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Philosophy adds humanness to nursing and facilitates holistic care. Philosophies like Ubuntu which purports that a person is only a person through other people and emphasises community cohesion and caring for each other can add humanness to nursing. Because Ubuntu validates subjective experience and its meaning in the lifeworld, it exemplifies the basis of holistic and individualised caring in nursing. Although nurses can make their own philosophy through critical reflexivity, the convergent point is the goal of meaningful caring that is, sustaining health and the well‐being of patients and significant others. Philosophy transcends job description, it encompasses visceral experience, personal beliefs and goals, resulting in purpose and deeper meaning to the nursing profession of caring as emulated by Florence Nightingale. While contemporary philosophy has been met with criticism as being detached from human concern, narrowly focussed and technical, it evokes critical thinking and promotes sociality in nursing practice. The Covid‐19 pandemic vividly brought philosophy to the fore as nurses sacrificially and vulnerably rose to the challenge of caring not only for the sick, but also for families who through infection control measures were deprived of sociality. This paper argues that philosophy adds humanness and substance to nursing in the context of COVID‐19. [ABSTRACT FROM AUTHOR]

Background: When nursing practice assumes a fix‐it view model, it limits the growing capacity of practice. The theory of communion‐in‐caring emerged as a hopeful response to the call to offer a new vista. This theory unifies caring and the endless potential of human care. Aim: The aim of the paper is to describe the theory of communion‐in‐caring grounded in the human science philosophical perspective. Generated from a focused review of scholarly literature from classical caring theories in nursing to contemporary theoretical viewpoints in nursing published within the last decade guided by a creative theory‐building process. This paper presents the theory of communion‐in‐caring with theoretical concepts and theoretical assumptions illuminating and supporting the contextual design and epistemological viewpoints of a caring‐based theory of nursing. Findings: Communion‐in‐caring is defined as a deliberate and a momentary occurrence of a nursing‐caring encounter in which the nurse and person nursed, together, design and express unique practice processes toward affirming and celebrating being human in a unitary‐transformative world. The theory further illuminates the foundational acts (i.e. love, hope, faith and charity) emulated into the embodied processes of communion‐in‐caring (i.e., caring‐nurturing encounter, caring‐nurturing inquiry and caring‐nurturing capacity). Such cyclical, rhythmical and moving processes yield a nurtured caring environment with ethical standpoints, resonate the meaning‐essence of caring through participation‐in‐being and offer culturally congruent care. Conclusion: This theory also realises that the discipline is overly influenced by technological advancements, digitalisation of care, the medicalisation of practice and a mechanistic lens of care. Thus, this theory calls for moral enrichment towards an identity that embodies participation‐in‐being, seeing self‐in‐others and communion‐of‐being. [ABSTRACT FROM AUTHOR]

This paper seeks to begin a discussion on researcher self‐care in response to the state of contemporary academia, which sees increasing issues of academic stress and anxiety, and the growing use of facile metrics. Specifically, we wish to explore the potential a critical engagement with self‐care poses for ourselves as academics and the communities of which we are a part – what kinpaisby (2008) refers to as the "communiversity." Our central argument is that self‐care may be regarded as a radical act that can push against the interests of the neoliberal university. We illustrate how researcher self‐care can be engaged as a reflexive process that operates to create and inform change within our communities through recognising ourselves as networked actors, rather than self‐contained individuals as the neoliberal ideology would have us believe. This paper is intended as an opening towards a much larger discussion regarding academia – of the communities, work environments, and "impacts" we wish to be a part of and how to begin working towards realising these. [ABSTRACT FROM AUTHOR]

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others' emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be humanely understood. Because we respond to others' very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. [ABSTRACT FROM AUTHOR]

The article informs that there will be a special issue of the journal "Child and Family Social Work" on the topic of young people leaving care, in August 2006. Papers on all aspects of leaving care will be welcome. In this context, "leaving care" refers to young people, aged 15-16 years or over, who leave, or age-out of, care from different types of care placements.

In this paper, we explore how the development of historical research methodologies during the last centuries can contribute to more diverse and interdisciplinary research in future caring science, especially towards a care focus that is more person‐centred. The adding of a historical approach by professional historians to the theory of person‐centredness and person‐centred care can develop knowledge that enables a more holistic understanding of the patient and the development of the patient perspective from the past until today. Thus, the aim was to show how developments within historical methodology can help us to understand elements of care in the past to further develop caring science in future. Historical research methodologies have advocated a "history from below" perspective, and this has enabled the evolution of systematic approaches to historical research that can be explored and critically analysed. Linked with this, the development of a more social and cultural oriented understanding of historical research has enabled historians to explore and add knowledge from a broader societal perspective. By focusing on the life of ordinary people and taking social and cultural aspects into account when trying to reconstruct the past, we can get a deeper understanding of health, care and medical development. However, an interdisciplinary research focus on person‐centredness and person‐centred care that includes professional historians can be challenging. In this paper, we argue that a historical perspective is necessary to meet the challenges we face in future delivery of health care to all people, in all parts of society in an ever more global world. [ABSTRACT FROM AUTHOR]

Family carers affected by violent, abusive or harmful behaviour by the older person for whom they care face social and epistemic challenges in developing and sharing knowledge about their experiences. These difficulties have contributed to a situation in which there is a paucity of evidence and public discourse about how we understand violence and harm instigated by people who have care needs or are 'vulnerable'. This paper reports the findings of a qualitative study that involved 12 in‐depth interviews with female carers affected by violence, abuse or harm. The study was informed theoretically by Miranda Fricker's concept of epistemic injustice which was used as a framework for analysis. There were two principal findings: (1) Carers were sensitive to anticipatory stigma and loss of moral autonomy. As a result, they self‐censured what they shared and, at times, were met with subtle but powerful processes of silencing. (2) Carers had limited linguistic and conceptual resources to explain the emotional and social aspects of the harm they experienced, exacerbated by implicit social norms about the 'private' and gendered nature of familial care. To conclude, we discuss the implications of these findings for sociological research and health and social care practice. [ABSTRACT FROM AUTHOR]

