The search for meanings in nursing: could Facet Theory be a way forward?

This paper examines some of the underlying tenets of Benner & Wrubel's Primacy of Caring, and suggests the use of Facet Theory as a possible route to overcome criticisms of the lack of systematic data collection and analysis in this approach to nursing research Some of the steps undertaken in Facet Theory are described, and its use in wider nursing research discussed It is proposed that Facet Theory offers a method of studying the multidimensional nature of nursing, which has the potential for a scientific approach without losing the essential ontological data     

Use of groin flap in the closure of through and through defect of a forearm: A case report

The groin flap is a vascularized axial flap based on the superficial circumflex iliac artery arising from the femoral artery just below the inguinal ligament. It is used regularly by many reconstructive surgeons for covering soft tissue defects of the hand. Although the development of various fasciocutaneous free flaps during the 1980s decreased the attractiveness of the groin flap, these flaps can be used in reconstructing significant defects of the forearm and hand where free tissue transfer is not feasible.     

Longer-term changes in quality of life in chronic leg ulceration

Studies that have examined patients' health-related quality of life have consistently shown improvements following intensive and effective treatments over relatively short follow-ups. However, little is known of the longer-term effects of treatment on patients. As part of a study in southwest London, United Kingdom, all patients having a current leg ulcer were examined (n = 113) and those who were able completed the Nottingham Health Profile (n = 95) and were then followed up at 24 and 48 weeks. The patients had a mean age of 76 +/- 13 (SD) years, with 60 (63.2%) being women. Before the study, the ulcer had been present for a median of 8 months (range 0.5-144), and a median area of ulceration of 4.0 cm2 (range 0.5-171.5 cm2). After 24 weeks, there was a significant improvement in pain (mean difference [d] = 9.6, p = 0.002), which was true for both the 41 patients with ulcers present (d=10.07, p = 0.013) and the 43 patients whose ulcers had healed (d = 11.46, p = 0.047). However, after 48 weeks, these improvements had been reduced in both groups (healed ulceration d = 5.76, unhealed patients d = 6.41). Energy, which had improved after 24 weeks in the patients whose ulcers, had healed (d = 11.46), deteriorated in both patient groups after 48 weeks (healed = -5.67, unhealed = -13.43). Mobility status was maintained with healed ulceration (d = 1.05) but deteriorated with unhealed ulceration (d = -13.19). The positive effects of treatment on health-related quality of life may not be sustained over time. This may be a consequence of the general deterioration in the health status of these elderly patients as they age.     

The Roy Adaptation Model: a consideration of its properties as a conceptual framework for an intervention study

The underlying premise of this paper is the belief that one of the core values of nursing research is its ability to demonstrate that nursing interventions influence care outcomes From this perspective the contribution offered by the Roy Adaptation Model for Nursing within an intervention study is evaluated Although it was believed that the model enriched the study in several ways, its overall contribution was likened to a 'conceptual stepping stone', used by the researcher en route back towards its underlying theories and classical     

Comparison of the effects of aminoguanidine and L-carnitine treatments on somatosensorial evoked potentials in alloxan-diabetic rats

The effects of aminoguanidine (AG) and L-carnitine (LC) on somatosensorial evoked potential (SEP) latency and neural levels of thiobarbituric acid reactive substances (TBARS), products of lipid peroxidation, were compared in alloxan-diabetic rats. AG and LC were given to diabetic rats starting from the 3rd week after the induction of diabetes and lasting for 4 weeks. SEP latency was measured by stimulating via caudal nerve and recording via cortex, once weekly during the treatments. Diabetes caused deficits in SEP (P < 0.05 vs non-diabetic control rats, respectively). AG and LC restored SEP latencies slightly but not significantly, with the exception of the prominent effect of AG at the first week and both treatments at the 4th week of the treatments (P < 0.05 vs untreated diabetic rats, respectively). Diabetes caused elevation in neural TBARS levels (P < 0.05 vs non-diabetic group), which was prevented by both AG and LC (P < 0.05 vs untreated diabetic rats, respectively). Weight and the glucose levels were not influenced by the treatments. Our results suggest that AG improves SEP latencies better than LC. Our results also suggest that the beneficial effects of both AG and LC on diabetic neuropathy are not associated with the regulation of glycemia, but these effects may be related in part with prevention of lipid peroxidation.     

Satisfying solutions? A review of some unresolved issues in the measurement of patient satisfaction

The measurement of patient satisfaction has been encouraged by a growing consumer orientation in health care, especially since it yields information about consumers'views in a form which can be used for comparison and monitoring However, drawing on literature from a variety of sources, this paper suggests that there remain several unresolved issues relating to the measurement of satisfaction, and some serious questions about the validity of the concept It is argued that current approaches to measuring satisfaction may not be grounded in the values and experiences of patients, therefore satisfaction surveys could be denying patients the opportunity to have their opinions included in the planning and evaluation of health care services     

Reflection and critical incident analysis: ethical and moral implications of their use within nursing and midwifery education

Despite the dearth of rigorous empirical investigation, reflection and reflective practice have become buzz words in nursing and midwifery education Reflection and critical incident analysis may be tools which can facilitate the integration of theory and practice It is proposed that in the absence of explicit and thorough preparation of lecturers and students, together with very careful curriculum planning, these activities may be counter-productive or even harmful In the absence of structure, reflection and associated critical incident analysis may lead to student disaffection or, worse, the potential for actual psychological disturbance Empirical studies on the use of identified models of reflection and critical incident analysis are urgently needed to assist nursing and midwifery lecturers and students to achieve predictable learning outcomes for this potentially valuable activity     

Project 2000: a review of published research

The findings of research into the implementation of the Project 2000 reforms of nurse education in England and Wales are reviewed in this paper The work of nine research teams who have published their findings between 1990 and 1994 is reviewed Following a brief summary of the major Project 2000 recommendations, the findings of the various research teams are presented Both successes and difficulties in implementing Project 2000 are highlighted The findings are discussed in the light of the original Project 2000 proposals, and it is concluded that, notwithstanding'teething'difficulties, the Project 2000 reforms are proving workable in practice