Nurses'' opinions of the introduction of computer-assisted learning for use in patient education

Computers have only recently begun to find a place in the everyday work of health care staff. The use of computer-assisted learning (CAL) in patient education is in its infancy. However, the medium appears to offer several advantages to patients. The successful integration of the medium into clinical practice requires the acceptance and support of staff members. Little research exists to date which examines staff responses to the introduction of CAL into their workplace. This small study (n = 14) aims to explore the reactions of staff to the introduction of an experimental CAL package for use in the education of renal patients on continuous ambulatory peritoneal dialysis (CAPD). The opinions of staff members to CAL are probed and their views ascertained regarding the usefulness of CAL to both staff and patients. Results suggest that, despite their initial reservations about CAL, staff were generally positive about the medium.     

Quality assurance: is it professional insurance?

Quality assurance (QA) is being hailed as a 'new frontier' of nursing. Its diffusion into nursing theory and practice in the United Kingdom is outlined. QA is not an alien import; favourable preconditions already existed. The systems-reasoning of the nursing process, which sprawned a plethora of models, each geared to the 'orderly' progression of stages, objectives and process, is resonant with the values and measurement techniques of QA. A major limitation of QA is that it downplays the organizational complexity of hospitals. Although QA is projected as being in the service of clients, its major impetus is concerned with professional self-defence, as regards other professions, the state and litigious clients. Further, QA enlisted by nursing strongly reproduces the ethos and logic of the dominant medical model; patients are 'objectified' as the technical products of production. The 'medical gaze' is now being joined with the 'nursing gaze'.     

In vitro studies and modeling of a controlled-release device for root canal therapy.

Endodontic disease is caused primarily by bacteria that interact with periradicular host tissues. Therefore, treatment of endodontic disease aims at the exclusion of bacteria from the root canal system. This work focused on in vitro studies and modeling of a controlled-release device for delivering antimicrobial agents in root canals. A cylindrical, needle-shaped device was prepared consisting of a matrix core and a polymer coating, loaded with 30-45% chlorhexidine (CHX). The composition of the core, a blend of water-permeable polymers, and the thickness of the coating were tailored to impart various release rates. A relatively steady release rate for over 40 days after an initial burst was achieved using a formulation for long-term release, which is desirable for establishing and maintaining the necessary therapeutic levels. Mathematical models were developed for both in vitro and in vivo drug release into a liquid of limited volume, taking into account a moving boundary of the dispersed drug and a time-dependent boundary condition. A concentration-dependent effective diffusion coefficient was used to count increased porosity as the solid drug had dissolved. The finite element method and computer programs were applied to solve the differential equations and predict the in vitro and in vivo release kinetics. The model prediction agreed well with the in vitro experimental data and provided guidance for designing the device for in vivo release in root canals. The result of in vitro antimicrobial tests, performed using a bovine tooth model, suggested that the device was effective in reducing growth of microbes.     

Nursing education research management: establishing priorities and optimizing the use of resources: a methodology

Many educational research projects start from a wide and nonoperational statement of the problem causing concern, and a difficult task for the research worker is to so refine the area of enquiry that useful and effective results of the research are produced within the constraints imposed by limited resources.
An evaluative research project into the role and preparation of the midwife teacher, undertaken in 1974–5 by the authors, at the request of the Royal College of Midwives, presented such a problem (Kilty & Potter 1975). This paper illustrates the methodology employed to establish priorities in order to resolve what was an entirely open-ended brief into a research that could be undertaken with limited resources.     

The abdication of the role of health education by hospital nurses

As nurses are in a unique position to influence patients and so carry out health education to their'captive audience', it is pertinent to discuss why so many nurses appear to abdicate this role. Reasons are suggested that the nurses'own education has failed to equip her with the skills necessary for the fulfilment of this role. Even basic communication skills appear to be poorly developed, let alone the more complex and analytical skills required by the nurse in order to effectively deliver a planned programme of health education to either individual patients or groups. A Health Belief Model (HBM) has been discussed and is proposed as a useful framework around which the nurse can formulate her health teaching. Variables to be considered include motivation, value of illness threat reduction, probability that compliant behaviour will reduce the threat of illness, and modifying and enabling factors. The HBM should be incorporated into an individualized nursing care plan, so that health teaching is an integral part of the patient's planned care in hospital. The ward sister is the key figure in implementing such procedures, and it is to her that education should also be directed     

The strengths and weaknesses of quantitative and qualitative research: what method for nursing?

The overall purpose of research for any profession is to discover the truth of the discipline This paper examines the controversy over the methods by which truth is obtained, by examining the differences and similarities between quantitative and qualitative research The historically negative bias against qualitative research is discussed, as well as the strengths and weaknesses of both approaches, with issues highlighted by reference to nursing research Consideration is given to issues of sampling, the relationship between the researcher and subject, methodologies and collated data, validity, reliability, and ethical dilemmas The author identifies that neither approach is superior to the other, qualitative research appears invaluable for the exploration of subjective experiences of patients and nurses, and quantitative methods facilitate the discovery of quantifiable information Combining the strengths of both approaches in triangulation, if time and money permit, is also proposed as a valuable means of discovering the truth about nursing It is argued that if nursing scholars limit themselves to one method of enquiry, restrictions will be placed on the development of nursing knowledge