Nursing codes of ethics and conduct are features of professional practice across the world, and in the UK, the regulator has recently consulted on and published a new code. Initially part of a professionalising agenda, nursing codes have recently come to represent a managerialist and disciplinary agenda and nursing can no longer be regarded as a self-regulating profession. This paper argues that codes of ethics and codes of conduct are significantly different in form and function similar to the difference between ethics and law in everyday life. Some codes successfully integrate these two functions within the same document, while others, principally the UK Code, conflate them resulting in an ambiguous document unable to fulfil its functions effectively. The paper analyses the differences between ethical-codes and conduct-codes by discussing titles, authorship, level, scope for disagreement, consequences of transgression, language and finally and possibly most importantly agent-centeredness. It is argued that conduct-codes cannot require nurses to be compassionate because compassion involves an emotional response. The concept of kindness provides a plausible alternative for conduct-codes as it is possible to understand it solely in terms of acts. But if kindness is required in conduct-codes, investigation and possible censure follows from its absence. Using examples it is argued that there are at last five possible accounts of the absence of kindness. As well as being potentially problematic for disciplinary panels, difficulty in understanding the features of blameworthy absence of kindness may challenge UK nurses who, following a recently introduced revalidation procedure, are required to reflect on their practice in relation to The Code. It is concluded that closer attention to metaethical concerns by code writers will better support the functions of their issuing organisations. [ABSTRACT FROM AUTHOR]

Introduction: This paper describes first‐line department healthcare professionals' experiences of conversations with young adults (16–25 years) who express existential concerns. Existential concerns encompass questions about the meaning of life and the choices people must make, and they are sometimes expressed during the period in which a child is becoming an adult. Sometimes the transition to adulthood can be difficult, and many young adults seek support from people in first‐line departments, such as primary care providers, youth guidance centre personnel and student health service employees in high schools and universities. Conversations in which existential concerns are recognised may be important for preventing mental illness in the future. Aim: The study aimed to describe healthcare professionals' lived experiences of conversations with young adults who express existential concerns. Approach and methods: This qualitative study utilises thematic meaning analysis. Interviews were conducted with healthcare professionals working in first‐line departments, and data were analysed based on the principles of reflective lifeworld research. The study followed ethical codes of conduct and conformed to the ethical guidelines adopted by the Swedish Research Council. Findings: The results are presented in three themes of meaning: searching for innermost thoughts requires being present, uncertainty about the unpredictable and awakening of one's own existential concerns. Conclusions and implications: Healthcare professionals are affected when young adults express their existential concerns, and they need more support to strengthen their ability to stay present and create inviting atmospheres. [ABSTRACT FROM AUTHOR]

Grandparents whose grandchildren are exposed to domestic violence are faced with some unique challenges in their grandparenting, which have thus far been little discussed in research. This paper discusses the narratives of 10 Swedish grandparents whose grandchildren have been exposed to violence towards their mother. The aim was to explore grandparents' narrations of their responses in the face of violence, and their understanding of the role they play in their grandchildren's social networks. Two significant responses are discussed: ‘being there’ and ‘acknowledging the independence and self‐determination of the adult children’. Grandparents experienced these responses as contradictory and felt powerless when it came to their possibilities to protect their grandchildren. The paper suggests that grandparents could be a resource for domestic violence services, and social work practice needs to assess the roles of grandparents of children exposed to domestic violence. Social workers should consider the challenges these grandparents are facing and what support they may need in order to support their grandchildren. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, I argue that care ethics should be understood as a form of value pluralism. Writers on the ethics of care tend not explicitly to address issues in the theory of value, although much of what has been written about care ethics may be taken to suggest that it endorses some form of value monism. I argue against this conception of care ethics by showing that the practical reality of caregiving is more accurately represented by a pluralist account of value. Practices of care are plausibly guided by a number of distinct and potentially conflicting values. These include quality of life, autonomy, dignity, personal development, and the value of nurturant relationships. Whilst caring takes each of these values to be important in its own right, they are not always jointly realisable, and carers are sometimes forced to promote one such value at the expense of another. The possibility of conflict between values is, of course, precisely what a pluralist conception of value tells us to expect. In this respect, then, value pluralism more faithfully reflects the reality of caregiving than does value monism, and care ethicists ought for this reason to endorse it. [ABSTRACT FROM AUTHOR]

Previous research identifies the increased exposure of birth children of foster carers to experiences of separation, grief, and loss due to the transient nature of foster care, but little is known about how birth children manage this loss. This paper reports findings from a qualitative study that examined the retrospective experiences of 15 adult birth children of foster carers (aged between 18 and 28 years) in Ireland. Findings suggest that birth children experience grief and loss when foster children leave their families. They report experiencing a range of emotional responses such as guilt, blame, and sadness. A reluctance to discuss their emotional responses with either their parents or foster care professionals was also reported. Instead, birth children developed strategies to manage the loss, such as distancing themselves from the foster care process. The study highlights the importance of social workers and foster carers explaining to birth children why foster children are leaving and, where possible, maintaining contact between birth children and foster children. Additionally, findings indicate the need for birth children to have safe nonjudgmental spaces to discuss their emotional reactions to loss. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this article is to fill the need for an updated concept analysis of compassion fatigue. Methods This review used Rodgers' Evolutionary Model to direct the analysis of 25 papers published between 2005 and 2015. This review focused strictly on healthcare providers in the formal healthcare setting. Conclusions The authors provided an analysis of the evolution of compassion fatigue and identified surrogate terms, attributes and defining characteristics, and antecedents and consequences of the term, true to Rodgers' Evolutionary Model. Related terms are also discussed and a brief case model is provided. Clinical Relevance A better understanding of compassion fatigue will allow researchers and clinicians to identify its causes, prevention, and treatment. This could impact the rate at which healthcare providers leave clinical practice and their ability to compassionately engage with patients. [ABSTRACT FROM AUTHOR]

