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Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

linden m. & kavanagh r. (2012) Attitudes of qualified vs. student mental health nurses towards an individual diagnosed with schizophrenia. Journal of Advanced Nursing 68(6), 1359-1368. Abstract Aim. This paper is the report of a study which sought to compare the attitudes held by student and qualified mental health nurses towards individuals with schizophrenia in the Republic of Ireland. Background. Media portrayals of individuals with schizophrenia often include images of aggression and violence. With global initiatives aimed at reducing the stigma and exclusion associated with mental illness, the attitudes of those who care for people with schizophrenia are of particular interest. Methods. A survey was administered to 66 student mental health nurses, and 121 qualified mental health nurses. Participants completed the community attitudes to mental illness scale and the social interaction scale in 2009. Multivariate analysis of variance was used to test for the effects of qualification, work setting, years of experience and education on the measures. Results. Nurses employed in a community setting held more positive attitudes, when compared with colleagues who worked in an inpatient setting, as measured by the community mental health ideology subscale, indicating their desire to promote community care for individuals with schizophrenia. Nurses working in an inpatient setting held more socially restrictive attitudes indicating that they felt individuals with schizophrenia were dangerous and should be avoided. These findings were statistically significant at the P < 0·05 level. Conclusions. Mental health nurses must be alerted to the fact that holding negative attitudes may adversely affect the therapeutic relationship and ultimately lead to stigmatization and its negative consequences. [ABSTRACT FROM AUTHOR]

o'leary d.f. & ni mhaolrúnaigh s. (2012) Information-seeking behaviour of nurses: where is information sought and what processes are followed? Journal of Advanced Nursing 68(2), 379-390. Abstract Aim. This paper is a report of a study on how nurses inform their decision-making in the workplace. Background. Despite the growing availability of research evidence, nurses have been slow to adopt it into their daily decision-making. Method. The study was undertaken in Ireland between 2006 and 2007 using a sequential mixed methods approach. In phase 1, the views of a quota sample of 29 nurses were explored using semi-structured interviews incorporating vignettes. Phase 2 involved the design and dissemination of a survey to a disproportionate stratified random sample of 1356 nurses. The response rate was 29%. Findings. In decision-making, nurses accessed other people, especially nursing colleagues, the most frequently. Sources that provided prepackaged information such as guidelines were favoured over sources that provided access to original research. The process of information-seeking for routine and non-routine decisions was different. Nurses making routine decisions relied mostly on their experience and an assessment of the patient. In non-routine decision-making, participants experienced more uncertainty about their decisions. Accordingly, sources of information used were more varied and the information-seeking process more extensive. The study highlighted the complexities of establishing whether information used in decision-making is research based or not. Conclusion. Routine practices should be reviewed and updated regularly through organizational mandates, as nurses do not generally question them. Research information to inform non-routine decision-making must be easily available to nurses in their workplace, as information searches generally prioritize finding enough, rather than the best, information to make a decision. [ABSTRACT FROM AUTHOR]

coyne i., o'neill c., murphy m., costello t. & o'shea r. (2011) What does family-centred care mean to nurses and how do they think it could be enhanced in practice. Journal of Advanced Nursing 67(12), 2561-2573. Abstract Aim. This paper is a report of the qualitative findings of a multisite survey in seven children's units in Ireland. In this survey, nurses caring for children identified their practice and perception of family-centred care. Background. International research has identified inconsistencies with the provision and application of family-centred care in practice. Existing research studies illustrate barriers to family-centred care including nurses' attitudes to families and a lack of support and resources for the philosophy. Method. A descriptive survey design was employed to collect data in 2008-2009. Questionnaires were distributed to nurses ( n = 750) which yielded a response rate of 33% ( n = 250). The nurses completed a 47-item questionnaire which examined nurses' perceptions and practices of family-centred care, the quantitative findings of this study will be reported in another publication. The questionnaire contained two open-ended questions and the data from these questions are reported here. Findings. While nurses accept family-centred care as an ideal philosophy for the care of children and their families, the implementation of family-centred care in practice would seem to present challenges for nurses. The majority in this study indicated that they required further organizational and managerial support to fully implement family-centred care practices. Two interrelated themes were identified 'the components of family-centred care' and 'enhancing family-centred care'. Conclusion. To provide good quality family-centred care nurses need adequate resources, appropriate education, support for managers and support from other healthcare disciplines. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a descriptive study of nurses' and midwives' clinical leadership development needs. Background. Nurses and midwives are expected to fulfil a leadership role at all levels, yet efforts to strategically support them are often unfocused. An analysis of clinical leadership development needs can provide the foundation for leadership initiatives to support staff. Method. A mixed methods design was used. A questionnaire was sent to 911 nurses and midwives and 22 focus groups comprising 184 participants were conducted. Data were collected between March and June 2009 across all promotional grades of nurses and midwives in Ireland. Repeated measures ANOVA with Greenhouse-Geisser adjustment was used for post hoc pair wise comparisons of the subscale dimensions of clinical leadership. ANOVA with Tukey's post hoc method was used for comparison between grades on each individual subscale. Thematic analysis was undertaken on the focus group data. Results. Results reveal that needs related to development of the profession were the highest for all grades. The staff grade expressed a higher need in relation to 'managing clinical area', 'managing the patient care' and 'skills for clinical leadership' than managers. Qualitative analysis yielded five themes; (1) clinical leadership and leaders from a nursing and midwifery perspective; (2) quality service from a nursing and midwifery perspective; (3) clinical leaders' roles and functions; (4) capital and (5) competences for clinical leaders and leadership and the context of clinical leadership. Conclusion. Clinical leadership concerns quality, safety and effectiveness. Nurses and midwives are ideally placed to offer the clinical leadership that is required to ensure these patient care outcomes. Development initiatives must address the leader and leadership competencies to support staff. [ABSTRACT FROM AUTHOR]

