African bats: evolution of reproductive patterns and delays

Nurses administer medications every day as part of their practice. Consequently, many studies have explored nurses and the part they play in medication administration. The focus of these studies has often been limited, concentrating on nurses and drug errors, rather than on incorporating a broader view of nurses and the medication administration process in general. In an attempt to broaden the focus of the discussion about nurses and medication administration, this study used Critical Incident Technique (C.I.T.) to identify registered nurses' perceptions of factors affecting the quality administration of medications in their practice setting. Five categories of themes emerged as having an impact on nurses and the administration of medications: the context, the procedures, the groups of professionals involved, the personal attributes of individual staff, and the client. Implications of the research for nursing education and practice are discussed.     

"Codependency". A disease or the root of nursing excellence?

A hermeneutic phenomenological study was conducted to explore how eight professionally competent nurses experienced and evaluated the relation between their childhood adaptation to dysfunctional families and their nursing careers. From the participants' discussion of this topic, the following themes emerged: escaping difficulties by becoming a nurse, coping roles guide nursing career, sensitivity to the untold, transforming dysfunctional responses, and wounded healers. The study did not support the view that children of alcoholics seek careers in nursing to meet their codependent needs for self-esteem, control, or belonging. Instead, its findings indicate that some children of alcoholics become competent nurses by finding positive application for the coping skills they learn in their families. This indicates that, when working with individuals from dysfunctional families, nurses could support them to create new avenues for their coping skills instead of trying to "exterminate" them because of their "codependent" nature.     

Home healthcare nursing in the managed care environment. Part II. The impact on clients and professional nurses

Part I, published in last month's issue of Home Healthcare Nurse, provided information about managed care and health maintenance organizations (HMOs). This article, Part II, presents an overview of the history of home healthcare nursing, the results of a purposeful sample, and interviews of home care nurses. Interviews were conducted to determine how nurses perceived the impact of managed care on their clients and nursing practice. Conclusions are presented in terms of emergent categories gleaned from the interviews. Recommendations for the continued growth and advancement of professional nursing in the context of managed care are given.     

Introduction of wireless, pen-based computing among visiting nurses in the inner city: a qualitative study

The purpose of this qualitative study is to understand how a sample of visiting nurses experienced the practice of home health nursing in the inner city and how they perceived the anticipated introduction of wireless, pen-based computing into their practice. Focus groups were held with visiting nurses 1 week before the introduction of the wireless, pen-based computers. The data were analyzed using Strauss and Corbin's (1990) method for concept development. The following central concepts emerged from the focus groups with visiting nurses: "Missing contact in the field," "Consumption of time writing on forms," "Using the computer to help with the practice of home health nursing," and "Home nursing is a lifeline." These concepts, based on the commentaries by visiting nurses, help one to understand the problems encountered by visiting nurses in the delivery of home health care, identify ways to incorporate evolving technologies to enhance nursing practice, and consider approaches to computer skill acquisition.     

Factor analysis of the Marital Interaction Coding System (MICS).

A significant source of confusion in the marital observation area is the proliferation of systems for collapsing microbehavioral codes into categories. This study used an archival data set of 995 couples' videotaped conflict negotiations coded with the Marital Interaction Coding System-IV (MICS). A factor analysis was conducted to provide some empirically based guidance for the formation of coding categories. Four factors emerged for both men and women: Hostility, Constructive Problem Discussion, Humor, and Responsibility Discussion. Suggestions are made for category formation with MICS codes and for the development of a new coding system based on these results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teamwork in primary care: the views and experiences of nurses, midwives and health visitors

This paper reports on findings from a study of teamwork in primary care in one family health services authority in England. It is based on interviews using a semi-structured questionnaire with practice nurses, district nurses, health visitors and midwives in 20 practices. Six topics emerged as important in relation to the views of nurses, midwives and health visitors and their experiences of teamwork: team identity; leadership; access to general practitioners; philosophies of care; understanding of team members' roles and responsibilities; and, disagreement regarding roles and responsibilities. Differences in the various views and experiences of teamwork were identified. Midwives and health visitors emerged as the least integrated members of the primary health care team. Recent changes to the organization of primary health care services, as well as professional changes, are seen as accounting for the different experiences of the nursing groups. The potential for teamwork in the future is discussed.     

How to measure service orientation.

