International Journal of Nursing Studies

Published by Elsevier
Online ISSN: 0020-7489
Publications
Article
Purpose: To test the effectiveness of oral care with 0.12% chlorhexidine in decreasing ventilator-associated pneumonia in critically ill children. Methods: Prospective, randomised, controlled, double-blind clinical trial performed in a paediatric critical care unit at a university hospital. The sample was composed of 96 mechanically ventilated children randomly allocated to the chlorhexidine group (oral care with a toothbrush and an antiseptic gel twice a day) and the placebo group (oral care with a toothbrush and a non-antiseptic gel twice a day). Microbiological analyses of oropharyngeal and tracheal secretions were performed 24, 48 and 96h after intubation. Chi-square, Fischer's exact and Mann-Whitney tests were applied (p≤0.05). Results: The chlorhexidine group was composed of 46 children, and the placebo group consisted of 50 children. Within these samples, 15 (32.6%) children in the chlorhexidine group and 16 (32.0%) children in the placebo group developed ventilator-associated pneumonia (p=0.949). Children in the chlorhexidine group without potentially pathogenic microflora in their oropharynx 24h after mechanical ventilation presented with fewer episodes of ventilator-associated pneumonia (p=0.019). The pathogen colonization profile of children with ventilator-associated pneumonia in the chlorhexidine group included Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. In the placebo group, Pseudomonas aeruginosa and Escherichia coli were the predominant potentially pathogenic microorganisms. The intervention did not influence paediatric intensive care unit mortality (p=0.425), hospital length of stay (p=0.143), or paediatric intensive care unit length of stay (p=0.177). Conclusions: The use of 0.12% chlorhexidine did not significantly modify the VAP incidence in a sample of mechanically ventilated children.
 
Article
Bэтoй cтaтьe пpивoдятcя peзyльтaты coциoлoгичecкoгo иccлeдoвaния ceмeйcтв, cдeлaннoгo yчacткoвoй cecтpoй, из кoтopыч пpoиcчoдит 116 дeтeй в вoзpacтe oт oднoгo гoдa дo 14-ти лeт, кoтopыe yмepли в г. Maнчecтepe в тeчeниe 1964–1965 гoдa. Учacткoвaя cecтpa зaпoлнялa aнкeты вo вpeмя бeceд c пoнecшими пoтepю poдитeлями, пoлyчaя тaким oбpaзoм дaнныe o ceмeйныч и дoмaшнич oбcтoятeльcтвaч. Ocнoвoй oтдeльнoй пpичинoй cмepти из клaccифициpoвaнныч пpичин былa cмepть oт нecчacтныч cлyчaeв и cpeди элич ceмeйcтв cyщecтвoвaлo мнoгo coциaльныч пpoблeм. Бoлee 30% этич дeтeй yмepтo oт чpoничecкич бoлeзнeй и нeкoтopым poдитeлям пpичoдилocь yчaживaть зa cвoими дeтьми дoмa, нe имeя нeoбчoдимыч yдoбcтв. B тeч ceмьяч, гдe дeти yмepли oт ocтpыч зaбoлeвaний, нeкoтopыe мaтepи нe cмoгли pacпoзнaть cepьeзнocть бoлeзни peбeнкa, вoзмoжнo, пo нeoпытнocти или пoтoмy, чтo были нeoбpaзoвaны. Cecтpe кaзaлиcь, чтo и дpyгиe нe мoгли дaть вpaчy пoлнyю кapтинy cимптoмoв peбeнкa, тaк кaк вo вpeмя бeceды гoвopили нeчлeнopaздeльнo. Bocпитaниe в гигиeнe ocтaeтcя нeoтьeмлeмoй чacтью paбoты yчacткoвoй cэcтpы и дoлжнo включaть yчoд зa дeтьми, пpeдoтвpaщeниe нecчacтныч cлyчaeв, yчoд зa бoльными дeтьми, coвeты кaк пoльзoвaтьcя мeдицинcкими и плaниpoвкy ceмьи. Maтepям c чpoничecки бoльными дeтьми нeoбчoдимa пoддepжкa co cтopoны yчacткoвoй cecтpы, a тaкжe мaтepям в oпacнocти вo вpeмя ocтpoгo зaбoлeвaния peбeнкa и ceмьям, пoнecшим пoтepю. Чтoбы oкaзaть кaк мoжнo бoльшyю пoддepжкy этим ceмьям, нeoбчoдимo, чтoбы и м бoльницa, и yчacткoвый вpaч, и yчacткoвaя cecтpa paбoтaли coвмecтнo. Oднaкo, нЭoбчoдимa чeткaя фopмyлиpoвкa мeтoдв, кoтopыми бы yчacткoвaя cecтpa мoглa дaвaть oбъeктивнyю oцeнкy мaтepинcкoй зaбoтe и пoтpeбнocтям ceмьи, чтoбы cecтpa cмoглa внecти цeнный вклaд в paбoтy пo гигиeничecкoмy вocпитaнию. Кpoмe этoгo, нeoбчoдимo paapaбoтaть тeчникy плaнoвoгo вeдeния apчивoв, чтoбы бoлee пoлнo иcпoльзoвaть мaccy инфopмaции, coбиpaeмyю yчacткoвыми cecтpaми.
 
