Children's views of health: a developmental study.

Two hundred and sixty-four first, fourth, and seventh grade children were asked to define health, state what it felt like to be healthy and not healthy, and to give criteria they would use to judge another person's health status. A chi square analysis was done to compare differences for age, sex, intelligence, and socioeconomic status. Results indicated that children saw health as a positive attribute which enabled them to participate in desired activities, that a person was healthy if he could do what he wanted to do, and that health and illness were two different cncepts rather than on a continuum as is often cited in the literature. Mental health was not considered as part of being healthy except by a few of the oldest children. There were both qualitative and quantitative changes with age which were consistent with theories of concept development. It is recommended that future studies be conducted with both adults and health workers. (There is some evidence that consumers and health professionals do not have the same ideas about health.)     

Developing public health nursing: barriers perceived by community nurses

OBJECTIVES: To understand the key issues for field nursing in developing their public health role within five primary care trusts (PCTs) in Merseyside, in the North West of England. DESIGN: Qualitative study. METHODS: Fourteen school nurses and 30 health visitors participated in 11 focus groups consisting of others from their profession working within the same PCT, and 24 practitioners responded to a questionnaire. RESULTS: The findings suggest that there are a number of shared obstacles that need to be overcome before the public health approach can be fully developed within community nursing. These include: the need for facilitation to deal with organisational change, lack of clarity around the public health role, inadequate administrative support, general practitioner attachment problems, poor interprofessional partnerships, competing priorities and resistance to change. CONCLUSIONS: The development of public health nursing in England envisaged in current government policy will not occur in full unless the kind of issues identified in this study are adequately addressed. This will require participative, interprofessional approaches to redesigning services by all relevant public health practitioners.     

Generic and specialist nursing roles in the community: an investigation of professional and lay views

In the UK, a number of policy documents have sought to outline and clarify the role of the community nurse in the past 10 years. Furthermore, the increasing specialisation of community nursing has been the topic of much debate in the UK and Ireland. The present study aimed to investigate the perceptions of community nurses, general practitioners (GPs), members of the public, and senior strategists and policy-makers in relation to specialist and generalist nursing roles within community nursing in Northern Ireland and the Republic of Ireland. Focus groups were undertaken with community nurses (n = 38), GPs (n = 14) and public representatives (n = 8). This was followed by a two-stage Delphi investigation using self-report questionnaires with the same samples. In addition, data were collected from 34 senior policy-makers using a semi-structured interview schedule. The results uncovered a mix of views. While there was much negativity about specialisation, the participants felt that the move away from generalism was unavoidable. There was concern that specialisation, whilst welcome in some areas, would lead to role conflict, role overlap and role confusion. Findings from this study have the potential to inform the specialisation-generalism debate within and outside the UK and Ireland. Recommendations are suggested for future policy and practice.     

A modest proposal for a new specialty: Children's community psychology

A children's community psychology is proposed. A children's community psychology would provide a new way to conceptualize children's issues to complement and counter more traditional views of children as individuals without a social context. It would explore the interaction between children and communities, looking at children as experienced by communities, and communities as experienced by children. More specifically, it would examine children's unique environments, the effect of larger environments upon children, cross-cultural development, and preventive interventions with children and their communities. Finally, a children's community psychology would better focus work involving children and communities, and renew impetus for primary preventive research and action involving young people.     

Educating nurses for the SUS: a challenge for nursing schools

The stuty shows the selection of some strategy to be used for the graduation courses in Nursing to arouse in the students more interest in the collective healthy area. The study is about a case study, that took place in a private graduation course in the Southern of Brazil, which was noticed the systematised option form the students to the hospital area when the choice of trainee fields to the development from the Essay when they accomplish the graduation course. It was used a method from Situation Strategic Planning (PES) like a tool to enlarge the analysis of the problem and reach the aim proposed. As a result, the method showed to be efficient in allowing a revaluation of the Teaching Strategy from the couse to reach the profile expected.     

