Preceptors' reflections on their educational role before and after a preceptor preparation course: A prospective qualitative study

During clinical practice, preceptors play an important educational role in helping nursing students become secure and effective practitioners. For this educational role they need adequate preparation. The aim of the present prospective study was to describe preceptors' experiences of their educational role before and after attending a university preceptor preparation course. This 7.5-credit, Master's level course is offered on a part-time basis and covers one semester. The theoretical approach was self-directed and reflective learning. Twentyseven preceptors participated in group interviews before and after the course, and data were analyzed using qualitative content analysis. The findings revealed a shift in preceptors' perceptions. Their view of the educational role changed from being characterized by individual experiences and notions to being guided by personal and formal demands. Before the course, the lack of sufficient preconditions for preceptorship predominated, whereas after the course participants described ways of creating such preconditions. Before the course, the supervisory process was described as teaching, whereas after the course it was described as a learning process for students. Using reflective learning in a preceptor preparation course can develop and strengthen preceptors' view of their educational role and help them manage and create the preconditions for preceptorship.     

Users' views of prison health services: a qualitative study

AIM: This paper is a report of a study of the views of prisoners about health services provided in prisons. BACKGROUND: Prison provides an opportunity for a 'hard to reach' group to access health services, primarily those provided by nurses. Prisoners typically have high health and social needs, but the views and experiences of prisoners about health services in prison have not been widely researched. METHOD: Semi-structured interviews were carried out with 111 prisoners in purposively selected 12 prisons in England in 2005. Interviews covered both prisoners' views of health services and their own ways of caring for their health in prison. Interviews were analysed to develop a conceptual framework and identify dominant themes. FINDINGS: Prisoners considered health services part of a personal prison journey, which began at imprisonment and ended on release. For those who did not access health services outside prison, imprisonment improved access to both mental and physical health services. Prisoners identified accessing services, including those provided by nurses, confidentiality, being seen as a 'legitimate' patient and living with a chronic condition as problems within the prison healthcare system. At all points along the prison healthcare journey, the prison regime could conflict with optimal health care. CONCLUSION: Lack of autonomy is a major obstacle to ensuring that prisoners' health needs are fully met. Their views should be considered when planning, organizing and delivering prison health services. Further research is needed to examine how nurses can ensure a smooth journey through health care for prisoners.     

肾动脉支架植入术患者术前心理状况调查分析

目的 探讨肾动脉支架植入术患者术前心理状况.方法 将40例肾动脉支架植入术患者和45例肾脏内科住院患者分为手术组和对照组,采用症状自评量表(SCL-90)分别进行问卷调查,并对比分析.结果 经皮肾动脉支架植入术患者躯体化(1.862±0.149)、人际关系(1.411±0.113)、抑郁(1.430±0.161)、焦虑(1.797±0.095)分值明显高于对照组,且差异显著(P＜0.01).结论 经皮肾动脉支架植入术患者术前存在不良心理状况,护理人员应高度重视,积极给予护理干预,促进康复.     

Iranian staff nurses' views of their productivity and management factors improving and impeding it: a qualitative study

As the biggest proportion of hospital personnel, Iranian nurses have a major role in providing quality care to patients. Nursing managers and nurses no longer feel that nurses' work is valued and they are concerned about their productivity. Nurses' views about productivity and management factors affecting it have been identified as the most important aspects affecting productivity. Thus, this study assesses productivity from the nurse's view. A grounded theory approach was used for this research. Purposive sampling and semistructured interviews were used. The data were analyzed using constant comparative analysis. Most participants felt that the qualitative nature (effectiveness) of productivity is very important. Also, participants indicated that management is the most important factor that can promote or impede their productivity. They suggested that managers' performance and their skill level are the factors influencing productivity. Effective management can improve nurses' productivity and the quality of care that nurses provide.     

Health professionals' views on advance directives: a qualitative interdisciplinary study

The aim of this study was to discover the views of health professionals in the Greater Glasgow area on advance directives, using semi-structured interviews and focus groups. The twelve participants interviewed included four hospital doctors, four general practitioners (GPs) and four nurses. The six focus groups comprised hospice nurses, GPs, consultant geriatricians, geriatricians in training grades and an interdisciplinary group. Participants were purposively selected to reflect a range of personal experiences with, and attitudes toward, the advance directive using key informants and a short questionnaire. Participants were asked to comment on a specially constructed sample advance directive. All research encounters were recorded, transcribed and analysed using accepted methods in qualitative research. The advance directive was seen as a means of promoting peace of mind in will makers, of allowing carers to honour the patients' wishes and of stimulating communication between all parties. Conversely the advance directive was seen as generating certain risks for the will maker--including those of coercion, misunderstanding, paradoxical overintervention and inadvertent undertreating. A core concern surrounded the issue of 'informedness' in will makers and the ethics of deciding for a future demented self.     

Community ambulation before and after hip fracture: a qualitative analysis

Purpose.?This qualitative study explored mobility levels around the home and in the community before and after hip fracture.

