基于Peplau人际关系理论康复护理模式对冠心病病人心功能、健康行为及自我管理能力的影响

目的:探讨基于Peplau人际关系理论康复护理模式对冠心病病人心功能、健康行为及自我管理能力的影响。方法:选取2020年7月—2021年9月收治的98例冠心病病人为研究对象,按照抽签法将其分为对照组和观察组各49例,对照组给予常规护理,观察组实施基于Peplau人际关系理论康复护理,干预3个月。观察两组病人心功能、健康行为依从性及自我管理能力的改善情况。结果:观察组病人心功能指标优于对照组(P<0.05);观察组病人自我管理能力评分高于对照组(P<0.05);观察组病人健康行为得分情况优于对照组(P<0.05)。结论:基于Peplau人际关系理论康复护理模式能更有效改善冠心病病人自我管理能力,增强病人健康信念与健康行为动机,促进心功能指标与心脏康复质量的改善,效果优于常规护理。     

Development of an instrument to test the middle-range theory for the self-care of home-dwelling elderly

Purpose: This paper describes the process of developing an instrument to test the middle-range nursing theory for the self-care of home-dwelling elderly. Background: Instrument development is a multiphase process, during which the researcher tests the reliability and validity of the instrument with various data and modifies it based on the test results. The aim of the study was to develop an instrument to test a theory, but also to be able to use it later in clinical settings to evaluate the self-care of home-dwelling elderly and factors associated with it. Methods: The instrument development was done in four phases. At the first phase, the initial version was created on the basis of the theory. At the second phase, two home-dwelling elders were pilot-interviewed, and 20 elders completed the structured questionnaire and commented upon its ease of use. The results were used to develop the second version of the instrument. At the third phase, the second version of the instrument was used to collect data from home-dwelling elders aged 75 or more from different parts of Finland (n = 200). Face validity, exploratory factor analyses, correlation coefficients and Cronbach's alpha were used to test and further develop the instrument. At the fourth phase, the content validity of the third version was assessed by three home-dwelling elders. Results: The agreement between the elders and the researchers about the contents of the instrument was acceptable, and exploratory factor analyses verified quite well the structure of the theory. Based on the Cronbach's alpha values (0.49-0.90), the internal consistency of the instrument was fairly good. Conclusion: The results provide sufficient evidence of the validity and reliability of the final version of the instrument, which has nine background questions and 82 items to measure the self-care of home-dwelling elderly and factors associated with it.     

The need for psychiatric nursing: towards a multidimensional theory of caring

Contemporary developments in health care have encouraged a review of the professional status of psychiatric nursing. Although research has documented psychiatric nursing activity, little study has been made of the 'need' for psychiatric nursing within a multidisciplinary service. Employing adapted grounded theory methodology, substantive theory was developed concerning the expressed need for psychiatric nursing, by patients, their carers and mental health professionals. The study was based on six sites from England, Eire and Northern Ireland. The study found some consensus across both recipients and providers of mental health care, that the essential feature of nursing (the core category) involved a complex of relationships: 'knowing you, knowing me'. Within that complex, nurses either elected, or were required, to move--or 'toggle'--between three discrete domains of relating: the Ordinary Me (OM); the Pseudo-ordinary or Engineered Me (POEM); and the Professional Me (PM). Four internal dimensions involving the nurses' depth of knowing, power, use of time and use of translation distinguished these domains. The emergent theory extends current awareness of the importance of interpersonal relations in nursing. To what extent current health care policy, which emphasizes the promotion of alternative roles for nurses, will challenge this essential focus remains unclear.     

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.     

Mental health nursing policy — an exploratory qualitative study of managers' opinions

Mental health nursing policy — an exploratory qualitative study of managers’ opinions During the 1990s, much of the legislation and policy that pertains to mental health services has sought to direct them towards a virtually exclusive concern with the seriously mentally ill, typified by the following recommendation from a recent Department of Health review of mental health nursing that stated: ‘The essential focus for the work of mental health nurses lies in working with people with serious or enduring mental illness’. On the other hand, pressure from the primary health care sector suggests the need for services to be provided for the less seriously mentally ill, particularly through the auspices of general practice fundholders. Following a review of the literature, a small-scale, exploratory study was initiated to seek answers to the following research question: How is the policy focus urging reorientation to the severely mentally ill viewed by nurse managers who have a responsibility through Mental Health Resource Centres and Community Mental Health Teams, to provide mental health services? The study was based within a Welsh National Health Service (NHS) Trust that employed six nurse managers of Community Mental Health Teams (CMHTs). Four of the managers additionally had responsibility for Community Mental Health Resource Centres (CMHRCs). Of the population of six managers, four composed the sample for the investigation. A qualitative research approach was employed, utilizing semistructured interviews as the data collection tool. Analysis of the data revealed that managers were finding creative solutions in order to meet the conflicting demands placed upon them. The research findings also indicated that many of the obstacles to providing a needs-led service were structural in origin, and could be resolved by central strategic intervention.     

