Assessing strength of preference for abortion method using 'willingness to pay': a useful research technique for measuring values

Policy makers and practitioners need to differentiate between patient preferences which are strongly held, and those which are not. This study measured not only women's preferences for medical abortion versus surgical vacuum aspiration, but also the strength of these preferences, using a 'willingness to pay' (WTP) technique. Fifty women were recruited and interviewed prior to and following termination of early pregnancy. Due to the sensitivity of the situation, the WTP approach was administered by interview. Results revealed that 34 (64%) preferred to have the medical method. The amounts offered for each method were similar; however, a minority gave higher values for the medical method, thus for those women their strength of preference for that method was more intense. Validity of the technique was supported by the finding of a positive association with social class and the importance women attached to having choice. It is argued that WTP is an acceptable method for the elicitation of strength of treatment preferences. Its further use by nurses and midwives to assess health care preferences should be explored, particularly when considering aspects of care which are traditionally difficult to identify and measure.     

Contract learning reconsidered: a critical examination of implications for application in nurse education

This paper defines and explores the nature of learning contracts. It also discusses the origins of learning contracts, presents a critical evaluation covering the implications of their use in nurse education and makes recommendations.     

Social and psychological context of childbearing

The transition to motherhood is an emotional watershed which is punctuated by feelings of loss as well as gain. Not surprisingly, it is a period that is associated with significant social and psychological changes and upheavals that may give rise to feelings of uncertainty and self-doubt. The National Services Framework for Children, Young People and Maternity Services (Department of Health 2004) acknowledges the demands of parenthood and identified clear standards for promoting health and wellbeing of women, children, partners and families as a whole, placing emphasis on supporting and helping parents prepare and adjust to their parenting role. Furthermore, it outlines a number of vulnerability factors that may have adverse consequences for maternal and neonatal outcomes. This, for example, takes account of social deprivation/social exclusion, teenage pregnancy, substance abuse, domestic violence and minority ethnic groups. To comprehend the enormity of childbearing on women’s lives this paper considers the social and psychological context of motherhood as a major life event.     

The assessment of therapeutic attitudes in the psychiatric setting

Although 'attitude change' is included as one of the aims of the 1982 training syllabus for psychiatric nurses, curriculum designers are given little guidance as to what constitute desirable attitudes in the psychiatric nurse, and how those attitudes are to be assessed and evaluated. This study has three aims: to attempt to outline what might count as desirable attitudes; to propose a theoretical framework for the measurement of those attitudes; and to devise a test instrument and pilot it on three groups with differing amounts of counselling skills and experience. The outcome of the pilot study produced surprising results, leading to the tentative hypothesis that counselling training and/or experience may have a detrimental effect on so-called 'therapeutic attitudes' in the nurse.     

Nursing ideology and the 'generic carer'

A review of the concept of ideology in a nursing context is presented. The meaning of a nursing ideology is explored and that meaning compared to the proposals for the future of nursing contained in the 1996 report on The Future Healthcare Workforce published by the University of Manchester, England. The paper suggests a number of core beliefs and values that are generally supported in nursing and their implications for the future development of the profession. These include a commitment to the role of science in nursing, the concept of caring in nursing practice and the continued pursuit of the professional project. The paper will demonstrate the extent to which the proposals contained within the report for a 'generic carer' compliment or conflict with the suggested ideology of nursing. It concludes with a reference to the policy-making process at local and national levels and the opportunities available to nurses to influence the direction of change. The paper reflects the volatility of the current political climate in health care and the extent to which nurses operating in that climate feel empowered or disenfranchised.     

Academic validation of prior and experiential learning: evaluation of the process

This report is a summary of an AP(E)L evaluative research project conducted at the University of Southampton School of Nursing and Midwifery. The project aimed to shed light on the perceptions of candidates and teachers in conjunction with the effectiveness of the accreditation process. Through initial semi-structured interviews with teachers ( n = 6) and candidates ( n = 6) offering their perceptions and experiences, an emergent questionnaire was sent to the remaining active accreditation candidates ( n = 60, response n = 39) and advisers/assessors ( n = 36), response n = 32). The effectiveness of candidate preparation for beginning an accreditation claim, the comprehensiveness of the types of credit available to capture learning through experience, the styles of advising and feedback from assessment are all reported on. Interestingly, the data highlight how preparing an accreditation claim can affect both adviser and candidate, in terms of being more self-critical and reflective in their areas of practice.