Methods.?Twenty-four people receiving rehabilitation after hip fracture were interviewed using an in-depth semi-structured format: 12 who were receiving rehabilitation as inpatients, and 12 who had been discharged home from inpatient rehabilitation and were continuing therapy as outpatients. The recorded interviews were transcribed and coded independently by two researchers. From these codes themes were developed.

Results.?Before their fracture, participants were independent about their houses, but their level of community ambulation had been reducing over recent months or years, often associated with another health problem. Participants who had returned home after inpatient rehabilitation for hip fracture reported much reduced levels of mobility both in their house and in the community compared with their pre-fracture performance. This reduced level of mobility was associated with psychological factors (fear, lack of confidence, frustration), physical factors (pain, the presence of another health problem) and social/environmental factors (reliance on daughter, and car). The level of optimism expressed by people receiving inpatient rehabilitation contrasted with the pessimism of those receiving outpatient rehabilitation.

Conclusions.?Patients living back in the community after hip fracture described a reduced level of functioning and a pessimism that contrasted with the optimism expressed by people who were still in the inpatient phase of rehabilitation. These findings, and the importance of psychological factors and social support, may be considered when designing rehabilitation strategies to support the successful transition of people to their community after hip fracture.     

Religious views of the 'medical' rehabilitation model: a pilot qualitative study

Purpose: To explore the religious beliefs that patients may bring to the rehabilitation process, and the hypothesis that these beliefs may diverge from the medical model of rehabilitation.

Methods: Qualitative semi-structured interviews with representatives of six major religions—Islam, Buddhism, Christianity, Judaism, Sikhism, and Hinduism. Representatives were either health care professionals or religious leaders, all with an interest in how their religion approached health issues.

Results: There were three recurrent themes in the interviews: religious explanations for injury and illness; beliefs about recovery; religious duties of care towards family members. The Buddhist, Sikh, and Hindu interviewees described beliefs about karma—unfortunate events happening due to a person's former deeds. Fatalistic ideas, involving God having control over an individual's recovery, were expressed by the Muslim, Jewish, and Christian interviewees. All interviewees expressed the fundamental importance of a family's religious duty of care towards ill or injured relatives, and all expressed some views that were compatible with the medical model of rehabilitation.

Conclusions: Religious beliefs may both diverge from and resonate with the medical rehabilitation model. Understanding these beliefs may be valuable in facilitating the rehabilitation of diverse religious groups.     

Norwegian and Swedish preceptors' views of their role before and after taking part in a group supervision program

The research literature has shown the expectations towards preceptors and their need of support in their role. Group supervision has been used for many years to promote nurses in their professional role, but no study has been found on how group supervision can support them as preceptors. This study aimed to explore how group supervision could influence the preceptors' views of their role and how they valued this participation. Forty-eight preceptors, who took part in a 1 year group supervision program conducted by nurse lecturers, filled in open-ended questionnaires before the first and after the last session. The data were analyzed by means of qualitative content analysis. The findings showed changes in the participants' views of the preceptor role, indicating that this group supervision model had a positive influence on the preceptors' pedagogical and professional thinking and supported their attainment of good preceptorship. Further research is needed in using group supervision as a tool to support preceptors.     

Psychiatric patients' views on the concept of self-determination: findings from a descriptive study

? Using content analysis of unstructured interviews, this study examined the views of 72 long-term psychiatric patients on the concept of self-determination. ? The aim was to shed further light on the meaning of the concept for the purpose of developing a better tool for evaluation. ? One-third of the patients were familiar with the concept, another third had never heard of self-determination. ? The majority (52 patients) presented their views and definitions regardless of whether they had heard of the concept before. ? Content analysis revealed two central aspects in the definitions: an intrapersonal aspect, with self-determination defined in relation to the patients themselves or to their own activities; and an interpersonal aspect, with the focus on the patients' relationship with other persons. ? In spite of its limitations, the study certainly adds to our understanding of the concept of self-determination. ? It demonstrates that psychiatric patients are capable of offering valuable insights into key concepts of nursing, even if they are abstract. ? The results open new avenues for strengthening the self-determination of psychiatric patients.     

Practice Nurses' views of their role in the management of Chronic Fatigue Syndrome/Myalagic Encephalitis: a qualitative study

Background  

NICE guidelines suggest that patients with Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) should be managed in Primary Care. Practice Nurses are increasingly being involved in the management of long-term conditions, so are likely to also have a growing role in managing CFS/ME. However their attitudes to, and experiences of patients with CFS/ME and its management must be explored to understand what barriers may exist in developing their role for this group of patients. The aim of this study was to explore Practice Nurses' understanding and beliefs about CFS/ME and its management.     

Psychiatric patients and families: moving from a catastrophic event to long-term coping

The families of psychiatric patients struggle throughout their member's illness with the change it brings and their own feelings about the illness. In the past, families were blamed for many of the problems that mentally ill people experienced, and although this perception of fault has changed, families still experience a catastrophic event when mental illness occurs. Coping will vary among families, and all experience grief as a result of their losses. Psychiatric home care can help families learn new and adaptive coping skills. Careful family assessment can be an important part of the patient's treatment, forming a partnership to reintegrate the ill person into the family and home.