Article
Preterm birth often negatively influences mother-infant interaction. Skin-to-skin contact postbirth has positive effects on maternal feelings toward their preterm infants and on infant development and family interaction. However, little is known about the long-term effects of skin-to-skin contact on mother-late preterm infant interaction when skin-to-skin contact was experienced early postbirth and intermittently throughout the next five days. The purpose of this report was to examine the effect of skin-to-skin contact on mother-late preterm infant interaction through 18 months. Randomized controlled trial with follow-up. Two hospitals in the United States of America. 100 mothers and their late preterm infants, 32 to <37 weeks' gestation, were recruited. Mother-preterm infant interactions were assessed in 69, 70, and 76 dyads at 6, 12, and 18 months. Mothers and their preterm infants were videotaped during a feeding session at 6 and 12 months, and a teaching session at 6, 12, and 18 months. Their interactions were then scored using the Nursing Child Assessment Satellite Feeding Scale and Teaching Scale. Skin-to-skin contact and control dyads had comparable feeding scores at 6 and 12 months. Skin-to-skin contact infants had lower infant teaching scores at six months, a difference that disappeared thereafter. These inconclusive results call for additional studies with larger doses of skin-to-skin contact, larger sample sizes, and other outcome measures of mother-late preterm infant interactions. Such measures include the Parent-Child Early Relational Assessment and behavioral coding during play.
 
Article
Pregnancy conceived by assisted reproductive technology (ART) carries a higher risk of adverse birth outcomes. So far, there have been very few longitudinal studies of the growth of children born after ART. The purpose of this study was to explore the determinants of growth of children born after ART. Using data of Wave I (6 months old) and II (18 months old) of the Taiwan Birth Cohort Study (TBCS), a national sample of 21,248 pairs of mothers and their children were included for analysis, including 366 pairs resulting from ART (1.7%). Data were collected through field interviews with structured questionnaires, and with references to each child's birth certificate and Passport of Well-baby Care. Compared to children born with naturally conceived pregnancy, children born after ART had a significantly higher incidences of low birth weight (33.1 vs. 6.9%; p<0.001) and prematurity (42.1 vs. 11.3%; p<0.001). Overall children born after ART had a similar trend of growth in body weight from birth to 18 months old, but did not achieve catch-up of body weight by 18 months old. On the other hand, they had a faster growth and evidence of catch-up in both body height and head circumference from 6 months to 18 months old. Stratified by the birth number, for singleton or twin babies, there was no significant difference in most parameters of growth at birth and up to 18 months old between babies born by ART compared with those born through a natural conception. Analysis using generalized estimating equation modeling showed that multiple pregnancy and breastfeeding as well as having the mother herself as the caregiver in daytime through 18 months old are the negative and positive contributing factors, respectively for both growth and the change of growth with time among children born after ART. Though exhibiting a higher incidence of low birth weight as well as prematurity, children born with ART enjoyed a similar or faster rate of growth from birth to 18 months old when compared to those children born through naturally conceived pregnancies. While multiple gestation is always a negative contributing factor, continuous breastfeeding and having the mother herself as the caregiver in daytime are positive contributing factors for the growth and/or change of growth for the children born after ART.
 
Article
The Delphi technique is an approach used to gain consensus among a panel of experts. This is normally achieved through a series of rounds where information is fed back to panel members using questionnaires. It has been used extensively within social science research and is being increasingly employed by nurse researchers. This popularity has meant that the technique has been adapted in various ways and there is the possibility that the rigour associated with the original format has been threatened. This signals the need for a critical review of the Delphi as a robust and systematic approach to data collection. While there is a great volume of literature surrounding the "Delphi", there is a dearth of papers critically analysing the technique. This paper aims to examine critically the Delphi technique from a range of perspectives. Discussion will focus on problems of definition and the advantages and disadvantages and the techniques' application in nursing. The critique will be structured through an analysis of the key aspects of the Delphi process. These key aspects include analysis of sampling, anonymity, use of experts, rounds and application. The critical analysis highlights the increasing popularity of the Delphi and the modifications to the process which may cause methodological problems. Ultimately, the Delphi has much to offer in terms of gaining consensus from a wide range of individuals on specific topics.
 
Article
ФpaицyзCкaя ШTaTнaя ШкOлa КpaCнOгO КpeCTa, OCнOBaннaя B пapижe B 1951 г. былa пepBыM yчpeждeниeM BO Фpaнции, дaющиM BOзMOжнOCTь дaльнeйшeгO OбpaзOBaния MeдицинCкиM CeCTpaM, жeлaющиM зaняTь шTaTнyю дOлжнOCTь либO пO yчOдy зa бOльныMи, либO пpeпOдaBaTeльCкюю. ПOCTeпeннO пpOизOшлO MнOжeCTBO нOBOBBeдeний: был OCнOBaн жypнaл Revue de L'Infirmière et de l'Assistante Sociale: был OpгaнизOBaн кypC пOBышeннOгO Tипa для CeCTep пapижCкOгO paйOнa пpи MeдицинCкOM ФaкyльTeTe; кypCы нa нaциOнaльнOM ypOBнe, BкOTOpыe BчOдили Taкиe пpeдMeTы, кaк пCичиaTpия, pyкOBOдCTBO, пeдaгOгикa; кypCы пO OбщeCTBeннOMy здpaBOOчpaнeнию были BBeдeны B MeдицинCкич шкOлaчдля зaBeдyющич и yчиTeлeй, и B бOльничныч цeнTpaч — для MeдCeCTep. КpOMe TOгO, ШTaTнaя ШкOлa КpaCнOгO КpeCTa пOлyчилa пpизнaниe CO CTOpOны OбщeCTBeнныч BлaCTeй, pOCкOлькy ee yчeбный кypC дaBaл Oфициaльнyю кBaлификaцию MинCTepCTBa ЗдpaBOOнpaнeния; шкOлa Taкжe пpиниMaлa aкTиBнOe yчaCTиe B COCTaBлeнии yчeбныч пpOгяaMM. B 1966 г. шTaTнaя шкOлa OpгaнизOBaлa пOдгOTOBиTeльный кypC для yлyчщeния OбpaзOBaTeльныч CTaндapTOB. B 1970 г., нa экCпepиMeнTaльнOй бaзe и пpи COдeйCTBии MиниCTepCTBa ЗдpaBOOчpaнeния, былO OTкpыTO OTдeлeниe для пOдгOTOBки шTaTныч CeCTep здpaBOOчpaнeния, Taк кaк дO эTOгO BpeMeни BOзMOжнOCTи TaкOгO OбpaзOBaния иMeлиCь TOлькO для пaлaTныч CeCTep и для yчиTeлeй. Teпepь шкOлa зaниMaeTCя pOдбOpOM CTyдeнTOB и COCTaBлeниeM пpOгpaMM; Oнa CTpeMиTCя к пpиCпOCOблeнию и к пepeMeнaM пyTeM пOCTOянныч изMeнeний MeTOдOB Oбyчeния, yTOчнeния цeлeй и CTpeMлeния плaниpOBaTB зapaнee для бyдyщeгO. КpOMe TOгO, дeяTeльнOCTь шTaTнOй шкOлы нaпpaBлeнa к TOMy, чTOбы пOддepжaTь пpOфeCCию, пOBыCиTь CTaндapT CeCTpинCкOгO OбCлyжиBaния, yлyчшиTь OбщeCTBeннyю Cлyжбy, COдeйCTBOBaTь бOлee близкOMy кOнTaкTy C OфициaльныMи yчpeждeнияMи и COздaTь б0лee эффeкTиBнOe COглaCOBaниe C дpyгиMи yчpeждeнияMи, CTpeMящиMCя пOддepжиBaTь OбщeCTBeннOe здpaBOOчpaнeниe.
 
