Mental health literacy survey of psychiatrically and generally trained nurses employed in a Singapore psychiatric hospital

Mental health literacy studies consider the capacity of respondents to recognize certain psychiatric disorders, judge the comparative utility of a range of interventions, and make estimates about outcome and prognostic issues. We report such a study involving a sample of nursing staff employed at a large psychiatric institution in Singapore, and who were provided with separate brief vignettes of mania, schizophrenia and depression. Subjects were highly accurate in 'diagnosing' schizophrenia, less accurate for depression and even less accurate in diagnosing mania. Depression was alternately diagnosed as stress, mania was most commonly misdiagnosed as schizophrenia, and for both psychotic conditions, a percentage returned non-psychotic diagnoses. In terms of treatment options, staff distinctly favoured a 'medical model' and viewed traditional and alternative healing options as distinctly harmful. Analyses contrasted psychiatrically trained and generally trained nurses, but identified few significant differences. Such information has the potential to shape the education and training of mental health professional staff, as well as provide important insights about how nurses may diagnose, view and favour alternative treatments and strategies to assist those with common psychiatric disorders.     

Control beliefs of orthopaedic nurses in relation to knowledge and prevalence of pressure ulcers

Data are reported from a larger study of perceptions of locus of control and value of pressure ulcer prevention to show the position of orthopaedic nurse control beliefs, their departmental knowledge level, and their value of pressure ulcer prevention relative to that of staff in other specialties. The survey population consisted of trained and assistant nursing staff in both hospital and community settings of a rural Health Service Trust. Overall results showed that key personnel, such as sisters, were significantly associated with prevalence, in that the more they believed they controlled pressure sore prevention, rather than the patient, the higher the prevalence. This has been explained using locus of control typology. The more it was thought that fate controls pressure sore prevention, the lower the departmental prevalence. Further, beliefs about specific conditions (e.g. pressure ulcer prevention) may be less important than generalized beliefs about control in terms of reducing prevalence.It is suggested that the study is replicated and refined, and that the value of pressure sore prevention needs raising. Certain types of attitudes amongst staff may be unhelpful in a broader range of conditions and outcomes. There may be a need to change control expectations of groups of personnel in order to protect patients.     

Evidence-based practice in Health Visiting. National conference organized by the Royal College of Nursing Health Visitors Forum, held at the Business Design Centre, Islington, London, England, 30 May 1998

The message that was conveyed throughout this conference, which attracted delegates from the four countries of the United Kingdom (UK), was that health visiting evidence-based practice was welcomed but it had to be tempered by information gleaned from clients' views and choices and professional experiences.     

The knowledge and attitudes of mental health nurses to electro-convulsive therapy

Three hundred and forty-five questionnaires containing the knowledge and attitude scale for ECT devised by Janicak et al . (1985 ) were distributed to mental health nurses working in Wales, the data were collected from the 167 returned. Limitations in the reliability of the instrument with respect to the degree of internal consistency were found, this suggested that the knowledge statements used were inconsistent in providing a reliable measure of respondents knowledge of ECT. Findings suggested that a higher level of knowledge appeared to be associated with the length of experience of the nurse and their area of clinical practice. In addition, there were substantial variations in actual knowledge, particularly with regard to cognitive side-effects with ECT. Attitudes to ECT in this study were significantly related to the place in which the nurse was practising and the degree of contact the nurse had with patients receiving the treatment. Greater knowledge scores were obtained by those nurses who indicated a more positive response towards ECT. The conclusions suggest that knowledge of ECT required improvement in many cases, and this has implications for nurse education. A relationship between knowledge and attitudes appears to exist in this study, however, such a relationship would need to be tested further in future research.     

Politics and professionalism in nursing

Nurses are increasingly being urged to become more politically aware and active. The relationships between political awareness, political activity and professionalism are explored, and it is argued that until nurses recognise and utilise the power engendered by their special and unique expertise they will not achieve professional development. It is particularly crucial that this fact is recognised by nurse educators and that political awareness is accepted as a legitimate curricular goal of nurse training.     

Numerical measures of integration

In a previous article the authors showed how, by following the clinical careers of individual student nurses, one could paint a coherent and illuminating picture of opportunities for clinical learning on the wards. By observing and counting, and using only the simplest methods of calculation, numerical measures of comparison were constructed. Here the authors turn to the question of the integration of classroom and ward. Indices of integration between theory and practice were devised and computed for three sets of students in three different training schools (72 students in all). The results were used to answer the following questions, (a) Within each training school what was the degree of equality of educational opportunity? (b) For each hospital what is the maximum level of integration which the organization of training makes possible, and what was the actual level achieved? (c) What is the connection between the achieved levels of integration and the type of training scheme (modular, block, etc)?     

Action and reflection: practice and theory in nursing

There are three issues related to theory and practice in nursing which are continually problematic. These are: the separation of theory from practice; reality vs the ideal; and nursing adherence to a scientific paradigm versus nursing adherence to an arts paradigm. It is suggested that Shotter's 'theory of personal action' (1974, 1975) may form the basis for a resolution of these three issues. Applying Shotter's work, a nursing action may be defined as an action which is deliberately thought out and which has as its goal the benefit of the patient and client. The 'deliberate thought and goal' of the action which is an integral component of it then forms the basis of nursing theory which is concerned with reasons for and reflections on action. This immediately unites theory and practice as two components of nursing action. The use which could be made of the theory of personal action in nursing practice, research and theory building and nurse education is explored.     

Postoperative temperature and infection in patients undergoing general surgery

During a study concerned with postoperative hypothermia, Closs (1985) noted an association between patients' core temperatures in the immediate postoperative period and respiratory infection. In this paper, a small follow-up study is reported in which the relationship between postoperative temperature and the development of infection (respiratory, wound or urinary tract) was investigated in 41 patients who underwent general surgery. Aural and oral core temperatures were monitored at 270, 300 and 330 minutes following return to the ward postoperatively. In the week following surgery, patients were monitored daily for any sign or symptom of infection. Reference was made to the patient, nursing notes, medical notes and physiotherapist (when available). Seven of the 16 patients (44%) exhibiting an aural core temperature of greater than or equal to 37.8 degrees C between 270 and 330 minutes post-return to ward developed infection while five of the 25 patients (20%) exhibiting an aural core temperature of less than 37.8 degrees C developed infection. Oral temperature measurements (using ward mercury-in-glass thermometers) showed a very similar pattern. Overall, infection was detected in 12 of the 41 patients (29%) in the 6 days following surgery, 11 having a respiratory infection and one a wound infection.     

Clinical supervision: insider reports of a private world

An exploratory study, funded by the Department of Health, London and the Scottish Home and Health Department, Edinburgh, was conducted over an 18-month period to provide an informed view on possible assessment tools that could be used to assess the impact of clinical supervision (CS) in nursing and to report on the CS activities in 23 selected sites in England and Scotland. The study not only examined the utility of several standardized research instruments, to be reported separately, but also explored the experience of a small sub-sample of nurses ( n =34) engaged in CS, as supervisors and supervisees. Interviews were undertaken to help better understand some of the issues involved around the domains of structure, process and outcome. Respondents reported an enthusiasm for the opportunity to talk meaningfully to a trusted colleague about their personal circumstances at work. Such opportunities were particularly welcomed by nurses who wished to reflect upon their own practice with patients, especially when dealing with their clinical conditions which were upsetting, or otherwise challenging, and sometimes harrowing. Substantive and methodological areas of interest for future research are suggested.