staff ratings of quality of care were measured pre- and post-intervention by questionnaire and compared to nurses’ quality ratings in a reference organization, where no toolbox was introduced.Results
Nursing staff ratings of quality of care improved significantly over time in the intervention organization. No improvements were found in the reference organization.Conclusions
Compared to a reference municipality, nursing staff ratings of quality of care improved in the organization where the toolbox was introduced. Competence development measures may have a positive impact on nursing staff's ratings of quality, but not on the quality ratings of care recipients and their family members. Further research is needed to understand the differences in these stakeholders’ perceptions. 相似文献11.
Van Bogaert P Clarke S Vermeyen K Meulemans H Van de Heyning P 《International journal of nursing studies》2009,46(1):55-65
Aim
To study the relationship between nurse work environment, job outcomes and nurse-assessed quality of care in the Belgian context.Background
Work environment characteristics are important for attracting and retaining professional nurses in hospitals. The Revised Nursing Work Index (NWI-R) was originally designed to describe the professional nurse work environment in U.S. Magnet Hospitals and subsequently has been extensively used in research internationally.Method
The NWI-R was translated into Dutch to measure the nurse work environment in 155 nurses across 13 units in three Belgian hospitals. Factor analysis was used to identify a set of coherent subscales. The relationship between work environments and job outcomes and nurse-assessed quality of care was investigated using logistic and linear regression analyses.Results
Three reliable, consistent and meaningful subscales of the NWI-R were identified: nurse-physician relations, nurse management at the unit level and hospital management and organizational support. All three subscales had significant associations with several outcome variables. Nurse-physician relations had a significant positive association with nurse job satisfaction, intention to stay the hospital, the nurse-assessed unit level quality of care and personal accomplishment. Nurse management at the unit level had a significant positive association with the nurse job satisfaction, nurse-assessed quality of care on the unit and in the hospital, and personal accomplishment. Hospital management and organizational support had a significant positive association with the nurse-assessed quality of care in the hospital and personal accomplishment. Higher ratings of nurse-physician relations and nurse management at the unit level had significant negative associations with both the Maslach Burnout Inventory emotional exhaustion and depersonalization dimensions, whereas hospital management and organizational support was inversely associated only with depersonalization scores.Conclusion
A Dutch version of the NWI-R questionnaire produced comparable subscales to those found by many other researchers internationally. The resulting measures of the professional practice environment in Belgian hospitals showed expected relationships with nurse self-reports of job outcomes and perceptions of hospital quality. 相似文献12.
Cina-Tschumi B Schubert M Kressig RW De Geest S Schwendimann R 《International journal of nursing studies》2009,46(2):164-171
Background
Patient falls are frequent incidents in hospitals, and various measurement methods are described in the literature to assess in-patient fall rates. However, the literature includes no validation of nurses’ estimates of fall frequencies, which are the preferred assessment method in multi-centre surveys.Objectives
To explore the concordance of nurses’ estimated fall frequencies with continuously collected data.Design
Cross-sectional, correlational secondary data analysis.Sample/Setting
Patient fall data from 21 wards in 2 Swiss acute care hospitals participating in the RICH Nursing Study.Methods
Registered nurses’ (N = 233) estimated fall frequencies, assessed by the International Hospital Outcome Study questionnaire in absolute number of falls over the last month, and, using a four-point Likert scale (never = 1; frequently = 4), over the last year, were compared to standardized hospital fall incident reports compiled over the same periods. Fall incident reports for the last month were assessed in absolute numbers and were calculated as fall rates per 1000 patient days, with data computed at the ward level. The concordance with nurses’ estimates was then tested using Spearman’s rho and Kendall’s tau correlations.Results
The mean last-year fall frequencies estimated by nurses on the four-point Likert scale ranged from 1.4 to 3.1 for non-injurious falls and from 1.0 to 2.6 for injurious falls per ward. The fall rates assessed using fall incident reports over the same period ranged from 0.1 to 3.8 non-injurious falls per 1000 patient days and from 0.1 to 2.6 injurious falls per ward.Nurses’ estimates and fall incident reports correlated significantly regarding the last year, both for injurious falls (r = 0.685, p = 0.014) and non-injurious falls (r = 0.630, p = 0.028), although no statistically significant correlations were found regarding the 1 month estimates.Conclusions
Nurses’ long-term estimates of patient incidents are concordant with continuously and systematically assessed data, and offer valid data where other measurement methods are unavailable. 相似文献13.
