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Purpose: This paper aims to outline a knowledge translation (KT) case study undertaken as part of a multi-component research programme aimed at evaluating new parenting supports in the earliest years. The study aimed to: explore the influencing factors relating to research use in an early years context; and to use the findings, at least in part, to execute an integrated KT plan – to promote stakeholder engagement, greater research visibility and to enhance the understanding of findings emerging from the research programme. Design/methodology/approach: A mixed-methods study was embedded within a large-scale, longitudinal research programme. In the present study, a national survey (n = 162) was administered to stakeholders working with children and families throughout Ireland. A series of one-to-one interviews were also undertaken (n = 37) to amplify the survey findings. Also, one focus group was carried out with parents (n = 8) and one with members of the research team (n = 3). Several dissemination strategies were concurrently developed, executed and evaluated, based partly on survey and interview findings and guided by the knowledge translation planning template (Barwick, 2008; 2013; 2019). Findings: The main factors influencing the dissemination of evidence, as identified by the stakeholders – were: a lack of resources; an under-developed understanding of research use and dissemination; insufficient collaboration and communication; and conflicting stakeholder priorities. Despite these challenges, the research programme was found to benefit from a multi-component KT plan to achieve the outlined dissemination goals. Practical implications: The KT planning process allowed the research team to be more accountable, introspective and to work more efficiently. This helped increase the likelihood of more targeted and successful dissemination of the research findings, delivering a better return on research investment. Originality/value: This is the first study of its kind (to our knowledge) to provide important insights for stakeholders in Ireland and elsewhere about how to improve the dissemination process. Effective KT planning can ultimately help to bridge the research-policy-practice gap and enable the effective translation of high-quality evidence in the early years' sector to enhance outcomes for families in the shorter and longer-term. [ABSTRACT FROM AUTHOR]

Introduction: Early assessment and management of depression and/or anxiety for patients post stroke is critical. However, suboptimal provision of psychological care is widely reported. Nurses are the largest professional group to care for patients post stroke and have an important role in addressing their emotional wellbeing. Aim: The aim of this paper is to examine nurses’ knowledge, experiences, and perceptions of the provision of psychological care to patients post stroke in Ireland. Methods: A cross-sectional descriptive survey design involving both quantitative and qualitative items was administered to a convenience sample of seventy-four (n=74) nurses working in six Irish community hospital rehabilitation units. Results: Fifty one (n=51) questionnaires were completed and returned which represented a 69% response rate. Findings demonstrate suboptimal psychological care provision for patients post stroke with no formal pre-defined care pathways. Despite nurses’ knowledge of psychological problems and symptomology, participants revealed receiving limited training in psychological monitoring and no systematic allocation of psychological care duties. This research suggests that pre-defined/formal care pathways; access to psychology expertise; further training and support for members of the Multi-Disciplinary-Team has the potential to improve the provision of psychological care for patients post stroke. Conclusions: This study has implications for the reform and development of rehabilitation services in relation to practice, education, and research. It identifies opportunities to support nurses to improve the delivery of psychological care for patients post stroke. [ABSTRACT FROM AUTHOR]

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.)

Introduction: Increased awareness of testicular diseases can lead to early diagnosis. Evidence suggests that men's awareness of testicular diseases is low, with many expressing their willingness to delay help‐seeking for symptoms of concern. The risk of testicular diseases is higher in gender and sexual minority groups. In this study, we discuss the codesign, refinement and launch of 'On the Ball', an inclusive community‐based 'testicular awareness' campaign. Methods: The World Café participatory research methodology was used. Individuals from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, policymakers, media/marketing experts and graphic designers were recruited. Participants were handed a brief for 'On the Ball', which was designed based on feedback from a previous World Café workshop. They were assigned to three tables. Participants rotated tables at random for three 20‐min rounds of conversations. Each table had a facilitator who focussed on one element of the campaign brief. Data were collected using audio recorders and in writing and were analysed thematically. Results: Thirteen individuals participated in the workshop. The following themes emerged from the data: (i) campaign identity, (ii) campaign delivery and (iii) campaign impact. Participants recommended enhancements to the campaign logo, slogan, social media posts and poster. They suggested delivering the campaign online via social media and offline using various print and broadcast media. Participants recommended targeting areas with a large number of men such as workplaces. To help measure the impact of the campaign, participants proposed capturing social media analytics and tracking statistics relating to testicular diseases. Recommendations were used to refine the 'On the Ball' campaign and launch it in a university. In total, 411 students engaged with the various elements of the campaign during the soft launch. Conclusions: 'On the Ball' campaign visuals ought to be inclusive. Online and offline campaign delivery is warranted to reach out to a wider cohort. Campaign impact can be captured using social media analytics as well as measuring clinical outcomes relating to testicular diseases. Future research is needed to implement the campaign online and offline, explore its impact and evaluate its feasibility, acceptability, cost and effect on promoting testicular awareness. Patient or Public Contribution: The 'On the Ball' campaign was codesigned and refined with members of Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policymakers, media and marketing experts and graphic designers using the World Café participatory research methodology. [ABSTRACT FROM AUTHOR]