This paper reexamines the Shuman seminal paper arguing against empathic behaviors in forensic evaluations. Shuman concluded that empathy by examiners seduces evaluees into believing a therapeutic relationship exists. We reconsider empathy as an element of rapport and a helpful supplement in a successful assessment. Actively avoiding empathy could lead to cold and callous examiner self-presentation, which may in turn produce biased and negative results. In this paper we assert that ethical forensic professionals may use moderate empathy during an assessment. Examiners should consider it not as a component of subjectivity and pseudotherapy, but rather as a potentially useful tool for effective assessments. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Philosophical and empirical work on the nature of the emotions is extensive, and there are many theories of emotions. However, all agree that emotions are not knee jerk reactions to stimuli and are open to rational assessment or warrant. This paper's focus is on the condition or conditions for compassion as an emotion and the likelihood that it or they can be met in nursing practice. Thus, it is attempting to keep, as far as possible, compassion as an emotion separate from both moral norms and professional norms. This is because empirical or causal conditions that can make experiencing and acting out of compassion difficult seem especially relevant in nursing practice. I consider how theories of emotion in general and of compassion in particular are somewhat contested, but all recent accounts agree that emotions are not totally immune to reason. Then, using accounts of constitutive conditions of the emotion of compassion, I will show how they are often likely to be quite fragile or unstable in practice and particularly so within much nursing practice. In addition, some of the conditions for compassion will be shown to be problematic for nursing practice. It is difficult to keep ideas of compassion separate from morality, and this connection is noticeable in the claims made of compassion for nursing and so I will briefly highlight one such connection that of the need for normative theory to give an account of the value that emotions such as compassion presume and that compassionate motivation is separate from moral motivation and may conflict with it. The fragility or instability of the emotion of compassion in practice has implications for both what can be expected and what should be expected of compassion; at least if what is wanted is a realist rather than idealist account of 'should.' [ABSTRACT FROM AUTHOR]

If we pause to recognise that as professionals we share the same sky and the same earth as those who seek our help, then we would come to understand that our experiences of spirituality are also intrinsically interlinked. Using case examples, this paper explores my experience of adopting combinations of systemic and narrative therapy interventions within a stance of 'radical presence' (McNamee, ) with 'spiritual relational reflexivity.' In this process, the mutual influence between professional, personal, and therapeutic contexts is viewed as a helpful resource for 'being with' clients spiritually. Reflexive 'ways of engaging spirituality' (being 'spiritually relationally reflexive') and opening up therapeutic and spiritual possibilities with clients, in the context of grief, are also explored. Essential to the process is viewing systemic therapy as an ongoing reflexive learning context. [ABSTRACT FROM AUTHOR]

This paper describes the discourses underlying nursing teachers’ talk about their own norm‐critical competence. Norm criticism is an approach that promotes awareness and criticism of the norms and power structures that exert an excluding effect in society in general and in the healthcare encounter in particular. Given the unequal relationships that can exist in healthcare, for example relationships shaped by racism, sexism and classism, a norm‐critical approach to nursing education would help illuminate these matters. The studied empirical material consisted of focus group interviews. Nursing teachers discussed their norm‐critical competence based on the university course “Norm‐Aware Caring” in which they had recently participated. Through a critical discourse analysis, three discourses were identified in their talk, all of which had the potential to disrupt traditional, normative nursing education. However, in all three discourses there was an underlying discourse of normality, clearly positioning the teachers as exemplifying the “normal.” The binary constructed between normality and otherness contradicts a basic tenet of the norm‐critical approach and may hamper the development of genuine norm‐critical competence in nursing education. [ABSTRACT FROM AUTHOR]

BRISKIN L. Nursing Inquiry 2012; 19: 285-296 Resistance, mobilization and militancy: nurses on strike Drawing on nurses' strikes in many countries, this paper explores nurse militancy with reference to professionalism and the commitment to service; patriarchal practices and gendered subordination; and proletarianization and the confrontation with healthcare restructuring. These deeply entangled trajectories have had a significant impact on the work, consciousness and militancy of nurses and have shaped occupation-specific forms of resistance. They have produced a pattern of overlapping solidarities - occupational solidarity, gendered alliances and coalitions around healthcare restructuring - which have supported, indeed promoted, militancy among nurses, despite the multiple forces arrayed against them. The professional commitments of nurses to the provision of care have confronted healthcare restructuring, nursing shortages, intensification of work, precarious employment and gendered hierarchies with a militant discourse around the public interest, and a reconstitution and reclamation of 'caring', what I call the politicisation of caring. In fact, nurses' dedication to caring work in the late twentieth and early twenty-first centuries may encourage rather than dissuade them from going on strike. This paper uses a trans-disciplinary methodology, qualitative material in the form of strike narratives constructed from newspaper archives, and references to the popular and scholarly literature on nursing militancy. [ABSTRACT FROM AUTHOR]