Aims. This paper reports the findings of a national study of the variations in the provision and correlates of respite breaks to families. Background. Internationally, respite breaks are a major support service to family carers, demand for which often exceeds supply for persons with an intellectual disability. Hence, the length of breaks available to families has to be rationed. Nurses are often involved in such decisions. Method. National data on the use of respite breaks by over 4000 families in a full calendar year (2008) were analysed to examine the variation within the Republic of Ireland on two indicators: namely the proportion of carers who had any access to breaks and the median number of days they had received. Findings. Striking differences across health service areas were found on both indicators of usage. These were not solely attributable to the availability of provision but also reflected variations in the criteria local services used to allocate places. However, those persons with more severe disabilities were given priority, whereas carer characteristics were not a major influence. Contact with social workers and community nurses also increased the likelihood of carers receiving respite breaks. Conclusion. Intra-country comparisons of service delivery should assist planners in creating more equitable access to respite breaks and the development of more explicit eligibility criteria for their use. Nurses are well placed to lead on this. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study measuring attitudes of primary care nurses towards caring for people with hepatitis C. Background. Hepatitis C is a major public health problem. Attitudes to caring for people with hepatitis C vary and can have an impact on nursing care practices. International literature has identified discriminating practices amongst healthcare professionals including nurses. There is limited research examining primary care nurses' attitudes to caring for people with hepatitis C. Methods. A cross-sectional postal census survey of 981 nurses working in one health board region in the Republic of Ireland was conducted during the period March 2006 to June 2006. Results. A response rate of 57.1% (n = 560) was achieved. Exploratory factor analysis of an attitude scale identified three latent variables: 'infection control behaviour', 'caring' and 'fear'. Attitudes were generally positive towards caring for persons with hepatitis C; however, 51.7% of respondents would use additional infection control precautions if caring for someone with known hepatitis C. Younger nurses and those educated to degree level and above held significantly more positive attitudes to caring. Nurses agreed that they have a central role in managing and treating people with hepatitis C; however, many agreed that they lack the knowledge and skills to care for persons with hepatitis C. Conclusions. Negative attitudes can result in discriminatory experiences for persons with hepatitis C or at risk. Nurses require ongoing education on hepatitis C to improve knowledge, to limit concerns and ensure adherence to infection control guidelines. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to compare knowledge of hepatitis C virus infection amongst three groups of registered nurses working in primary care, to identify their current sources of information and access to educational resources. Background. Hepatitis C virus infection is a public health problem;no vaccine exists to prevent the disease. Previous studies identified limitations in nurses' knowledge of hepatitis C virus infection and the impact on care. Limited research has been conducted in primary care. Methods. A cross-sectional postal census survey of 981 nurses working in one Irish health board region was conducted March--June 2006. Questionnaires measured knowledge of hepatitis C virus infection. Data were collected on demographics, current working practices, information resources and previous education. Results. The response rate was 57.1% (n = 560). A minority (27.3% 145/531) of respondents agreed they were well informed about the virus. Almost 40% reported having contact with clients with the virus; however, information and service provision differed. Factors influencing higher knowledge included: contact with clients with hepatitis C virus infection (P < 0.0001), working in the addiction services (P < 0.0001), educated to degree level and above (P < 0.010) and previously attending education programmes (P < 0.0001). Only 21.5% (119/553) of respondents had attended any form of education on hepatitis C virus infection. Conclusion. Gaps in nurses. knowledge exist and can limit information and advice. Educational and information resources need to be developed for registered nurses working in primary care; care for clients with hepatitis C virus infection is not the sole remit of the addiction services. [ABSTRACT FROM AUTHOR]

