Determining quality in a unit where nursing is the primary intervention

Determining quality in a unit where nursing is the primary intervention This paper discusses the use of a variety of quantitative and qualitative methods of measuring quality in a nursing unit. It reports the result of comparing the quality of nursing care between patients admitted to the nursing unit concerned (in Oxford, England) following admission to an acute ward, with patients who spent the whole of their hospitalization in an acute ward. The findings suggest that quality can be best assessed by using a number of methods, and the quality of nursing care delivered in a unit which focuses on therapeutic nursing is significantly and consistently higher than that delivered in acute hospital wards.     

It’s not just about heart failure – voices of older people in transition to dependence and death

This paper explores the experiences of older people living with heart failure and their transitions from independence to dependence and for some death. New Zealand’s ageing population is predicted to increase from 12% in 2001 to 25% by the year 2051, similar to the worldwide trend of ageing. A high proportion of these people will have one or more chronic illnesses. Associated with the increase in survival is a growing body of research examining the needs of the older person with heart failure and finding particular problems with end of life care. Older people face many challenges in living with their heart failure, in particular the transition to dependence. To study the transition a longitudinal qualitative study using General Inductive approach was used. Participants were interviewed every 3 months for a 12‐month period during 2006–2008. A total of 79 interviews with 25 people were completed. Our findings showed that transition was not a simple linear process with the older person moving from one phase to another; instead their experiences illustrated the complexity of transitions they faced and what helped them to manage these. The older people in this study illustrated the importance of trust in health professionals and believed they would receive good care. Their fears revealed concerns about being a burden as they deteriorate and becoming more dependent. Understanding the complex issues related to transition to dependence can provide health professionals with a framework for assessment and approaches to providing the support required.     

Theory of nursing as curriculum content

This article presents an introduction to theories of nursing, and a discussion of the structure of the discipline, its relationship to the nursing curriculum, and nursing theories as curriculum content. Some results of a content analysis of curricula for Australian post-basic clinical nursing courses are presented. Such curricula do not appear to afford much coverage of the nursing process and theories of nursing.     

Understanding intimacy as experienced by breastfeeding women

The woman who is breastfeeding her infant may experience intimacy in a variety of ways. The author explores some of those ways, starting with identity and the woman's intimacy with herself and proceeding to the woman's intimate interaction with her infant, partner, family, or significant friends. The characteristics associated with intimacy, such as reciprocity, mutual joy, harmony, concern for other, trust, and closeness, have all been described as part of successful breastfeeding experiences. Researchers have acknowledged the influence of emotional support on breastfeeding but have failed to recognize the dynamics of intimacy as other than physical or sexual. The popular concepts of intimacy as sexual and the breast as sexual derive from a male perspective, one that restrains and shapes women's attitudes toward breastfeeding. Research on this topic is required if professionals hope to help women and their partners to understand the psychosocial dynamics of breastfeeding.