Sister (Sr.) Marie Simone Roach, of the Sisters of St. Martha of Antigonish, Nova Scotia, died at the Motherhouse on 2 July 2016 at the age of 93, leaving behind a rich legacy of theoretical and practical work in the areas of care, caring and nursing ethics. She was a humble soul whose deep and scholarly thinking thrust her onto the global nursing stage where she will forever be tied to a central concept in nursing, caring, through her Six Cs of Caring model. In Canada, she was the lead architect of the Canadian Nurses Association's first code of ethics, and her influence on revisions to it is still profound more than 35 years later. In this paper, four global scholars in nursing and ethics are invited to reflect on Sr. Simone's contribution to nursing and health‐care, and we link her work to nursing and health‐care going forward. [ABSTRACT FROM AUTHOR]

SARGENT A. Nursing Inquiry 2012; 19: 134-143 [Epub ahead of print] Reframing caring as discursive practice: a critical review of conceptual analyses of caring in nursing This study critically examines the way in which the concept of caring is presented in the nursing literature through conceptual analytic approaches. A critical reflection on the potential consequences of representing a concept of caring as vague and ambiguous, yet central to ontology and epistemology in professional nursing is presented drawing on comparisons between the conceptual analyses of caring, and of structuralist perspectives of language, and how this potentially limits scholarship in this area. A search of the literature revealed nine conceptual papers. These papers highlight the self-referential characteristics of the concept of caring, and of analytical methods in general. It is proposed that this is the result of a systematic adherence to a rigid, structuralist view of language, whereby stable relationships between words and their meanings are assumed. An alternative perspective is offered by viewing caring as a discursive practice rather than a fixed conceptual entity, calling into question the role that the concept plays in nursing practice. A poststructuralist perspective requires caring to be perceived as a discourse of nursing that is fluid and contingent, rather than a central and guiding concept, opening up a new orientation for nursing scholarship in caring research. [ABSTRACT FROM AUTHOR]

In this paper I lay out the ground for a creative dialogue between Buddhist thought and contemporary nursing. I start from the observation that in tracing an arc from the existential human experience of suffering to finding compassionate responses to suffering in everyday practice Buddhist thought already appears to present significant affinities with nursing as a practice discipline. I discuss some of the complexities of entering into a cross-cultural dialogue, which is already well under way in the working out of Western forms of Buddhism, and which is beginning to be reflected in nursing literature. I introduce philosophical hermeneutics as a useful framework for elaborating an open and constructive exchange. I then discuss key Mahayana Buddhist concepts of emptiness and two truths that lead to a dynamic and open way of understanding reality and responding in the world. I turn to examples of original texts to give a flavour of the varied and distinctive forms of literature in the Buddhist tradition. This is intended partly to keep the reader alert to cultural difference (from a Western standpoint, that is) while exploring the creative potential of Buddhist thought. Hermeneutics again provides a framework for interpretation. This paper establishes a philosophical ground for a critical and creative dialogue between Buddhist thought and nursing. [ABSTRACT FROM AUTHOR]

Aim: This paper introduces the notion of ‘Caring science’ as a way to delineate and develop particular kinds of knowledge relevant to caring practices in critical care. Relevance for practice: Firstly, one particular development of person centred care, lifeworld led care is offered. Its relevance for critical care nursing is analysed by pointing to examples of studies which describe temporality, spatiality, intersubjectivity and embodiment and how they may manifest with reference to the person as ‘body object/body subject' and the matter of technology in critical care environments. Secondly, by use of an imagined practice scenario, the challenge of expanding our traditional notions of evidence to encompass ways of knowing that are more intimately embodied and practice related is discussed. Such knowledge, referred to as ‘embodied relational understanding’ is particularly relevant to a conception of caring for persons' in a holistic way. Conclusion: The paper concludes by pointing to the potential for caring science, grounded in lifeworld led care, to offer some integrating ideas that legitimate the full range of resources, ‘head’, ‘hand’ and ‘heart’, that nurses can draw upon in everyday holistic critical care practice. [ABSTRACT FROM AUTHOR]

Please cite this paper as: van Lonkhuijzen L, Dijkman A, van Roosmalen J, Zeeman G, Scherpbier A. A systematic review of the effectiveness of training in emergency obstetric care in low-resource environments. BJOG 2010;117:777–787. Background Training of healthcare workers can play an important role in improving quality of care, and reducing maternal and perinatal mortality and morbidity. Objectives To assess the effectiveness of training programmes aimed at improving emergency obstetric care in low-resource environments. Search strategy We searched Pubmed, Embase, Popline and selected websites, and manually searched bibliographies of selected articles. Language was not an exclusion criterion. Selection criteria All papers describing postgraduate training programmes aimed at improving emergency obstetric care in low-resource environments were included. Data collection and analysis Two reviewers independently extracted the data and classified these according to the level of the measured effects (reaction of participants, improved knowledge and skills, changes in behaviour and outcomes in practice). Any disagreements were resolved by discussion with a third author until agreement was reached. Main results A total of 38 papers were selected. Training programmes vary considerably in length, content and design. The evaluation of effects is often hampered by inadequate study design and the use of non-validated measuring instruments. Most papers describe positive reactions, increased knowledge and skills, and improved behaviour after training. Outcome is assessed less frequently, and positive effects are not always demonstrated. Measures that can contribute to a positive effect of training programmes include hands-on practise, team approaches and follow-up on training efforts. Author’s conclusions Training programmes may improve quality of care, but strong evidence is lacking. Policymakers need to include evaluation and reporting of effects in project budgets for new training programmes. [ABSTRACT FROM AUTHOR]