Migrant care workers make a substantial contribution to older adult care in Ireland and the United Kingdom (UK). However, little is known about the relational aspects of care involving migrant care workers and older people. Given that the care relationship is closely linked to quality of care, and that the Irish and UK sectors are increasingly restricted by economic austerity measures, this lack of information is a concern for care practice and policy. Our paper explores the relationship between migrant care workers and older people in Ireland and the UK and draws on data collected in both countries, including focus groups with older people (N = 41), interviews with migrant care workers (N = 90) and data from a survey of and interviews with employers. The findings illustrate the complexity of the migrant care worker–older person relationship; the prevalence of need orientated, friendship and familial-like, reciprocal, and discriminatory interlinking themes; and the role of individual, structural and temporal factors in shaping these relationships. [ABSTRACT FROM PUBLISHER]

Aims and objectives To identify the reported predictors of the practice of restricting a child for a clinical procedure in hospital. Background Previous work in this area is dominated by discussion papers and suggestions for addressing the issue of restriction. This is the first study to explore reported predictors of this practice with a view to implementing change based on research findings. Design A factorial survey was developed, which incorporated the use of vignettes with various scenarios. The factorial design enabled exploration of the interaction of multiple factors on the practice of restriction. Methods One hundred and sixty-six nurses caring for children were each sent 10 vignettes and asked to rate their likelihood to restrict a child based on the vignettes. A total of 105 nurses responded to the survey, representing a response rate of 63%. Hierarchical linear regression was used to identify reported predictors of restriction. Results Nurses were more likely to restrict a child if they had prior instruction on safe holding, if there was no play therapist available, if the nurse was a registered general nurse with no other registration qualification, if the child required cannulation or if the child was less than five years of age. Conclusion This study identified predictors of restriction from the perspective of practicing nurses; the evidence needs to be used in developing clinical guidelines and in multidisciplinary education. Relevance to clinical practice There is a need to move from any presumption of restriction towards more critical consideration of the individual requirements of the child. There is a need to increase the numbers of nurses receiving specialist training on the care of a child in hospital. The importance of a well-resourced play therapy service is supported, and there is a need for multidisciplinary work to explore alternatives to restriction. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Background. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non-statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. Design. A large quantitative, cross-sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Method. Directors of Public Health Nursing ( n = 24) and Public Health Nurses ( n = 204) completed self-report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Results. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self-assessed confidence and competence. A wide variety of non-statutory support exists for breastfeeding but is not always used to their full potential. Conclusion. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Relevance to clinical practice. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive role of Public Health Nurses and facilitate continuing professional development. [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]

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: To explore the mobilization of nurses/midwives in a designated hospital group in Ireland during a global pandemic. Background: The recent global pandemic has resulted in the large‐scale worldwide mobilization of registered nurses and midwives working in the acute care sector. There is a dearth of literature reporting the mobilization of this professional workforce. Method: Mixed‐methods design using an electronic survey and facilitated discussion across one Irish hospital group. Results: Eight of 11 hospitals responded to the survey. There was a 2% vacancy rate prior to the pandemic. Mobilization included reconfiguration of clinical areas and redeployment of 9% of the nursing/midwifery workforce within 2 weeks of the pandemic. A total of 11% (n = 343) of nurses/midwives were redeployed in 3 months. Nurses/midwives required re‐skilling in infection prevention control, enhancement of critical care skills and documentation. Conclusions: Three key areas were identified to enable the nursing workforce readiness. These are referred to as the three 'R's': Reconfiguration of specific resources, Redeployment of nurses to dedicated specialist areas and Re‐skilling of nurses to safely care for the patients during the pandemic. Implications for Nursing Management: A centralized approach to reconfiguration of clinical areas.Redeployment is enabled by closing non‐essential departments.Hands‐on re‐skilling and reorientating staff are essential. [ABSTRACT FROM AUTHOR]

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.)

AUTH Why you should read this article: • To be aware of the benefits of timely diagnosis and disclosure of dementia for patients and their families • To gain knowledge of the enablers and barriers to timely diagnosis of dementia in primary care • To understand the expanding role of nurses practising in primary care and community mental health services in the care, diagnosis and management of patients with dementia Background: Timely diagnosis involves making and sharing a diagnosis at a time and in a way that are most appropriate for the physical, emotional, medical and other needs of the patient and their family. GPs are often the first point of contact for people who are concerned that they may have dementia and, therefore, have an essential role in the timely diagnosis and disclosure of this condition. Aim: To explore the views of GPs in relation to the timely diagnosis and disclosure of dementia for patients and their families in primary care. Method: This was a small-scale qualitative study in which a survey questionnaire was sent to GPs practising in one health service executive locality in the west of Ireland. A total of ten GPs completed the questionnaire, and descriptive content analysis was used to explore their responses. Findings: Enablers of timely diagnosis and disclosure of dementia included: patient and family awareness of dementia; access to diagnostic resources and multidisciplinary assessments; having sufficient time to disclose the diagnosis sensitively; and the availability of community-based, dementia-specific support. Barriers to timely diagnosis and disclosure of dementia included: diagnostic uncertainty; concerns about misdiagnosing patients; and concerns about the stigma associated with dementia and how patients and their families might react to disclosure of such a diagnosis. There was widespread agreement among the GPs that timely diagnosis and disclosure benefit patients and their families, but also some scepticism regarding the efficacy of diagnosis and treatment for dementia (therapeutic nihilism). Conclusion: The diagnosis and disclosure of dementia in primary care could be enhanced by improving GPs' access to resources such as multidisciplinary assessments, memory clinics and community-based support schemes. Primary care and community mental health nurses have an important role in providing expertise to GPs and support to patients and their families. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to report the development and psychometric testing of the clinical leadership needs analysis instrument (CLeeNA). Background: Limited emphasis is placed on the clinical leadership needs of nurses and midwives that are fundamental to supporting the delivery of high quality, safe patient care. Methods: A development and validation study of CLeeNA was undertaken using cross‐sectional data. A sample of 324 registered nurses and midwives completed the questionnaire using a 7‐point adjectival scale. Principal component analysis was conducted to explore scale grouping of items (n = 103 items). Results: Principal component analysis, item reduction and parallel analysis on the items of the instrument resulted in seven factors consisting of 56 items. These factors were identified as: Staff and Care Delivery; Technology and Care Initiatives; Self and Team Development; Standards of Care; Financial and Service Management; Leadership and Clinical Practice; Patient Safety and Risk Management. Conclusion: The identified factors are reflective of an ever‐changing health care environment. Implications for Nursing Management: Potentially, after further testing, this instrument could be used by nursing management and educators to measure clinical leadership needs, inform the design of clinical leadership training programmes and provide valuable information about health care leadership development. [ABSTRACT FROM AUTHOR]