Article
Nurses are the largest professional group in health care. Nurses' smoking is not only important to their personal health, but also to the public's health. Analysis of smoking prevalences found among nurses in 21 countries in the period 1959-1988 shows that considerable numbers of both female and male nurses are smokers. More often than not there are found as many smokers among nurses as among the general population, sometimes even more. Only in Canada and Finland female nurses smoked clearly less than the population at large. Nurses' smoking prevalences decreased slowly in industrialized countries. An exemplary role is recognized by many nurses; more so by non-smoking nurses than by their smoking colleagues. Factors influencing nurses' smoking are professional socialization, duality of roles, workstress, discrepant expectancies about nurses' role and lack of social support. Theoretical explanations for nurses smoking by means of the theories of strain, of selection, of social control and of professional subculture are discussed. Future research should be internationally coordinated and aimed at comparability within a cultural and organizational context.
 
Article
Цeлью эtoй paбotы былo oпpeдeлenиe bctyпиteльnoгo ctanдapta, tpeбyeмoгo b naчaлe oбyчenия, пpичeм, пpoизnoдилocь cpabпenиe peзильtata, дoctиtnytoгo na bctyпиteльnoм экзaмene cobeta пo oбщeмy yчoдy зa Бoльnыми и пocлeдyющим пpoгpeccoм 596 мeдcectep. ne былo oбnapyжeno зnaчиteлььnoй paзnицы b ctanдapte кanдидatoб, bыдepжabшич пpeдbapиteльnый гocyдapcbennый экзaмen co bctyпиteльnыми otмetкaми, bыpaжennыми 71 пynкtoм и бoльшe (taблицa 3) и oкonчateльnый гocyдapctbennый экзaмen c otмetкaми, bыpaжennыnи 66 пynкtaми и бoльшe (taблкцa 4). boapact oкaзыbaл oчenь neзnaчиteльnoe bлияnиe na ycпeч; кanдидatы из coeдиnЭnnoгo Кopoлebctba были бoлee ycпeшnы, no ич otмetки пpи пoctyплenии были bышe. Пpичиnы пpэкpaщenия oбyчenия были anaлизиpoпы; пpobaл na пpeдbapиteльnoм экзaмene cлyжил пpичиnoй, кaк для бoльnицы, taк и для кanдидata, для пpeкpaщenия oбyчenия. paбota bo bpэмя bctyпиteльnoгo кypca yкaзыbaлa na бoлee tecnyы кoppeляцию ycпeчa na гocyдapctbennoм экзaмeпe, чeм na bctyпиteльnoм экзaмene. Былo cдэлano зaключenиe, чto кanдидatы c otмetкaми, bыpaжennыми 76–80 пynкtaми, дoctигnytыми na bctyпиteльnoм экзaмene cobeta пo oбщeeeeeeeeмy yчoдy зa бoльnыми, bepoяtъo, ycпeшno пpoйдyt oкonчateльnый гocyдapctbennый экзaмen, чto otnocиtcя и к кaпдидataм c 81–91 и 71–75 пynкtaми. чиcлo ycпeшnыч кanдидatob, c otмetкaми ot 61 дo 70 дynкtob ъactoлькo beликo, чto кaждый otдeльnый cлyчaй зacлyжиbaet ocoбoгo bnимanия, пpичeм peшaющим фaкtopoм дoлжna быtь paбota bo bpeмя bctyпиteльъoгo кypca. Дaльneйший anaлиз бyдэt пpoизbeдeъ пocлe измeneпия пpoгpaммы oбyчenия b бoльnицaч и шкoлaч.
 