Developed a personality measure designed to be used in practical selection contexts and examined its construct validity. Three duty categories that involved service orientation were reviewed by supervising nurses and incumbent nursing aides and then used to develop a job analysis task inventory. 17 nursing supervisors and 20 incumbent nursing aides completed this inventory. The Hogan Personality Inventory was used as an item pool. Criterion specification proceeded through 2 steps that involved supervisors' ratings of 101 nursing aides along the 3 duty categories and direct evaluation of service orientation. Concurrent validity studies were conducted with 4 additional samples: 37 senior nursing students (19–32 yrs old), 30 employees of a suburban nursing home, 100 clerical personnel of a large insurance firm, and 56 truck drivers. The pattern of correlations was explored with 169 Naval volunteers (aged 19–25 yrs) who also completed selected psychological inventories. Although findings indicate that this Service Orientation Inventory holds promise for assessing aspects of job performance that are unrelated to technical competence but crucial for maintaining good relations between an organization and its customers, the present authors' primary goal was to provide an example of a construct validity study using a personality measure in an applied context. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting breast feeding: the perceptions of Vietnamese mothers in Sydney, Australia

A review of the literature indicated that the majority of Vietnamese mothers bottle fed their infants after migration to western countries. Those who breast fed weaned their infants very early. This study aimed to explore, from the Vietnamese mothers' perspective, their experiences of infant feeding and the attributes of nurses, midwives, other health professionals and the health care system that were considered to be important in encouraging the immigrant Vietnamese women to breast feed in Sydney, Australia. A convenience sample of 124 postnatal Vietnamese women were recruited from the western and southwestern suburbs of Sydney of New South Wales, Australia. In-depth interviews were conducted in the privacy of the respondents' homes. An ethnographic approach guided the concurrent data collection and content analysis. Through constant comparison of categories, nine concepts emerged from the findings to describe the women's process of decision making, experiences and perceptions of breast feeding: believing, complying, rewarding, facing the unexpected, experiencing pleasure and pain, fulfilling, communicating, counselling and supporting. These findings highlighted the significance of social, cultural and economic factors which influenced the women's decisions and maintenance of breast feeding. Implications for nursing practice and further research are discussed.     

Theoretical assessment of family-centered care

The purpose of this study was to develop a theoretical concept system to describe family-centred care in a child welfare clinic. A hybrid model was used as a method for concept development. The aim was to test categories which describe family-centred care. The categories were based on the review of the literature and on the analyse based on the interviews of the public health nurses and their client families. The results show that family-centred care at the child welfare clinic can be described by six categories: the life situation and the living conditions of the family, the individuality of the family, the relationship between the family and the public health nurse, nursing actions, the expert knowledge of the public health nurse and her individuality. The results show the different levels of family-centered care. The child, all the members of the family or the whole family system can be chosen as a starting point of nursing. The public health nurses considered that the whole family is the starting point of the family-centered nursing.     

Dreams about the therapist: Mood, interactions, and themes.

Analyzed the mood, interactions, and themes in the manifest dream representations reported by 67 25–71 yr old psychotherapist volunteers, who each reported 1 dream about his/her own therapist. Ss tended to have unpleasant dreams featuring therapists who were frustrating or gratifying. In the dreams, friendly, aggressive, and sexual interactions were initiated by therapists; only the friendly interactions tended to be reciprocated. Four overarching themes emerged: separation-rejection, seduction-antagonism, protectiveness-responsiveness, and praise. It is proposed that these characteristic ways of dreaming about the therapist depict issues of central importance for many patients, and reflect patients' effective use of the transference to work on their concerns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving undergraduate nursing research education: the effectiveness of collecting and analyzing oral histories

Nine oral histories of retired RNs (age range from 60 to 77) were collected by trained senior nursing students in their nursing research class. Attitudes toward nursing research of the 18 undergraduate baccalaureate nursing students participating in the collection and analysis of oral histories were compared with 20 students who did not participate. Both groups of students completed a pretest and posttest Attitudes Toward Nursing Research Questionnaire. The participating students had significantly positive changes in their attitudes toward nursing research. The nonparticipating group did not. While reminiscing about their careers, the retired RNs related historical events that influenced their nursing practice. Three themes emerged: World War II, technology, and intensive care units. Through an open-ended, written questionnaire following the interview, the nurses expressed positive benefits of participation. The collection and analysis of oral histories was an effective experiential learning strategy with positive outcomes for the students and the retired nurses who were interviewed.     

