Search

Presents a review of paper published in the Journal of Advanced Nursing, 1976–1979 and 1989–1992. Criteria noted on the submission of the papers; Final analysis on the characteristics of authors under the headings; General topics addressed in papers.

Presents an analysis of papers published in the "Journal of Advanced Nursing" throughout 2002. Country of origin of the papers; Categorization of the papers; Data collection methods used in empirical papers.

Presents a brief review of papers published in the 'Journal of Advanced Nursing,' 1983–1992. Classification of paper; Topics covered in the papers; Number of publications and papers featured.

Focuses on the selection of keywords for several research papers to be published in the "Journal of Advanced Nursing." Limitation in the number of keywords for each paper; Categories of selecting keywords for papers.

Title. Is children’s choice in health care rhetoric or reality? A scoping review. Aim. This paper is a report of a scoping review examining children and young people’s health services with respect to choice in order to inform future development of choice initiatives. Background. The importance of including children and young people in the choice agenda reflects the increasing acknowledgement that, individually and collectively, they are important consumers of health care in their own right. Data sources. A scoping review of all major health and medical research databases was undertaken using current guidelines to identify original relevant research papers and grey literature sources from 1990 to 2006. Review methods. Reference Manager software was used to collate, summarize, categorize, store and retrieve the search results. Papers meeting the inclusion criteria were read in full and descriptively summarized using a data extraction sheet. Each paper was repeatedly selected using a snowballing approach until saturation was reached. Results. Children and young people want more say in the planning and development of appropriate hospital and community health services. However, little evaluative research was found about whether these choices are acted upon and lead to more responsive services. Conclusion. Choice for children and young people is viewed as a positive development in health care and many innovative examples of their involvement in decision-making were found. These illustrated that, given the opportunity, children and young people are willing and able to make decisions about their healthcare services. However, there is a long way to go before the rhetoric of the choice agenda is realized. [ABSTRACT FROM AUTHOR]

Title. Exploring research supervision through Peshkin’s I’s: the yellow brick road Aim. This paper is a report of a systematic approach used to explore subjectivity as a research student and demonstrates how the process enhanced the quality of the research experience. Background. High non-completion rates of research students are of global concern and means of enhancing the quality of the doctoral experience are needed. Among the literature on doctoral education, very little is authored by students. This paper is influenced by the work of Peshkin from the discipline of education. Peshkin articulated the need for researchers to systematically identify their subjectivity by searching for their subjective I’s. I share my experience of adopting this approach as a research student by using reflexive journal entries made during 2005–2007 as data. Findings. I use the analogy of the ‘Yellow Brick Road’ from The Wizard of Oz to represent my experience of being a doctoral student and draw comparisons between my subjectivity and the characters in the story. I demonstrate how a systematic approach to exploring my subjectivity revealed aspects of my being as a research student that had potential for influence throughout the entirety of my experience. I argue that cognizance of my subjective I’s improved the quality of my research endeavour. Conclusion. The approach is offered for consideration by other research students as a means of exploring subjectivity. I argue that the resultant self-awareness can enhance the quality of the doctoral experience. The flexibility of the approach means it has transferability across a number of disciplines and cultural contexts. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a concept analysis of forgiveness. Background. Worldwide interest in and funding for forgiveness research has brought about a body of knowledge from many disciplines that could be clinically useful to nursing. At this time, nurse scholars are beginning to challenge one another to focus on this important area of inquiry. To date, however, most scholarship on forgiveness has been conducted in related disciplines, rather than in nursing. Conceptual and theoretical work is needed in nursing to promote knowledge development in this area. Method. The CINAHL, Medline and PsycInfo databases were searched for papers published between 1990 and 2007 using the keywords, forgiveness, forgive, or reconciliation in the title or abstract. The non-linear evolutionary process of concept analysis was used to identify the concept of interest, its origins, realm, attributes and context, characteristics, and implications. Forgiveness was also explored from an international multi-cultural perspective. An exemplar is included to illuminate the concept. A total of 34 scholarly works from a variety of disciplines were included in the analysis. Findings. A definition of forgiveness emerged from the analysis, as well as a multicultural understanding of the concept. Three important attributes of forgiveness are that it is the relinquishing of a negative response, replacing the negative response with a benevolent response, and a process that occurs over time. Multi-cultural attributes centre on group harmony, re-establishing harmonious connections between people, and the morality of considering others as worthy of love and understanding. Conclusion. A multi-cultural understanding of forgiveness may provide the impetus for further theory development and research in nursing, and could be used to educate nurses on beginning interventions in this area. [ABSTRACT FROM AUTHOR]