Family‐focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family‐focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family‐focused behaviours and other factors that impact family‐focused activities. Hierarchical multiple regression identified 14 predictors of family‐focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family‐focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family‐focused practice. This study extends current research by clearly highlighting predictors of family‐focused practice and reporting how various enablers promoted family‐focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition that dysphagia has significant implications for a person's psychological well‐being, social participation and quality of life (QOL). However, a paucity of research exists regarding the clinical management of this area. To inform future research and the development of appropriate and beneficial resources and guidelines, a better understanding of the current practice of speech and language therapists (SLTs) in this area would be useful. This information will highlight current challenges to clinical practice and the ongoing development needs of the profession, which are, as of yet, undocumented. Aims: To determine the practices of SLTs when addressing QOL issues in individuals with dysphagia, the beliefs of SLTs regarding the impact of dysphagia on QOL, the current trends in assessing and managing QOL in dysphagia, and if variations in beliefs and practices in this area exist. Methods & Procedures: An anonymous cross‐sectional, non‐experimental survey study was used. The survey consisted of 18 questions exploring participants' beliefs and opinions regarding dysphagia and QOL, current clinical practice in the area, perceived facilitators and barriers, and education, training and development needs. The survey was created on Survey Monkey and disseminated by e‐mail link to SLT professional bodies. Purposive and snowball sampling were used and participants self‐selected based on the information provided alongside the e‐mail link. Inclusion criteria for the study were a qualification in speech and language therapy, proficiency in the English language, and access to a computer with the internet. Outcomes & Results: A total of 148 SLTs working across the UK, Ireland and South Africa completed the survey. Over 90% of respondents believe that dysphagia has a negative impact on QOL, but only 25% are currently satisfied with the amount of clinical time they can dedicate to this area. Staffing, resources, a lack of best‐practice guidelines and disease‐specific QOL assessment tools were cited as contributing factors. A number of facilitators and barriers to best practice were also highlighted. Based on these findings, professional development actions for the future are suggested. Conclusions & Implications: SLTs believe they have an important role to play in supporting QOL issues in dysphagia. However, it is reported that the area is currently under‐developed, under‐resourced and under‐supported. Increased awareness raising of the role of SLT, alongside the development of best‐practice guidelines and disease‐specific QOL assessment tools, will enhance the quality of care that can be offered in this area. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of an early intervention programme, Preparing for Life, on dietary intake between 12 and 36 months of age, and the mediating role played by diet on cognitive functioning.Design: A randomised controlled trial evaluation of a community-based home visiting programme. The intervention involved biweekly visits from mentors from pregnancy until age 5 years and parent training at age 2 years. Dietary intake was assessed at 12, 18, 24 and 36 months using an FFQ to calculate the proportion meeting dietary recommendations. Cognitive functioning was measured at 24 and 36 months. Treatment effects were estimated using conventional χ 2 tests, permutation testing, inverse probability weighting and the stepdown procedure. Mediation analysis examined the indirect effect of the intervention on cognitive functioning via its effect on dietary intake.Setting: Socio-economically disadvantaged communities in Dublin, Republic of Ireland.Subjects: Pregnant women (n 233) were assigned to the intervention (n 115) or control (n 118) group using an unconditional probability randomisation strategy.Results: Positive treatment effects were observed for meeting dietary recommendations for protein foods at 24 (OR=2·52) and 36 (OR=2·42) months, and all food groups at 24 (OR=3·92) months. There were no effects on grain, dairy, fruit and vegetable, or fatty/sugary food recommendations in most models. The conventional and more novel methods yielded similar results. Mediation analysis indicated that 13 % of the intervention's effect on cognitive functioning was mediated by 36-month protein food consumption.Conclusions: The study demonstrates some potential to alter early childhood dietary patterns through community-based intervention programmes. [ABSTRACT FROM AUTHOR]

