Quality of care in nursing homes: from the resident's perspective

This paper derives from a study conducted by the Deakin Institute of Nursing Research between 1988 and 1990, whose major objective was to determine the impact of staffing mix on nursing residents' quality of care and life Resident satisfaction with life in the nursing home is a key element in determining the quality of care and quality of life provided Both the literature review and the study objectives supported the view that resident outcome can be collected through assessing the quality of care and the quality of life, through assessment by informed observers using instruments derived from explicitly stated standards, and through eliciting the perceptions of residents themselves A schedule designed to measure satisfaction with care was developed and resident interviews were undertaken using this measure and the Life Satisfaction Index (A) The majority of responses to the resident satisfaction schedule were positive The high percentage of positive responses did not correlate with the observations of the research assistants and there was some concern that while residents were able to assess care they were reluctant to criticize the staff or their behaviour     

Selecting a database for literature searches in nursing: MEDLINE or CINAHL?

This study compares the usefulness of the MEDLINE and CINAHL databases for students on post-registration nursing courses We searched for nine topics, using title words only Identical searches of the two databases retrieved 1162 references, of which 88% were in MEDLINE, 33% in CINAHL and 20% in both sources The relevance of the references was assessed by student reviewers The positive predictive value of CINAHL (70%) was higher than that of MEDLINE (54%), but MEDLINE produced more than twice as many relevant references as CINAHL The sensitivity of MEDLINE was 85% (95% CI 82–88%), and that of CINAHL was 41% (95% CI 37–45%) To assess the ease of obtaining the references, we developed an index of accessibility, based on the holdings of a number of Irish and British libraries Overall, 47% of relevant references were available in the students' own library, and 64% could be obtained within 48 hours There was no difference between the two databases overall, but when two topics relating specifically to the organization of nursing were excluded, references found in MEDLINE were significantly more accessible We recommend that MEDLINE should be regarded as the first choice of bibliographic database for any subject other than one related strictly to the organization of nursing     

Can concept mapping be used to promote meaningful learning in nurse education?

Recent changes in nurse education have led to a desire in nurse educators to promote meaningful learning rather than rote learning of facts A major metacognitive learning strategy that appears to promote this is concept mapping However, many nurse educators appear to be unaware of this strategy's existence, or of the research evidence available that supports the claim of promoting meaningful learning This paper sets out to address these issues It explores the nature of a concept map, the research on concept mapping and meaningful learning and possible reasons why its use has not been noticeable in nurse education By addressing these issues it is hoped that more nurse educators will attempt to use concept mapping in the promotion of meaningful learning     

Elderly care recipients in a Swedish municipality living in their own homes: their diseases, functional health status and care provided as reported by formal carers

The aim of this study was to investigate from the perspective of formal carers the care given to people aged 65 and over, who are cared for in their own homes by informal care. Thirty-three district nurses (DNs) and 20 home service assistants in a municipality with 13500 inhabitants (over 65 years old), were interviewed about the location of care recipients and 398 care recipients were located. Most of them were over 80 years old and had more than one disease (62%), mostly related to the circulatory system (27%). Dependence in three or more of the Katz ADL categories was seen in 30%, reduced mobility in 67%, reduced memory in 34% to a degree that restricted their everyday life and 34% of them could seldom or never be alone. Care had been given for three years or more for 57% of these people. The monitoring of the disabilities and reduced functional health status differed significantly between the diagnostic groups. Home help service was associated with the care recipients' ADL index but not with their need for continuous monitoring. The DNs' care did not relate to any of the variables. In conclusion, diagnoses, the care recipients ability to be alone and functional health status are important variables to include when assessing the demands for home care and when planning supplementary care for home care recipients and their informal caregivers.     