kearney p.m. & pryor j. (2004) Journal of Advanced Nursing 46(2), 162–170 The International Classification of Functioning, Disability and Health (ICF) and nursing Nursing conceptualizes disability from largely medical and individual perspectives that do not consider its social dimensions. Disabled people are critical of this paradigm and its impact on their health care. The aims of this paper are to review the International Classification of Functioning, Disability and Health (ICF), including its history and the theoretical models upon which it is based and to discuss its relevance as a conceptual framework for nursing. The paper presents a critical overview of concepts of disability and their implications for nursing and argues that a broader view is necessary. It examines ICF and its relationship to changing paradigms of disability and presents some applications for nursing. The ICF, with its acknowledgement of the interaction between people and their environments in health and disability, is a useful conceptual framework for nursing education, practice and research. It has the potential to expand nurses’ thinking and practice by increasing awareness of the social, political and cultural dimensions of disability. [ABSTRACT FROM AUTHOR]

whitehead l. (2004) Journal of Advanced Nursing 45(5), 512–518 Enhancing the quality of hermeneutic research: decision trail Researchers have ethical and professional obligations to produce research of a high standard. The constituents of quality in research appear to differ between authors, leaving readers unsure about which pathway to follow. This can reflect inadequate consideration of the theoretical framework guiding the study. Many papers fail to consider the theoretical underpinnings of the methodology chosen and the link between these and the methods employed. These need to be accessible to readers in order to assess the trustworthiness of the research. This paper discusses the development of trustworthiness in hermeneutic phenomenological research. Referring to a study on lived experience of Chronic Fatigue Syndrome/myalgic encephalitis, I describe the decision trail and discuss the strengths and limitations of the choices made throughout the study. The methodology focused my approach more fully on the importance of recognizing the influences that I brought to the study and the impact of these in generating the data. It highlighted the fact that the process of setting out my horizon can never be complete, the importance of analysing the data at a macro and micro level, acknowledging the evolution of the data over time, and ensuring that analysis does not move beyond the data and out of the hermeneutic circle. In seeking to make the decision trail clear to others, researchers must distill the philosophical principles of the methodology and set these out in a way that is accessible and open to scrutiny. [ABSTRACT FROM AUTHOR]

lindsay b. (2004) Journal of Advanced Nursing 45(1), 84–94 Randomized controlled trials of socially complex nursing interventions: creating bias and unreliability? The randomized controlled trial is viewed by many researchers as the ‘gold standard’ research design. It is used increasingly to evaluate the effectiveness of socially complex activities such as nursing interventions. This use is seen by many commentators as problematic, while others are concerned about the quality of many published trial reports. One area of concern is that of intervention bias: the impact that a sentient intervention, such as a nursing one, may have consciously or unconsciously on study outcomes. This paper reports on an analysis of intervention definitions and possible intervention bias in 47 reports of randomized controlled trials of nursing interventions published in 2000 or 2001. This study evaluates four characteristics of the included reports: intervention sample size, intervention definition, involvement of intervention nurses in other aspects of the trial, and the claimed generalizability of results. Reports of randomized controlled trials published in 2000 or 2001 were identified. Full-text versions of 47 papers were obtained and information about the four characteristics was extracted and analysed. Problems relating to possible intervention bias were identified in each of the papers. Inadequate intervention definition was the commonest problem, leading to difficulties in calculating the ‘intervention dose’ and in replicating or generalizing from the studies. None of the included studies met the requirements of the Consolidated Standards of Reporting Trials. Four types of intervention bias were identified, and their possible implications for the reporting of trials of nursing interventions are discussed. This was a small-scale study, limited by time and resources. Its results are suggestive of a major problem of intervention bias but larger-scale investigations are necessary to quantify its extent. Intervention bias is potentially a problem in randomized controlled trials. Lack of detail about interventions in published papers could be corrected by stricter adherence to guidelines such as the Consolidated Standards of Reporting Trials, but this will not correct the underlying problem of inadequate study design that appears to be widespread in randomized controlled trials of nursing interventions. [ABSTRACT FROM AUTHOR]

This paper is concerned with the evaluation of a workshop for teachers of nursing devoted to an individualized teaching and learning strategy. The paper gives a brief account of the history of such workshops and continues by defining individualized teaching. Following this the characteristics of the Keller Plan strategy are outlined. This is followed by details of the course organization; its aims and objectives, and the characteristics of the course members. Finally, the method of evaluation is described and results are discussed. [ABSTRACT FROM AUTHOR]

