Negotiating Relationships in Single‐Mother Households: Perspectives of Children and Mothers

Little research has considered the nature of parent‐child relationships in stable single‐parent households that have not undergone transitions such as divorce and repartnering. This study explored how single mothers and their children negotiated their relationships in a context where the mother has been parenting alone continuously from early in the child's life. Thirty‐eight children and adolescents and their mothers participated in qualitative semistructured interviews. Both mothers and children characterized their relationship as highly intense and exclusive. Perceived limitations in mothers' resources yielded opportunities for shifting dynamics of power and dependence where children adopted an ethic of care in their relationships with their mothers. In response to this, mothers worked to reaffirm clear distinctions between parent and child roles and protect against role boundaries becoming blurred by exercising their authority and managing children's exposure to household responsibilities. These findings provide insight into how mothers and children negotiated interdependence as they moved functionally between vertical and horizontal interactions in their relationship.     

A service evaluation describing a nurse‐led prostate cancer service in NHS,Ayrshire and Arran

From 1999, the NHS Ayrshire and Arran Health Board implemented an innovative nurse‐led collaborative care model for the management of patients with prostate cancer (PC). This article describes the model and presents the results of a local evaluation to assess its impact. The evaluation comprised a retrospective audit of the service against national standards for PC management, undertaken in 2012. Seventy‐one patients, who were under the care of the service during June 2008, were included. Patient and staff satisfaction were also assessed using questionnaires distributed to 75 patients undergoing outpatient or telephone reviews during April 2012 and 7 one‐to‐one semi‐structured staff interviews. The patient audit showed good compliance with standards relating to selection of appropriate PC treatments according to tumour stage and grade; radiotherapy dosing and referral‐to‐treatment times. Areas requiring improvement were the documentation of patients' risk and performance status and provision of verbal and written information to patients and carers. Seventy‐three per cent of the patient questionnaires were returned, with 96% of respondents rating their overall care as ‘excellent’ or ‘very good’. Staff satisfaction was also high and interviewees described many benefits of the service for patients, hospital staff, GPs and the NHS/health board. Negative responses related mainly to demand/capacity issues. Overall, the evaluation showed good compliance with many national standards and high levels of patient and staff satisfaction. This suggests that with trained and competent nursing staff and collaborative multidisciplinary team working, safe and appropriate care can be achieved for more complex, as well as very stable PC patients.     

Sexual boundaries in the relationship between clients and clinicians practising sexology in the UK

Abstract

A survey was carried out with the collaboration of seven European countries to identify clinicians working within the field of sexual and psychosexual medicine, and to gain insight into the varied practices of physicians, psychologists, nurses and therapists in this area. In the UK a questionnaire was sent to 2352 potential practitioners working in the field of human sexuality, of which 814 responded detailing their training, professional practice and opinions about sexology. Clinicians were categorised by their initial training as either physicians or non-physicians. A total of 279 physicians responded and 535 non-physicians. One area of investigation was the relationship between clients and their doctor or therapist, exploring the extent to which boundaries and in particular sexual boundaries are appropriately maintained. This paper seeks to explore the issues surrounding breach of boundaries by therapists and doctors working in sexology, including our findings on the extent to which various sexual practices or clients' sexual experiences have made clinicians feel uncomfortable.     

Validation Study for Impaired Personal Boundaries, Proposed Nursing Diagnosis

The authors propose a new nursing diagnosis of impaired personal boundaries based on their experience in psychiatric nursing, a concept analysis of the literature and diagnostic content validation by a panel of experts. Impaired personal boundaries are common in a number of mental disorders including, schizophrenia, borderline personality, substance abuse and enabling. Recognition of this patient problem has implications for further research and nursing interventions.     