Background: Interventions to increase cooking skills (CS) and food skills (FS) as a route to improving overall diet are popular within public health. This study tested a comprehensive model of diet quality by assessing the influence of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. The correspondence of two measures of diet quality further validated the Eating Choices Index (ECI) for use in quantitative research. Methods: A cross-sectional survey was conducted in a quota-controlled nationally representative sample of 1049 adults aged 20-60 years drawn from the Island of Ireland. Surveys were administered in participants' homes via computer-assisted personal interviewing (CAPI) assessing a range of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. Regression models were used to model factors influencing diet quality. Correspondence between 2 measures of diet quality was assessed using chi-square and Pearson correlations. Results: ECI score was significantly negatively correlated with DINE Fat intake (r = -0.24, p < 0.001), and ECI score was significantly positively correlated with DINE Fibre intake (r = 0.38, p < 0.001), demonstrating a high agreement. Findings indicated that males, younger respondents and those with no/few educational qualifications scored significantly lower on both CS and FS abilities. The relative influence of socio-demographic, knowledge, psychological variables and CS and FS abilities on dietary outcomes varied, with regression models explaining 10-20 % of diet quality variance. CS ability exerted the strongest relationship with saturated fat intake (β = -0.296, p < 0.001) and was a significant predictor of fibre intake (β = -0.113, p < 0.05), although not for healthy food choices (ECI) (β = 0.04, p > 0.05). Conclusion: Greater CS and FS abilities may not lead directly to healthier dietary choices given the myriad of other factors implicated; however, CS appear to have differential influences on aspects of the diet, most notably in relation to lowering saturated fat intake. Findings suggest that CS and FS should not be singular targets of interventions designed to improve diet; but targeting specific sub-groups of the population e.g. males, younger adults, those with limited education might be more fruitful. A greater understanding of the interaction of factors influencing cooking and food practices within the home is needed. [ABSTRACT FROM AUTHOR]