The proposition of this paper is principally that if the term 'reassurance' is used by nurses its meaning should be clearly stated and the methods by which it may be achieved should be clearly identified. The author begins by attempting to identify a workable definition of the term and by arguing a case for taking the approach that it is a nursing interpersonal skill rather than a nursing psychotherapy. Using this as the basis for the rest of the discussion he then suggests that as an interpersonal skill it is open to analysis and behaviours can be identified which help to achieve a restoration of the patient's confidence. Further to this, learning objectives are stated in the hope that the concept of reassurance can be seen as a skill which can be enhanced by educational processes. Full competence in the use of interpersonal skills is not a stable feature in all human beings; in every individual nurse there is scope for the development and training of interpersonal skills. Finally, the author attempts to achieve the major aim of the paper--stating nursing actions which may be employed in order to achieve this reassurance of the patient. [ABSTRACT FROM AUTHOR]

This paper is a methodological discussion on a qualitative research project which involved interviewing lesbians and gay men about their experiences of nursing care. The research project arose primarily because most of the knowledge available on the subject was based on hearsay and anecdote. It is worthy of note that those who felt there was an issue to be addressed, as well as the bearers of anecdote, were by and large what would be termed 'insiders' in ethnographic research, and zealots with an axe to grind in less academic circles. It is the nature of this 'insider' status which is of interest throughout the research process of what was and remains a sensitive research topic. 'Insider' status can reduce many of the problems associated with conducting sensitive research in terms of access, rapport with subjects, ethical concerns, and stigma contagion, but by the same token lays researchers open to the charge of bias thought to be inherent in going native, or rather in this case being native. However, there are some problems associated with 'insider' status as well and this paper offers a discussion of the methodological problems we have encountered in relation to this, as well as more general methodological issues when conducting research considered to be sensitive. Ethical dilemmas also arose during the research when lesbian and gay patients who were currently receiving hospital care contacted the researchers directly because they felt threatened by nursing and medical staff. The paper is an attempt to describe some fairly conscious strategies to use the research team's 'insider' status for methodological reasons and to explain the ethical position we took when we felt compromised. [ABSTRACT FROM AUTHOR]

This paper examines the progress made in the measurement of the 'outcomes' of nursing. Although nursing has a long history of outcome research which extends as far back as Florence Nightingale, an examination of the literature over the past 30 years gives little impression of progress. Significant difficulties still remain in identifying outcomes relevant to nursing intervention, measurement techniques and appropriate study designs. However, progress has been made. The paper examines various recent trends which point to ways forward for outcome research. In particular it is emphasized that future work should build upon the strengths of past work in the use of measurement tools and the identification of relevant variables. Outcome research in nursing should not be limited to identifying the immediate results of nursing intervention, nor should research into 'structure' or 'process' variables be neglected. Such concepts are vital to determining the nursing contribution to changes in a patient's health and well being. The future of outcome research depends on a range of appropriate research methods and measurement techniques. [ABSTRACT FROM AUTHOR]

There are signs that researchers and practitioners are seriously attempting to work more closely together to bring research and practice into closer alliance. This paper describes one such attempt in the form of an 'experiment' in collaboration between academic reserchers and practising nurses in the undertaking of a practice-based research project. Positive benefits of collaborative research became evident and are highlighted in this paper. No attempt was made to evaluate the 'experiment' objectively and so this is a subjective account, aimed at encouraging other efforts towards closer collaboration between researchers and practitioners in nursing. [ABSTRACT FROM AUTHOR]

Aim. The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Background. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. Method. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. Discussion. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. Conclusion. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to describe how treatment fidelity is being enhanced and monitored, using a model from the National Institutes of Health Behavior Change Consortium. Background. The objective of treatment fidelity is to minimize errors in interpreting research trial outcomes, and to ascribe those outcomes directly to the intervention at hand. Treatment fidelity procedures are included in trials of complex interventions to account for inferences made from study outcomes. Monitoring treatment fidelity can help improve study design, maximize reliability of results, increase statistical power, determine whether theory-based interventions are responsible for observed changes, and inform the research dissemination process. Methods. Treatment fidelity recommendations from the Behavior Change Consortium were applied to the SPHERE study (Secondary Prevention of Heart DiseasE in GeneRal PracticE), a randomized controlled trial of a complex intervention. Procedures to enhance and monitor intervention implementation included standardizing training sessions, observing intervention consultations, structuring patient recall systems, and using written practice and patient care plans. The research nurse plays an important role in monitoring intervention implementation. Findings. Several methods of applying treatment fidelity procedures to monitoring interventions are possible. The procedure used may be determined by availability of appropriate personnel, fiscal constraints, or time limits. Complex interventions are not straightforward and necessitate a monitoring process at trial stage. Conclusion. The Behavior Change Consortium's model of treatment fidelity is useful for structuring a system to monitor the implementation of a complex intervention, and helps to increase the reliability and validity of evaluation findings. [ABSTRACT FROM AUTHOR]

