Palliative care nurses' views on euthanasia

BACKGROUND: In debates on euthanasia legalization in Belgium, the voices of nurses were scarcely heard. Yet studies have shown that nurses are involved in the caring process surrounding euthanasia. Consequently, they are in a position to offer valuable ideas about this problem. For this reason, the views of these nurses are important because of their palliative expertise and their daily confrontation with dying patients. AIM: The aim of this paper is to report a study of the views of palliative care nurses about euthanasia. METHODS: A grounded theory approach was chosen, and interviews were carried out with a convenience sample of 12 palliative care nurses in Flanders (Belgium). The data were collected between December 2001 and April 2002. FINDINGS: The majority of the nurses were not a priori for or against euthanasia, and their views were largely dependent on the situation. What counted was the degree of suffering and available palliative options. Depending on the situation, we noted both resistance and acceptance towards euthanasia. The underlying arguments for resistance included respect for life and belief in the capabilities of palliative care; arguments underlying acceptance included the quality of life and respect for patient autonomy. The nurses commented that working in palliative care had a considerable influence on one's opinion about euthanasia. CONCLUSION: In light of the worldwide debate on euthanasia, it is essential to know how nurses, who are confronted with terminally ill patients every day, think about it. Knowledge of these views can also contribute to a realistic and qualified view on euthanasia itself. This can be enlightening to the personal views of caregivers working in a diverse range of care settings.     

Primary care nurses' attitudes, beliefs and own body size in relation to obesity management

AIM: This paper is a report of a study to explore primary care nurses' attitudes, beliefs and perceptions of own body size in relation to giving advice about obesity. BACKGROUND: Primary care nurses have a key role in the management of obesity. Their responses to the stigma of obesity and the effects of their own body size in this context have not been investigated. METHODS: A purposive sample of 15 primary care nurses of markedly different body size were interviewed in a qualitative study undertaken in 2006 in the north of England. FINDINGS: Participants were aware of obesity stigma and this, among other factors, contributed to perceptions of obesity as being a sensitive issue to discuss. Communication tactics were employed in managing the sensitivity, with emphasis placed on maintaining good rapport. Participants took care to avoid stereotypes in presenting their beliefs about obesity, which were complex and in some respects ambivalent. They were conscious of their own body size in interactions with patients. A slim build appeared to amplify sensitivities surrounding obesity and add concerns about appearing to lack empathy or authentic experience. Those with a large body size made a virtue of their perceived greater empathy and experience, but had concerns about being poor role models. Self-disclosure techniques oriented to demonstrating personal understanding and rapport were employed to manage impressions made by body size. CONCLUSION: It is important to consider the effects of own body size in educating nurses, and further research should investigate its effects on patient outcomes.     

Management of obesity in primary care: nurses' practices, beliefs and attitudes

AIM: This paper is a report of a study to investigate patterns of clinical practice, beliefs and attitudes of primary care nurses with respect to obesity management. BACKGROUND: Nurses in primary care potentially play a key role in managing obesity, which has become a priority issue. There have been few studies of either the extent of clinical practice of nurses, or their attitudes and beliefs in this setting. METHODS: A correlational survey design was employed. Structured questionnaires were posted to 564 nurses and health visitors in primary care organizations in England. The response rate was 72.3%. The survey was conducted in April and May 2006. FINDINGS: Very few respondents reported training in obesity management, and most did not believe that organizational support was in place. Only practice nurses reported substantial clinical activity in obesity management, accounting for almost 5% of their contracted hours. This activity, comprised of assessment, lifestyle change support and referral, occurred in one-to-one consultations. Other nurses and health visitors reported much less activity, although they believed obesity to be an important health issue and its management an appropriate part of their role. Whilst outright negative stereotypes were rare, there were nevertheless a range of potentially negative beliefs and attitudes relating to obesity and obese patients. These views were related to the respondent's own body mass index but not to gender, age, experience and occupation. CONCLUSION: Training and organizational support for obesity management are required by primary care nurses. Training should also address beliefs and attitudes about obesity and obese persons.     