Integration into professional nursing by graduates of an innovative entry-level MSN program

Recently, nursing programs that admit nonnurse college graduates to graduate study in nursing have emerged around the country. The University of Texas at Austin has such a program called the Alternate Entry Master of Science in Nursing (AEMSN) program. Using a grounded theory approach, 13 telephone interviews were conducted with alumni of the AEMSN program to examine the socialization of these nontraditional graduates into the profession of nursing. Participants reported some anxiety as they approached graduation. They were particularly aware of a disconnection between their academic credentials and their limited professional nursing experience. To manage others' and their own expectations of them, the participants chose various strategies, such as using positive self-talk and seeking a manager who understood and favored the AEMSN program. Eventually the graduates found places where they felt comfortable and where they could hone their skills. As they began to function in roles that they believed were consistent with master's level nursing, the AEMSN graduates began to embrace the identity of master's-prepared nurses.     

Verbal therapeutic behavior of expert psychoanalytically oriented, gestalt, and behavior therapists.

Asked 18 expert psychoanalytically oriented, gestalt, and behavior therapists to submit representative, audiotaped therapy interviews. A content analysis of therapist verbal behavior was conducted by means of the System for Assessing Therapist Communications, an instrument developed by the authors. Comparisons across the 3 theoretical orientations were made on 6 dimensions of behavior: type of therapeutic activity, temporal focus, interview focus, initiative, communication, and therapeutic climate. Results indicate that according to prediction, these expert therapists were similar in their communication of empathy, the basis for their therapeutic relationships. Theoretical orientation, however, differentially influenced the use of direct guidance and facilitative techniques, interview content focused on the client, therapist self-disclosure, therapist initiative, and supportive therapy climate. Gestalt therapists were most dissimilar from the other therapists. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Answer changing: a meta-analysis of the prevalence and patterns

In order to determine the prevalence and patterns of answer-changing behavior, a meta-analysis of 61 studies was conducted. The findings of the individual primary studies were supported, which increased confidence in the conclusion that most students will change answers and this behavior will likely improve test scores. Moreover, neither age, gender, academic ability, personality traits, beliefs about answer changing, nor item characteristics systematically influenced answer-changing behavior. Practitioners of continuing nursing education need to know the effect of answer changing on test scores so that they may appropriately advise nurses who are preparing for objective tests.     

Determinants of home health visit length: results of a multisite prospective study

OBJECTIVES: The authors (1) compare visit length across four categories of skilled nursing home health visits which reflect recent changes in home health casemix-AIDS-related, hospice/terminal (HT), intravenous (IV) therapy, and maternal and child health (MCH)-with general adult medical/surgical (MS) visits and (2) identify factors influencing visit length. METHODS: The study sites were 12 nonproprietary Massachusetts home health agencies (HHAs). Staff nurses collected data concurrently on a sample of visits they provided between December 1, 1992 and November 30, 1993. The visits were stratified by agency, time of year, and visit category. The authors used analysis of variance to test for significant differences across visit categories in Home Length of Visit (the number of minutes between when the nurse entered and left the home) (HLOV). The authors used multivariate regression analysis to develop models identifying determinants of HLOV and adjusted R2 to measure the explanatory power of partial models. RESULTS: In univariate analysis, the categories differed significantly from each other in length (P < 0.0001). HT visits were the longest (median visit length = 60, 80, and 59 minutes for HT Only visits, visits in both the HT and AIDS categories (HT/AIDS), and HT/IV visits, respectively). MS visits were the shortest (median = 30 minutes). The remaining categories were intermediate in length (medians = 37 to 50 minutes). Almost half the variability in HLOV was explained by the full multivariate regression model, which includes all independent variables (adjusted R2 = .4486; P < 0.0001). Visit characteristics alone in a partial model explained 18% of the variability in HLOV. Three other variable sub-groups-agency, client characteristics, and nursing workload-each explained about 15% of the variability in HLOV. Nursing activities performed during the visit explained 11%; several of these related to teaching, education, or assessment. CONCLUSIONS: Accurate reimbursement reflecting casemix differences is important to protect the teaching, education, and assessment functions of nurses; measure nurse productivity and allocate caseloads; maintain access to services for clients with greater needs; and avoid creating economic disincentives to the agencies that serve them. Payers formulating prospective payment systems can adjust per visit reimbursement rates to reflect differences in visit length by category and incorporate functional limitations, clinical instability, and case coordination as classification variables. Developers of home health casemix systems can use factor analysis to improve the robustness of multivariate models and include nursing workload in predicting visit length. Home health agencies measuring productivity and caseload across complex client populations can classify visits into three groups-MS; HT; and AIDS, IV, and MCH-or use the regression results to develop more refined predictors of visit length and nursing caseload.