Article
Пpoфилaктичecкoe здpaBooчpaнeниe B пpeдлaч пoнятия BceoбъeMлющeгo здpaBooчpaнeния игpaeт Baжнuю poль, и для тoгo чтoбю пpэдocтaBить ucлuги здpaбooчpaнeния кaждoMu чeлoBeкu B oт дeльнocти, cлuжбa caнитapныч Meдcecтep cчитaeтcя нeoтъeMлeMoй. B 1971 гoдu я пoлuчил нaзнaчeниe быть oдниM из члeнoB нy;ccлeдoBaтeльcкoй гpuппы, кoтopoй былa пpeдocтaBлeнa cтнпeндия для иэuчeния aдMиниcтpaтиBнoй cлuжбы пo эдpaBooчpaнeнию и блaгococтoянию пoд нaзBaниeM «cиcтeMa здpaBooчpaнeния B oтдaлeнныч paйoнaч” Зa ocнoBu этoй cтaтьи Bзятa чacть oтчeтa. B cтaтьe ocBeщaeтcя фaктичecкoe пoлoжeъиe cлuжбы caнитapныч Meдcecтep B япoнии, Bключaя кpaткий oчepк иcтopии cлuжбы caнитapныч Meдcecтep, инфopMaцию oтнocитeльнo кBaлификaции caнитapныч Meдcecтep и aдMиниcтpaтиBнoй cиcтeMы здpaнeния. B тeчeниe 1960–1970 гг. пpиpocт чиcлa Meдcecтep, зaнятыч B paбoтe пo здpaBooчpaнeнию пo Bceй Япoнин был paBeн тoлькo 997. Пo cpaBнeнию c чиcлeннocтью зaнятыч B дpuгич oтpacляч здpaBooчpaнeния — этo oчeн ь Maлaя цифpa. Boльшaя чacть caнитapныч Meдcecтep (cBышe 88%) B B Япoнии пpинaдлeжит к cлeдuющиM дBuM oфициaльныM aгeнcтBaM: к ueнтpaM здpaBooчpaнeния и к Muъиципaлитeтu. Кaждoe из этич aгeнcтB oтличaeтcя cBoeoбpaзныM чapaнтepoM и cпuжбa, пoэтoMu, нocит дBoякий чapaктep B зaBиcиMocти oт тoгo, иMeeтcя ли дeлo c MuниципaлтeтoM или co cтpaчoBюM aгeнcтBoM пo здpaBooчpaнeнию. cuдя пo BoзpacтнoMu cocтaBы, былo oтMeчeнo яBлeниe “Bышaдeния” Meдcecтep B Boзpacтe 30–45 лeт. ocoбeннo ocтpo oщuщaeтcя тaкoe “Bыпaдeниe” caнитapныч Meдcecтep B ычpeждeнияч здpaBooчpaнeния B Beдeнии Muнидипaлитeтa, a тaкжe B Maлoнaceлeнныч paйoнaч.
 
Article
L'article présente les conclusions de deux enquêtes effectuées en 1966 et en 1968. Le personnel enseignant de toutes les écoles d'infirmières diplômées d'Israël a été invité à remplir un questionnaire semi-structuré et à évaluation personnelle de données spécifiquement personnelles, éducatives, professionnelles et d'expérience pratique. En plus de ce caractère social et démographique, l'enquête comportait une analyse de la relation existant entre, d'une part, la formation et l'expérience clinique des infirmières et, d'autre part, l'enseignement de certaines matières. On a aussi procédé à la comparaison des deux groupes étudiés au cours de la période sous revue. 102 enseignants, fixes et itinérants, ont répondu au questionnaire de 1966 et 154 à celui de 1968.
 
Article
B cвoeм вcтyпитeльнoм cлoвe нa кoнфepeнции Accoциaции мeдицинcкич paбoтннкoв пoмoщи нa дoмy пpeдceдaтeльницa, г-жa M. Ф. Beллep, пpeдcтaвилa oтчeт o paзвитии Accoциaиции c мeмeнтa ee oбpaзoвaния ceмьдecят лeт тoмy нaзaд. Na ocнoвaнии oтчeтoв, cocтaвлeнныч c paннич днeй 1910 г. и дo тeпepeнeгo вpeмeни, был пpocлeжeн пpoгpecc в paбoтe члeнoв чepeз пepиoд экoнoмичecкич тpyднocтeй, бeднocти и эпидeмий дo тeпepeшнич днeй coциaльнoгo oбecпeчeния, иммyнизaции и coвpeмeннoй лeкapcтвeннeй тepaпии. Oпa yкaзaлa, чтo caмa Accoциaция нaчaлacь c oбъeдинeния жeнcкич caнитapныч инcпeктopoв, кoтopыe в тo вpeмя пpoизвoдили coциaльнyю paбoтy пo нapoднoмy здpaвooчpaнeнию в Beликoбpитaнии, нo в cвязи c пoявлeниeм тpeбoвaний нa бoлee cпeциaлизиpoвaннyю paбoтy cpeди мaтepeй и мoлoдыч ceмeйcтв, cecтpы пoмoщи нa дoмy пpoшли cпeциaльнoe oбyчeниe и в cвoe вpeмя cocтaвили бoльшинcтвo члeнoв Accoциaции. Кoнфepeнции, кypcы пo здpaвooчpaнeнию и пo пoвышeнию квaлификaций пpeдcтaвляли coбoю cocтaвнyю чacть paбoты Accoциaции для coдeйcтвия мeдицинcким paбoтникaм пoмoщи нa дoмy. Paзницa мeждy для coдeйcтвия мeдицинcким paбoтникaм пoмoщи нa дoмy. Paзницa мeждy нaзвaниями лeкций 50 лeт тoмy нaзaд и тeпepь cлyжит yкaзaтeлeм пpoгpecca в oблacти пapoднoгo здpaвия. Упoминaлacь тaкжe oбщecтвeннaя cтopoнa paбoты Accoциaции, кoтopaя включaлa пpaзднoвaниe cтoлeтия пoмoци нa дoмy в 1962 г. и pacпpeдeлeниы билeтoв cpeди пecкoлькич члeнoв, кoтopыe yдocтoилиcь пpиглaшeния нa Кopoлeвcкий пpиeм в Бyкингaмcкoм двopцe в Лoндoнe. Г-жa Beллep зaкoнчилa cвoй дoклaд пpeднoлoжeниeм o бyдyщeм, кoтopoe oткpывaeтcя пepeд paвoтникaми пoмoщи нa дoмy и пepeд Accoциaциeй. Пpeдпoлaгaлocь тaкжe, чтo в тeчeниe ближaйшич лeт мoжeт пpoизoйти yвeличeниe чиcлa бpaтьeв милocepдия c пoдoбными жe квaлификaциями, paбoтaющич нa cлyжбe мeдицинcкoй poмoщи нa дoмy.
 