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     

Nurse teacher stress in Northern Ireland

Occupational stress among a 60% sample of all nurse tutors in Northern Ireland was investigated by means of the General Health Questionnaire (GHQ), Maslach Burnout Inventory and a stress questionnaire Seventy per cent of tutors judged themselves to be worse or much worse than usual on 45% of GHQ items Significant levels of moderate and high burnout were discovered on the sub-scales of emotional exhaustion and depersonalization, with an almost unanimous (95%) report of high burnout arising out of feelings of lack of personal accomplishment Male nurse tutors reported more frequent and more intense signs of burnout than their female counterparts at a statistically significant level of difference in emotional exhaustion ( P = 0 028 and P = 0 003 respectively) and in depersonalization ( P < 0 003 and P = 0 007 respectively) The work stressor most commonly identified by tutors (72%) was that of experiencing too little time to perform their duties to their satisfaction The most common request for help to alleviate workplace stress (61%) was for more support and appreciation from their seniors     

Clinical supervisors' views of their leadership role in the clinical supervision process within nursing care

The purpose of this study was to investigate nurse supervisors 'views of their supervisory styles, their personal qualities and their leadership role, and the development of these styles The sample consisted of 18 clinical nurse supervisors The data were collected by interviews using 15 open-ended questions, and a 10-item questionnaire, and the analysis was a combination of hermeneutical and factor analysis The analysis revealed two specific styles the emotional and the cognitive supervisory style The supervisors' personal qualities were willingness and preparedness to show understanding, bringing out genuine feelings and 'confirming', the latter being the most important in the nurse supervisors 'styles The supervisors' views of their leadership role showed that high values were given to the following three factors techniques in providing clinical supervision, responsibility for facilitating process, responsibility for creating a climate conducive to supervision and focusing on the main themes     

A study of consumer-defined need amenable to community nursing intervention

This paper describes the first stage of a research project investigating unmet needs for community nursing services The research analyses the relationships between differences in perception of valid needs between the public and staff, ways of working and organizational constraints on community nursing practice, and the incidence and nature of consumer-defined unmet needs The aim of the first stage was to analyse the level and kind of consumer-defined need anemable to community nursing intervention and identify possible shortfalls in current provision The study used a postal questionnaire and samples were selected using proportional, stratified random sampling from a Community Health Index The sample size was 1770 and the response rate 38% Analysis involved frequency counts for all variable data and statistical analysis of relationships between variables, using the chi-square test with the level of significance set al 5% Analysis of the questionnaire identified possible latent need in relation to activities of daily living and health problems The 57–69 and 70 + age groups were found to have the highest level of self-perceived difficulties with the above, many of which were said to be unmet Fewer respondents in the younger age groups experienced these difficulties, however, those who did were less likely to be receiving help In most cases, respondents with perceived unmet needs had never sought help In relation to community nursing, this may be associated with the lack of knowledge and misconceptions about the roles of community nurses which were identified from questionnaire responses The study also indicated possible unmet need among carers for education and guidance about the services available for them and how to gain access to them Possible unmet need was identified in relation to health promotion activities Analysis of attendance and interest in health groups and sessions suggested the need for more of this type of activity and more education on the possible benefits which can be gained from them     

Patient Advice and Liaison Services: strengthening the voices of individual service users in health-care organizations

OBJECTIVE: To explore the roles of Patient Advice and Liaison Services (PALS) in their interactions with service users. CONTEXT: Every National Health Service health-care provider in England now has a PALS, which provides service users with information and help in resolving concerns and dissatisfactions with health care. DESIGN: Longitudinal qualitative study, 2002-4. This paper draws on data from 27 semi-structured interviews. SETTING AND PARTICIPANTS: PALS personnel working in six case study PALS in London. FINDINGS: PALS personnel adopt seven roles in order to support their clients in sorting out problems with health care: information provider; listener; messenger (passing on information from service users to staff); go-between (passing information forward and back); supporter (helping service users to present their own views); mediator (when two or more parties are in dispute); resource mobilizer (when the support of senior staff or other agencies is necessary to resolve a problem). CONCLUSIONS: Though these are not new functions, PALS is a universal service which is better placed than front-line health-care staff to offer such support, and increases choice for service users looking for sources of information and advice.