Boredom makes people attempt to re-establish a sense of meaningfulness. Political ideologies, and in particular the adherence to left- versus right-wing beliefs, can serve as a source of meaning. Accordingly, we tested the hypothesis that boredom is associated with a stronger adherence to left- versus right-wing beliefs, resulting in more extreme political orientations. Study 1 demonstrates that experimentally induced boredom leads to more extreme political orientations. Study 2 indicates that people who become easily bored with their environment adhere to more extreme ends of a political spectrum compared with their less easily bored counterparts. Finally, Study 3 reveals that the relatively extreme political orientations among those who are easily bored can be attributed to their enhanced search for meaning. Overall, our research suggests that extreme political orientations are, in part, a function of boredom's existential qualities. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify and describe the triggers of emotional distress among long-term caregivers (more than 1 year postdiagnosis) of people with head and neck cancer. Background Limited research has been conducted on the factors that cause head and neck cancer caregivers to become distressed. Design Qualitative cross-sectional. Methods In-depth semi-structured interviews. Interviews were conducted via telephone. The study setting was the Republic of Ireland. Results Interviews were conducted with 31 long-term caregivers (mean time since diagnosis 5·7 years, SD 2·9 years). Head and neck cancer caregivers experienced significant distress. Six key triggers of emotional distress were identified: understandings and fears of illness, lifestyle restrictions and competing demands, facial disfigurement, financial problems, comorbid health problems and witnessing suffering. Cutting across all of these individual causes of distress was a strong feeling of loss caused by head and neck cancer. Conclusions Some head and neck cancer caregivers became considerably distressed by their caring role. Although distress appears to decline with time for many caregivers, some continue to be distressed for years following the patient's diagnosis. It would be useful for future research to explicitly investigate caregivers' experiences of loss. Relevance to clinical practice Health professionals may be able to reduce distress in this group if they can help caregivers to access resources that can be used to buffer financial problems. Health professionals may also be able to reduce distress if they can work with caregivers to help them to obtain something of personal value or significance from their experience of loss and suffering. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? The Advancing Recovery in Ireland ( ARI) project (Health Service Executive, 2012) promotes recovery-orientated services. A previous study of Irish mental health practitioners (Cleary & Dowling ) identified the need to improve knowledge and attitudes towards recovery., To facilitate implementation of ARI and monitor progress, this study provided a 'benchmark' of current knowledge and attitudes to recovery., What this study adds to existing knowledge? The study provides important baseline information on recovery knowledge and attitudes which can be used to assess the impact of the ARI Project. It also provides valuable information that can be compared to recovery approaches employed in other countries., Despite the increased emphasis on recovery in Ireland, knowledge and attitudes of health care practitioners towards recovery remain relatively unchanged between 2007 and 2013., Working in dual settings, being a non-nurse, and training was associated with better RKI scores. Training appears to be the strongest factor in predicting better recovery knowledge., The findings suggest that knowledge levels and attitude changes following education may not be sustained over time and ongoing training may be required., What are the implications for practice? There is considerable scope to improve recovery knowledge. Key recommendations include the need for more recovery training, evaluate whether training translates into clinical practice, using 'Recovery Champions', introducing peer support workers and developing local policies and protocols to support recovery practice., Abstract Introduction A study of Irish mental health practitioners (Cleary & Dowling ) identified the need to improve knowledge and attitudes towards recovery. This led to the Advancing Recovery in Ireland Project ( ARI) which promoted recovery-orientated services and a need to 'benchmark' progress. There is little evidence regarding the types of educational interventions that maintain positive recovery knowledge and attitudes in providers. Aim The study assessed current knowledge and attitudes to recovery. Methods The methodology of Cleary & Dowling () was replicated. A survey was administered to practitioners (n = 337) using the adapted Recovery Knowledge Inventory ( RKI) (Cleary & Dowling ). Results No significant differences were found in recovery scores compared to Cleary & Dowling () or by level of experience. Working in dual settings, being a non-nurse, and training was associated with better recovery scores. Significantly more respondents had received training in recovery (40% versus 23%) compared to Cleary & Dowling (). Training appears to be the strongest factor predicting better recovery knowledge. Conclusions There is considerable scope to improve recovery knowledge. Key recommendations include the need for more recovery training, using 'Recovery Champions', introducing peer support workers and developing local policies and protocols to support recovery working. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Background. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. Design. A postal survey design was used to examine registered nurses' and mid-wives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. Methods. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Results. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal consequences, time restrictions and lack of remuneration. Professional satisfaction, patients' needs, organisational support and having access to continuing professional education were perceived as facilitators of practice expansion. Older nurses and midwives as well as nurses and midwives holding more senior promotional grades, such as clinical nurse manager grades, perceived fewer barriers than their younger and more junior counterparts. Conclusions. Nurses and midwives continue to experience difficulties in relation to expanding their practice. Practitioners can operate to optimal scope of practice when practitioner-centred and workplace-based circumstances are optimal. The optimal circumstances for practice expansion exist when the facilitators of practice expansion outweigh the barriers. Relevance to clinical practice. Given the critical role that nurses and midwives play in modern health services, it is important that they are empowered and enabled to expand their practice and to work to full scope of practice when patient needs and service requirements warrant it. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim was to examine and describe aspects of the current scope of practice among nurses and midwives in Ireland. The objective was to describe practitioners' decision making associated with the scope of practice. Background Regulatory frameworks on the scope of practice describe the roles and activities an individual registrant is permitted to undertake in the course of professional practice. Research into the scope of practice has examined practitioners' perspectives on particular frameworks or their experiences of practice expansion, and suggests that frameworks are helpful in guiding practitioners; however, local circumstances and practitioner competence often determine scope of practice. Design A national postal survey of registered nurses and midwives was conducted to elicit self-reports of current scope of practice. Methods A stratified random sample of 2354 registered nurses and midwives in Ireland were surveyed using the Scope-Q, a 64-item self-report questionnaire. Results While over half of the respondents consulted others when making scope of practice decisions, the majority relied on their own professional judgement, acted only when they believed that they were competent to act, and recognised the limitations of their own competence. Although a small number of statistically significant associations were observed between respondents' age and self-reported scope of practice, respondents' current scope of practice was independent of either grade or gender. Conclusions When making a decision about scope of practice, practitioners may consult other resources, including published frameworks, professional colleagues and line managers; however, most particularly, older, more experienced practitioners, rely on their own professional judgement when making scope of practice decisions. Relevance to clinical practice While published scope of practice frameworks guide practitioners on how they may act in circumstances of uncertainty, regulatory authorities should continue to emphasise individual accountability and self-reliance in everyday decision making, so that practitioners' actions are grounded in local circumstances and self-assessed practitioner competence. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the pretreatment symptoms and symptom clusters that women awaiting breast cancer surgery are experiencing and the impact of these symptoms on their quality of life. Background Most women diagnosed with breast cancer will have surgery as a first-line treatment. The presence of presurgery symptoms may be significant in contributing to distress and impaired quality of life. While it seems that women with breast cancer may experience the symptoms of fatigue, pain, depression and sleep disturbance as a cluster, this has not yet been confirmed by empirical research in the presurgery time period. Design A multiple-point prospective longitudinal cohort panel design is used. Methods Presurgery symptoms and quality of life were assessed using the Hospital Anxiety and Depression Scale, Insomnia Severity Index, Functional Assessment of Cancer Therapy-Fatigue, Brief Pain Inventory and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(3). Results Participants ( n = 94, age range 30-92) experienced symptoms prior to surgery, with pain being a more prevalent symptom (35%) than fatigue (32%), sleep disturbances (25·5%) or depression (11%). global quality of life was significantly impacted on by fatigue and showed a moderate correlation with emotional functioning and a weak correlation with physical and social functioning. Hierarchical cluster analysis identified the presence of five clusters with symptoms present in differing intensities in each cluster. Conclusion In this cohort of women, healthy other than having a diagnosis of breast cancer, symptoms were impacting on quality of life. It is evident that clusters of symptoms are present presurgery that must be assessed and managed. Relevance to practice Healthcare delivery systems must ensure that early symptoms are addressed effectively in the presurgery period to improve quality of life and reduce adverse outcomes postsurgery. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer and the relationship between bowel symptom experiences and the self-care strategies used. Background Earlier diagnosis of rectal cancer allows for less invasive surgical treatments such as sphincter-saving procedures to be performed. Although a permanent stoma is generally not required, patients experience changes in bowel function following this surgery. However, limited research exists on patients' bowel symptom experiences and the self-care strategies used to manage symptoms following sphincter-saving surgery of rectal cancer. Design Quantitative descriptive correlational. Methods A convenience sample of 143 patients aged 30 to over 70 years was used. Data were collected (April 2010-December 2010) using the Illness Perception Questionnaires, the Difficulties of Life Scale and a researcher developed Self-care Strategy Measure. The research was underpinned by the Symptom Management Theory. Findings Relating to the four most effective self-care strategies used respondents reporting more bowel symptom were more likely to use the self-care strategy proximity/knowing the location of a toilet at all times. Females, respondents with high timeline cyclical scores and respondents with high physiological responses scores were more likely to use protective clothing. Respondents reporting more bowel symptom and with high social responses scores were more likely to use bowel medication. Females were more likely to wear incontinence pads. Conclusion This research provides insights into the daily bowel symptom experiences of patients following sphincter-saving surgery for rectal cancer. It demonstrates the range of self-care strategies that individuals use to manage their bowel symptoms and the self-care-strategies that were most effective for them. Relevance to clinical practice Patients should be encouraged to report on-going bowel problems following sphincter-saving surgery for rectal cancer. Supportive care for patients should be comprehensive and tailored to meet individual needs. [ABSTRACT FROM AUTHOR]

