Historical continuities and constraints in the professionalization of nursing

Historical continuities and constraints in the professionalization of nursing
The support of medicine and the state may be crucial to nursing's current professional aspirations for legitimation and implementation of nursing reforms and for new roles for nurses in health care. As such, medicine and the state are in the invidious position of influencing nursing's occupational future. This situation is not new. An historical analysis of the establishment of nursing at Prince Alfred Hospital, Sydney, Australia, at the end of the nineteenth century reveals that the State Government of NSW and the medical profession supported nursing's occupational development, yet set the framework within which this could occur. For instance, the state provided patronage to nursing through recommendations of the 1873 Royal Commission and because it financially backed Prince Alfred Hospital, while the medical profession defined nursing knowledge and practice through its control of the nursing curriculum. Membership of the hospital board provided both medicine and the state with powerful positions over hospital policies that affected nursing. While nursing became established as a distinct occupation for women with the aid of State and medical support, its subordinate position in health care was, and continues to be, constrained by these traditional supporters. This relationship between nursing, medicine and the state has implications for nursing's current professionalization strategies and aspirations.     

佩皮劳人际关系模式的理论评价与实践应用

从人际关系模式的基本构架、人际关系模式的应用价值对佩皮劳人际关系模式的理论进行了评价。     

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau ¶ Nursing typically has been viewed as a moral practice, for instance by new developments in the ethics of care. Nevertheless, many philosophical-ethical presuppositions of nursing theories remain to be clarified. This paper presents a philosophical-ethical analysis of the work of Hildegard E. Peplau. Analysis of the philosophical-ethical background of Peplau's works illuminates a view on nursing practice that is relevant today. Three main components are analysed more deeply, i.e. the professionalization of nursing, the philosophical underpinnings of Peplau's view on nursing science, and the nurse–patient relationship as the central event in nursing.     

Explorations in body image care: Peplau and practice knowledge

Practitioners in mental health care have long utilized the work of Hildegard Peplau, both for nursing discourse and for practice. At a time when the role of theory in practice is once more being debated, and when theories are being applied in new contexts, this paper examines the contribution that Peplau's work may have to offer altered body image nursing care. A case study is used to highlight concepts in practice, the paper examining the ways in which Peplau's Theory of Interpersonal Relations complement the other elements of practice knowledge that the nurse uses to assist patients and lay carers alike.     

Peplau人际关系理论在护士沟通能力训练中应用的效果评价

目的 评价Peplau人际关系理论对于提高护士沟通能力的影响.方法 对宁波市某三甲医院共50名护士进行了8次的Peplau人际关系理论训练,对训练前后护士的临床沟通能力进行比较.结果 训练后护士的临床沟通能力明显高于训练前,差异有统计学意义.结论 Peplau人际关系理论训练能够有效提升护士的临床沟通能力.     

Peplau人际关系理论在护理实践中的应用现状

阐述Peplau人际关系理论的核心内容,综述Peplau人际关系理论在国内外护理实践中的应用现状。     

Peplau人际关系模式在实习护生管理中的应用

目的探讨Peplau人际关系模式在实习护生管理中的应用效果。方法按照Peplau人际关系模式中认识期、确认期、进展期、解决期4个阶段对护生进行管理,并对实施与未实施人际关系模式护生实习成绩及护生对临床带教老师的评价进行对比。结果实施人际关系模式的护生实习成绩及护生对临床带教老师评价均高于未实施组（P〈0．01或P〈0．05）。结论Peplau人际关系模式的应用实现了临床带教工作的系统化、科学化、规范化,提高了实习护生的理论成绩、临床实践能力及临床带教老师的专业素质。     

Transforming Practice Knowledge into Nursing Knowledge—A Revisionist Analysis of Peplau

Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice-based theory, as well as nursing theory-based practice.     