This paper examines the history of care in modern society and seeks to expose how deep transformations in care arise from wider social relations. From historical survey we may discern a series of transitional points, where the practice and the experience of care was greatly, sometimes suddenly, redefined. Each betrayed deeper political and ethical struggles that went to the core of social relations, and which weren't merely therapeutic in nature. This paper explores two such ‘moments’. I first examine the emergence of a new institutional landscape during the middle industrial era, in the wake of a series of legal and political reforms that sought to settle a social order uprooted and distressed by raw modernisation. I provide a composite, yet incomplete view, of how this transformation proceeded in one urban setting, colonial Melbourne. In the second instance, I review the ambitions and process of deinstitutionalisation in the late 20th century. Ostensibly, this reform sought, inter alia, to collapse the great division between ‘fit’ and ‘unfit’ established in 1834. Again, empirical reference is made to the reconstitution of care in Melbourne, Australia, this time during its late 20th experience of institutional reform. The focus in this case is the process of downscaling and closure for a major congregate facility, Kew Cottages. The major conclusion is that periods of intense transition in the ideology and mode of care are reflective of wider social transformations not merely of therapeutic or institutional shifts. [ABSTRACT FROM AUTHOR]

Background The paper argues that a high quality personal relationship between professionals and clients is a necessary condition of professional knowledge. This epistemological claim is developed against the background of current methods of quality assessment that rely on objectively measurable ‘indicators’. Method A philosophical analysis regarding the nature of professional knowledge in the care sector. The analysis proceeds from Michael Polanyi's concept of tacit knowledge to account for the personal dimension of professional expertise in the care sector. Results Quantitative methods of quality assessment understand ‘quality of care’ as being independent from the professional who generates it. Consequently, quality assessment as currently practiced necessarily renders the personal dimension of professional knowledge invisible, thereby excluding it from managerial attention and support. To indicate the relevance of Polanyi's concept of tacit knowledge, the paper offers some observations from the practice of care in a group home for people with intellectual disabilities. Conclusion The paper concludes that a high quality relationship between professionals and their clients is crucial for quality of care. This relationship generates the positive interaction that enables professionals to gain adequate insight in the needs of their clients. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify and describe how Kristen Swanson’s middle-range theory has been used in nursing practice/research presented in international journals. A total of 120 studies were included in the review and 23 were analysed further. An overview of the studies is presented, followed by four categories of how the theory has been used: referring to the theory (97 papers), applications of the theory to practice/research and/or theoretical discussions (nine papers), relating findings to and/or validation of the theory (eight papers), and development of measurements from and/or testing of the theory (six papers). The use of the theory and conclusions of the studies related to criteria for evaluation of theories were discussed. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a concept analysis of emotional labour. Background. Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. Data sources. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, PsycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. Review methods. We followed Rodgers' evolutionary method of concept analysis. Results. Emotional labour is a process whereby nurses adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements: organization (i.e. social norms, social support), nurse (i.e. role identification, professional commitment, work experience and interpersonal skills) and job (i.e. autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions: nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e. productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive). Conclusion. The concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients. [ABSTRACT FROM AUTHOR]

The purpose of this paper, the first of a series of two discussion pieces, is to introduce some of the issues in the debate surrounding qualitative research to the readers of Musculoskeletal Care. Recent issues of the Journal have seen an informative focus on quantitative methods and statistical analysis, and here we provide an equivalent introduction to semi-structured interviewing and qualitative analysis in this series. In the qualitative tradition, we have tried to keep our discussion reflexive, transparent and contextualized within the history of the approach and the theoretical considerations that underlie it, including the origins, nature, methods and limits of the approach. We provide information that we hope is useful for readers with all levels of familiarity with qualitative research, building from an introduction to some basic assumptions and ethical issues. We also introduce one specific qualitative approach, interpretative phenomenological analysis, which researchers might wish to apply. In the accompanying paper in a subsequent issue of Musculoskeletal Care, we will describe the potential application of this approach. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim. To explore and analyse the role of the nurse teacher. Background. This paper examines the issue of clinical credibility among nurse teachers which has been ongoing for over a decade. The move of nurse education from colleges of nursing to the Higher Education Institutes was seen in 1992. Since then, nurse teachers have been faced with the need to juggle the roles of teaching, administration, research and clinical support for students. Nursing students within these Higher Education Institutes require more than the traditional theoretical classroom teaching. Nurse teachers have a role beyond this in encouraging students to link theory with practice, and practice with theory. Therein lies a challenge for nurse teachers to ensure they remain credible within the clinical setting and continue to provide education and support, which is firmly grounded in both practice and theory. Method. The authors have critically reviewed the evidence related to the role of the nurse teacher in an attempt to identify key concepts and ideas, assumptions, supporting examples and the implications for their role. Conclusion. The role of the nurse teacher, it would appear, is a dynamic one that needs to engage actively the needs of the student. Nurses therefore need to be dynamic in their approach in order to respond to both local and global demands and ensure that students become competent, professional, knowledgeable and caring in their approach. Relevance to clinical practice. This paper demonstrates the complex and ever changing role of the nurse teacher. This paper attempts to help nurse teachers understand the complex nature of their role. [ABSTRACT FROM AUTHOR]