阻碍护理人员报告护理异常事件因素的质性研究

目的了解护理人员对报告护理异常事件的真实想法和感受,识别阻碍护理人员顺利报告的因素。方法运用质性研究的方法 ,对上海市2所三级甲等医院的12名护理人员进行个别深入访谈。结果通过分析,提炼出3个主题:护理人员的认知、管理人员的负向态度和医院的组织文化因素是阻碍护理人员报告的主要原因。结论应加强护理人员的护理异常事件报告的培训,改变护理管理人员对护理异常事件报告的负向态度,建立健全护理异常事件监测体系,以提高护理人员对护理异常事件的发现能力和报告能力。     

Graduated nurses' experiences with baccalaureate thesis writing: A qualitative study

This study explores the perceptions of newly graduated nurses regarding the baccalaureate thesis (BT) writing process. A qualitative approach with content analysis was adopted. Thirteen newly graduated nurses participated in the study. The inclusion criterion was having completed the BT during their university education as nurses within 3 years of the study. Information was obtained through semistructured interviews. Data collection began in June 2018 and ended in March 2019, once saturation of information was reached. Three major categories were identified: the beginning of the process, the advantages of Baccalaureate thesis writing, and the teacher's role. The participants expressed that their training focused on a synthetic and particular type of writing that is necessary for clinical scenarios but not suitable for scientific academic texts. Additionally, reflective diaries were described as a powerful writing practice during their studies. Participants conceive the realization of the baccalaureate thesis as a difficult process, especially as regards selecting, synthesizing, and writing about the available information, processes that they indicated generate anxiety. Academic writing skills should be specifically included in the nursing curriculum.     

Dying well: nurses' experiences of 'good and bad' deaths in hospital

Aim: This paper reports a study investigating hospital nurses' experiences of death and dying. BACKGROUND: Despite advances in medical science and health care, together with the push towards individualizing approaches to patient care in the developed world, significant variation in the care of dying patients still exists. The international issues relating to differing types of death reveal both its complexity and diversity, with evidence of 'good death' experiences largely focused on hospice experiences, and a lack of research on death in general hospitals. METHOD: In-depth interviews were conducted in 1999 with a convenience sample of 29 Registered Nurses in the United Kingdom based on their hospital death experiences. Semiotic analysis was used to identify the 'deep structures' that underlie and form part of cultural communication as a way of understanding how nurses made sense of death. Data interpretation was enhanced through the use of a typology of 'good and bad deaths'. FINDINGS: The findings suggest that different experiences of death are based on the extent to which nurses were able to exert control over the dying process. The management of death in hospital is a major source of conflict for nurses. Good and bad death experiences were constructed according to their impact on the sentimental order of the ward, the intangible, but real patterns of mood that influenced nurses' feelings. Moreover, good and bad deaths focused less on patients' needs and the dying process and more on the death event and nurses' abilities to manage organizational demands. CONCLUSION: There is a need to improve communication with patients and families about diagnosis and prognosis to ensure that effective communication takes place and 'blocking behaviour' is avoided. The findings also challenge practitioners to focus attention on death as a process, and to prioritize patients' needs above those of the organization. Moreover, there is the need for guidelines to be developed enabling patients to have a role in shaping events at the end of their lives.     

Promoting evidence-based practice: the roles and activities of professional nurses' associations

AIM: This paper reports a study exploring the role perceptions and current activities in evidence-based practice promotion of professional nurses' associations in the Netherlands. Background: The promotion of evidence-based practice contributes to professional standards in nursing and good quality care for patients. As professional nurses' associations can be key players in this process, the nature of their roles and current activities deserves to be explored. METHODS: Roles and activities were explored for 43 professional nurses' associations (83% of all national associations). Data were collected using interviews with the associations' board members. Findings from the interviews were validated with those from an analysis of the associations' policy reports and other publications in the previous 2 years. RESULTS: Board members primarily thought that they had roles in the selection and distribution of evidence. The roles of participant (n = 13) and performer (n = 13) in selecting evidence, and those of facilitator (n = 12), initiator (n = 15) and performer (n = 41) in the distribution of evidence were often addressed. A few respondents reflected on roles in generating evidence and implementing evidence-based practice in patient care. A majority of the associations was contemplating activities in the promotion of evidence-based practice. Specific activities for each of six relevant aspects in the promotion of evidence-based practice were found in fewer than five associations. CONCLUSION: Professional nurses' association roles in the promotion of evidence-based practice need to be viewed in relation to the tasks to be accomplished, especially those of selecting and distributing evidence. Although many organizations expressed motivation, professional nurses' associations have a long way to go in the promotion of evidence-based practice among their members.     