Article
Any study which includes cultural origins of the respondents tempts one to wander into fields not directly in the paths laid down. In this study of a selected group of young persons who were highly interested in entering nursing (as evidenced by their being accepted to discuss the practical aspects of entering a school), was given a questionnaire asking about motivation for wanting to be a nurse, information relevant to age, origins, and similar data to determine future recruitment plans. The hypotheses that the latter years of high school were the best time to start recruitment, and that all news media were good for propaganda purposes were disproved. Findings showed that young people began thinking seriously about a nursing career before they completed elementary school, and that the recruitment material they most used was factual information about entrance requirements and the actual work of nurses.
 
Article
Пoтpeбнocть в yлyчшeнии кaчecтвa oчpaны нaтepинcтвa в Зaпaднoй Hигepии пoбyдилa aвтopoв иccлeдoвaть вoпpoc o выбope и кaчecтвe yчoдa зa poжeницaми в Ибaдaнe. B нacтoящeй cтaтьe oпиcывaютcя дaнныe oтнocитeльнo пpeдпoчтитeльнoгo выбopa мeждy мaтepинcким yчoдoм нa дoмy или в cтaциoнape. Для ycтaнoвлeния пpeдпoчтeния мaтepeй к тoй или дpyгoй фopмe yчoдa иcпoльзoвaлcя oткpытый oпpocный лиcт. 95%, или 57 из 60 жeнщин, пpeдпoчли yчoд нa дoмy. Глaвными пpичинaми этoгo выбopa были: (1) лyчший yчoд, (2) бöльшaя пpиeмлeмocть co cтopoны пepcoнaлa, (3) близocть к ceмьe, (4) coдeйcтвиe в oбyчeнии. Эти фaкты coвпaдaют c вывoдaми из пpeжнич иccлeдoвaний, кoтopыe пoкaзaли, чтo ceмeйнaя oбcтaнoвкa cпocoбcтвyeт бoлee лeгким бepeмeннocти, poдaм и выздopoвлeнию. Кpoмe тoгo, aкyшepcкий пepcoнaл, кoтopый пpoвoдил нeпpepывный yчoд в пpoдoлжeниe вceгo пэяиoдa poдoв, вcтyпaл в бoлee близкyю cвязь c мaтepью и лyчшe пpeпoдaвaл. Кaк мaть, тaк и мeдицинcкий пepcoнaл, были лyчшe пoдгoтoвлeны для пpивлeчeния пoмoщи co cтopoны члeнoв ceмьи в этoм oпытe. Oбнapyжилиcь тaкжe дpyгиe пepeмeнныe вeличины, нyждaющиecя в дaльнeйшич иccлeдoвaнияч. Moжнo ли вooдyшeвлeниe пpи дoмaшнeм yчoдe co cтopoны пepcoнaлa иcпoльзoвaть для yлyчшeния кaчecтвa тaкoгo yзoдa? Cyщecтвyeт ли пoдoбнoe пpeдпoчтeниe к дoмaшнeмy yчoдy y бoлee oбpaчoвaнныч жeнщин и y жeнщин, пpинaдлeжaщич к гpyппaм cбoлee выcoким дoчoдoм? Moжeт ли иcпoльзoвaниe вpeмeни oжидaния в клиникe для пpeпoдaвaния yвeличить пpeдпoчтeниe мaтepeй и ич yдoвлeтвopeниe кaчecтвoм yчoдa? Эти дaнныe пoддepживaют плaн пpaвитeльcтвa Зaпaднoгo Штaтa pacшиpть poдoвcпoмoгaтeльнoe oбcлyживaниe yвeличeниeм чиcлa дoмaшнич aкyшepcкич цeнтpoв.
 
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The purpose of this study was to describe the current status, stage of staffing change, and findings of research relating to shift length variations in nursing. This was accomplished through a review of the literature to (a) evaluate the quality of the research, (b) summarize and draw conclusions related to variations in nursing shift length, and (c) identify gaps in the literature for the purpose of making recommendations for future studies related to nursing shift length variations. Multiple methods were utilized for locating potential studies to include in this project. Smith and Stullenbarger's (1991) Quality of Study instrument was used to rate the studies. None of the research reviewed explicitly identified a conceptual or theoretical framework or model, and few studies could be classified as scientifically rigorous. This study illuminates the state of the art and findings related to length of shift variations in nursing, and as such has implications for practice and research in nursing service administration.
 
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Although bibliometric analysis affords significant insight into the progression and distribution of information within a particular research field, detailed longitudinal studies of this type are rare within the field of nursing. This study aimed to investigate, from a bibliometric perspective, the progression and trends of core international nursing journals over the longest possible time period. A detailed bibliometric analysis was undertaken among 7 core international nursing periodicals using custom historical data sourced from the Thomson Reuters Journal Citation Reports®. In the 32 years between 1977 and 2008, the number of citations received by these 7 journals increased over 700%. A sustained and statistically significant (p<0.001) 3-fold increase was also observed in the average impact factor score during this period. Statistical analysis revealed that all periodicals experienced significant (p<0.001) improvements in their impact factors over time, with gains ranging from approximately 2- to 78-fold. Overall, this study provides one of the most comprehensive, longitudinal bibliometric analyses ever conducted in the field of nursing. Impressive and continual impact factor gains suggest that published nursing research is being increasingly seen, heard and cited in the international academic community.
 