The future of the Theory of Interpersonal Relations? A personal reflection on Peplau's legacy

The work of Hildegard Peplau represents the most significant influence, worldwide, on the development of psychiatric nursing practice. Her use of the Theory of Interpersonal Relations created the basis for defining the potential significance of the psychiatric nurse's role as a therapeutic agent. Forty years later she has indicated the means by which nurses might sharpen their focus on the person often overshadowed by the 'patient' label. Peplau's writings have, over this 40-year period, helped clarify the broad range of roles required of the nurse in general and in particular, within psychotherapeutic nursing.     

Being reborn: the recovery process of postpartum depression in Taiwanese women

AIM: This paper reports a qualitative study describing the process of recovery from postpartum depression in Taiwanese women. METHODS: We carried out a study using grounded theory with a purposive sample of 23 postnatally depressed women in 2001-2002. The Beck Depression Inventory was used to screen for severe depression. Women with scores higher than 16 at 6 weeks after childbirth were categorized as having postpartum depression. Only two out of the 23 mothers were being treated for depression at the time. The data were analysed by constant comparative method. FINDINGS: 'Being reborn' was the core concept that emerged from the data on the mothers' experience of going through postnatal depression, which was a process of descent into near-death insanity and eventual rebirth. Such postnatally depressed mothers often underwent four stages of coping with the loss of self or loss of former identity and attachment to their new lives as mothers. The four stages were: (1) shattered role identity, (2) feeling trapped and breaking down, (3) struggling for self-integrity and (4) regaining vitality. CONCLUSION: The experience of postpartum depression should be examined within the social and cultural contexts in which it occurs. These Taiwanese data can be used to develop culturally-sensitive health care. The nursing role is primarily that of reflective listening to help the women adjust to the process of being reborn--an internal process of painful growth represented by motherhood and striving to protect the real self in order to maintain emotional health while negotiating a developmental transition. Preventive interventions might include providing guidance for parenting, counselling of individual mothers, and facilitating the development of support groups.     

Forensic nursing educational development: an integrated review of the literature

The forensic area of practice has been a popular career choice and area of study for many of the health science disciplines. Forensic nursing is a nursing specialty with subspecialties that focus on nursing practice who care for victims and offenders, living and deceased at the clinical legal interface. This integrated review of the literature overviewed the historical development of each of the forensic nursing subspecialties and identified gaps in specialty nursing educational development. Although multiple studies for the last 30 years identified the need for forensic nursing education, recommendations did not soon translate into educational curriculum development. The literature showed that role development was not concurrent with educational development in all forensic nursing subspecialties.     

The use of theory in qualitative approaches to research: application in end‐of‐life studies

Title. The use of theory in qualitative approaches to research: application in end‐of‐life studies. Aim. This paper is a report of an analysis of the use of theory in qualitative approaches to research as exemplified in qualitative end‐of‐life studies. Background. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end‐of‐life studies is used to illustrate application of theory to study design and findings. Data sources. A review of theoretical literature was carried out, focusing on definitions and use of theory in qualitative end‐of‐life studies published in English between 1990 and 2008. Discussion. The term ‘theory’ continues to be used in a variety of ways by theorists and researchers. Within the reviewed end‐of‐life studies, the use of theory included theory creation or provision of a comparative framework for data analysis and interpretation. Implications for nursing. Nurses who conduct qualitative studies should examine the philosophical and theoretical bases of their selected methodological approach, articulate a theoretical framework that fits the phenomenon being studied, and adopt a critical, flexible and creative attitude when applying theory to a study. Conclusion. Theory can be put to several uses in qualitative inquiry and should guide nurse researchers as they develop and implement their studies. Nurse educators who teach qualitative approaches to research should emphasize a variety of ways to incorporate theory in qualitative designs.     

The ‘realities’ of part‐time nursing: a grounded theory study

Aim To develop a theory that explains the ‘realities’ of part‐time nursing. Background While little is known about the phenomenon of part‐time nursing, increasing numbers of nurses work in part‐time employment. Methods Grounded theory. Results The problem that part‐time nurses shared was an inability to achieve their personal optimal nursing potential. Motivators to work part‐time, employment hours, specialty, individual and organizational factors formed contextual conditions that led to this problem. Part‐time nurses responded to the challenges through a process of adaptation and adjustment. Conclusion Harnessing the full productive potential of part‐time nurses requires support to limit the difficulties that they encounter. The developed theory provides a valuable guide to managerial action. Implications for nursing practice Nurse Managers need to consider the developed substantive theory when planning and managing nursing workforces.     