Multidisciplinary team perception of games-based therapy in critical care: A service evaluation

Background

As survivorship following critical illness improves, there is greater focus on maximizing recovery. As well as physical effects, critical illness often results in cognitive impairments such as delirium, anxiety, or disorientation. In other populations, such as delirium, non-pharmacological approaches to manage these conditions are preferred, including re-orientation and ensuring personal care needs are met. Cognitive rehabilitation is also well documented for patients with neuropsychological deficits. Treatments include memory aids, compensation strategies, and functional execution. In other hospital populations, games and activities have been utilized to optimize patient engagement, stimulation, and aid recovery, but it is considered an emerging therapy in intensive care.

Aims

This service evaluation aimed to gather multidisciplinary team members' perceptions of the use of games based therapy (GBT) in critical care, including patient engagement and acceptability in clinical practice.

Study design

A UK-based single-centre qualitative service evaluation. Purposive sampling was used to identify interviewees within an adult intensive care who had experience of using a recently implemented GBT intervention. Qualitative data were collected through semi-structured interviews, which were recorded and transcribed verbatim. Data were analysed using thematic analysis.

Results

Eight staff members across the multidisciplinary team were interviewed. One overarching theme of humanizing health care was identified, with three sub-themes of enhancing recovery, non-physical components of care, and bespoke tailoring. In addition, further recommendations for development of the service were summarized.

Conclusion

GBT was well received by staff in clinical practice. It was described as a supportive adjunct to traditional care and rehabilitation, enhancing staff-patient relationships. While it was recognized it may not suit all patients, GBT has the potential to enhance cognitive and physical recovery.     

Collaboration and control: nurses' constructions of the role of family in nursing home care

AIM: This paper reports a study examining how nursing home staff experienced working with residents' families. BACKGROUND: Working collaboratively with the family in residential aged care to provide care is consistent with nursing philosophy. The quality of the experience, however, is frequently fraught with problems for both the family and staff involved. Little research has focused on the nature of family involvement in nursing homes from the perspective of nursing home staff. METHODS: The study adopted a naturalistic paradigm. Data were collected from 30 nursing home staff members drawn from a range of metropolitan and rural facilities in Victoria, Australia by means of conversational in-depth interviews. Issues concerned with how participants constructed the role of the family in the nursing home were explored. The data were collected in 2001-2002. RESULTS: Four key elements are presented in this paper: (1) Making the transition; (2) Forming ties; (3) Keeping them at a distance and (4) Unacceptable behaviour. Some nursing home staff have developed a substantive family orientation and had adopted practices which were inclusive of the family. Equally, many attitudes which cast the family into an adversarial and competitive role were noted, and many staff members outlined practices which were indicative of a need to control the family. CONCLUSION: A rhetoric of family partnerships is prevalent in some nursing homes. The activities of staff in these homes are still primarily geared towards provision of physical care, and families' needs become secondary to getting the work done. A new model of practice is needed that sees working collaboratively with families as a legitimate and necessary part of the staff role.     

基于中国护理科技核心期刊的质性研究抽样报告现状分析

目的 了解护理类期刊中质性研究抽样报告存在的问题并提出建议,为未来规范质性研究抽样的实施提供参考.方法 检索EQURTOR、国际指南协作网、Cochrane library中的质性研究报告规范,根据专家建议选取书籍,制定抽样报告条目.检索2017-2020年中国护理科技核心期刊的质性研究文章,审查抽样过程.结果 共产生...     

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.