Title. Clinical decision-making skills on the developmental journey from student to Registered Nurse: a longitudinal inquiry Aim. This paper is a report of a study to explore, from the perspective of nursing students, how they acquire clinical decision-making skills and how well-prepared they feel in this respect regarding their responsibilities as Registered Nurses. Background. Previous research has focused mainly on exploring experienced nurses’ judgement and decision-making. Some studies have elicited senior nursing students’ understanding of the process, but none has explored the development of clinical decision-making skills throughout the educational programme and in the first year as a Registered Nurse. Method. A volunteer sample of 20 respondents, broadly representative of the student cohort regarding qualifications, age, gender and nursing specialty, was recruited. A longitudinal hermeneutic phenomenological study was carried out from 2000 to 2004, using interviews, reflective journals, care studies, critical incident analyses and document analysis. Findings. Ten conceptions of nursing and 10 perceptions of clinical decision-making were identified and a growing pattern of inter-relationships between them became apparent. A ‘matrix model’ was developed by cross-referencing the two thematic categories within the timeline of respondents’ developmental journey through significant milestones and changing contexts. As Registered Nurses they found having to ‘think on your feet’ without the ‘comfort blanket’ of student status both a stressful and formative learning experience. Conclusion. Further collaboration between education and health service partners is recommended to integrate clinical decision-making throughout the nursing curriculum, enhance the development of such vital skills, and facilitate the transition from student to Registered Nurse. [ABSTRACT FROM AUTHOR]

Title. The essence of nursing care: Polish nurses’ perspectives Aim. This paper is a report of a study to identify Polish nurses’ definition of the concept of nursing care. Background. Polish nursing currently is in a period of scientific research focusing on development of precise definitions of concepts. Definitions of nursing are influenced by culture, social expectations and healthcare systems. Accepted scientific definitions of concepts should be based on empirical verification that takes theoretical and practical perspectives into account. Methods. A survey questionnaire was constructed from analysis of a random sample of 27 essays about nursing care that had been completed by 300 Polish nurses. The survey questionnaire, which was designed to measure the essence of nursing care, was completed by 324 Polish nurses during 2004 and 2005. Findings. Analysis of survey questionnaire responses revealed that the essence of nursing care encompasses providing care, communicating, supporting, helping, assisting, accompanying and managing. Participants indicated that nursing care recipients include healthy persons, ill persons and persons at risk for disease. Conclusion. The concept of nursing care encompasses several traits or characteristics that can be applied to both well and ill people. [ABSTRACT FROM AUTHOR]

Title. Using a conceptual model in nursing research – mitigating fatigue in cancer patients Aim. This paper is a discussion of the use of the Levine Conservation Model to guide the investigation of an exercise intervention to mitigate cancer-related fatigue. Background. Researchers use conceptual models or theoretical frameworks to provide an organizing structure for their studies, to guide the development and testing of hypotheses, and to place research finding within the context of science. Selection of an appropriate and useful framework is an essential step in the development of a research project. Method. A descriptive approach is used to present the components of the conceptual model and details of the articulation of the study intervention and outcomes with the model. Findings. The Levine Conservation Model provided a useful framework for this investigation, conducted in 2002–2006, of the effects of exercise on fatigue and physical functioning in cancer patients. The four conservation principles of the model guided the development of the exercise intervention, the identification of salient outcomes for patients, and the selection of appropriate instruments to measure study variables. The model is also proving useful in the analysis and interpretation of data in relation to the conservation principles. Conclusion. Use of an appropriate conceptual model facilitates the design and testing of theory-based interventions and the development of science to support nursing practice. [ABSTRACT FROM AUTHOR]