Background Despite increasing interest in nurses' job satisfaction relatively few studies have investigated job satisfaction among public health nurses. Aim To establish current level of job satisfaction among public health nurses and identify the main contributing variables/factors to job satisfaction among this population. Design Quantitative descriptive design. A simple random sample of 1000 public health nurses was conducted yielding a response rate of 35.1% ( n = 351). Data was collected using the Index of Work Satisfaction Questionnaire. Descriptive and inferential statistics were deployed. Results Low levels of job satisfaction among public health nurses emerged. Professional status, interaction and autonomy contributed most to job satisfaction while pay and task-related activities contributed least. Age and tenure were the only biographic factors that correlated significantly with job satisfaction. Conclusion Public health nurse managers/leaders need to find creative ways of improving the factors that contribute to job satisfaction and address robustly those factors that result in low job satisfaction. Implications for nursing management The critical issue for public health nurse managers is to determine how job satisfaction can be improved. Greater collaboration and consultation between managers and public health nurses can be regarded as a useful way to begin this process, especially if contemporary nursing is to embrace a responsive approach within the profession. [ABSTRACT FROM AUTHOR]

Very little is known about the experiences of lesbian, gay, bisexual, and transgender ( LGBT) people in relation to mental health services. Therefore, the overall aim of the current research was to explore LGBT people's experiences of mental health service provision in Ireland. The objectives were to identify barriers and opportunities, to highlight service gaps, and to identify good practice in addressing the mental health and well-being of LGBT people. A mixed methods research design using quantitative and qualitative approaches was deployed. A multipronged sampling strategy was used and 125 respondents responded to the questionnaire. A subset of phase 1 ( n = 20) were interviewed in the qualitative phase. Quantitative data was analyzed using descriptive statistics. Qualitative data were analyzed thematically. The sample consisted of LGBT people ( n = 125) over 18 years of age living in Ireland. Over three-quarters (77%) had received a psychiatric diagnosis. Findings include that whilst 63% of respondents were able to be 'out' to practitioners, 64% felt that mental health professionals lacked knowledge about LGBT issues and 43% felt practitioners were unresponsive to their needs. Finally, respondent recommendations about how mental health services may be more responsive to LGBT people's needs are presented. [ABSTRACT FROM AUTHOR]

Introduction: There is no national or international recommendation for nursing students to receive the influenza vaccine. Nurses are among the group of health professionals who traditionally have a low uptake of the vaccine and who arguably have the closest contact with patients. Aim: To investigate the uptake of influenza vaccination among student nurses, explore reasons for either declining or receiving it in the past, and establish if and to what extent the theory of planned behaviour (TPB) can explain vaccination behaviour. Methods: A quantitative, descriptive, correlational design was used. Data were collected with a researcher-developed questionnaire; 131 student nurses participated. Ethical approval was gained. Results: 79% (n=104) had never received the vaccine. The most common reason was 'I don't need it as I rarely get ill'. Low mean 'intention' scores indicated that students were unlikely to get the vaccine once qualified. Past behaviour was significantly associated with future intentions. The TPB explained 41.9% of the variance in intention. Attitude emerged as the greatest predictor. Conclusion: Student nurses do not have strong intentions to get the vaccine. Results serve to guide future educational and occupational health initiatives, which would benefit from a framework based on TPB. [ABSTRACT FROM AUTHOR]

Family-centered care (FCC) is a philosophy of care that recognizes the family’s central role in the child’s life and in the delivery of care. We used a survey design to investigate the practices and perceptions of nurses toward FCC in Ireland. Data were obtained from 250 nurses in seven hospitals using the Family-Centered Care Questionnaire–Revised (FCCQ-R). Findings indicated that nurses’ practices were significantly different from their perceptions of FCC. Nurses with dual registration (children and adult) had significantly lower mean scores on the total current (practice) scale than the other registration subgroups. Nurses with a baccalaureate or a higher academic qualification had higher mean scores than nurses who held a certificate-level qualification on the total necessary (perception) scale, which assessed the activities perceived to be necessary for FCC. Findings showed that nurses support FCC but perceive the design of the health care system and parent–professional collaboration as barriers to FCC practice. [ABSTRACT FROM PUBLISHER]

Introduction: Driving is a job, a hobby and a form of transport that enables occupation. This research investigated the impact of the inability to drive due to epilepsy on community mobility and occupational participation, and compared both men and women's perceptions of the impact of driving cessation on romantic relationships and family involvement. Method: By means of an internet-based survey, data were collected concerning community mobility, personal impact of driving cessation, previous driving practices, epilepsy and demographics. Statistical analysis was performed on quantitative data and content analysis was used with responses to open questions. The survey received 95 eligible participants. Findings: Participants used public transport more than the general population; however, when unable to drive, being driving by friends or relatives was the main mode of transport. As a result, people experienced restricted access to the community, had to give up activities, had a reduced quality of life and a lowered self-esteem. Significantly more men than women felt that driving cessation had a negative impact on romantic relationships (p = 0.024) yet men and women did not differ significantly in their feelings about the impact of driving cessation on family involvement (p = 0.58). Conclusion: Independent access to the community is often dependent on the ability to drive. [ABSTRACT FROM AUTHOR]