Operating room nurses continue to draw criticism regarding the appropriateness of a nursing presence in the operating room. The technological focus of the theatre and the ways in which nurses in the theatre have shaped and reshaped their practice in response to technological change have caused people within and outside the nursing profession to question whether operating room nursing is a technological rather than nursing undertaking. This paper reports findings from an ethnographic study that was conducted in an Australian operating department. The study examined the contribution of nurses to the work of the operating room through intensive observation and ethnographic interviews. This paper uses selected findings from the study to explore the ways in which nurses in theatre interpret their role in terms of caring in a technological environment. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2004; 18; 424–436On the absence of a‘Socio-emotional Enablement’ discourse component in international socio-economic development thoughtSocio-emotional well-being, established through nurturing relationships and community experiences, enables children and adults to evolve into caring, nonviolent, emotionally healthy citizens.This paper analyses purposefully selected development texts, authored by three prominent contributors of socio-economic development discourse: the United Nations, the World Bank and the International Monetary Fund. On the basis of a socio-emotional capacity development framework that draws from research produced in the areas of developmental psychology, biopsychology, brain research and peace psychology, the study evaluates texts’ tendencies to make socio-emotionally conducive– or neglectful– programme recommendations.The study finds that United Nations conference reports indirectly acknowledge the relevance for socio-emotional enablement and protection, in the context of discussions related to human and children's rights, education or women's empowerment. However, they only marginally discuss the need to foster socio-emotional well-being as a human capacity development rationaleper se.The International Monetary Fund, while acknowledging responsibility for the social conduciveness of macro-economic development interventions, does not address socio-emotional capacity development issues. The World Bank's strategic plan and other strategy papers touch on issues of socio-emotional capacity development only tangentially.The study concludes that the discourse communities authoring the selected development texts largely ignore the question of socio-emotional capacity development. Their discourses‘background’ discussions about the kind and nature of social structures necessary for nurturing socio-emotional enablement. Developmental psychologists are challenged to‘infect’ socio-economic development discourse by calling for the effective integration of the theme of socio-emotional well-being into socio-economic development publications. [ABSTRACT FROM AUTHOR]

The primary prevention of child abuse is both a clinical and political priority. Home visiting programmes consisting of structured visits by a professional over an extended period of time during the perinatal period have been identified in a number of studies as being a potentially effective means of achieving this. The use of professionally delivered home visiting programmes in the UK to date, however, has been limited. This paper describes the development of an innovative, primary care-based home visiting service, which is aimed at the primary prevention of maltreatment, abuse and neglect and the promotion of positive parenting and secure attachment. The paper provides a description of the rationale and policy context for the new service and an account of its development, with particular emphasis on the aim of working `in partnership' with families. [ABSTRACT FROM AUTHOR]

AIMS OF THE PAPER: This paper examines the care provision for people suffering from dementia and explores the potential benefits associated with an approach to care that emphasizes the importance of relationships. BACKGROUND: Recent research findings have provided an incentive to re-evaluate the established approaches to care for this client group. Two separate studies identified education and intellectual stimulation as important determinants of the onset of Alzheimer's disease (Ott et al. 1995, Snowdon et al. 1996). These findings have encouraged the hypothesis that potential symptomatic benefits may be achieved by providing a more stimulating environment for people with dementia. METHODS: A case study is outlined which illustrates an approach to caring influenced by the Continental philosopher, Emmanuel Levinas. Primacy is given to the relationships that make up caring, and not to a method that sets out to achieve an identified objective. The issue of mutual responsibility within the provision of care is highlighted in the case study. FINDINGS: The hypothesis presented in this paper is that a person has more of an opportunity to develop to the limits of their potential by establishing the importance of relationships in providing care by means of education and training of the people involved. The beneficiaries might be the caregiver or the person in receipt of care. CONCLUSIONS: An environment that attempts to educate people to recognize the importance of relationships will be more effective in achieving the potential benefits of symptom alleviation identified by the research into Alzheimer's disease outlined in this paper. [ABSTRACT FROM AUTHOR]

In this paper we examine the provision and use of rural childcare, drawing on original data collected as part of a study of formal and informal childcare services in the County of Devon in England. The paper goes beyond existing discussions of childcare in rural areas in attempting to place patterns of use in the broader context of household gender relations and the cultural construction of rurality. We argue that decisions around child care by rural families need to be considered in relation not only to the availability of different sorts of service but also to the employment aspirations and choices of men and women and the assumptions of the primacy of women’s mothering role. Such issues are underpinned, we contest, by idyllic constructions of rural family life and social relations. [ABSTRACT FROM AUTHOR]

Going home from hospital: the carer/patient dyad Aims. This study aimed to provide an in-depth understanding of the process of hospital discharge experienced by the carers of patients ‘at risk’ of unsuccessful discharge from medical wards in three hospitals in the North of England. Background. The Community Care Act and the Carers Recognition and Services Act placed responsibility on service providers to ensure the smooth discharge of patients from hospital making sure that appropriate community services are in place to support the patient and their informal carer following discharge from hospital. The study, from which this paper is taken, identified patients at risk of unsuccessful discharge and tracked the experiences of the patient and their carer through the discharge process. For the purpose of the study unsuccessful discharge is defined as unplanned readmission within 6 weeks of discharge or extended length of stay. Design. The study combined qualitative and quantitative methods to identify factors leading to unsuccessful discharge. Logistic regression was used retrospectively with the records of 1500 patients to identify factors predicting unsuccessful discharge. A sample of medical patients predicted to be at risk of unsuccessful discharge, their formal and informal carers, were followed through the discharge process using qualitative techniques to look at decision-making and outcomes related to discharge. Findings. This paper presents findings relating to patient/carer experiences of the discharge process. It explores the obligate moral climate in which the role of carer is negotiated between professionals, patients, family members, friends and neighbours and the differing assumptions about duty associated with caring roles in hospital and in family and community settings. Conclusion. The discussion adopts a critical theory perspective to examine the contradictions confronting practitioners, patients and carers arising from hospital policies which promote cost-effective and efficient use of expensive technical resources while simultaneously seeking to identify and meet the needs of patients and carers for care. [ABSTRACT FROM AUTHOR]

