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Rationale. Qualitative and quantitative research rely on different epistemological assumptions about the nature of knowledge. However, the majority of nurse researchers who use multiple method designs do not address the problem of differing theoretical perspectives. Traditionally, symbolic interactionism has been viewed as one perspective underpinning qualitative research, but it is also the basis for quantitative studies. Rooted in social psychology, symbolic interactionism has a rich intellectual heritage that spans more than a century. Underlying symbolic interactionism is the major assumption that individuals act on the basis of the meaning that things have for them. Aim. The purpose of this paper is to present symbolic interactionism as a theoretical perspective for multiple method designs with the aim of expanding the dialogue about new methodologies. Conclusion. Symbolic interactionism can serve as a theoretical perspective for conceptually clear and soundly implemented multiple method research that will expand the understanding of human health behaviour. [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 study reported in this paper was carried out to investigate a group of nursing teachers' (n=37), nursing students' (n=166), nursing administrators' (n=33) and physicians' (n=127) perceptions of barriers to and facilitators of nurses' use of research findings in clinical practice. The results were compared with the corresponding figures for a reference group of nurse clinicians (n=237). The Barriers Scale and a questionnaire for the demographic issues were used for data collection. The organization and the communication of research were seen as barriers to research utilization by the nursing teachers, students and administrators in agreement with the nurse clinicians. The nurses' research-related competence and awareness were seen as barriers by the nursing teachers, students and administrators to a greater extent than by the nurse clinicians themselves. The physicians perceived barriers to a lesser extent than the other groups did. The students' perceptions were closest to the nurse clinicians, while the physicians' perceptions differed most. Education to increase the nurses' knowledge of research and to develop their competence to evaluate research results, increased resources for education, more staff, support from the administration and research presented in a user-friendly way were the most frequently suggested facilitators. The nurses' isolation from knowledgeable colleagues with whom to discuss the research was seen as a barrier by the majority of the participants. This indicates a need for positions in clinical practice for nursing researchers, in order to promote a research-based, nursing practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The primary aim of the study was to evaluate the effectiveness of two approaches to increase research awareness among midwives and nurses. DESIGN: Quasi-experimental with the attitudes of staff in the two groups being measured at two points (January and October 1997). SAMPLE: All midwives and nurses working in four clinical areas in an acute NHS Trust. The intervention arm of the study involved all midwives and nurses in the Clinical Directorate of Obstetrics and Gynaecology, while the control arm involved all nurses working in a specialist oncology and haematology unit and in the children's directorate. ETHICS: The Joint Ethics Committee considered approval unnecessary because the study involved staff and not patients. DATA COLLECTION: Data were collected by self-complete questionnaires. INTERVENTIONS: A programme of education with policy and practice interventions targeted at ward sisters. OUTCOME MEASURES: Staff attitudes to, knowledge of, and level of involvement in, research. RESULTS: The study demonstrated a significant increase in both knowledge and use of research resources. Following the programme of education, staff in the intervention group were significantly more likely to use resources associated with research utilization and to report that they had read a research paper within the last month. STUDY LIMITATIONS: The time scale of the intervention was restricted by the funding available; a significant Hawthorne effect was evident with both groups showing an increase in knowledge; the pragmatic nature of the study meant that it was not possible to randomize the study groups; the scale of the study did not permit an economic evaluation. CONCLUSIONS: The introduction of clinical governance challenges healthcare providers to improve the care they deliver. There are huge opportunities for Trusts to invest in developing staff knowledge and use of research. However, staff will only seize these opportunities if there is an appropriate, enabling environment--an environment that delivers intensive interventions and is sensitive to the wider structural factors in the NHS affecting staff morale and commitment. In the absence of this environment, what may be seen as opportunities to managers may be regarded as just another burden by staff. [ABSTRACT FROM AUTHOR]

This paper demonstrates that the different sources of non-response in survey research must be considered by researchers in order to minimize the potential for bias, and that careful planning and management during sample selection, sample recruitment and data collection can control the extent of response failure. The findings of an interview survey of nurses and nurses' aides illustrate, however, that the success of strategies designed to reduce the loss of data in survey research depends upon researchers acknowledging the complex relationships that exist between non-response phenomena throughout the research process. [ABSTRACT FROM AUTHOR]

Practice innovation is an inevitable feature of a health culture preoccupied with evidence-based practice. The cyclical process of defining best practice, implementing and evaluating change represents an unparalleled opportunity for nurse researchers to engage in, and develop, practice through 'realistic evaluation'. However, the methodological dilemmas and challenges inherent in evaluation research which informs policy should not be under-estimated. This paper seeks to introduce and wrestle with some of the political tensions and methodological issues surrounding practice innovation when it is undertaken within an evaluative research framework. A critical pathway is presented to stimulate discussion and guide novice evaluators through this often perplexing methodological maze. A case study in audiological rehabilitation in elder care is used to illustrate the issues raised. [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]