Background Previous research has focused on physician's perspectives of end-of-life ( EOL) decision making as well as patient and family EOL decision making. There is a lack of research pertaining to the EOL treatment preferences of nurses and especially nurses working in a variety of care settings. Aim The aim of this study was to compare nurses' EOL treatment preferences in Hong Kong, Ireland, Israel, Italy and the USA. Methods A comparative descriptive design was used with a convenience sample of nurses (n = 1089). A survey questionnaire using EOL hypothetical clinical case scenarios was used to collect data between June 2011 and July 2012. Results Nurses in every country consistently chose a more aggressive option for patients than for themselves or for a parent. The treatment preferences of nurses varied from country to country. Lack of knowledge of patients' wishes and duty of care were the main influencing factors on treatment preferences. Study Limitations The study was limited to the hypothetical nature of the scenarios; however, the study highlights numerous future research questions. Conclusions This study is the first to examine and compare nurses' preferred EOL treatment choices in five countries from three different continents. The findings of this study raise several important questions for healthcare researchers, for policy development, and highlight the need for further international collaboration. [ABSTRACT FROM AUTHOR]

Aims and objectives. To measure and compare the perceived levels of job-related stress and stressors of newly qualified nurses and fourth-year student nurses in the clinical environment and to explore the participants' views on stress and stressors. Background. Stress in the nursing workplace has significant consequences for the person, the patient and the organisation, such as psychological and physical health deterioration and impaired professional practice. To address this problem, stress and stressors need to be measured and identified. Design. This study used a cross-sectional survey design and self-reporting questionnaires to measure and compare levels of stress in both groups. Convenience sampling involved all newly qualified nurses ( n = 120) and fourth-year student nurses ( n = 128) in Dublin North-East region in Ireland. Methods. The instrument used was 'The Nursing Stress Scale' (Gray-Toft & Anderson 1981, Journal of Behavioral Assessment 3, 11-23). Descriptive, qualitative analysis was conducted on an open-ended question. Data were obtained from newly qualified nurses ( n = 31) and fourth-year student nurses ( n = 40) in six acute hospital sites. Results. Levels of perceived stress and stressors were high in both groups. Themes identified from the responses to the open question by both groups included excessive workload, difficult working relationships and unmet clinical learning needs. Student nurses also reported the combination of academic demands with clinical placement as a major stressor. There was no significant difference between each group. Conclusion. Stress continues to be a problem for nurses in the clinical setting. Excessive workload requires urgent attention by hospital managers in view of widespread retention difficulties. Themes identified could provide a framework for possible interventions for improving the clinical environment for nurses. Relevance to clinical practice. These results can help stakeholders in nurse education and practice to develop interventions to reduce stress for both groups and to ease the transition from student to graduate nurse. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy students complete practice education placements as part of their degree programmes. Sufficient support during these placements is vital since the transition from the classroom to clinical practice can present many challenges. Ensuring support can be difficult, given that these placements occur across a wide geographical area. Blogs were identified as a possible innovative way of providing distance support and a study was undertaken to examine the usefulness of this tool in occupational therapy practice education. Methods: A descriptive investigation of a private blog at Trinity College, University of Dublin, and a public blog at the University of Limerick was conducted during one practice education placement. An online survey was used to capture quantitative and qualitative data on the students' experience of blogging during practice education. Findings: Blogging was not found to be a useful tool for developing reflection or clinical reasoning skills by this student sample, but was found to be beneficial for peer support and learning. Conclusions: The research indicates the potential of using blogging as a tool for peer support and learning. Further research on its application and the use of other social media in healthcare education is required. [ABSTRACT FROM AUTHOR]