winch s., henderson a.&creedy d. (2005) Journal of Advanced Nursing50(1), 20–26Read, Think, Do!: a method for fitting research evidence into practiceThis paper discusses a process for research utilization that overcomes well-known barriers in order to influence clinical decision-making and practice change.Read, Think, Do! is a problem-solving approach to research utilization and practice development which has the potential to overcome barriers to research utilization.Any process for research utilization at the practice level needs to overcome numerous barriers in order to influence clinical decision-making and practice change. Access to research-based knowledge is an obvious first step in the evidence-based approach to care delivery, but is clearly inadequate alone in influencing the improvement of practice.Read, Think, Do! acknowledges the complexity of problem-solving processes from the outset by looking for (1) the evidence, (2) assessing the value to practice, and (3) addressing the social and cultural milieu of the practice setting to ascertain the best strategies for initiating and sustaining practice change. This approach draws distal forms of empirical knowledge that have the capacity to improve patient outcomes into the proximal knowledge base of the clinical nurse. This is achieved by collaboration, planning and evaluation involving all levels of staff and a specialist facilitator, the Clinical Nurse Consultant in evidence-based practice.Read, Think, Do! is a method of research utilization and practice development that has the potential to overcome barriers to research utilization and avoid the‘misplaced concreteness’ that can occur when trying to fit empiricism into practice. By addressing the breadth and diversity of issues surrounding research utilization in a systematic manner it presents a sustainable method for practice change informed by evidence. [ABSTRACT FROM AUTHOR]

BACKGROUND: A neonatal community nursing service may help families to cope with the early transfer of small, vulnerable infants to home. The previous literature has relied on self-reports to explore this kind of work. AIM: This paper reports a study exploring the work of a community neonatal nursing team in order to describe the strategies and interventions used to support families of preterm infants. METHOD: A qualitative case study design was adopted. Data were collected using fieldwork observations, semi-structured interviews and documentary analysis with a team of four community neonatal nurses. A nursing model of transition was explored as a possible framework for practice. FINDINGS: Thematic data analysis yielded two broad themes: Working with Mothers and Working with Others. Subcategories of Working with Mothers consisted of Baby Well; Mum Happy; Keeping in Touch and One of the Family. Working with Others focussed on multidisciplinary liaison activities. DISCUSSION: The complexity of nursing work was interdependent with maternal caregiving and dependent upon effective liaison with other health care professionals. The nursing model of transition requires further development to offer a sufficiently coherent practice model to direct neonatal nursing care delivery. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is mounting pressure on nurses and midwives in the United Kingdom to use research findings to inform their practice. However, many still find research difficult to understand and are poorly prepared by education to make use of it. Hence, there is a pressing need to evaluate the research education included in nursing and midwifery curricula. AIM: This paper reports a study assessing the impact of research education on the attitudes towards research and use of research findings in practice by graduate nurses and midwives. METHOD: A cross-sectional survey using a self-completed postal questionnaire was conducted with a sample of 340 nurse and midwife graduates in the South East of England. FINDINGS: A response rate of 51% was obtained. A large number of respondents stated that their critical appraisal (96%) and search skills (87%) had improved following graduation and they reported using research findings in practice (16.8% all the time, 50.5% frequently and 32.6% sometimes). Furthermore, the majority expressed positive attitudes towards research and these were related to the research education received. However, a significant number reported finding statistics difficult to understand, lack of time to read research and limited access to research findings at their place of work. Also, a number of respondents would still like more help with searching the literature, implementing research findings in practice and developing their critical appraisal skills further. CONCLUSION: It is crucial that some of the major barriers to research utilization are addressed at both individual and organizational levels if evidence-based care is to become a reality. Also, health service managers should consider a number of strategies suggested by respondents to increase the use of research findings in clinical settings. [ABSTRACT FROM AUTHOR]

gudmundsdottir e., delaney c., thoroddsen a. & karlsson t. (2004) Journal of Advanced Nursing 46(3), 292–302 Translation and validation of the Nursing Outcomes Classification labels and definitions for acute care nursing in Iceland The Nursing Outcomes Classification (NOC), second edition, consists of 260 patient outcomes with definitions. This has been translated into five languages, but has not been clinically validated outside the United States of America (USA). The aim of this paper is to describe the translation of the labels and definitions from the NOC, second edition from English to Icelandic and validation for acute-care nursing in Iceland. A survey that has been designed to identify nurses’ perception of the percentage of patients’ for whom each NOC outcome is relevant in clinical nursing practice was used for clinical validation in this study. The translation procedure involved source to target language translation, parallel comparison, pilot test and field test. Validation included test–retest to measure the reliability for each of the 260 outcome variables. Data collected from 140 clinical nurses from 54 departments within 13 nursing specialties at Landspitali University-Hospital in Iceland, in November 2001, were analysed to establish construct validity by confirmatory factor analysis. Internal consistency was calculated. Translation was successful. Test–retest showed that 181 of the 260 NOC outcomes were significant ( P < 0·05) and moderately or highly correlated ( r > 0·50) (Pearson's correlation). The confirmatory factor analysis showed that 22 of the 29 NOC classes had only one factor at the loading criteria ≥0·30. Of the 260 outcomes, 244 had loading on one factor (≥0·30) within its class. Internal consistency was >0·80 (Cronbach's alpha). Low response rate was a limitation. The indicators of each NOC outcome were not addressed. The Icelandic version of the NOC survey is a comprehensive tool that can be applied to nursing in acute-care for research purposes as well as to prepare for the implementation of NOC in clinical information systems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Critical realism is a relatively new philosophical perspective that combines a realist ontology with a relativist epistemology in subscribing to a form of 'robust' relativism. The potential benefits of adopting a critical realist approach are considered in two areas of evaluation research: theory-driven programme evaluation and policy evaluation. AIM: The aim of the paper is to identify the main features of critical realism and explore its potential as a philosophical framework in the field of evaluation research. CONCLUSION: We argue that critical realism provides a coherent framework for evaluation research that is based on the understanding of causal mechanisms. This is particularly important for frontline services seeking to use evidence-based interventions, as interventions need to be properly understood if they are to be used effectively in the context of clinical practice. Critical realism can also add depth to policy analysis. However, there is a potential for critical realists to drift beyond the boundary that separates scientific knowledge from speculative theory when making recommendations about the best course of action to follow. [ABSTRACT FROM AUTHOR]