The use of focus group methodology — with selected examples from sexual health research ¶ This paper describes in detail the use of the focus group approach in research. The following issues are discussed: when, why and how focus group methods are used, their advantages and disadvantages and how data are analysed. Selected examples from four research studies on sexual health using this methodology are reported together with some of the problems experienced with␣their use. The importance of using focus groups in qualitative research is␣addressed and an argument is suggested for their more general use. [ABSTRACT FROM AUTHOR]

Consensus among nurse scholars has not been reached regarding suitable qualities for accepting or rejecting the evidence arising from various world views. The authors' purpose in writing the paper is to describe the qualities or warrants for evaluating scientific findings (the 'evidence') of different research perspectives. The warrantable evidence pertinent to post-positivist, interpretivist, critical social theorist, and feminist perspectives are described and common warrants are suggested. Three warrants common to these scientific perspectives are proposed: (a) scrutiny and critique of methodological rigor and findings by the scientific community; (b) corroboration and intersubjectivity; and (c) scope of the evidence. The identification of common warrantable evidence will assist nurses in developing some core values regarding the constituents of good science or good scholarship even in the face of pluralism in nursing science approaches. [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]

A comparison of pre-Project 2000 and Project 2000 nurses’ perceptions of their research training, research needs and of their use of research in clinical areas ¶Most of the literature on the research training and education of nurses has focused on teaching strategies. Only a few authors have assessed systematically the impact of research modules or courses on the knowledge and attitudes of nurses. There is a lack of research on nurses’ use of research following their preparation. This paper reports on some of the data from a large-scale survey of the utilization of research among nurses in Northern Ireland. In particular, a comparison is made of the perceptions of pre-Project 2000 and Project 2000 qualified nurses of their research training, research needs, and use of research in clinical areas. A questionnaire was distributed to a convenience sample of 2600 nurses from 23 hospitals in 14 Trusts in Northern Ireland. The response rate was 52·6% (n = 1368). The findings show, among others, a shortfall in research preparation of pre-Project 2000 nurses in important aspects of research. While Project 2000 nurses reported receiving more training, they did not report higher rates of research utilization than pre-Project 2000 nurses. Registered mental nurses (RMNs) and registered nurses mental handicap (RNMHs) also reported lower rates of research utilization than registered general nurses (RGNs), despite reporting the same amount of research preparation as RGNs. The implications of these findings are discussed. [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]

The following paper discusses the process of doing research on a sensitive and politically charged topic; 'mixed sex' psychiatric wards. It also highlights the conceptual and methodological difficulties of carrying out this enquiry. The particular deconstruction presented is suggested as knowledge or data alone, even though they are rarely found in finished research projects. It starts by setting the broader context of the research at The Bethlem and Maudsley Trust by looking at National policy, other studies in this subject area and media attention. It shows the triggers that caused a re-evaluation and changes in the original research question and assumptions about 'mixed sex' wards. It accounts for the research as it happens, rather than presenting a sanitised process of discovery. This forms the basis for describing some of the dilemmas for carrying out the in-depth research; showing how the reconfigured research subject became focused on the safety and effectiveness of 'mixed sex' wards for women. The grounded methodological approach to this study is outlined and the paradoxes it identified in psychiatric discourse are mentioned. Excerpts of findings from three separate research studies at The Bethlem and Maudsley Trust are given and discussed. The conclusion analyses the complexities of the subject and suggests that the 'mixed sex' ward problem may be the contemporary emergence of a much older and fundamental problematic inherent to psychiatry. Consequently, no simple answer is recommended. [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]

Meeting needs is the aim of health care frequently espoused in textbooks, policy documents and reports of research studies; provision of health care is also now described as 'needs-based', rather than 'service-based'. The purpose of this paper is to explore the concept of need, using concept analysis, with the aim of providing greater clarity. Two approaches to concept analysis are compared: the linear model proposed by Walker and Avant and Rodgers' cyclical model. On both a philosophical and practical level, Rodgers' model was felt to be more appropriate for analysis of the concept of need. The rigid divisions which the Walker and Avant model seeks to establish (particularly in relation to the construction of additional cases) were felt to restrict, rather than clarify the concept. The attributes, antecedents, consequences and references of need are described, following stratified random sampling of the available literature, and a model case is presented. The themes of priority and perception of need arose consistently within the literature, highlighting the value-laden nature of the concept and the importance of achieving a common understanding to enable purchasers, providers and consumers to better satisfy health care needs. [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]

Multiple triangulation is an approach to research which is becoming increasingly popular among nurse researchers. It is an attempt to improve validity by combining various techniques in one study. Provided that the researcher is well informed, the approach can be successful. However, the issue becomes clouded because in their excitement some nurse researchers seem to have forgotten that the roots of research stem from one of two paradigms, or world views. This has led to the suggestion that paradigms may be combined, and has caused the validity of multiple triangulation to be called into question. In an attempt to unravel the muddle this paper describes multiple triangulation and goes on to suggest where the confusion has occurred. It concludes that multiple triangulation is a valid technique providing that researchers remember that their work will always be influenced by a single paradigm. [ABSTRACT FROM AUTHOR]

Moral certainty and uncertainty have a profound impact on nurses' ethical choices. In order to describe these concepts, the author examined long-term care nurses' convictions about the issue of withholding or withdrawing artificial nutrition and hydration from elders. A convenience sample of 25 BSN and MSN-prepared long-term care nurses were interviewed and asked to describe their experiences with this issue. A qualitative analysis utilizing Colaizzi's (1978) methodology was performed. Five categories of conviction emerged from the data. These five categories included absolute moral conviction, strong moral conviction, moderate moral conviction, moral uncertainty with conviction and moral uncertainty. Eighty-four per cent of the sample was convinced that tube feeding was not always in the resident's best interest. Sixteen per cent of the sample were uncertain, but were convinced that the resident should not suffer. A pattern emerged from the interview results and the answers to three additional questions. The pattern suggests that the more experience a nurse has with nontreatment the more likely she or he is to agree with it. In this paper. the five categories of conviction are compared and contrasted, the pattern of conviction described, and the implications of the findings for nursing discussed. [ABSTRACT FROM AUTHOR]

Universal prescriptivism is a recently developed moral decision-making theory that combines utilitarian and Kantian theories with two levels of moral thinking. A combined approach offers a creative solution to the weaknesses inherent in traditional moral theories. The paper describes the theory and discusses important implications for nursing education, practical ethical decision-making, and research. The relationship of an ethical theory of caring to traditional moral theory is discussed. [ABSTRACT FROM AUTHOR]

Telephone interviews were employed by nurse researchers as a means of collecting data from elderly people following their discharge from hospital. The paper reviews the literature concerning interviews with elderly patients by telephone and recounts first-hand experience of the method on the basis of over 500 telephone interviews. Although some difficulties were encountered in conducting interviews with the hearing-impaired and the unwell, the method was found to be a cost-effective and useful means of obtaining follow-up data for research purposes. The prime factor in ensuring successful use of the method was the recruitment of subjects via personal interview prior to telephone contact. [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]

Increasingly, qualitative research methods are being embraced by nurse researchers because these approaches allow exploration of human experience. Failure to explicate qualitative methodologies is resulting in a body of nursing research that is either mislabelled or is classified broadly as qualitative and subject to charges that qualitative research lacks rigour. In this paper, the authors discuss the importance of specificity in methodology and distinguish between phenomenology and grounded theory, two frequently misused terms in the description of qualitative methodology. [ABSTRACT FROM AUTHOR]

There has been increasing interest in the attitudes that the general public and health care professionals hold towards cancer, the effect these have on an individual's likelihood to present early with symptoms, and the quality of care patients with the disease receive from carers. The research appears to indicate that the attitudes of both groups are largely negative and stereotyped, and cancer is seen as being more devastating than other life threatening diseases. These attitudes have been associated with patterns of poor communication and care for cancer patients. This paper looks critically at the research into the attitudes of nurses towards cancer and calls for more innovative methods than have been used to date. There is a need to increase our understanding of this complex problem before indications for education and practice can be made. [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]

The ward sister role is increasingly coming understudy. This paper summarizes research into learning in the ward environment. The study being one of several on a similar theme, to have been published in the past 2 years. The research concentrated in particular on the behavioural characteristics of trained nurses perceived as good teachers. Attitudes and perceptions of teaching and teaming were investigated by interviewing trained and trainee nurses. The data concerning good teachers collected at interviews were developed into a questionnaire and the results factor analysed+ In the third phase of the study trained nurse-trainee verbal communications were observed and analysed to determine any relationship between verbal behaviours and effective teaching. The findings of the study led to the conclusion that on the job teaching of nurses is a complex global act in which the role model presented to the Learner has a powerful influence while it could nor be said conclusively that a link between effective teaching and verbal behaviour was identified, a trend towards a more participative mode of communication was noted in two identified good teachers. [ABSTRACT FROM AUTHOR]

This paper describes a study of the usefulness of academic gaming in nurse education. The research has been carried out over the course of 3 years and represents an attempt by a nurse tutor to carry out a study on research lines, during the course of normal working and with a minimum of interference to the normal working of a nurse education department. The study involved psychiatric nurse learners at Winterton Hospital, Sedgefield, Durham and attempted to assess the usefulness of academic gaming by evaluating one academic game which has been designed for nurse learners. This game aims to teach various aspects of the digestive system and digestive processes. The questions which required answers were, can nurse learners learn from academic games? Do they like this method of learning? How does this method compare with other learning methods? Eighty-six learners participated in a test/game/test situation and completed a questionnaire after playing the game. Results suggest that learners can increase their knowledge of the subject by playing the game but it may be most useful as a consolidation method. Learners most often stated that they enjoyed the game and when ranked according to preference, gaming was preferred to film, reading and discussion methods but equally preferred to the lecture method. [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]

A list of review papers, research and theoretical papers to be published in the forthcoming issue of the journal is presented.

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.

A list of the research papers related to nursing that are featured in the February 2008 issue of this journal is presented, which includes "Improving Decision-Making in Caring for People With Epilepsy and Intellectual Disability: An Action Research Project," "Stress and Eustress in Nursing Students" and "School Nurses and Sex Education: Surveillance and Disciplinary Practices in Primary Schools."

A list of research papers in the October 2007 issue of the "Journal of Advanced Nursing" is presented.

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.