基于人际关系模式的家庭访视在抑郁症患者中的应用及效果评价

目的 探讨基于 Peplau 人际关系模式的家庭访视在抑郁症患者中的应用效果。 方法 运用 Peplau 人际关系模式,对我院 2015 年 3 月- 12 月出院的 48 例抑郁症患者进行家庭访视。 在访视前后采用自知力与治疗态度问卷、服药依从性问卷和服药信念量表对患者进行评价,比较家庭访视前后患者自知力与治疗态度、服药依从性情况。 结果家庭访视 6 个月后,患者自知力与治疗态度得分高于访视前（ P＜0.01 ）;服药依从性问卷得分低于访视前（ P＜0.01 ）;服药信念量表各维度得分均优于访视前（ P＜0.01 ）。 结论 基于 Peplau 人际关系模式的家庭访视可有效提高出院抑郁症患者治疗的依从性,改善其对疾病的认知,促进康复。     

The future in the past: Hildegard Peplau and interpersonal relations in nursing

Researchers, educators and clinicians have long recognized the profound influence of the mid‐twentieth century focus on interpersonal relations and relationships on nursing. Today, in nursing, as well as in medicine and other social sciences, neuroanatomy, neurobiology and neurophysiology have replaced interpersonal dynamics as keys to understanding human behavior. Yet concerns are being raised that the teaching, research and practice of the critical importance of healing relationships have been overridden by a biological focus on the experiences of health and illness. As a way to move forward, we return to Hildegard Peplau's seminal ideas about the transformative power of relationships in nursing. We propose that Peplau's formulations and, in particular, her seminal Interpersonal Relations in Nursing can provide direction. We do not propose that her formulations or her book be simply transposed from the 1950s to today's classroom and clinic. But we do believe that her ideas and writings are dynamic documents containing concepts and derived operations that can be brought to life in clinical practice. Finally, we explore Peplau's transformative idea that nursing is, at its core, an interpersonal process both to acknowledge an idea that has shaped our past and can guide us into our future.     

The therapeutic relationship: historical development and contemporary significance

The therapeutic relationship is a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realized in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualizations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses.     

The sunshine act and medical publications: Guidance from professional medical associations

Objective. To review guidance from professional medical associations to physicians on the Sunshine Act, with a focus on industry support for medical publications. Methods. Using ‘Sunshine Act’ as a search term, we searched PubMed (dates February 2013 to November 2014) and the ‘grey literature’ using Google and Google Scholar. Online information was extracted from websites of pre-identified professional medical associations. Results. Some professional medical associations have published peer-reviewed recommendations, position statements or general advice on their websites and in journals around the Sunshine Act. Associations also provided broad online educational resources for physicians. There was universal agreement between peer-reviewed publications, including guidelines, for the need for full transparency and disclosure of industry support. Surveys by some professional associations showed variance in opinion on the forecasted impact of the Sunshine Act on physician–industry relationships. There was scarce information specifically related to reporting requirements for industry-supported medical publications. Conclusions. There is a shortage of information for physicians from professional associations regarding the Sunshine Act and support for medical publications. Due to the lack of clear guidance regarding support for publications, there are presently varying interpretations of the Sunshine Act. The literature debates the potential impact of the Sunshine Act and expresses some concerns that physician-enabled innovation in drug development may be hindered.     

The emergence of the microstatistical paradigm in managed care

Although commentators have argued that managed care constitutes a paradigm shift in the American health care system, it is argued that the guiding organizational assumptions driving orthodox managed care arrangements (i.e., HMOs and capitation) have been drawn from a paradigm that is 300 years old: the business of insurance. As such, traditional managed care directives have taken a macrostatistical organizational viewpoint. However well a macrostatistical paradigmatic view serves certain constructs such as the business of insurance, it is far too coarse a method for organizing and reforming the badly fragmented production processes of health care. As a corrective complement, a new microstatistical paradigmatic view is coming of age whose methodological directives are based in the episode of care, and which will ultimately allow for a more highly refined pricing and care process system to emerge.     

Specialist practice: advancing the profession?

In 1994, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) completed its framework for post-registration education and practice. The UKCC's strategy was based upon the two principles of compulsory re-registration for all practising nurses and graduate-level (or equivalent) entry to specialist practice. It may be seen as the culmination of a gradual process of professionalization, as well as a response to changes in the organization and delivery of health care in the late 20th century. This paper uses both primary and secondary sources to trace the development of the new strategy, and its wider implications for the profession.