Measuring melancholy: a critique of the Beck Depression Inventory and its use in mental health nursing

The Beck Depression Inventory (BDI) is one of the most commonly used depression measurement instruments. Mental health nurses often utilize the BDI to assess the level of depression in clients, and to monitor the effectiveness of treatments such as antidepressants and electroconvulsive therapy. Despite the widespread use of the BDI in both clinical practice and research, there is surprisingly little nursing literature critically examining the BDI or its use by mental health nurses. This paper reviews the origins, purpose, and format of the BDI, discusses some of the strengths and limitations of the BDI, and concludes with some implications for mental health nursing.     

The middle-range theory of nursing intellectual capital

Title. The middle-range theory of nursing intellectual capital Aim. This paper is a report of the development of the middle-range theory of nursing intellectual capital. Background. Rising healthcare costs and advances in technology have contributed to the need for better understanding of the influence of nurses’ knowledge, skills and experience on patient and organizational outcomes. Method. The middle-range nursing intellectual capital theory was developed using the strategies of concept and theory derivation. The principles of research synthesis were used to provide empirical support for the propositions of the theory. Findings. The middle-range nursing intellectual capital theory was derived from intellectual capital theory to make it relevant and applicable to a specific aspect of nursing, continuing professional development. It proposes that the nursing knowledge available in healthcare organizations is influenced by variables within the work environment, and influences patient and organizational outcomes. Conclusion. The middle-range nursing intellectual capital theory should be tested in different healthcare systems and in different settings and countries to determine its effectiveness in guiding research.     

Psychiatric nursing staffs’ attitudes towards the use of containment methods in psychiatric inpatient care: An integrative review

One of the international objectives in psychiatric care is reducing the use of coercion. Containment methods are meant to keep patients safe, yet usually include coercion. Nurses play a key role in deciding whether or not containment should be used and, as such, their attitudes towards containment can significantly impact the extent to which these methods are applied. The aim of this integrative review was to identify, analyse, and synthesize the available research on psychiatric nursing staffs’ attitudes towards containment methods in inpatient psychiatric care. An electronic search was conducted using the CINAHL, Scopus, and PsycINFO databases. In addition, the citations of identified studies were screened for relevant research. A total of 24 relevant papers published between 2002 and 2017 were selected for further analysis. These studies revealed variation in nursing staffs’ attitudes towards the use of containment methods. The use of containment methods seems to be widely accepted and nurses reported rarely considering alternative measures. It appears that attitudes towards containment have continuously become more negative, although the change has not been very pronounced. The concept of attitude was only defined in two studies. Thus, future research should strive to clarify this concept, as a generally accepted definition for attitude within nursing research and the utilization of all dimensions of this concept are both essential to the nursing field. Currently, it would be important to focus on changing attitudes among psychiatric nursing staff to reduce the use of containment methods; this calls for more research on nursing staffs’ attitudes.     

Orem 自理与心理护理在肿瘤患者化疗中的作用

目的探讨Orem自理理论和心理护理在肿瘤患者化疗过程中的效果方法选取2013年2月~2013年12月入住我院放疗科的140例患者按入院顺序随机分为两组,对照组采用常规分级护理,实验组在对照组基础上进行Orem自理和心理护理,比较两组患者化疗后患者的不良反应发生率、焦虑与抑郁不良情绪发生情况以及患者对护理工作满意度。结果经过4~6周Orem自理和心理护理干预后,实验组胃肠道反应发生率明显低于对照组,P<0.05;实验组焦虑和抑郁不良心理状态发生率明显低于对照组,P<0.05;实验组患者对护理工作满意率（97.1%）明显高于对照组（73.3%）,P<0.05。结论对接受化疗的肿瘤患者进行Orem自理和心理护理能够显著缓解患者焦虑和抑郁情绪,提高其对护理工作的满意度,显著减少胃肠道反应的发生。     

The recovery alliance theory of mental health nursing

The recovery alliance theory (RAT) is a mid-range theory of mental health nursing based on humanistic philosophy. The conception of the RAT was the outcome of collaboration among service users, practising mental health nurses, educationalists and managers and was developed in the context of a number of political and social changes as well as changes in the mental health field. The theory is composed of six constructs: humanistic philosophy, recovery, partnership relation, strengths focus, empowerment and common humanity. The derivation of three concepts from these constructs, namely coping, self-responsibility/control and working alliance, forms the basis for the translation of the constructs into a system of mental health nursing practice [Partnership in Coping system (PinC)]. The constructs underpinning the RAT were clearly demonstrated in a preliminary trial of the PinC system.