Triangulation: a means of reconciliation in nursing research

The nursing profession has adopted many of its theoretical foundations, including research approaches, from other academic disciplines This has resulted in the acceptance of one epistemological perspective to the exclusion of others In this context, the evolution of nursing research reflects a rather conservative approach The quantitative approach was the dominant paradigm of the 1950s, 1960s and during the 1970s and 1980s the research approach has been increasingly located in the qualitative paradigm It is noted that each research perspective has several inherent differences which give rise to a specific type of research endeavour Within the literature there is general support for the separateness of the quantitative qualitative paradigm However in accepting the inherent differences between the two methods, nurse researchers have been concerned that neither method in isolation from the other will truly provide an understanding of human beings and of their health-related needs, problems or nursing care Triangulation as a research strategy represents a means of integrating the two research approaches Triangulation, first used in 1959, is defined as a combination of multi methods in a study of the same object or event to depict more accurately the phenomenon being investigated The literature exploring the merits of triangulation is incomplete However, it is reported that triangulation, by reconciling the paradigmatic assumptions inherent to quantitative and qualitative methods, provides rich and productive data Triangulation does offer an alternative to the bi-polar quantitative and qualitative approaches and a means of reconciling the two methodological encampments     

A comparison of recovery following hysterectomy and major cardiac surgery

Although monitoring progress is an everyday nursing activity, methods currently employed remain relatively undeveloped. In the past most studies documented physical recovery, tending to focus upon complications such as infection rates, which are quantifiable. Patients' satisfaction with progress is seldom taken into account, although it may provide a more accurate reflection of progress. In this paper, recovery following major cardiac surgery and hysterectomy performed for benign lesions are compared in terms of psychological adjustment to the effects of surgery and resumption of a wide range of activities within and outside the home, in addition to physical progress. On the whole patients accepted the effects of hysterectomy and their own assessments of recovery proved favourable despite considerable residual physical problems of a minor but troublesome nature. In contrast, recovery from cardiac surgery was more difficult and proceeded more slowly, as expected following this major operation.     

Diabetic patients facing long-term complications: coping with uncertainty

A major problem of diabetes mellitus lies in its complications. Fourteen Type 1 diabetic patients with severe long-term complications were interviewed on two occasions with the aim of gaining a deeper understanding of their coping strategies. The study has a qualitative design and a grounded theory approach was used. The data-based categories 'Coming to terms', 'Keeping going' and 'Making sense' serve as a framework for the presentation of the substantive issues raised by the respondents. It was found that the problem of uncertainty featured prominently.     

Simulation: current status in nurse education

This paper suggests that in the light of recent developments in nurse education a review of available teaching and evaluation strategies is required. It is further suggested that the use of simulation for both teaching and evaluation purposes has much potential which has as yet to be fully exploited in nurse education.     

The problem of motivating teaching staff in a complex amalgamation

This paper addresses some of the problems brought about by the merger of a number of schools of nursing into a new complex amalgamation A very real concern in the new colleges of nursing and midwifery in the United Kingdom is the effect of amalgamation on management systems and staff morale The main focus of this paper is the motivation of staff during this time of change There is currently a lack of security amongst staff and in many instances the personal job satisfaction of nurse teachers and managers of nurse education has been reduced, which has made the task of motivating staff difficult Hence, two major theories of motivation and the implications of these theories for managers of nurse education are discussed The criteria used for the selection of managers within the new colleges, leadership styles and organizational structures are reviewed The amalgamations have brought about affiliation with higher-education institutions Some problems associated with these mergers and the effects on the motivation of staff both within the higher-education institutions and the nursing colleges are outlined Strategies for overcoming some of the problems are proposed including job enlargement, job enrichment, potential achievement rewards and the use of individual performance reviews which may be useful for assessing the ability of all staff, including managers, in the new amalgamations     

Career guidance during nurse training: findings from an exploratory study

This research into the career guidance experiences of nurses during their training was undertaken as an exploratory study upon which a series of larger studies will subsequently be based. Additionally, it contributed to a national cohort study of the careers of newly qualified registered general nurses. One hundred and twelve nurses were involved in the development and testing of questions for a postal questionnaire to be used in the cohort study of careers. Some problems encountered when investigating career guidance by questionnaire are described, in the light of which a revised research design is proposed and the career guidance experiences of 31 nurses presented. Twenty-one aspects of guidance were investigated, covering information and advice about applying for first post, post-basic courses and longer-term plans.     