14.
Background
Although nurse turnover is a serious problem, the fact that each nurse has different work-related needs/values, and leaves their job for different reasons makes it difficult for organisations to develop effective countermeasures against it. Understanding nurses’ needs and the reasons for job turnover by the generation in which they were born may provide some feasible solutions.Objectives
The purpose of the study was to identify specific work-related needs and values of nurses in three generations (born in 1946-1959, 1960-1974, 1975-present). The study also aimed to explore generation-specific reasons that might make nurses consider leaving the jobs.Settings
The study was conducted in three public hospitals in Japan.Participants
A convenience sample of 315 registered nurses participated in the study.Methods
A survey method was used to collect quantitative and qualitative data. Quantitative data were analysed by ANOVA, and qualitative data were analysed by content analysis.Results
Nurses born between 1960 and 1974 embraced high needs and values in professional privileges such as autonomy and recognition, while those born after 1975 expressed low needs and values in the opportunities for clinical challenge. For nurses born between 1960 and 1974, the imbalance between their jobs and personal life made them consider leaving their jobs. For those born after 1975, losing the confidence to care made them consider turning over. Nurses born after 1960 tended to value economic return and job security more highly compared to those born between 1946 and 1959.Conclusions
Nurses in different generations have different sets of needs/values and reasons for job turnover. Understanding generation-specific needs and values of nurses may enable organisations and Nurse Managers to develop feasible and effective countermeasures to reduce nurse turnover. 相似文献15.
Objectives
The aim of this review is to describe nurses’ work motivation from the perspective of staff nurses. This information would be useful for the development of motivation strategies and further research into nurses’ work motivation.Design
A thorough review of the research literature.Data sources
The literature search was performed using four databases: CINAHL, PubMed, PsychINFO, and SocINDEX. Only studies that met the following criteria were selected for review: (1) were published between 1990 and 2009, (2) were written in English, (3) dealt with work motivation, (4) concerned working staff nurses, (5) involved empirical research, (6) clearly and explicitly provided the research results about the factors affecting nurses’ work motivation. Altogether 24 studies met these criteria and were included in this review.Review methods
Inductive content analysis was carried out to analyse and categorise the data.Results
Nursing research has neither clear understanding nor consensus about the concept of work motivation; nor has a universal definition been adopted. Despite limited empirical evidence it may be concluded that staff nurses appear to be motivated. Five categories of factors affecting their work motivation were identified: (1) work-place characteristics, (2) working conditions, (3) personal characteristics, (4) individual priorities, and (5) internal psychological states.Conclusions
Further research is needed to gain a more comprehensive insight into nurses’ work motivation and the factors affecting it. This can be achieved by defining the concept of work motivation as precisely as possible, working out a pertinent research methodology, and subsequently developing and testing a theoretical model of nurses’ work motivation. 相似文献16.