Background. Rhetoric about spirituality and nursing has greatly increased, as scientific-based approaches are not fully able to address many human problems, such as persistent pain. Despite the renewed interest and growing literature on spirituality, there is no consensus on a definition of this concept. There is also ambiguity on how this concept is incorporated into nursing practice, research, and education. Aim. This paper aims to contribute toward clarification of the meaning of spirituality in relevance to health and nursing today through a conceptual analysis process. Methods. Information was obtained through dictionary definitions and electronic database searches of literature on spirituality spanning the past 30 years. The criteria for selection included scholarly articles and books with a definition of spirituality, and research studies that investigated the meaning of spirituality to individuals' health. A total of 76 articles and 19 books were retrieved for this analysis. Findings. Spirituality is an inherent component of being human, and is subjective, intangible, and multidimensional. Spirituality and religion are often used interchangeably, but the two concepts are different. Spirituality involves humans' search for meaning in life, while religion involves an organized entity with rituals and practices about a higher power or God. Spirituality may be related to religion for certain individuals, but for others, such as an atheist, it may not be. Conclusion. In order to provide clarity and enhance understanding of this concept, this analysis delineates antecedents, attributes, constructed case examples, empirical referents, and consequences of spirituality. A proposed definition of spirituality emerged from this process, which may be applied broadly. Implications for nursing practice, education, and research are discussed. [ABSTRACT FROM AUTHOR]

Research information in nurses’ clinical decision-making: what is useful? Aim. To examine those sources of information which nurses find useful for reducing the uncertainty associated with their clinical decisions. Background. Nursing research has concentrated almost exclusively on the concept of research implementation. Few, if any, papers examine the use of research knowledge in the context of clinical decision-making. There is a need to establish how useful nurses perceive information sources are, for reducing the uncertainties they face when making clinical decisions. Design. Cross-case analysis involving qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England, United Kingdom. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 hours and 122 nurses were involved in the Q modelling exercise. Results. Text-based and electronic sources of research-based information yielded only small amounts of utility for practising clinicians. Despite isolating four significantly different perspectives on what sources were useful for clinical decision-making, it was human sources of information for practice that were overwhelmingly perceived as the most useful in reducing the clinical uncertainties of nurse decision-makers. Conclusions. It is not research knowledge per se that carries little weight in the clinical decisions of nurses, but rather the medium through which it is delivered. Specifically, text-based and electronic resources are not viewed as useful by nurses engaged in making decisions in real time, in real practice, but those individuals who represent a trusted and clinically credible source are. More research needs to be carried out on the qualities of people regarded as clinically important information agents (specifically, those in clinical nurse specialist and... [ABSTRACT FROM AUTHOR]

Examination of the qualitative methodological literature shows that there appear to be conflicting opinions and unresolved issues regarding the nature and process of grounded theory. Researchers proposing to utilize this method would therefore be wise to consider these conflicting opinions. This paper therefore identifies and attempts to address four key issues, namely, sampling, creativity and reflexivity, the use of literature, and precision within grounded theory. The following recommendations are made. When utilizing a grounded method researchers need to consider their research question, clarify what level of theory is likely to be induced from their study, and then decide when they intend to access and introduce the second body of literature. They should acknowledge that in the early stages of data collection, some purposeful sampling appears to occur. In their search for conceptually dense theory, grounded theory researchers may wish to free themselves from the constraints that limit their use of creativity and tacit knowledge. Furthermore, the interests of researchers might be served by attention to issues of precision including, avoiding method slurring, ensuring theoretical coding occurs, and using predominantly one method of grounded theory while explaining and describing any deviation away from this chosen method. Such mindfulness and the resulting methodological rigour is likely to increase the overall quality of the inquiry and enhance the credibility of the findings. [ABSTRACT FROM AUTHOR]