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The 1980s have seen a significant number of pressures placed on the health care system and the nursing profession. Such pressures include an adverse economic climate, the impact of technology, the rise of consumerism, the transfer of basic nurse education into the tertiary education sector and the move to privatization in health care. These pressures require skills not previously expected of nurse administrators in order to effect a smooth transition through these times of change. Failure to manage effectively has led to staff shortages and increased industrial militancy, two symptoms present in Australia at the moment. An overview of the present climate in this country is presented for consideration of effective management practices for the future.
 
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This study compared the conceptual foci and methodological characteristics of research projects which tested the effects of nursing interventions, published in four general nursing research journals with predominantly North American, and two with predominantly European/International authorship and readership. Dimensions and variables of comparison included: nature of subjects, design issues, statistical methodology, statistical power, and types of interventions and outcomes. Although some differences emerged, the most striking and consistent finding was that there were no statistically significant differences (and thus similarities) in the content foci and methodological parameters of the intervention studies published in both groups of journals. We conclude that European/International and North American nursing intervention studies, as reported in major general nursing research journals, are highly similar in the parameters studied, yet in need of overall improvement. Certainly, there is no empirical support for the common (explicit or implicit) ethnocentric American bias that leadership in nursing intervention research resides with and in the United States of America.
 
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Gerontological nursing has lain almost dormant in academia like a sleeping giant waiting its turn for nurses’ attention. The burgeoning elderly population forecast by sociologists, and their corresponding health care needs, forecast by gerontological nursing pioneers, has arrived. Full credit is given to those faculty members and nurses in practice and other positions, who for the past twenty years have kept lighted the lamp of enlightened gerontological nursing, hoping that its illumination will ignite complacent colleagues previously inattentive to the inevitable coming flood of elderly people needing nursing care. Since 1966, when the American Nurses’ Association declared gerontological nursing a specialty, faculties in schools of nursing have made sporadic attempts to prepare themselves and their students in this specialty. Concurrently, the aged population has exploded to the magnitude predicted by the demographers. This paper will review the present status in the nursing of the aged with implications for planning based on statistically demonstrated need and within the context of nursing’s responsibilities. Five issues to be examined include educational needs of faculty, the number of nurses prepared in gerontological nursing, consumer needs of the aged as indicated by demographic studies of the health status of the aged, identification of factors facilitating or inhibiting the professional advancement of gerontological nursing faculty members including employment availability for such faculty by deans or directors of schools of nursing, and identifying guidelines for the knowledge upon which gerontological nursing is based. The demography of the aged and their health status The United States is experiencing a growing urgency related to the health care of its aged. The over-65 population constitutes an increasing proportion of the country’s population. Specifically, the over-65 population now comprises about 25 million, approximately 12%, of the total population. By the year 2030 this age group will contain a predicted 50 million people, over 18% of the total population. Moreover, the over-75 age group has increased even more rapidly than the 65-74 age group. While all the aged share some problems, the over-75 are most vulnerable to the physical, mental and social assaults that lead to the need for nursing care. In 1975 the over-75 age group represented
 
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Numerous analyses of research published in scientific nursing journals have been examined over the past decades. However, a comprehensive analysis of trends in research has not been reported since 1980. The aim of this analysis was to review randomly selected research articles published in four scientific nursing journals for the years 1985, 1990, 1995, 2000, 2005, and 2010 to identify changes in selected aspects of research and to compare the findings with those from an earlier similar study. This descriptive study used percentages to present trends in published studies in four scientific nursing journals for twenty-five years. A total of 976 studies were identified; 50% were randomly selected for each year analyzed. The foci of the research problem, care orientation, conceptual bases, research designs, data analysis procedures, discussion of findings, and recommendations and implications were analyzed. Most studies from 1985 (66%) through 2010 (73%) focused on nursing practice issues; in 2010 they focused on primary health (46%) and chronicity (41%). A decrease in theory-testing research from 1985 (32%) to 2010 (21%), and in theory-based studies from 1985 (31%) to 2010 (22%) was noted. Qualitative studies increased from 1985 (3%) to 2010 (21%). Psychological variables and adult populations continue to be studied mainly over 25 years. For quantitative studies, there were increases in correlational designs from 1985 (35%) to 2010 (38%), experimental designs from 1985 (16%) to 2010 (18%), and methodological studies from 1985 (5%) to 2010 (24%). There were decreases in descriptive studies from 1985 (20%) to 2010 (5%), and comparative studies from 1985 (19%) to 2010 (10%). The use of multivariate statistics increased over time. In 1985, 61% of researchers did not link their findings to theory guiding the study; 52% did not in 2010. For qualitative research, approximately 50% fell in the "other category" over the 25 years; in 2010, grounded theory (15%), phenomenological (15%) and ethnographic (20%) designs were used. Trends indicated that the building of science has been slow, incremental, and subtle, as found in the earlier study. Trends suggest a growing maturity in the research designs.
 
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An attempt was made to define the concept of ‘quality of life' and outline the development of a self-assessment instrument for detecting the changes in life as a whole which result from the presence and treatment of malignant disease. A comparison was made between three different scoring systems, familiar in psychometric assessment, although less familiar in nursing. The items selected for inclusion in the measurement instrument were based on an existing symptom distress scale and on the previously identified concerns of cancer patients. The relationship between such symptoms and the activities of daily living was explored. Each item, and the instrument as a whole, appeared to be reliable and to represent a valid means of assessing the impact of the disease on patient well being. It was simple to use and straightforward to score and appeared accurately to reflect the patients' general condition.
 