In this paper, I discuss the findings of an ethnographic study of a fertility unit. I suggest that caring as 'emotional awareness' and 'non-caring' as 'emotional distance' may be forms of nursing akin to Fabricius's (1991) arguments around the 'good enough' nurse. This paper critiques caring theories and contributes to the debates over the nature of caring in nursing. I discuss the implications raised for nurses if patients want a practical approach to caring and do not expect an emotionally intimate relationship from nurses. [ABSTRACT FROM AUTHOR]

This paper examines the discursive work undertaken by family members caring for people with dementia when interacting with community psychiatric nurses. The paper outlines the theoretical basis of this approach and brings it to bear upon data taken from a study of home visits to family carers by community psychiatric nurses. The paper provides insights into the way family carers and welfare agencies manage their interface through the use of language. In particular, the paper illuminates how these interactions construct the identity of people with dementia and their carers and locates them in a specific socio-political context. The paper has important implications regarding the future development of dementia care nursing and also the future development of policy relating to dementia care. [ABSTRACT FROM AUTHOR]

Who cares? Offering emotion work as a ‘gift’ in the nursing labour process The emotional elements of the nursing labour process are being recognized increasingly. Many commentators stress that nurses’ ‘emotional labour’ is hard and productive work and should be valued in the same way as physical or technical labour. However, the term ‘emotional labour’ fails to conceptualize the many occasions when nurses not only work hard on their emotions in order to present the detached face of a professional carer, but also to offer authentic caring behaviour to patients in their care. Using qualitative data collected from a group of gynaecology nurses in an English National Health Service (NHS) Trust hospital, this paper argues that nursing work is emotionally complex and may be better understood by utilizing a combination of Hochschild’s concepts: emotion work as a ‘gift’ in addition to ‘emotional labour’. The gynaecology nurses in this study describe their work as ‘emotionful’ and therefore it could be said that this particular group of nurses represent a distinct example. Nevertheless, though it is impossible to generalize from limited data, the research presented in this paper does highlight the emotional complexity of the nursing labour process, expands the current conceptual analysis, and offers a path for future research. The examination further emphasizes the need to understand and value the motivations behind nurses’ emotion work and their wish to maintain caring as a central value in professional nursing. [ABSTRACT FROM AUTHOR]

Compassionate care: a moral dimension of nursingThis paper focuses on the concept of compassion and its meaning for nursing practice. Compassion is often considered to be an essential component of nursing care; however, it is difficult to identify what exactly comprises compassionate care. To begin with, there is a general discussion of the meaning of compassion and an examination of its common usage. An argument then is presented that compassion is more than just a natural response to suffering, rather that it is a moral choice. The paper outlines the extent to which this concept has implications for nursing care, highlighting some of the obstacles that nurses need to overcome in order to maintain this essential moral value of the caring role. [ABSTRACT FROM AUTHOR]

• Countries throughout the developed world have introduced a policy of community care for older people to reduce costs to the state and maintain quality of life. • In reality community care is largely family care and recognition of the need to support family carers is being promoted through the notion of partnership with professional carers. • Such a partnership calls for a more complete understanding of how carers’ needs change over time and how professional support can be most effective. • Support is particularly important at the start of care-giving in order that carers can exercise free choice and be adequately prepared for their role. • This paper provides an overview an ongoing longitudinal study and reports specifically on the findings of data from a preliminary study in which a convenience sample of seven experienced carers of stroke survivors who attended a stroke and carers club were interviewed in their own homes. • Based on initial data from a longitudinal study of stroke victims, this paper outlines four themes: ‘What’s it all about’, ‘Going it alone’, ‘Up to the job’ and ‘What about me?’ These themes highlight the difficulties carers experience in the immediate aftermath of stroke. [ABSTRACT FROM AUTHOR]

Examines the power of compassion over mourning illustrated in the article by Joyce McDougall which described the psychoanalytic voyage of a 40-year old female cancer patient. Explicitness of the paper in illustrating the triumph of an individual's psychoanalysis; Explanation of the theoretical implications of the paper.

Schools are increasingly seen as key sites for support to HIV-affected and other vulnerable children, and teachers are assigned the critical role of identifying and providing psychosocial support. Drawing on the life--work history narratives of 12 teachers in Zimbabwe, this paper explores the psychosocial processes underpinning teachers' conceptualisations of these caring roles. The influence of prolonged adversity, formative relationships, and broader patterns of social and institutional change in teacher identity formation processes speak to the complex and embodied nature of understandings of 'care'. In such extreme settings teachers prioritise the material and disciplinary aspects of 'care' that they see as essential for supporting children to overcome hardship. This focus not only means that emotional support as envisaged in international policy is commonly overlooked, but also exposes a wider ideological clash about childrearing. This tension together with an overall ambivalence surrounding teacher identities puts further strain on teacher--student relationships. We propose the current trainings on providing emotional support are insufficient and that more active focus needs to be directed at support to teachers in relation with their students. [ABSTRACT FROM AUTHOR]

This paper reports findings about parents' experiences of caring for young people with Autistic Spectrum Conditions (ASCs) moving into adulthood. In‐depth interviews were conducted with 38 parents of young people (15–21 years) with ASCs. Data were analysed thematically. In the perceived absence of service support, parents' acted as ‘care‐coordinators’ and ‘life‐supporters’ for their child as they moved into adulthood. These roles came with little choice, emotional demands and personal restrictions. Being supported was important for parents, but preferences differed regarding what this should look like. Implications for policy are discussed. [ABSTRACT FROM AUTHOR]

