An examination of the implications of adopting a process approach to curriculum planning, implementation and evaluation

A process may be seen as that which has purpose, organization and structure, facilitating an act of moving forward. Thus, a process reflects Bruner's view of education as facilitating cognitive growth and as a way in which individuals explore and gain mastery over a complex world. A process approach is not without its problems, namely in that some nursing skills require a precise, predetermined outcome best achieved by the use of behavioural objectives. A curriculum promoting growth and continued learning calls for increased funding, which may cause problems in today's financial climate. Exploration of concepts calls for careful planning of practical experience and may be difficult where supernumerary status is not fully implemented. However, a process approach may reduce the theory practice gap and lead to a reflective and proactive practitioner. On-going education of clinical staff is required and increased communication between educational and clinical staff. This approach may lead to a more holistic view of nursing education and achievement measured in not only quantitative but also qualitative terms. Solving the problems that a process approach may present may cause nursing education to be enhanced.     

Promoting Health Through A Developmental Analysis of Adolescent Risk Behavior

Adolescents are the only U.S. population group not to improve morbidity and mortality since 1960. Social and behavioral etiologies of adolescent morbidity and mortality are best addressed in schools, since health care providers rarely are seen by teen-agers for other than organic health complaints. The relevance of physical, cognitive, and psychosocial development for adolescent risk-taking and their attendant health problems are discussed. Recognizing adolescent risk-taking as a means of achieving autonomy and identity, nurses and health educators can intervene to promote health-enhancing alternatives to achieve those ends. Social learning theory provides a basis for interventions to personalize the curricula, change behaviors, and shape the environment.     

The evaluation of a community coronary specialist nursing service in Northern Ireland

Providing an efficient service depends partly on evaluation, which itself should take into account, amongst other things, the clients' views. This study set out to evaluate clients' perception of a coronary specialist nursing service (CSNS) in one area health board in Northern Ireland. Postal questionnaires were sent to a random sample of 70 clients of the CSNS. Results showed that the majority expressed satisfaction with the service, as well as with the information they received prior to discharge into the community. Their responses provide food for thought to those involved in the provision of such services.     

Role of the artificial urinary sphincter in the treatment of stress incontinence in women.

The artificial urinary sphincter (AUS) is rarely indicated in the treatment of women with stress incontinence because most of these women have deficient urethral support rather than pure sphincter weakness and the AUS is a treatment specifically for pure sphincter weakness. The procedure is contraindicated after pelvic radiotherapy and after previous sling surgery because of the high incidence of cuff erosion. Otherwise the artificial sphincter gives excellent results comparable to those seen in men with post-prostatectomy incontinence and much better than in neuropathic bladder dysfunction.     

The family, crisis and chronic illness: an evolutionary model

While chronic illness has a profound impact upon the individual, an immense burden is imposed upon the family. When the competing demands of an illness and the family escalate exponentially, there may be a crisis. Traditionally, crisis theory has been applied to acute care contexts such as emergency, intensive care and mental health nursing. Yet, clinical experience with families and chronic illness supports the notion of periodic crises from the prediagnostic phase to the long-haul of the illness. Moreover, the authors hypothesize that the family's perception of the event determines whether the crisis is perceived as a threat or a challenge. This paper thus addresses the perception of crisis within the framework of chronic illness from a biological and family systems nursing perspective. First, the theory of Humberto Maturana, a Chilean biologist, is explored and applied to clinical observations regarding family, crisis and chronic illness. Second, an evolutionary model for conceptualizing crisis and chronic illness is presented. Third, the role of beliefs in the family perceptions of crisis and chronic illness is discussed.     

Should relatives of patients with cardiac arrest be invited to be present during cardiopulmonary resuscitation?

Witnessing the attempted resuscitation of a loved one is likely to be traumatic and distressing. However, because the majority of patients requiring cardiopulmonary resuscitation (CPR) die, this raises the question, within the hospital environment, of whether relatives should be invited to be present. There is a distinct lack of nursing research available on this subject, particularly with regard to the possible long-term effects on relatives. Much of the information is anecdotal and focuses on the positive aspects of this practice. With particular reference to the intensive care unit (ICU), the discussion in this paper includes not only family presence during CPR from the perspective of the patient, relatives and healthcare professionals, but also the potential legal implications. Recommendations for nursing practice are offered.