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The aim of this paper is to provide an analysis of the extent to which gay, lesbian and bisexual service user experiences are represented within the critical care literature. A survey of five well established critical care journals, covering the period 1988-1998, was conducted in order to reveal the range of themes addressed within them. The findings suggest that these groups are invisible in this field of practice and consequently their particular concerns have remained marginalised. The implications of this absence are far reaching, potentially inhibiting nurses from establishing effective caring relationships with either lesbians, gays or bisexuals and from identifying and developing appropriate interventions for the care of these patients and their families.
 
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This paper provides an overview of the empirical research literature on nursing advocacy. It offers a description of the contexts, methods and issues of validity and reliability used in studies of nursing advocacy, as well as advocacy definitions, activities and consequences as results of those studies. The review focuses on empirical articles retrieved from the CINAHL and MEDLINE databases published between 1990 and 2003. It draws attention to complexity the concept of advocacy, difficulties in operationalisation, and concentration on reactive advocacy from nurses' perspective. There is a lack of research on patients' perspectives of nursing advocacy in general hospital settings.
 
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Pre-admission nursing assessment is a widely accepted practice in forensic mental health services, yet has never been described or evaluated. The costs and merits of this practice have not hitherto been the subject of systematic investigation. This article describes the practice of pre-admission assessments and details a method for estimating the cost of forensic nursing assessments in terms of the investment of nursing time. The method was then employed to evaluate the cost of nursing assessments to a Welsh medium secure unit over a 9-year period. The results showed that the demand for, and location, of pre-admission nursing assessment varied considerably over 9 years. Assessments were expensive in the demands that they placed on the resources of the nursing department. Due to the high investment costs, evidence is required to support such practice.
 
Article
Pre-admission forensic nursing assessment is a tradition that has no research evidence base, little documentary support and is an expensive drain on nursing resources from clinical environments. Such an expensive practice warrants some evaluation of the quality of these nursing assessments. This study assessed the quality of nursing risk assessments through comparison with the HCR-20, a well-established and widely validated violence risk assessment instrument. There was a high degree of correspondence between nurse assessments and the contents of the HCR-20. The results offer support for forensic nurses' abilities to develop effective measures and practices based upon nursing knowledge and experience where no formal evidence base previously existed.
 
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One important strategy to address nursing shortages is to tap into the pool of licensed nurses who are not currently working in nursing and induce them to return to the nursing labour market. However, there is a paucity of research examining their likelihood of return to the active labour market. Analyze the career transitions of nurses registered with the College of Nurses Ontario but not working in the province's nursing labour market to determine the proportion of these nurses rejoining the active nursing workforce and examine the variation by inactive sub-category and age group. Quantitative analysis of a linked longitudinal database for all those registered with the College of Nurses of Ontario for the years 1993-2006. Registration records of all 215,687 nurses registered at any time in those years were merged by their unique registration number. Each nurse was placed for each year into an employment category. Two groups of nurses were defined: active (registered, working in nursing in Ontario) and inactive (registered, not working in nursing in Ontario). Inactive nurses were then sub-categorized into five mutually exclusive sub-categories: 'not working and seeking nursing employment', 'working in non-nursing and seeking nursing employment', 'not working and not seeking nursing employment', 'working in non-nursing and not seeking nursing employment' and 'working outside Ontario'. One-year career movements of nurses were tracked by generating 13 year-to-year transition matrixes. In the short-term, inactive nurses seeking a nursing job had the highest average rate of return to the active workforce (27.3-30.8%), though they might become high risk of leaving the profession if they do not find employment in a timely manner. Inactive nurses not seeking nursing employment are a heterogeneous group, and include nurses on leave who are likely to subsequently rejoin the active workforce should appropriate opportunities arise. The proportion of nurses rejoining the active workforce decreased with age. Because 'inactive' nurses are a heterogeneous group, their optimal reintegration to the nursing workforce requires governments, professional associations and employers to work collaboratively to design targeted and timely recruitment strategies to avoid the permanent loss of skilled nursing resources.
 
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Surveys of the leaders of the UK's post-qualifying education courses for community mental health nurses have taken place, on an annual basis, for over 10 years. In this paper, findings from the survey undertaken in the 1998--99 academic year are reported. These findings include: that most course leaders do not personally engage in clinical practice; that interprofessional education takes place at a minority of course centres, and that course philosophies and aims are characterised by an emphasis on both outcomes (in terms of, for example, skills acquisition, knowledge development and the ability to engage in reflective practice), and process (adult learning).
 
Article
A series of twenty-six interviews, fourteen with district nursing sisters and twelve with students they supervised, was conducted in 1992 in one Project 2000 demonstration district in England. The data were collected as part of an English National Board funded research study; data were reinterpreted in 1994 and formed one element in the author's PhD thesis. Participants described the ways in which a supervisor might enable a student to learn during a community placement. One of the most important means by which supervisors could provide assistance was by creating an environment in which the students felt supported. Students described how supervisors demonstrated concern, acceptance and understanding, attributes which bore striking resemblance to the qualities of congruence, unconditional positive regard and empathic understanding identified by Carl Rogers as enabling learning.
 
Article
The Australian Nursing Competency Incorporated (ANCI) 2000 standards provide a standardised framework of accepted professional standards for the registered nurse. The study aimed to examine the psychometric properties of the ANCI 2000 national competency standards for measuring nursing competence in new graduate nurses. One hundred and sixteen new graduated nurses from three metropolitan public hospitals were surveyed. The psychometric properties of the ANCI 2000 including internal consistency and construct validity were examined. The mean score was lowest for competency unit 6 (mean 5.96) and highest for competency unit 4 (mean 8.83). The internal reliability for the total ANCI 2000 was alpha=.93 and for the domain alpha=.81 (Domains 1 and 3), alpha=.79 (Domain 2), and alpha=.77 (Domain 4). Confirmatory factor analysis using the domains as factors confirmed the 4 factor structure although 3 factors had two items each with loadings in the .4-.5 range. There are inconsistencies in the psychometric properties of the ANCI 2000 which suggest that further investigation is warranted before it can be used as an instrument for the measurement of new graduate competencies.
 
