ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00324.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The purpose of the study was to examine the allocation of nursing time to various activities of registered and assistant nurses during the day shift. Twenty‐three registered (RN) and eighteen assistant nurses (AN) working in medical and surgical wards of five large hospitals were studied. The findings have shown that the most frequent activities performed were: indirect care representing 35.6% of the time, direct care representing 23.8% of the time, personal activities representing 16.8% of the time, and direct nursing interventions representing 8.2% of the time. Cross‐tabulation revealed that RNs provided direct care less frequently and indirect care more frequently than ANs (25.3 activities per RN and 27.5 per AN, 62.1 activities per RN and 32.6 per AN, respectively). Many indirect care activities were found to be the responsibility of the head nurse (64), secretary (465), and others (104). Less expected results were the minimal amounts of time spent on both education and research activities (1.3% and 0.0% respectively). Nurse managers have to free nurses from subsidiary work and to find mechanisms to distribute nursing valuable time more efficien

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00325.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This article describing the first phase in the development of an assessment scale of nursing‐care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing‐care dependency scale. The scale aims to characterize the patients' nursing‐care dependency as part of the assessment step in the nursing process, and is based on Henderson's 14 human needs. The Delphi technique, using two panels of experts (n = 44), was applied to reach consensus on significant indicators of nursing‐care dependency. The experts' reasoning was used to develop criteria for the assessment of nursing‐care dependency. Ultimately, the Delphi rounds generated 15 NCD items with their descriptions and item criteria. There was no fundamental difference between the NCD scales for demented and mentally handicapped patients. Nevertheless, there are two versions of the NCD scale because of the need to apply specific concepts in the nursing care of either population. The original Dutch version of the NCD scale is also available in English and in

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00326.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In the present article an endeavour is made to present an introduction to a new theoretical framework for caring for the elderly. The theory of gerotranscendence holds that old age is a stage with its own specific quality of life. The venture included two main phases—the introductory phase and the impact evaluation phase. During the introductory phase, ways of understanding and caring for the elderly (the new theory) were presented and discussed among 90 nurses and aids, constituting almost the entire staff working with the elderly in institutional settings in a small Swedish municipality. Six months after the end of the introductory phase, the impact evaluation was carried out using a mail survey. The impact evaluation revealed that almost half of the staff came to a new understanding of specific care recipients and that a third of the staff also changed their attitude towards caring for specific care recipients. The introduction of the new theory also reduced staff members' feelings of guilt about inadequacy at wor

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00327.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Narratives from patients (n = 80) and patients' relatives (n = 12) were collected in order to illuminate experiences of good and bad caring episodes and to obtain descriptions of good caring. Narratives describing good caring included such task aspects as swift and correct assessment and access to information. Aspects less frequently mentioned were, for example, being given time, receiving pain relief and good food. Relationship aspects mentioned; having an interest shown in the care, being taken seriously and being cared about. There are parallels regarding relationship aspects between the narratives concerning good and bad caring episodes; for example what was praised in the good caring narratives was criticized in those describing bad caring. Such parallels were being/not being trusted, being/not being believed and being/not being respected. The narrations concerning bad caring were more specific and more vivid than those about good caring. The authors' interpretation was that the bad episodes were unexpected and very painful and therefore remained imprinted in the patients' memories. The descriptions of good caring included relationship aspects in only 34 cases, task aspects in only five cases and a combination of both in 50 cases. The ultimate purpose of the study was to obtain a basis for the development of a policy for good caring founded on patients' experiences. It is desirable that further studies be undertaken within various clinical specialities which would also take into consideration medical, social and cultural perspectives.