Kasia Bail Robert Cook Laurie Grealish 《International journal of nursing studies》2009,46(11):1457-1466
Background
Nursing work is governed by a web of overarching documents from professional bodies, registration bodies, and individual health care organisations. The focus for these documents is to maintain high standards and protect patients and organisations from unnecessary risk. The presentation of the nurse within these documents has important implications for the ability of nurses to function as autonomous professionals.Objectives
How the role of the nurse is situated in hospital procedural policy, and more specifically how these presentations of the nurse define, limit, and enable nursing practice is the focus of this paper.Design
A combination of random and purposive sampling of the nursing policies of one tertiary level hospital was utilised to collect policy documents for thematic content analysis.Setting
The study was completed in a tertiary level health institution, in one Australian jurisdiction with a population of approximately 500,000 people. This health institution employs over 4000 people and admitted 49,000 patients in the 2004-2005 financial year.Methods
An inductive approach, which utilised theoretical and contextual comprehension of the nursing policies, informed the collation of coded data which determined the themes of the study.Findings
Analysis consisted of coding of particular words, textual structure and theory content. Practice was presented in the nursing procedural policies in two themes, called ‘lingering tradition’ and ‘bureaucratic template’.Conclusions
The discourse of hospital procedural policy situates the nurse as obedient to organisational requirements by limiting practice to a performance of actions without explicit recognition of professional autonomy. This sets up a puzzling contradiction between performance expectations from the employing organisation and the nursing profession. Writing hospital policy in the discourse of procedural directives reduces nurses’ ability to act as autonomous, critically thinking professionals, with implications for patient safety, nurse autonomy and the professional status of nursing. 相似文献17.
West E Mays N Rafferty AM Rowan K Sanderson C 《International journal of nursing studies》2009,46(7):993-1011
Objectives
To evaluate the empirical evidence linking nursing resources to patient outcomes in intensive care settings as a framework for future research in this area.Background
Concerns about patient safety and the quality of care are driving research on the clinical and cost-effectiveness of health care interventions, including the deployment of human resources. This is particularly important in intensive care where a large proportion of the health care budget is consumed and where nursing staff is the main item of expenditure. Recommendations about staffing levels have been made but may not be evidence based and may not always be achieved in practice.Methods
We searched systematically for studies of the impact of nursing resources (e.g. nurse-patient ratios, nurses’ level of education, training and experience) on patient outcomes, including mortality and adverse events, in adult intensive care. Abstracts of articles were reviewed and retrieved if they investigated the relationship between nursing resources and patient outcomes. Characteristics of the studies were tabulated and the quality of the studies assessed.Results
Of the 15 studies included in this review, two reported a statistical relationship between nursing resources and both mortality and adverse events, one reported an association to mortality only, seven studies reported that they could not reject the null hypothesis of no relationship to mortality and 10 studies (out of 10 that tested the hypothesis) reported a relationship to adverse events. The main explanatory mechanisms were the lack of time for nurses to perform preventative measures, or for patient surveillance. The nurses’ role in pain control was noted by one author. Studies were mainly observational and retrospective and varied in scope from 1 to 52 units. Recommendations for future research include developing the mechanisms linking nursing resources to patient outcomes, and designing large multi-centre prospective studies that link patient's exposure to nursing care on a shift-by-shift basis over time. 相似文献18.
Background
Very few neurological rehabilitation programmes have successfully dealt with patients’ and relatives’ social needs. Furthermore, the nurses’ contribution in those programmes is poor or unclear.Objectives
To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers.Design
In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home.Settings
Two neurological wards of a hospital in Spain.Participants
The programme evaluation included 27 nurses, and two groups of patients and relatives (control group = 18 patients and 19 relatives, intervention group = 17 patients and 16 relatives).Methods
The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses.Results
The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses’ attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved.Conclusions
This rehabilitation programme was feasible and effective. Patients and relatives benefited from better understanding of the socialisation process, as a result of advancing nurses’ knowledge, experience and role in psychosocial care. 相似文献19.
Patrik Rytterström Elisabet Cedersund Maria Arman 《International journal of nursing studies》2009,46(5):689-698
Aim
The aim is to understand and develop the concept of care and caring culture and to do so based on the empirical/phenomenological standpoint of nurses’ lived experiences of working in different environments.Background
Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the ‘caring culture’ as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means.Method
A phenomenological-hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working on different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses 1 year later for validation of the findings.Findings
Thematic analyses revealed five themes: you have to adapt to the existing care culture; seeing the invisible; being yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as “homelike”, nurses may act in a way that reflects their own values.Discussion
The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring. 相似文献20.
Aitken LM Burmeister E Clayton S Dalais C Gardner G 《International journal of nursing studies》2011,48(8):918-925