Article
This paper reports on part of a 4-year study monitoring the implementation of Project 2000 in one health authority. Its focus is on the consequences for the nursing service of replacing traditional, pre-Project 2000 students with permanent staff. It is argued that the Department of Health, who have been responsible for funding the replacement programme, have underestimated the numbers of permanent staff required to replace the traditional student workforce, and that the Project 2000 replacement exercise has contributed to a deterioration in staffing levels and skill mix.
 
Article
Evidence-based practice has become an imperative for efficient, effective and safe practice. Furthermore, evidences emerging from published research are considered as valid knowledge sources to guiding practice. The aim of this paper is to review all research articles published in the top 10 general nursing journals for the years 2000-2006 to identify the methodologies used, the types of evidence these studies produced and the issues upon which they endeavored. Quantitative content analysis was implemented to study all published research papers of the top 10 general nursing journals for the years 2000-2006. The top 10 general nursing journals were included in the study. The abstracts of all research articles were analysed with regards the methodologies of enquiry, the types of evidence produced and the issues of study they endeavored upon. Percentages were developed as to enable conclusions to be drawn. The results for the category methodologies used were 7% experimental, 6% quasi-experimental, 39% non-experimental, 2% ethnographical studies, 7% phenomenological, 4% grounded theory, 1% action research, 1% case study, 15% unspecified, 5.5% other, 0.5% meta-synthesis, 2% meta-analysis, 5% literature reviews and 3% secondary analysis. For the category types of evidence were 4% hypothesis/theory testing, 11% evaluative, 5% comparative, 2% correlational, 46% descriptive, 5% interpretative and 27% exploratory. For the category issues of study were 45% practice/clinical, 8% educational, 11% professional, 3% spiritual/ethical/metaphysical, 26% health promotion and 7% managerial/policy. Published studies can provide adequate evidences for practice if nursing journals conceptualise evidence emerging from non-experimental and qualitative studies as relevant types of evidences for practice and develop appropriate mechanisms for assessing their validity. Also, nursing journals need to increase and encourage the publication of studies that implement RCT methodology, systematic reviews, meta-synthesis and meta-analysis methodologies. Finally, nursing journals need to encourage more high quality research evidence that derive from interpretative, theory testing and evaluative types of studies that are practice relevant.
 
Article
This paper suggests that the new paradigm for nurse education is being prevented from fulfilling itself because of factors operating within the taught, hidden and wider curriculum. Firstly it is argued that the theoretical components relating to social science, health education/promotion and nursing need to be clearly integrated for nursing students. This integration is demonstrated through the analysis of two nursing models. Secondly it is argued that the taught curriculum needs to be supported by a suitable hidden curriculum both within the educational and clinical setting. Role models which demonstrate integrated theory occurring in practice are a vital component of this. Thirdly it is argued that without the wider social and political context supporting the aims of the 'new' nurse education, meaningful success will be very difficult to achieve.
 
Article
This study focussed on time as a key resource within a hospital setting. The introduction of casemix-based funding, which changed the ways funds were obtained and distributed within the hospital, was accompanied by large cuts in the funds available to the hospital system. From the introduction of casemix-based funding to the conclusion of this study there was an increase of 20% in the number of cases through the operating suite. The increase was achieved, with a reduced budget, by intensifying work and increasing flexibility in the use of time. This approach to changing the use of time imposed considerable real 'costs' on staff, especially nurses, and created concerns about safety.
 
Article
This paper reports a study that examined the extent to which nurse researchers internationally disproportionately include females as participants in their research. A bias toward predominantly male samples has been well-documented in medical research, but recently a gender bias favoring women in nursing research has been identified in studies published in four North American journals. We extracted information about study samples and characteristics of the studies and authors from a consecutive sample of 834 studies published in eight leading English-language nursing research journals in 2005-2006. The primary analyses involved one-sample t-tests that tested the null hypothesis that males and females are equally represented as participants in nursing studies. Studies from different countries, in different specialty areas, and with varying author and methodologic characteristics were compared with regard to the key outcome variable, percent of participants who were female. Overall, 71% of participants, on average, were female, including 68% in client-focused research and 83% in nurse-focused studies (all p<.001). Females were significantly overrepresented as participants in client-focused research in almost all specialty areas, particularly in mental health, community health, health promotion, and geriatrics. The bias favoring female participants in client-focused studies was especially strong in the United States and Canada, but was also present in European countries, most Asian countries, and in Australia. Female overrepresentation was persistent, regardless of methodological characteristics (e.g., qualitative versus quantitative), funding source, and most researcher characteristics (e.g., academic rank). Studies with male authors, however, had more sex-balanced samples. The mean percentage female in client-focused studies with a female lead author was 70.0, compared to 52.1 for male lead authors. Nurse researchers not only in North America but around the globe need to pay attention to who will benefit from their research and to whether they are adequately inclusive in studying client groups about which there are knowledge gaps.
 
Article
The publisher regrets that this article is an accidental duplication of an article that has already been published in the International Journal of Nursing Studies, volume 45 (2008) 971-974, doi:10.1016/S0020-7489(08)00116-8. The duplicate article has therefore been withdrawn.
 
Top-cited authors
Louise Barriball
  • King's College London
Peter Donald Griffiths
  • University of Southampton
Alison While
  • King's College London
Christine Duffield
  • Edith Cowan University
Ian James Norman
  • King's College London