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00328.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The aim of the study was to describe clinical microbiological practices in a hospital setting. A grounded theory was developed from qualitative data in two steps: initial participant observation to describe the clinical work‐flow, and a main case study based on in depth interviews and analyses of work practices using a video‐based stimulated recall technique. Six physicians, 2 senior medical laboratory technologists and one head nurse were interviewed in depth based on their organizational positions. Stimulated recall interviews were conducted with 11 nurses, 6 secretaries, 6 medical laboratory technologists, and 3 physicians. An informal clinical microbiological ‘workgroup’ was found to co‐operate around two physical objects: the microbiological sample and the laboratory request form. Work organization was divided into planning, based on science and legislations, and performance based on tradition and local supervision. None of the practitioners had a total overview of an analysis cycle, all being occupied with a discrete part of planning, practical work and information management. The conclusion of the study is that fragmentation in the division of labour may be a critical hindrance to development in clinical microbiology. If a common strategy is not shared between specialities and professions, even minor changes in routines by individual practitioners may influence patien

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00329.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The subjective Global Assessment technique was evaluated with regard to its reliability and validity in a Swedish elderly population. Ninety patients, 70 years of age or older, and newly admitted to the geriatric clinic, participated in the study. The nutritional state was assessed subjectively by two independent observers using the Subjective Global Assessment form, and objectively, using a combination of anthropometry and serum‐protein analysis. The subjectively assessed malnutrition rate was about 20% higher than that assessed objectively. The agreement level between the two observers was 77.8%, Kappa 0.56 (<0.001), and the levels between the subjective and objective assessments were 57.8% (Kappa = 0.17) and 73.3% (Kappa = 0.46), respectively. The experienced observer identified 85.2% of those who were defined as malnourished using the objective criteria and the less experienced observer, 66.6%. Furthermore, a regression analysis indicated weight index as the main significant objective factor influencing the subjective assessment. The subjective technique could be regarded as reliable from a clinical and preventive perspective since the agreement between the two rates was just under 80%. It seems also to be valid since the subnormalities in the selected criteria showed a similar pattern. The necessity of being well trained in order to manage nutritional status assessment, for both clinical and research purposes, is obviou

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00330.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Interviews with 15 nurses working in child health care revealed that most of them were very keen not to apportion blame when discussing smoking habits with parents. Thus, half of those interviewed chose a passive approach to counselling, which meant that they were cautious, evasive and tactful so as not to risk alienating or offending parents. Those who were more active tackled the issue of smoking by giving advice and suggesting ways in which the parents could cope with their smoking. A third approach was observed in which some of the nurses were judgemental, which they expressed by moralizing about the smoking habits of the parents. The present study shows that there is a need to develop a patient‐centred methodology, whereby smoking can be discussed from the standpoint of the parents, without making them feel guilt

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00331.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Postoperative pain is often a big problem after gastrointestinal surgery. The aim of the present investigation was two‐fold; To see whether supplying of lidocaine spray in the surgical wound influences postoperative pain and to evaluate the role of patients and caring factors on the perception of postoperative pain. Sixty consecutive patients undergoing major abdominal surgery were randomized into a control or a treatment group. Pain relief, apart from lidocaine, was given according to routine. The methods included interviews, pain registration on a visual analogue scale and registration of administered analgesics. No effect could be attributed to lidocaine. Nurses' ability to predict pain was unreliable, patients predicted pain better. Younger patients suffered greater pain than elderly. Preoperative anxiety correlated to postoperative pain, whereas malignant diagnoses did not. Most of the studied patients had considerable postoperative pain. Routines for postoperative pain relief should be improve

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00332.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Too many children in Sweden grow up under difficult circumstances. Every child should have the opportunity to grow up to be a confident person. We know today that the new‐born child is able to influence its surroundings. The main purpose of child health care in Sweden is to reduce mortality, morbidity and disability in children, and also to reduce any detrimental effects on the family. Child Health Care (CHC)‐nurses provide continuity and security for parents and children in developing relationships. The aims of this study were to identify how CHC‐nurses view a mother‐infant relationship, and how they can improve this relationship. Ten CHC‐nurses were interviewed about mother‐infant relationships. Verbatim transcripts were analysed using constant comparative analysis. The emerging core category was interplay. Under this construct there were two categories; maternal ability and signals from the infant. Different substantive codes were given under these categories, viz. body language, vocal language, poor health, expectations and life situation. In describing how to improve the mother‐infant relationship, promoting an understanding of interplay was the core category. Three categories/strategies were perceived; visualize, respect and demonstrate. The results were then compared with the literature. This study indicates that interplay is of greatest importance in a mother‐infa

ISSN:0283-9318    

DOI:10.1111/j.1471-6712.1996.tb00333.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY