Integration of therapeutic approaches: a new direction for mental health nurses?

In this paper, the author reviews the value of the taking up of a specific therapeutic school or base for practice in mental health nursing, such as cognitive behavioural therapy or client-centred therapy. This is examined against a background of increased interest in non-'purist' forms of therapeutic approach in the fields of psychotherapy and counselling. The common factors present in effective helping relationships are highlighted, along with a way of understanding the fundamental form of a given helping relationship which is perhaps independent of theoretical orientation. Thinking in this mode cuts across traditional 'models of nursing/therapy' speak. This may allow the mental health nurse to adopt appropriate client-need-driven interventions, which are not hamstrung by theoretical dogma. Given this, the paper suggests an 'honourable position' of eclecticism for mental health nurse education and practice.     

Therapeutic activities for people with dementia — what,why… and why not?

This paper reviews the literature pertaining to the provision of therapeutic activities for elderly people suffering from dementia. It relates both the provision of such activities, and the types of activity done, to the values and beliefs held by nurses and other professional carers. The range of therapeutic activities cited in the literature is explored, and reasons why activities are sometimes not offered to patients are discussed. Finally, research findings into the effectiveness and value of therapeutic activities for this group of people are reviewed.     

The integration of nursing and midwifery education within higher education: implications for teachers — a qualitative research study

This study was a qualitative narrative that reviewed the historical developments that led to the integration of nursing and midwifery education with higher education in the United Kingdom (UK). A sample of teachers was investigated with particular reference to role conflicts they may have experienced as a result of integration. In addition to this the views of established academic university staff were assessed. The methodology adopted for the research was an eclectic qualitative one, drawing on several approaches, and sought to enquire into individuals personal perception of these events. In this paper the progression of events, nationally and locally, that led to the educational reforms in nursing and midwifery in the 1990s are examined. This narration includes a brief history of the creation of a new university department. Following this there is detail of how data were collected and analysed from a teacher population within this new department. The findings, whilst difficult to generalize to the wider population of nurse and midwife teachers, demonstrate that the sample of teachers examined, all of whom have been involved in the process of integration, have been exposed to stress that has resulted in role conflict. Established university staff, however, were more objective, expressing some broad anxieties regarding the resource demands and research capability of the new department.     

Nursing assessment of clients at risk of deep vein thrombosis (DVT): the Autar DVT scale

Deep vein thrombosis (DVT) poses a threat to hospitalized clients' recovery It is preventable and the cost of treating this problem is considerably more than that of preventative practices Accurate DVT risk assessment facilitates the application of the most appropriate venous thromboprophylaxis Founded on Virchow's triad of risk factors in the genesis of deep vein thrombosis, the Autar DVT scale was developed as a predictive index The DVT scale is composed of the following seven risk categories increasing age, build and body mass index (BMI), immobility, special DVT risk, trauma, surgery and high risk disease The DVT scale was tested on two trauma wards and the study was essentially a data generating exercise Clinical data were gathered on 21 clients to validate the reliability, sensitivity and specificity of the DVT scale Pearson moment correlation coefficient (r) and total percentage agreement (T%) measurement yielded a value of rat 0 98 and a T% ranging between 70% and 87% respectively for both reliability studies Predictive validity of the scale calculated from a threshold score of 16 achieved 100% sensitivity and 81% specificity The Autar DVT scale has produced some interesting results and holds considerable promise as a predictive index However, as this was a small study further testing in diverse clinical areas of a large client population is recommended     

An examination of nurses'practices when performing aseptic technique for wound dressings

The purpose of this study was to establish if nurses'actions when carrying out'aseptic technique'using the'gloves technique'are simple and based on up-to-date knowledge and do not incur unnecessary wastage A sample of convenience was used involving 21 trained nurses Observation and formal interviews were used to collect quantitative and qualitative data Results showed that not all nurses in the sample applied a 'simple aseptic technique'The rationale for the practice of aseptic technique was not always research based, though other aspects of wound management were derived from research findings The study highlighted other areas of aseptic technique which require investigations     

Decision making in community nursing: an analysis of the stages of decision making as they relate to community nursing assessment practice

This paper considers the nature of decisions made in the context of community nursing practice, in the light of the stages of decision making distilled by Carroll & Johnson from the work of various theorists, and explores the relevance of each stage to community nurses 'decision making Illustrative examples of specific theoretical perspectives are included throughout the paper The discussion forms part of the literature review for research currently being undertaken by the authors into patient assessment by community nurses As decision making is a key element of community nurses' assessment practice, the paper argues that decision making theory forms a useful conceptual framework for investigating this aspect of community nursing     

Health promotion and health education: what role should the nurse adopt in practice?

Health promotion and health education: what role should the nurse adopt in practice? ¶ Health promotion is widely accepted as part of the role of the nurse, midwife and health visitor. Theoretical definitions of health promotion and health education are presented. The author suggests that a variety of different approaches to health promotion can be adopted by nurses in practice, including education, persuasion, manipulation and attempts to promote an environment where healthy decisions about lifestyle can be made. Each strategy is examined and the advantages and the ethical limitations are explored. It is suggested that nurses may theoretically accept the notion of being a health promoter, but that in the reality of practice, their role may be primarily that of the health educator. The importance of recognizing that there are a variety of determinants of health, including social and environmental factors, as well as individual lifestyle, is emphasized throughout the paper.     

Fund-holding and contracting for community nursing services: a selective review of the literature

In the context of social, political and economic pressures fund-holding has been described as the 'wild card' in the Health Care Reforms in the United Kingdom of the 1990s. Set against an international drive to reform health care and increase the efficient and effective use of resources, fund-holding by general practice is seen as one means of enhancing the contribution of a primary care led National Health Service (NHS). It is advocated that a primary care led NHS will enhance and strengthen the position of nursing in the health care context. In order to fully exploit such a position it is argued that primary care nurses must adopt a systems view, recognizing broader strategic issues upon which to base marketing approaches to the contracting process.