Supporting women with postpartum anxiety: exploring views and experiences of specialist community public health nurses in the UK

Anxiety is common among postpartum women and can have adverse effects on mother's and child's somatic and psychological health if left untreated. In the UK, nurses or midwifes with a specialisation in community public health nursing, also called health visitors (HVs), work with families who have children younger than 5 years of age and are therefore in a key position to identify and support women with postpartum mental health issues. Until recently, postpartum mental health support provided by HVs mainly focused on identifying and managing depression, but the updated clinical guidance by the National Institute for Health and Care Excellence also includes guidance regarding screening and psychological interventions for perinatal anxiety. This study therefore aimed to explore HVs' experiences of supporting women with postpartum anxiety and their views on currently available care. Using a qualitative approach, in‐depth semi‐structured interviews were conducted with 13 HVs from the UK between May and October 2015. Participants were interviewed in person at their workplace or on the phone/Skype. Using thematic analysis, four main themes emerged: identification and screening issues; importance of training; service usage; and status of current service provision. Women with postpartum anxiety were commonly encountered by HVs in their clinical practice and described as often heavily using their or other related healthcare services, which puts additional strain on HVs' already heavy workload. Issues with identifying and screening for postpartum anxiety were raised and the current lack of perinatal mental health training for HVs was highlighted. In addition, HVs described a current lack of good perinatal mental health services in general and specifically for anxiety. The study highlights the need for HV perinatal mental health training in general and postpartum anxiety specifically, as well as better coverage of specialist mental health services and the need for development of interventions targeted at postpartum anxiety.     

The evaluation of a burnout workshop for community nurses

This study evaluates the effects of a burnout workshop that was conducted for community nurses (N = 64). The workshop included relaxation training, didactic and cognitive stress management, interpersonal skills training, and the enhancement of a more realistic professional role. The nurses' symptom levels (i.e., emotional exhaustion, tedium, psychological strain, and somatic complaints decreased significantly. However no significant changes were observed in the attitudinal component of burnout: the nurses' negative attitudes toward their recipients (depersonalization) and toward their performance on the job (reduced personal accomplishment) did not decrease. In addition, personality (i.e., the nurses' level of reactivity) played a moderating role: low reactive nurses who, by definition, are rather resistant to stress benefited more from the workshop than did high reactive nurses who are less resistant to stress. Since no control group was included, the results of this study are tentative and should be confirmed by future research.     

Children's views on attending a remedial class - because of concentration difficulties

Background An increasing number of segregating solutions (e.g. remedial classes) can be seen in Swedish schools. The aim of this article is to stress how children describe why they attend a remedial class and what it means to be a pupil in that setting. Methods The data collection consists of semi‐structured interviews with 10 pupils between 10 and 12 years old attending 10 different remedial classes because they had been attributed with having concentration difficulties or diagnosed with attention deficit/hyperactivity disorder. The content of the interviews was described and analysed in relation to the classroom context. The socio‐cultural perspective is used as a screen to describe and understand the children's comments about attending remedial class. Results and conclusions All interviews with the children indicate that they are carriers of their schools' compensatory perspective. This means that they are fully aware of the fact that they are regarded as difficult, with annoying and problematic behaviour, deviating from pupils' in general. The remedial class creates social difficulties for the children; they see themselves as deviant, they lose old friends and there are limited possibilities of establishing new friendship in remedial classes.     

Anxious adults vs. cool children: children's views on smoking and addiction

Tobacco addiction represents a major public health problem, and most addicted smokers take up the habit during adolescence. We need to know why. With the aim of gaining a better understanding of the meanings smoking and tobacco addiction hold for young people, 85 focused interviews were conducted with adolescent children from economically deprived areas of Northern Ireland. Through adopting a qualitative approach within the community rather than the school context, the adolescent children were given the opportunity to freely express their views in confidence. Children seem to differentiate conceptually between child smoking and adult smoking. Whereas adults smoke to cope with life and are thus perceived by children as lacking control over their consumption, child smoking is motivated by attempts to achieve the status of cool and hard, and to gain group membership. Adults have personal reasons for smoking, while child smoking is profoundly social. Adults are perceived as dependent on nicotine, and addiction is at the core of the children's understanding of adult smoking. Child smoking, on the other hand, is seen as oriented around social relations so that addiction is less relevant. These ideas leave young people vulnerable to nicotine addiction. It is clearly important that health promotion efforts seek to understand and take into account the actions of children within the context of their own world-view to secure their health.     