The recent emphasis on community care for those with mental illness has changed working patterns and modified inter-professional role boundaries within multi-disciplinary teams. Clients with serious mental illness are usually prescribed medications, which have a wide range of side effects. However, it is uncertain who is responsible for monitoring clients for the side effects of their medications, ensuring clients' and carers' understandings of their prescribed medications and optimizing compliance with medication. This paper discusses the findings of the first phase of an ongoing study designed to assess the role of community mental health nurses (CMHNs) in managing clients' medication and the provision of appropriate continuing professional education. Our respondents were 14 CMHNs, seven of whom were preparing to undertake a pharmacology module as part of a higher education diploma, and seven who were to act as comparators. Data from questionnaires, interviews and clinical observations were triangulated. All respondents felt that issues surrounding clients' medication were not accorded a sufficiently high profile and that it was, in part, their responsibility to expand their roles to meet these unmet needs of clients. Administering and managing clients' medications were considered to be the main area of 'occupational territory' which distinguished CMHNs from social workers. However, the nurses felt that their practice was limited by lack of appropriate educational preparation. [ABSTRACT FROM AUTHOR]

Developing a method that is pragmatic yet theoretically consistent with the philosophies of hermeneutics and phenomenology is a constant hurdle for any researcher endeavouring to engage their inquiry in this manner, particularly when its proponents refute the credence of hermeneutics as a research method. This paper discusses how Van Manen's six research activities can act as a framework, that when modified to suit the particular needs of the research project, can promote a process of inquiry that works with these philosophies towards an unfoldment of new understandings of the human experience in illness. [ABSTRACT FROM AUTHOR]

This paper makes the point that for psychiatric patients the nursing process based on a systems approach may be more useful than that based on problem-solving or activities of daily living. Some of the key concepts used in this approach are (i) listing component parts of a system, (2) defining the inside and outside of systems, the outside being described as environment, (3) changing the boundaries or the interface of various systems, as appropriate, (4) observing the impact of the environment and especially of the nurse herself as a part of the system or the environment, (5) tracing input, output and throughput, and (6) drawing distinctions between open and closed systems and accounting for a steady state in the system. [ABSTRACT FROM AUTHOR]

This paper gives a review of the pertinent literature related to the use of clinical glass thermometers in body temperature recordings, historically and up to the present day. An attempt is made to give this commonly practised nursing procedure a scientific basis. Aspects of methods involved are discussed, particularly from the viewpoints of accuracy and safety. Some of the discrepancies inherent in current practice are pointed out and, where relevant, suggestions are made on the revision of this in the light of research findings and scientific data. [ABSTRACT FROM AUTHOR]

The nursing process was originally adopted by the North American nursing profession from the general systems theory (GST) and quickly became a symbol of contemporary nursing as well as a professionalist nurse ideology. In contrast its initial introduction in the United Kingdom (UK) was not a complete success. This could be attributed to the mode of its implementation, which utilized a power-coercive change strategy, that is, comprising of imposition from above without sufficient time for education regarding its scientific and philosophical foundations. Consequently the nursing process was initially regarded as a professional and educational mandate rather than an organizational component of nursing care delivery. It has been maintained that the theoretical basis from which the nursing process was derived, together with the theoretical developments in diagnostic and intervention studies, has established the nursing process as a key element of the nurse's role in research, education and practice. This paper will briefly review the early theoretical developments and fate of the nursing process as a tool for clinical practice and research. It will then examine recent attempts to revitalize and modernize the theory for practice through research into nursing diagnosis. [ABSTRACT FROM AUTHOR]

In this paper it is argued that integrative nursing research has a great potential for clarifying the theoretical perspective and substance of the nursing discipline as well as making research-based knowledge more accessible to clinical nurses. Two general kinds of integrative research are introduced and illustration provided of how these have been practiced within nursing. Significant strengths and weaknesses in current practice is highlighted. It is argued that nursing should pay more attention to this kind of research, specifically in terms of developing sound methodological approaches and overcoming the traditional schism between empirical and theoretical research. Sound integrative nursing research promises to improve the development of nursing science as well as making the products of nursing research more easily available for clinical nurses. [ABSTRACT FROM AUTHOR]

