An investigation into the feasibility of parental participation in the nursing care of their children

Family-centred care has been recognized as a basic tenet of paediatric nursing for some time because it is believed that children benefit from the continuous presence of their parents It is for this reason that the concept of care by parents has evolved Although such a philosophy is beneficial for the child, it has undoubtedly evolved due to low staffing levels, and in such an environment the guidelines for safe practice are easily called into question In the wake of a new paediatric oncology ward, it was decided to consider instituting care by parents In an effort to do this in a structured way, it was decided to make our practice research based A teaching tool was formulated and five mothers who presented consecutively to the paediatric oncology ward were taught how to administer intravenous antibiotics to their child Mothers' views on the teaching programme were sought using taped interviews, and the data were analysed using grounded theory This methodology allowed a theoretical framework based on realistic data to emerge, and the resultant themes provided a valuable insight into Mothers' views on the subject It emerged that nurses' attitudes towards care by parents require clarifying and that changes need to take place if this concept is to be taken on board Negotiation to allow mutual understanding between parents and nurses is essential to the successful implementation of such a scheme     

A family nursing approach to the care of a child with a chronic illness

Chronic illness in childhood affects family functioning, and professional support is required when the child is being cared for at home. The focus of concern for this study is the nursing contribution to the support of the family. A longitudinal ethnographic study of the experience of four families caring for a child with cystic fibrosis provided data. Analysis of the four case studies provides insight to the effect of cystic fibrosis on family interaction. The genetic aspects and the life-threatening nature of the illness are seen to have a profound effect on the parents' lives. The experience of crisis and the chronic burden of care are described. The context of long-term care requires the nurse to share the illness trajectory with the families and to help family members to travel it together. This is seen to require a high level of interpersonal skill and considerable emotional investment. The issues for nursing are examined. The research arose from practice, and it contributes to theoretical explanation of nursing interaction, and the relationship of systems thinking to understanding of the nursing situation. The case for the development of family nursing practice to meet contemporary health care needs is argued.     

Cancer rehabilitation for children: a model with potential

The dramatic improvements in the treatment of children's cancers has lead to the identification of a growing need for the development of comprehensive rehabilitation programes. These programmes should include help in learning to live with cancer, and maximize levels of independence for the child with cancer and their family. In this paper, the author will demonstrate the potential for childhood cancer rehabilitation, highlighting factors already in place and those areas that could benefit from development.     

Understanding caring through arts and humanities: a medical/nursing humanities approach to promoting alternative experiences of thinking and learning

It is often claimed that nursing is both an art and a science, yet nursing education has been reluctant to accord arts and literature a prominent place within nursing curricula. While the discipline of medical humanities has been developing for around two decades, there has been no comparable movement within nursing. This paper describes the development, implementation and initial hermeneutic evaluation of a new course, 'Understanding Caring Through Arts and Humanities' which we believe to be unique in being a fully accredited unit which is offered within a BA (Honours) Health Studies Degree for nurses and other health care professionals.     

Are electronic thermometry techniques suitable alternatives to traditional mercury in glass thermometry techniques in the paediatric setting?

Are electronic thermometry techniques suitable alternatives to traditional mercury in glass thermometry techniques in the paediatric setting? ¶Three thermometers, mercury in glass, Becton-Dickinson digital and IVAC tympanic membrane thermometer, were compared. The study was designed to test the null hypothesis that there is no difference between the thermometer recordings, meaning that electronic thermometry is a suitable alternative to traditional mercury in glass thermometry. Children aged between 0 and 15 years old were entered into the study, n = 114. Standard procedures were used throughout the study to minimize the risk of errors in the data collection and technical errors were recorded. The data were analysed using graphical techniques described by Bland and Altman. The differences between the temperature recordings were plotted against their mean (the estimated true value), with the bias and limits of agreement (2 standard deviations from the mean) calculated for the mercury in glass/digital, mercury in glass/tympanic and digital/tympanic temperature recordings. The range of temperatures were 35·1°C–38·5°C, with a mean of 36·85°C for the mercury in glass thermometer, 36·8°C for the digital thermometer and 36·65°C for the tympanic thermometer. The bias for each comparison was 0·36°C, 0·21°C and 0·17°C and the limits of agreement were wide, ?0·516°C to 1·234°C, ?0·84°C to 1·252°C and ?0·94°C to 1·244°C for the mercury in glass/digital, mercury in glass/tympanic and digital/tympanic recordings respectively. A difference of 0·2°C is usually accepted for clinical practice, therefore the null hypothesis was rejected.     

Decision making: the context of nurse prescribing

From October 1994 qualified district nurses and health visitors from eight demonstration sites in England have been able to prescribe from a limited list of formulary items. Data collected from nurses formed only one part of the evaluation of nurse prescribing. These data highlighted a number of areas where prescribing nurses were faced with difficult decisions. A number of authors have considered how both doctors and nurses make decisions, and the factors which may influence the decision making process. With reference to the literature this paper focuses on the findings related to decision making in the context of nurse prescribing.     

The Delphi technique: a methodological discussion

As in nursing, recent curriculum reform in radiographer education has resulted in the development of undergraduate programmes, and a study referred to in this paper investigated the activities of supervising radiographers in support of the undergraduate curriculum. Following on from 'ward learning environments' research in nursing, the most important activities which assist radiography students'clinical learning were investigated by means of the Delphi technique. At the design stage, a deficiency in previous work using the technique was identified, in that decisions relating to consensus among research respondents appeared to be based on arbitrary or post hoc rationales rather than predetermined or objective criteria. As the Delphi technique is being increasingly employed in nursing and similar research, it is important to explore issues of consensus, validity and reliability. The paper makes recommendations for improving these aspects in future studies.