Skills mix in Australian nursing homes

This study investigated the relationships between skills mix, resident dependency and the quality of care and life of residents in a stratified random sample of 200 non-government homes in four Australian states. The study considered various measures of skills mix including the qualifications of the staff (staffing mix), the exposure of staff to in-service training and the leadership style of the director of nursing. The only relationships found between staffing mix (that is, the proportion of qualified and unqualified staff) related to the positive effect of therapy staff on the variety of experience of residents. Significant relationships between a number of other components of skills mix and the outcomes of care were found. Specifically, exposure to in-service training of staff and the leadership style of the director of nursing affected quality of care. State enrolled nurses were found to be significantly less satisfied with their work than registered nurses or untrained nurse assistants. Further studies are suggested in these areas and a review of skills mix in relation to them is recommended.     

Universities and nursing education

Trends reflected by Department of Health and Social Security statistics on the nursing workforce are examined and the ratios between grades discussed. Recruitment into nursing degree courses in the UK is considered in relation to overall recruitment into nursing.
The somewhat ambiguous position of nursing degree courses in the UK leads into consideration of policy statements by the universities and the nursing profession. The importance of such policies is emphasized in the current financial climate, as are the potential contributions of university departments to professional debate, for example standards of care.
Comparisons are drawn between the goals of courses involving full-time studentships as opposed to part–time apprenticeships and the present boundaries between these noted, especially in relation to the expanding roles of courses.
On–going research into the preparation of nurse–tutors in the UK is mentioned, together with a preliminary analysis of the academic basis in the biological sciences possessed by learners and tutors. Out of this is derived a suggestion that the present–day shortage of nurse teachers could be helped by varying the existing patterns of recruitment, especially involving subject specialists in the biological, behavioural and social sciences.     

Moral reasoning and the student nurse

The traditional curriculum in nurse education has tended to emphasize the acquisition of knowledge and practical skills and to ignore, for the most part, close examination of the social and moral dimensions of the nuree's role. The authors suggest that we ought to include a much more substantial consideration of moral issues in the nurse education and, in particular, they argue that Kohlberg's model of moral development could provide a theoretical framework. This model is based on a cognitive-developmental approach in which an individual's level of reasoning is assessed by the use of a variety of hypothetical dilemmas. Kohlberg claims to identify six qualitatively distinct stages and argues that the transition from one stage to the next results from the individual's active attempts to resolve conflicts arising from moral dilemmas. Some suggestions are made about the ways in which discussion of moral dilemmas might be incorporated within a moral reasoning module in the nurse education curriculum and proposals are made for methods of teaching such a module.     

Use of implicit criteria in evaluation of mental nurses

This paper describes the development of an instrument based on implicit criteria currently used by mental nurses in deciding whether a nurse is a good or a poor mental nurse. Existing implicit means of assessing mental nurses in the form of ward reports have been found to be inadequate. The study consisted of two stages: firstly, the production of a preliminary questionnaire using statements describing good and poor mental nurses obtained by interviewing mental nurses; secondly, the production of an assessment instrument, the Mental Illness Nurses' Evaluation Test, derived from the results of factor analysing responses of mental nurses to the preliminary questionnaire. The criteria used to evaluate mental nurses that emerged in order of importance were benevolence-malevolence to other nurses, amiable-irascible, regard-disregard for patients, confident-uncertain, directive-non-directive and professional-unprofessional. The study exposes current values used in judging mental nurses and constitutes a first important step in developing a valid and reliable instrument in assessing mental nurses in terms of their prescribed role.