Medieval fatherhood, like masculinity, was built upon intersecting identities. The present paper aims to identify those identities, to analyse the way in which they were constructed and to examine the linkages between fatherhood and masculinity in the context of fourteenth- and fifteenth-century Montpellier, a great city in Mediterranean Languedoc. Fatherhood is a dynamic research field in medieval studies that is now enriched by the gender studies’ conceptual frame. Becoming and being a father had many social and cultural implications in late-medieval societies that correlated to gendered constructs. Of this complex subject, our inquiry in the Montpellier archives can offer only a fragmentary view. The article focuses on three fields of history connected to the study of medieval fathers: legal history, the history of the emotions and economic history, and illustrates how those fields can benefit from a more gendered perspective, helping us to enrich our understanding of medieval fatherhood and its relationship with masculine identity. [ABSTRACT FROM AUTHOR]

This paper utilizes data generated during a qualitative study in palliative and maternity care settings to guide discussion of the current discourse, which emphasizes patient autonomy and derides paternalism. Data are presented which illustrate that this ideology is established in nursing practice. Respect for patient autonomy is identified as an essential element of individualized, patient-centred and ethical care but conversely, it is suggested that overemphasis may confuse and suppress beneficent intervention. The value of ethical theory to provide an objective means to explore ethical dilemmas in practice is not debated, but exploration of the issues raised by the data suggest, that principle-based ethical theory suffers the following constraints: the predetermined balance of ethical principles in favour of respect for autonomy prevents an unbiased perspective and optimum guidance; in contrast to caring relationship, application of ethical theory does not reveal the particulars necessary to guide ethical decisions aimed at promoting good for the individual; current discourse appears to disregard the inherent inequality in the relationship between the helped and helper and practitioners' need to preserve their own moral integrity. Consequently, this paper argues that beneficence derived through caring should not be superseded uncritically and suggests that mutual nurse-patient relationship, which balances respect for patient autonomy and beneficent guidance based on practitioner's clinical expertise, protects the moral integrity of both patient and practitioner. For conciseness, the term patient will be used to indicate recipients of both nursing and midwifery care and while both nurses and midwives are not always specified, any term referring to nurses, denotes both. [ABSTRACT FROM AUTHOR]

Many authors view practice theory as the strongest form of theory for an applied discipline like nursing. It is based upon the idea that theory emanates from practice, is strengthened and is returned to inform practice. The first part of this paper is concerned with identifying the contribution that practice theory can make to patient care. While there are many positivistic ways of generating practice theory, one method which is getting increasing attention is reflection. In this paper, Bond et al.'s framework for reflection is used to identify phenomena related to the empowerment of patients and staff in psychiatric hospitals (Bond et al. 1985). A real life case study is described and concepts and beginning propositions are uncovered. Conclusions are drawn which form the basis for theory development and testing. [ABSTRACT FROM AUTHOR]

The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. The paper is presented in two parts. Part 1 included the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and draws conclusions drawn from the study as a whole. Patients and nurses in hospital wards were interviewed using the critical incident technique. We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. The themes were grouped into eight clusters: therapeutic context for care, attitudes and sensitivity, teaching and leadership, motivation to nurse, monitoring and informing, high-dependency care, efficiency and thoroughness, reflection and anticipation. As shown in Part 1 of the paper, congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis. The findings support an emerging theory of interpersonal competence and quality in nursing care. [ABSTRACT FROM AUTHOR]

Seldom is the work of philosophers invoked by health professionals when examining aspects of care from a philosophical perspective. Instead, students of health care, especially nurses, have been introduced to ‘philosophies’ which are often superficially examined and poorly understood. This practice fails to develop in students an appreciation of the work of philosophers or to acquire the art of critical thinking. The introduction of models and theories of nursing in the past three decades has alerted nurses to the importance of possessing critical skills in order to identify sound theory and implement good practice. This paper goes beyond mere philosophising and examines aspects of mental health care from the perspectives of one of nineteenth century Europe’s most notable philosophers, Friedrich Nietzsche. It argues that understanding his work can enhance one’s ability to reflect on nursing practice, as well as bringing a new dimension to how we analyse ‘mental health’ problems. His work provides many insights into how we can improve our understanding of the effect of mental illness and mental health care on the individual, and how we conceptualise the process of care. This paper provides an overview of his life’s work, his impact on the history of ideas and develops some of the more provocative implications of his work for mental health care. [ABSTRACT FROM AUTHOR]

This paper will examine the claim that caring is an appropriate ethical ideal for nursing. Initially it will examine nursing's philosophy of care and caring, highlighting some areas of difficulty and dissatisfaction articulated by many of its contemporary theorists. Evaluation of the notion of caring as an appropriate ethical ideal for nursing will be balanced against those in opposition, and in this process their critique will be discussed. This discussion will focus on areas such as virtue, virtue ethics, moral responsibility, feminine values, mothering and the debate between male and female caring. Different forms of caring will be evaluated and balanced against different forms of nursing. The paper will then suggest that current views which hold aloft nursing as a bedmate of caring may be detrimental to both the cared-for and the carer, advocating in the process a move toward change. [ABSTRACT FROM AUTHOR]

There is an extensive literature discussing the 'care:cure dilemma'. This usually puts forward the position that it is doctors who do the curing and nurses who do the caring. Patients are rarely included in the discussion. This paper considers some of this literature and examines whether this separation of functions is a valid one, the part of lay carers in the process, and the perspective of patients. It focuses particularly on cancer because this is an area where the issues seem particularly pertinent. The paper concludes by proposing an alternative and integrated conception which includes patients, nurses and doctors in a cognitive-phenomenological model of coping. It is suggested that this model moves forward from the previous limitations of the care:cure approach and enables more fruitful research and education of practitioners to be undertaken. [ABSTRACT FROM AUTHOR]