white c. & gallagher p. (2010) Effect of patient coping preferences on quality of life following renal transplantation. Journal of Advanced Nursing 66(11), 2550-2559. Aim. This paper is a report of a study investigating the relationships between quality of life, patient coping preferences, and desire to be actively involved in care following renal transplantation. Background. While the general consensus is that quality of life is improved greatly by kidney transplantation, it is apparent that it is not uniformly a positive experience in this regard. There is a need to identify individual difference factors that influence quality of life following renal transplantation. Method. A correlational study was conducted in the national referral centre for renal transplantation in the Republic of Ireland in 2006 with a sample of 172 transplant recipients. Data were collected using a questionnaire composed of standardized instruments to measure the key concepts. Results. Participants perceived that they had good quality of life, and used more problem-solving than avoidance coping strategies. Avoidance coping strategies were associated with statistically significantly lower quality of life following transplantation. Being younger, attaining a higher education level, being in employment and being married were associated with higher quality of life following transplantation. Conclusion. Assessment of coping strategies among the transplant population should be further explored in clinical practice, and steps employed to promote the use of positive coping strategies in order to maximize quality of life after transplant. [ABSTRACT FROM AUTHOR]

Aim The aim was to identify key patient outcomes and to compare these outcomes across services that employed clinical specialists (either nurse or midwife) or advanced nurse practitioners with matched, non post-holding services. Background In nursing and evaluation research, it is recognized that, further patient outcome studies, which measure and evaluate the impact of the new advanced roles, are urgently needed. Design A cross-sectional study design with a comparison group was implemented across Ireland. Method A total of 279 surveys were completed by service users in 41 services in 2009/10. Key outcomes were identified, then chosen as primary outcomes and assessed for differences across post-holding and the matched comparison sites. To identify the priority of importance of the key outcomes, a logistic regression model was computed with difference in overall care observed (yes or no) as the dependent variable, and gender, age grouping and the key outcomes as the independent predictors. Results Analysis revealed that the key outcomes were, on anxieties, dignity and respect, time waited, confidence in the clinician and the clinician making a positive difference. Results of the logistic modelling of the key outcome on noticing any difference in the care given by the clinical specialists or advanced nurse practitioners compared with the care from others revealed that the single most important predictor was being treated with respect. Conclusion Further studies evaluating advanced health professions roles measuring these six key outcomes, at a minimum, will ensure that service users' main concerns are being accounted for. [ABSTRACT FROM AUTHOR]

Aim To report a study designed comparing the roles, responsibilities, and perceived outcomes of Clinical Nurse Specialists, Clinical Midwife Specialists, and Advanced Nurse Practitioners in Ireland. Background A clinical career pathway that encompasses progression from staff nurse or midwife through clinical specialist to advanced practitioner level was introduced in Ireland in 2000. Such roles are common internationally, but little evaluation has been conducted and few comparisons have been made between roles. Design A mixed-method case-study design was used. Methods Following Research Ethics Committee Approval, data were collected in 2009-2010, using non-participant observation (92 hours) of 23 Clinical Specialists and Advanced Practitioners, interviews with 21 clinicians and 13 Directors of Nursing or Midwifery. A survey was completed by 154 service-users. Results A clear difference was seen between Clinical Specialist and Advanced Practitioners, with advanced practice roles providing improved service delivery, greater clinical and professional leadership, increased research, and a clear governance and accreditation structure. Clinical Midwife Specialists were rated at a similar level to Advanced Nurse Practitioners for certain aspects and rated more highly for 'continuity of care and carer'. Conclusion Advanced Practitioners do give a higher level of care, particularly at a strategic level. Existing Clinical Specialists should therefore be encouraged to develop their skills and education to achieve advanced practice level and more specialist and advanced practice posts should be instituted. [ABSTRACT FROM AUTHOR]

Aim. To report a mixed-methods study of the development of self-confidence in Irish nursing students undertaking the first year of an undergraduate nursing programme. Background. Self-confidence underpins nurses' competence to carry out care effectively, yet there is little empirical evidence of how this attribute is fostered in pre-registration preparation. There is an assumption, however, that self-confidence develops independently and spontaneously. Design. A sequential, mixed methods three-phase design was used. Method. The design involved pretest and posttest measurements of self-confidence, focus group interviews, a student self-evaluation questionnaire and analysis of the relevant curriculum content. Data were collected between September 2007-April 2008 and sampling was from three cohorts of students at three different Institutes of Technology in Ireland. Data collection matched the nature of the data, including descriptive, non-inferential statistics and qualitative content analysis. Results. There was considerable variation in the amount and nature of theoretical preparation. Factors in clinical practice exerted the most influence. Self-confidence fluctuated during the first clinical placement and as students' self-confidence developed, simultaneously, motivation towards academic achievement increased. Conversely, self-confidence was quickly eroded by poor preceptor attitudes, lack of communication, and feeling undervalued. Conclusion. The development of self-confidence is complex and multi-factorial. This study offers further understanding of facilitators and barriers that may be relevant elsewhere in promoting student nurses' developing self-confidence. The development of self-confidence must be recognized as a central tenet for the design and delivery of undergraduate programmes. [ABSTRACT FROM AUTHOR]