Stress and job satisfaction among social workers, community nurses and community psychiatric nurses: implications for the care management model

The introduction in April 1993 of new arrangements for assessment and care management following the NHS and Community Care Act 1990 (Department of Health 1990a) heralded a period of major transition for front-line workers in the health and social services. Policy expectations for the development of the purchaser/provider split and the 'new managerialism' have posed unprecedented ideological, organizational and professional challenges. Two years after the full implementation of the reforms a postal survey of the experiences of care managers about policy and practice changes was undertaken in Wales. This paper focuses on the stresses and satisfactions of care management practice among three distinct groups of front-line workers: social workers, community nurses and community psychiatric nurses. The results of multiple regression analyses, corroborated by qualitative data, implicate an increased workload in general and administrative work in particular, combined with reduced opportunities for client contact, as the main sources of stress. Being able to control or shape those factors impinging on the experience of stress and job satisfaction appears to lie at the heart of the dilemma. Practice and policy implications are considered.     

Strengthening communities: changing roles for community health nurses

Future nursing roles in the community will be influenced bycurrent initiatives to achieve Health For All by strengtheningcommunity health. During a national consultation process onstrengthening community health services, informal workshopsinvolving community members were held in several rural and urbancommunities in Manitoba (Canada). Data obtained during thisprocess were analysed using the framework of caring communities(First National Community Health Action Conference, Bradford,United Kingdom, 1986). Two major issues with implications forfuture roles of Community Health Nurses emerged from the dataThese were: (i) who will determine the nature of community healthnursing practice? and (ii) to whom will community health nursesbe accountable? Implications for the practice of community healthnursing the education of community health nurses, and the futuredirection of research in the area of community health are identified.The authors conclude that successful resolution of these issueswould advance community health nursing's role in strengtheningcommunities.     

Parents' and teachers' differing views of short children's behaviour

Summary Short children, over two standard deviations below height expectation, have been described as being behaviourally immature and shown to be emotionally inhibited. The present study sought to extend these findings by systematically evaluating what role age and sex factors may have in the behavioural adjustment of groups of children with constitutional delay (CD), growth hormone deficiency (GHD) or Turner's syndrome (TS). Adolescent females were rated by teachers and parents as showing greatest behavioural immaturity and emotional inhibition of the groups studied. Although teachers' ratings discriminated among children's behaviour by age and sex factors, parent ratings appeared more influenced by children's diagnoses. Significant school problems were noted on parent ratings for all groups of children, except the young CD group. Peer teasing was frequently reported and a relatively large proportion (25%) of the studied short children were retained in kindergarten through second grade, apparently because of small size and immaturity.     

The essence of 'community' within community nursing: a district nursing perspective

Over the past decade or so, there has been a marked shift in the location and nature of nursing care from the hospital setting to primary and community care. The past decade has also witnessed the development of a number of policy initiatives which indicate that the drive towards the community as a key location of nursing care is set to continue. Although notions of community have been explored extensively within the literature from a number of perspectives, there is an absence of a clear definition, and more particularly for the purposes of the present study, one from a nursing perspective. This lack of conceptual clarity is further compounded when notions of community and the place of nursing within the community are considered contemporaneously. The present pilot study, which was based on semi-structured interviews with district nurses, seeks to address this deficit and explore how district nurses define the nature of their role, both in terms of providing nursing care within the community and also in terms of defining community within the context of their work. The study illuminates the principal position of the home in defining the essence of community within community nursing and notions surrounding the nature of relationships which exist within this setting. This is highlighted through the identification of emerging themes: the maintenance of personal-professional boundaries, notions of holistic care and professional definitions of community. These observations raise important questions regarding the extent to which the location of care and the taken-for-granted assumptions surrounding community-based nursing care have been translated into practice to date. This also raises key issues regarding the tensions which exist for nurses trying to balance notions of community and community-based care within the parameters of organisational and professional boundaries.