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The development of instruments to measure clinical competence in nursing shows little evidence of a systematic approach and studies of reliability and validity are absent. The present study was carried out using data on practice assessment collected in the course of a post-registration nursing programme. The data were analysed for internal consistency and intra-rater reliability. The instrument used to assess practice in the present study is highly internally consistent and there is evidence to support intra-rater reliability. However, further development and testing of the instrument is required.  相似文献   
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This paper describes a district nursing study that considered the experiences and responses of primary health care professionals and their patients to changes taking place within the community. As a qualitative study it employed interviews as the main method of data collection and was informed by both ethnography and interpretative phenomenology. Forty-three study participants were interviewed, eliciting opinion on whether care is more than just a hands-on activity, whether patient need is being met and to what extent service policy is in tune with care delivery. Describing the views of primary health care professionals and patients in order to illustrate the complexity of the district nursing service and professional roles, the paper finds little shared vision between staff and managers of each other's responsibilities. It concludes that a more holistic approach to understanding professional roles is needed in order to satisfy the differing agendas of managers, staff and patients. It propounds the need for closer collaborative practice between health care professionals, for it finds that they value the ability to communicate as an essential element of their jobs. It reflects that, without such collaboration, it will be difficult for nurses to take a lead position on changes shaping community care.  相似文献   
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This paper examines one study of nursing practice that utilized ethnography as a research approach. The general overview of the ethnographic method and the symbolic interaction framework used are described. An overview of the specific approach is included. The findings of the study are presented. The strengths and problems of the approach for nursing research are then reviewed. Some potential uses of an ethnographic approach for clinical nursing research are outlined.  相似文献   
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