Nurses currently construct careers in a climate of continuing occupational and organizational change. A longitudinal project is in progress which is documenting the post-qualification histories of a cohort of registered general nurses, and studying the extent to which their careers represent occupational choice, a response to organizational constraints, or a combination of both. Three elements comprise the core of the research: questions which provide information on the cohort's career plans, charts which document their career histories and questions which explore the relationship between the two. The basis of the design is the first element, and this paper focuses on the problems encountered in designing the questions and routeing structures which enabled all cohort members to describe their plans for the future. The importance of extensive pilot work is demonstrated in the development of options tailored for each potential career pathway and to allow expressions of uncertainty to emerge at points when appropriate to respondents. Of the 1164 members of the cohort, 1015 returned the questionnaire; a response rate of 87%. Findings are presented on the cohort's plans at qualification. The majority of respondents (86%) saw themselves as remaining in nursing and in clinical practice in the early post-qualification period. Eighteen per cent said they intended to practise abroad at some point, 30% foresaw a likelihood of working in the private sector, 59% wanted to take one or more English National Board courses and 42% expressed interest in obtaining an undergraduate or postgraduate degree. [ABSTRACT FROM AUTHOR]

Patient/client advocacy has been claimed as a new role for the professional nurse. This paper presents a critical review of the literature on advocacy in nursing. After briefly outlining the conditions which may have instigated the need for patient advocacy, meanings and models of advocacy are discussed. It is argued that although there are many examples of the advocacy role in health care, models proposed for the nurse as advocate are indeterminate which leads to multiple interpretations and lack of clarity in operationalizing advocacy. Much of the literature focuses on justification arguments for claiming the advocacy role. Key themes are outlined and include: patient advocacy as a traditional role, nurses are in the best position in the health care team, nurses have the knowledge to advocate and finally nurses and patients can be partners in advocacy. However, critical examination reveals many counter-arguments to the above claims and finally concludes that advocacy is a potentially risky role to adopt. It is argued that support systems are inadequate except in low- risk situations and ultimately acts of advocacy remain a moral choice for the individual nurse. Finally the need to conduct research into the interpretation of the patient advocate role by nurses in the United Kingdom is highlighted. [ABSTRACT FROM AUTHOR]

In this paper, the author seeks to address issues of personal and professional development that may occur during the research process. Whilst research reports now abound in the nursing literature, this personal aspect is often neglected. As we seek to encourage research awareness within the profession, many student and qualified nurses now produce a small research project, and this often concentrates on measurable outcomes. By examining her own perceived learning in resolving epistemological pluralism whilst undertaking such a project as a tutor student, the author has attempted to resolve the problem of ignoring the personal. Indeed, she believes that increased self-awareness can only enhance nursing professionalism. [ABSTRACT FROM AUTHOR]

Recently, the relationship between theory and research has received more attention. It seems that in the past 10 to 15 years more research studies have been published that are more or less conceptualized within (nursing) theories. However, it is not always clear how the theory has been used. The purpose of this study was to analyse the role of theory in nursing practice research. To this end, papers published in six nursing journals between 1986 and 1990 have been studied. It can be concluded that, in comparison with earlier analyses, the use of theories in nursing research studies has increased (from 13% to 21%), but the use of nursing theories has not become more frequent. However, the testing of nursing theories is minimal. On the other hand, research results are being cumulated progressively in regard to theory or to other research. [ABSTRACT FROM AUTHOR]

Since sleep and healing appear to be associated, achieving the optimum quality of sleep among hospital patients should be a priority for both clinical nurses and researchers. This paper discusses various methods of sleep assessment which may be used by those intending to conduct research in this field. [ABSTRACT FROM AUTHOR]

It is well recognized that admission to hospital is a stressful experience for patients, and little attention is directed towards helping patients to adapt to hospitalization. This paper reports the replication of a descriptive study which explored the patient's welfare after the use of a patient-centred nursing approach designed to alleviate stress on admission to hospital. It also attempts to determine the patient's perception of the nurse during the implementation of the admission procedure, and his general reactions toward the admission procedure. [ABSTRACT FROM AUTHOR]

The article discusses the new format for the "Journal of Advanced Nursing." The section that features research papers is subdivided into the categories Original Research and Research Methodology. The journal will also publish theoretical research studies that offer scholarly analysis and discussion of conceptual, philosophical, theoretical or professional issues that have relevance to the journal's readership.

Presents views on an academic paper submitted by E. Van Teijlingen and V. Hundley and published by the 'Journal of Advanced Nursing.' Dilemmas involved in publication; Results of the delay in publication; Challenge to the researchers.