AIM: The aim of the study was to describe nurse managers' conceptions of quality management in their work as promoted by peer supervision. BACKGROUND: Quality management is one of the topical issues in a nurse manager's demanding and changing work. As first-line managers, they have a key role in quality management which is seen to create the system and environment for high quality services and quality improvement. Despite the official recommendations and definitions of quality management, several published reports have shown that there is no single solution for quality management. Peer supervision or the support provided by it to nursing managers have rarely been a subject of study. This study was carried out at Tampere University Hospital between 1996 and 1998. The peer supervision intervention was organized once a month, 2 hours at a time and in closed supervisor-led groups of nine nurse managers. METHODS: Data were collected by themed interviews. Fifteen nurse managers participated in the study. The data were analysed using the phenomenographic method. FINDINGS: Two main categories were formed of nurse managers' conceptions. The first described supportive and reflective characteristics of peer supervision. This main category was described by horizontal, hierarchical categories of support from peer group and reflection. The second main category described nurse managers' conceptions of individual development of leadership during peer supervision. This main category was also described by three horizontal categories: personal growth, finding psychological resources and internalization of leadership. CONCLUSION: The finding of this study show that peer supervision benefited nurse managers in quality management through reflection and support. The reflective and supportive characteristics of peer supervision promoted the nurse managers' individual development, but also that of leadership. It can be concluded that peer supervision promotes quality management in nurse managers' work. 相似文献
Hakulinen T, Paunonen M, Laippala P. International Journal of Nursing Practice 1997; 3: 247–254 Relationships between demographic variables and family dynamics of childbearing families In this study relationships between demographic variables and family dynamics of childbearing families in Finland were studied. The sample was 160 urban families expecting their first or second child in the third trimester of pregnancy. One-hundred and eighteen families participated in the study. The Family Dynamics Questionnaire (FDQ) and the Family Dynamics Measure (FDM) were used in this study. Most expectant parents reported their family was well-functioning. Mothers of higher socioeconomic status found more flexibility in their families than mothers of lower socioeconomic status. Fathers in families expecting their first baby reported more mutuality, role reciprocity and more stability than second-time fathers. The findings contribute cues for public health nurses and midwives regarding parity, socioeconomic status and family dynamics to provide more specific family guidance during the transition to parenthood. Realistic information on the changes in family dynamics after childbirth should be given to pregnant parents. 相似文献
MicroRNAs (miRNA, miR) are negative regulators of gene expression that play an important role in diverse biological processes such as development, cell growth, apoptosis and haematopoiesis, suggesting their association with cancer. Here we analysed the expression signatures of 157 miRNAs in 58 diffuse large B-cell lymphoma (DLBCL), 46 follicular lymphoma (FL) and seven non-neoplastic lymph nodes (LN). Comparison of the possible combinations of DLBCL-, FL- and LN resulted in specific DLBCL- and FL-signatures, which include miRNAs with previously published function in haematopoiesis ( MIRN150 and MIRN155 ) or tumour development ( MIRN210 , MIRN10A , MIRN17-5P and MIRN145 ). As compared to LN, some miRNAs are differentially regulated in both lymphoma types ( MIRN155 , MIRN210 , MIRN106A , MIRN149 and MIRN139 ). Conversely, some miRNAs show lymphoma-specific aberrant expression, such as MIRN9/9* , MIRN301 , MIRN338 and MIRN213 in FL and MIRN150 , MIRN17-5P , MIRN145 , MIRN328 and others in DLBCL. A classification tree was computed using four miRNAs ( MIRN330 , MIRN17-5P , MIRN106a and MIRN210 ) to correctly identify 98% of all 111 cases that were analysed in this study. Finally, eight miRNAs were found to correlate with event-free and overall survival in DLBCL including known tumour suppressors ( MIRN21 , MIRN127 and MIRN34a ) and oncogenes ( MIRN195 and MIRNLET7G ). 相似文献
Case history, light and electron microscopic findings of a case of a lymphocytic hypophysitis in coincidence with a suprasellar germinoma in a 12-year-old girl are reported. The girl presented with a long time case history of diabetes insipidus and subsequent panhypopituitarism. Two years after the diagnosis of diabetes insipidus magnetic resonance imaging (MRI) showed a tumorous enlargement of the sellar content and pituitary stalk. A transnasal exploration was initially performed and revealed a lymphocytic hypophysitis. Light microscopy showed a dense infiltration of mature lymphocytes and plasma cells in the interstitium of the anterior pituitary gland. The stalk area could not be exposed to exclude a germinoma. One year later the lesion relapsed despite dexamethason therapy and a second operation by another neurosurgeon had to be performed. Light microscopy showed lymphocytic infiltrates, fibrosis and necrosis. The diagnosis was a lymphocytic hypophysitis again. Though transcranially exposed only pituitary tissue was removed. No infundibular mass became visible at surgery as shown by MRI. The girl developed five months later multiple cerebral lesions, which revealed to be a germinoma. Lymphocytic hypophysitis in children is very rare and a coincedence with a germinoma has not been described from histopathological aspect until now. The origin of the pituitary infiltration is discussed. 相似文献
Objective. This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies.
Design. A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases.
Results. Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards.
Conclusions. Cultural-level variables may account for the development of adolescent BD. 相似文献
The current study investigated the impact of physical disability on sexual feelings, sexual experiences, and sexual esteem. Thirty-five respondents (18 males and 17 females), with physical disabilities between 19 to 60 years (SD = 10, mean = 38) participated in focus groups where they discussed how their physical disability impacted on their sexuality. They also responded to a series of questions that were designed to examine disability-specific issues in sexual esteem using a four-point Likert-type scale. The data demonstrated that the participants struggled with many social and sexual barriers that were associated with having a physical impairment. This appeared to lead to increased feelings of negativity in many participants, including a belief that they were less sexually desirable than an able-bodied person and that having a disability seriously limited their sexual expression. The implications of these findings for practitioners and suggestions for future research are discussed. 相似文献
Goals of work The purpose of this study was to better understand various variables related to food intake and eating problems in children with cancer during their chemotherapy.Patients and methods Twenty-two consecutively admitted children, diagnosed with cancer and undergoing chemotherapy, participated in this study. Twenty-one of them, their parents and attending nurses participated in semi-structured interviews. Ten of the children underwent a taste acuity test, and recognition thresholds for the four basic tastes were determined.Main results The shared view of both children and parents was that altered taste was the predominant cause of the eating problems. In contrast, the nurses perceived that nausea was the most important cause of the children’s eating problems. In addition, psychological aspects such as learned food aversions and negative attitudes towards hospital food were regarded as important by children, parents and nurses. The taste test showed that the patients had higher thresholds for bitter taste and made more taste recognition errors compared to controls.Conclusions Changes seem to exist both in the primary gustatory sense as well as in food perception in paediatric cancer patients undergoing chemotherapy. Single solutions, such as efforts to serve “tasty food”, do not suffice alone. A more effective solution may be to combine different strategies and combinations of oral, enteral and parenteral nutrition should be considered to prevent malnutrition. 相似文献