higgins a., sharek d., nolan m., sheerin b., flanagan p., slaicuinaite s., mc donnell s. & walsh h. (2012) Mixed methods evaluation of an interdisciplinary sexuality education programme for staff working with people who have an acquired physical disability. Journal of Advanced Nursing 68(11), 2559-2569. Abstract Aim. To report a study evaluating the effectiveness of a 1-day interdisciplinary sexuality education programme for staff working with people with acquired physical disability. Background. Changes associated with an acquired physical disability can diminish a person's self-esteem, sense of attractiveness, relationships, and sexual functioning. Research suggests that people are dissatisfied with the quality of information and support around sexuality during their rehabilitation. Design. A mixed methods design was used, involving pretest and posttest questionnaires and interviews. Methods. Questionnaire data were analysed using descriptive statistics and paired samples t-tests to evaluate the effects of the programme on knowledge, skills, and comfort. Interview data were analyzed thematically, with particular emphasis on participants' opinions about the application of the course within practice. Participants were working in the area of acquired disability and rehabilitation, and were drawn from a number of disciplines. Data were collected between 2008-2009. Results. Comparison of the pre- and postmeasures, based on paired samples t-tests, showed that the programme statistically significantly increased participants' knowledge, skills, and comfort. Participants felt positive and enthusiastic about the programme and reported numerous incidents where they were more willing to raise issues for discussion and create a supportive listening space for patients to talk about their concerns around sexuality. Conclusion. Providing healthcare practitioners with a 1-day programme leads to positive changes in knowledge, skills, and comfort towards sexuality. Sexuality education may be an ideal topic for bringing practitioners together within an interdisciplinary education context. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study is to examine the subjective burden experienced by nurses when they provide care for patients with acute delirium. Background. Nurses' responses to dealing with the increased functional and copious demands associated with caring for a patient with delirium are not well explored. Design. The study was descriptive and retrospective, adopting quantitative research methodologies. Methods. The Strain of Care for Delirium Index (SCDI) was used to collect data in 2007 from a random sample of the national nurses' register ( n = 800), in the Republic of Ireland. Results. The subjective burden that nurses experience when caring for patients with delirium was high ( M = 2·97). The hyperactive/hyperalert subscale was deemed the most challenging to deal with ( M = 3·41). In relation to individual behaviours, the patients who averaged highest in terms of burden are those who are uncooperative and difficult to manage ( M = 3·58). Conclusion. This study represents the first reported measurement and examination of the subjective burden nurses experience when caring for patients with delirium, following initial development and testing of a sensitive tool ( International Journal of Nursing Studies 41, 775). Findings outlined the subtypes and behaviours that increase the burden of caring for patients with delirium. This is an issue that needs to be addressed and further research is needed to explore the impact of nurse reactions further and to identify supportive/preventative methods for nurses. A specific examination into the factors that cause high levels of strain needs is required. Relevance to clinical practice. This study highlights and confirms that nursing patients with delirium is challenging for nurses. It raises awareness of the practice and policy implications of nurses' potential negative reactions to these patients. It highlights the need for additional training and education to ensure that nurses understand this condition to provide for prevention, early detection and prompt intervention. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine the relationships between social support, maternal parental self-efficacy and postnatal depression in first-time mothers at 6 weeks post delivery. Background. Social support conceptualised and measured in different ways has been found to positively influence the mothering experience as has maternal parental self-efficacy. No research exists which has measured the relationships between social support, underpinned by social exchange theory and maternal parental self-efficacy using a domain-specific instrument, underpinned by self-efficacy theory and postnatal depression, with first-time mothers at 6 weeks post delivery. Design. A quantitative correlational descriptive design was used. Method. Data were collected using a five-part questionnaire package containing a researcher developed social support questionnaire, the Perceived Maternal Parental Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Four hundred and ten mothers completed questionnaires at 6 weeks post delivery. Results. Significant relationships were found between functional social support and postnatal depression; informal social support and postnatal depression; maternal parental self-efficacy and postnatal depression and informal social support and maternal parental self-efficacy at 6 weeks post delivery. Conclusion. Nurses and midwives need to be aware of and acknowledge the significant contribution of social support, particularly from family and friends in positively influencing first-time mothers' mental health and well-being in the postpartum period. The development of health care policy and clinical guidelines needs to define and operationalise social support to enhance maternal parental self-efficacy. Relevance to clinical practice. These findings suggest that nurses and midwives need to be cognisant of the importance of social support for first-time mothers in both enhancing maternal parental self-efficacy and reducing postnatal depressive symptomatology in the early postpartum period. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine the relationship of empathy and professional quality of life in cancer healthcare professionals. Methods: A Professional Quality of Life instrument measuring compassion satisfaction and compassion fatigue, and the Interpersonal Reactivity Index measuring empathy were distributed to healthcare professionals working in cancer care in the Republic of Ireland. Final analysis was conducted on 117 participants. Results: A quarter of participants experience high levels of compassion satisfaction, and a quarter are at risk of compassion fatigue. A positive correlation was found between personal distress and compassion fatigue, and a negative correlation was found between personal distress and compassion satisfaction. A positive correlation was found between empathic concern and secondary traumatic stress. Conclusion: These findings suggest that healthcare professionals working in cancer care are at risk of compassion fatigue. Also, healthcare professionals working in cancer care experience personal distress that may impact negatively on professional quality of life. Implications for practice include a need to identify those HCPs who are at risk of compassion fatigue. The implication for further research suggests further exploration of the impact of personal distress felt by cancer healthcare professionals during empathic engagement. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore the role dimensions, competence and professional development needs of practice nurses in Ireland from both the general practitioner's and practice nurse's perspective and highlight any agreement/disagreement between the professions. Background. Economic pressure on healthcare delivery is promoting a re-evaluation of professional roles and boundaries. This coupled with a primary care sector that is evolving prompted an investigation into the role dimensions and competence of the practice nurse. There is a lack of empirical data comparing the general practitioner's and practice nurse's perspective on the current role of the nurse, clinical competence (existing and required), strategic direction for the role and continuing professional development. Design. A descriptive cross-sectional survey design was used. Methods. A random sample of general practitioners ( n = 414) and a purposeful sample of practice nurses ( n = 451) participated. Data from each profession were analysed and comparisons drawn. Results. General practitioners and practice nurses agree (±5%) that the nursing role is centred on immunisation, direct clinical care and elements of chronic disease management. However, in some areas such as preconceptual advice, family planning, advice on menopause, continence promotion and research, there was a 30% difference between the general practitioners perceptions of the nurse's involvement and the practice nurse's actual involvement in the role. Perceived competency differed in a number of areas with nurses more likely to indicate competency in health promotion activities. Both disciplines acknowledged that only a minority of practice nurses were competent in audit, research and dealing with 'problems with living' (relationship breakdown, addiction and parenting). Conclusion. There is some congruence of opinion among practice nurses and general practitioners in Ireland regarding the current role of the practice nurse. Divergent opinions on the nurses' involvement in a particular aspect of the role may be due to the general practitioners underestimating the nurse's involvement in the role. Training is required in the areas of audit, research and 'problems with living'. Relevance to clinical practice. This research provides data for role clarity and evidence-based role development for practice nurses within the context of evolving primary care services. It also indicates how general practitioners perceive the nursing role. [ABSTRACT FROM AUTHOR]