Nurse teacher's clinical work: a survey report

This paper reports on the results of a survey of nurse teachers in four colleges of nursing in England (n = 126) Data were collected using a questionnaire survey In this survey a five-point Likert scale was developed from an earlier study, to explore nurse teachers' perception of their clinical role The findings indicate that a number of factors may be influential in the way in which nurse teachers approach their clinical activity This includes personal factors such as age, educational grade and the length of time spent working in nurse education Organizational factors also appear to make a difference in the teacher who worked in an organizational model which ensured a smaller number of link ward areas were more likely to exhibit a positive orientation towards clinical work Factor analysis of the clinical scale resulted in loading of items relating to confidence in clinical role, preparation for the role, influence in clinical area and supervision of students in clinical areas The implications of these findings are discussed     

The clinical role of the nurse teacher: a conceptual framework

A small scale qualitative study explored the clinical role of the nurse teacher and concluded by proposing a conceptual framework that seeks to illustrate how nurse teachers manage the clinical aspect of their work. Three conceptual categories (role clarity, fitting in and role justification) are proposed as a means of describing how the respondents approached their clinical role.     

Philippine guidelines on the screening for tuberculosis prior to the use of biologic agents

Aim: To develop practice guidelines in tuberculosis screening of patients and their households and close contacts, prior to the use of biologic agents. Method: A technical research committee formulated an evidence‐based draft, based on existing literature regarding the tests used in tuberculosis screening among immunocompromised patients. The evidence‐based draft was then circulated to an expert panel. An en banc meeting of the panelists was held and a consensus was declared if more than 50% agreed on a recommendation. Issues not resolved by consensus were discussed by correspondence and voted upon. The guidelines were presented in a public forum and feedback by stakeholders were reviewed and integrated into the final draft. Recommendations: 1. Patients for biologic therapy should be screened for latent and active tuberculosis prior to initiating treatment. 2. All patients who are candidates for biologic agents should be screened by tuberculin skin test for latent TB, and a chest radiograph for active tuberculosis. 3. Household and close contacts of candidate patients should be screened for active tuberculosis. 4. All household and close contacts of candidate patients should be screened for active TB using chest radiograph. 5. Treat latent and active tuberculosis according to local guidelines. 6. Delay treatment with biologic agents in patients with latent or active tuberculosis. 7. Administer tuberculosis prophylaxis to the patient for biologic therapy exposed to household contacts with active tuberculosis. Conclusion: These recommendations emphasize the importance of screening patients, household and close contacts for latent and active tuberculosis prior to initiating biologic therapy.     

The learner-centredness of two registered general nursing and two registered mental nursing courses as perceived by third-year nursing students

Using the conceptual framework of the Nottingham Andragogy Group, two first-level British courses in general nursing and two in psychiatric nursing were studied to investigate their degree of perceived learner-centredness. Boydell's Scale for Measuring the Learner-Centredness of a Course was administered to a non-random sample of all 172 third-year students at three schools of nursing. Preference for learner-centred nursing education was investigated using Boydell's Preferred Teaching Style Rating Scale with the student sample and by 31 nurse teachers. Results indicated that first-level nursing courses were perceived to be highly teacher-centred in terms of planning, direction, sequence, pace and evaluation of learning. The climate of learning proved to be moderately learner-centred though teacher-student relationships were perceived as formal. Variety of learning approach was seen as limited with a tendency towards positivism rather than relativism of knowledge. Both students and teachers of nursing expressed a slight preference for teacher-centred courses despite the former's dissatisfaction with lack of participation in determining learning objectives. Significantly greater perceived learner-centredness of a psychiatric course was attributed to variations in the philosophy of learning within a particular school rather than to the course per se.     

The reflective dialogue and repertory grid: a research approach to identify the unique contribution of nursing, midwifery or health visiting to the therapeutic milieu

This paper seeks to demonstrate the use of two research methods within the interpretive paradigm the reflective dialogue and the repertory grid At first sight, the use of these two methods might appear contradictory, however this paper seeks to demonstrate the complementary fashion in which both techniques elicit rich and contextualized data Both methods use extended interviews to illuminate practitioners' perceptions about their unique contribution to the therapeutic milieu The approach primarily seeks to identify how practitioners' perceptions alter in the light of contextual change and seeks to enable practitioners to identify their developmental needs to meet future challenges Fundamental assumptions underpin the approach reciprocity, the equality of researcher and participant, and that research can be an act of empowerment and education These issues are explored throughout the paper which closes with an invitation to add to the debate about the evolution of such an approach     

Reluctant collaborators: do patients want to be involved in decisions concerning care?

Against the background of the popularity of the concept of 'patient collaboration' in care, this paper describes, from the frame of reference of the patients, how they perceive being involved in decisions concerning their own treatment and nursing care. A convenience sample of 12 patients were selected. The data collection and analysis were informed to some extent by the approach known as grounded theory. Although only 12 in-depth interviews were conducted, one major theme emerged from the data and that was named 'toeing the line'. The data suggests that some patients are more concerned about doing what is right, that is, pleasing the nurse, than participating in decisions concerning care. It is contended that if nurses adopt practices which encourage involvement they may unwittingly coerse patients to comply. It is argued that patients will accept this situation even if they do not wish a collaborative role. Despite the small sample size, interesting questions are raised concerning the underlying rationale of patient involvement. The conclusion is drawn that promoting individualized care is not necessarily synonymous with active patient involvement as advocated in much of the literature.     

Exploring the value of clinical nursing practice: the practitioner's perspective

This paper describes a preliminary study which attempted to explore the value of nursing practice from the viewpoint of practitioners The objective was to further knowledge and develop insights into nursing practice, identifying concepts central to therapeutic care Integral to the study was the development of a model for reflective practice     

Development of a questionnaire for identification of the risk factors for osteoarthritis of the knees in developing countries. A pilot study in Iran and Bangladesh. An ILAR–COPCORD phase III study

Background: Knee osteoarthritis (OA) is one of the most prevalent rheumatic disorders in the Asia‐Pacific region. Identification of modifiable risk factors is important for development of strategies for primary and secondary prevention of knee OA. Objective: Developing a core questionnaire for identification of risk factors of knee OA at the community level. Methods: Steps performed: (1) item generation from literature, existing knee OA questionnaires and patient focus group discussions; (2) development of a preliminary APLAR‐COPCORD English questionnaire; (3) translation into target language, back translation and development of a pre‐final target language version; (4) adaptation of the pre‐final target language version through tests of comprehensibility, content validity, test–retest reliability; and (5) finalization of the English questionnaire. Investigators in Bangladesh, Iran, China, Philippines and Indonesia participated in steps 1 and 2. Subsequent steps were carried out by Bangladeshi and Iranian investigators. Results: Fifty‐three items were generated. Fourteen were obtainable from physical examination and placed in an examination sheet. Two radiological items were not included. A preliminary English questionnaire comprising the remaining 37 items was constructed and translated into Bengali and Persian. The preliminary Bengali and Persian versions were adapted as a result of tests of comprehensibility, content validity and test–retest reliability. The English questionnaire was adapted through repeated exchange of ideas and experiences among participating investigators. A 35‐item English core questionnaire was finally developed. Conclusion: The questionnaires may be used to identify risk factors of knee OA in Asia‐Pacific communities after validation and further adaptation. From these data strategies for primary and secondary prevention of knee OA can be developed.