Autosomal-dominant Parkinson's disease linked to 2p13 is not caused by mutations in transforming growth factor alpha (TGF alpha)

Summary. A susceptibility gene for Parkinson's disease (PD) with late onset and typical Lewy-body pathology maps to chromosome 2p13 (PARK3). In the present study we examined the gene for transforming growth factor alpha (TGF alpha), which is located in the PARK3-region, as a potential candidate gene. This polypeptide mitogen exerts trophic actions on dopaminergic neurons and TGF alpha-deficient mice have fewer dopaminergic neurons. We did not find mutations in the exonic or exon-flanking intronic sequences of index patients of two families linked to 2p13. This result excludes mutations in the coding region of TGF alpha as a cause for hereditary PD, but does not rule out a possible role of sequence variants in regulatory regions or splice sites. Received March 12, 2001; accepted April 27, 2001     

Blurring, moving and broken boundaries: men's encounters with the pregnant body

Abstract This paper draws on the findings of a longitudinal ethnographic study of men's transition to fatherhood, conducted in the United Kingdom (UK). It is concerned with their encounters with the pregnant and labouring body. Until relatively recently there has been surprisingly little work, either theoretical or empirical, on the experience of pregnant embodiment. Work in the last decade has indicated that women's experience of ‘being‐with‐child’, their experience of living in and being a pregnant body, can be an ambivalent affair, as some find disconcerting the experience of simultaneously being self and yet Other. If women, who possess the embodied and therefore privileged knowledge of pregnancy, can feel ambivalence, perhaps the case for expectant men is more so. This paper draws on interviews with men making the transition to fatherhood and analyses their experiences of and relation to the pregnant and labouring body. The theoretical analysis of their empirical accounts explores in particular the blurring, moving and broken boundaries of the pregnant and labouring body and how these changing body boundaries can challenge the taken‐ for‐granted assumption that bodies should always be contained, strong and firm. The implications of men's encounters with this ‘differently bounded’ body are examined.     

Interprofessional relations between doctors and nurses: perspectives from South Wales

Interprofessional relations between doctors and nurses: perspectives from South Wales This paper discusses findings from a study of interprofessional relationships between doctors and nurses in medical wards in three provincial general hospitals in south Wales. The aim of the research was to investigate the changing nature of doctor-nurse relations, and in particular, how far the notion of the doctor-nurse game, as developed by Leonard Stein (Stein 1967, 1990), remains relevant to contemporary hospital work. The present paper concentrates on a subset of the findings concerned with doctors' and nurses' accounts of the hospital division of labour and the extent of any overlap in their work activities. Semi-structured interviews were conducted with 20 doctors and 39 nurses in their places of work over a period of 4 months. Inductive analysis of the data indicated that, whilst doctors and nurses perceived their roles in largely traditional terms, there was some recognition of blurring of occupational boundaries, especially when considering work pressures, working at night and differences in practice in more specialized clinical areas. Although nurses were generally reluctant to challenge doctors' authority, some used the notion of patient 'advocacy' to frame and justify their questioning of particular decisions. Whilst doctors valued 'experience' in nurses and saw experienced nurses as the group who might most legitimately move into doctors' territory, nurses valued formal education and saw advanced nursing qualifications as the route to role expansion.     

Towards an understanding of the dynamic sociomaterial embodiment of interprofessional collaboration

Many notions of interprofessional collaboration appear to aim for the ideal of trouble‐free co‐operative communication between healthcare professionals. This study challenges such an ideal as too far removed from the complex and contested relations of power that characterise the albeit skilful everyday social interactions which take place within healthcare practice, along with the associated pragmatic compromises made by disempowered practitioners. It is noted that these may be facilitated by modes of comforting myth and denial. To underline this point, psychiatric illness diagnosis is used as an illustrative example of how a historically powerful societal discourse can become thoroughly entrenched. The influence of a paradigmatically dominant discourse is shown to extend beyond the repetition of narrative within open dialogue and debate and to continue as tacitly reflected patterns within unconsciously habituated behaviour and durable artefacts that crystallise future affordances and limitations on action. However, the authors conclude by introducing optimistic theoretical speculation around the dynamic social mechanics of reflexive awareness and creativity, as these emerge within moments of significant dissonance between dialectically interacting layers of individually internalised and contextually embedded discourse, conversation and direct experience.