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Dorothea Orem and Madeleine Leininger are two nursing scholars who are contributing significantly to the body of nursing knowledge. This paper contrasts their backgrounds, the origins of their theories, their views of the nature of nursing, use of thoery development strategies, and contributions to nursing science. The concepts of Leininger's care and Orem's self-care will be compared as these relate to their theories with the examination of similarities and differences. [ABSTRACT FROM AUTHOR]

Although sleep has been identified as an activity generally considered necessary for normal functioning, the nursing literature on the subject is relatively scanty. This paper is an attempt to review sleep and its relationship to nursing practice. A discussion of nursing interventions that are likely to ensure that adequate sleep is maintained is included. [ABSTRACT FROM AUTHOR]

The major importance of pain control is also highlighted. This is clearly an extreme stress for families and again careful planning and proactive intervention is essential. Families need proactive and timely services that anticipate and meet needs almost before they arise. This requires careful joint planning with families and regular evaluation of their needs. Parents have a great need for information and real training and education as they are usually taking the main strain of caring and often undertaking new and professional roles in nursing and treatment. Again this training should be proactive and not provided in a piecemeal fashion.

Comments on an article about nursing care. Issue on relationship; Objection to the concept of an ideology of compassion; Discussion on nursing ethics.

A lists of nursing diagnosis papers submitted for review since the March 2006 NNN Conference is presented. "Chronic Low Self-Esteem," by Céline Larouche and Lina Rahal will be revised for the addition of several details. Other nursing diagnosis papers include "Risk for Maternal/Fetal Distress," by Sheri Holmes and "Smoking," by Jose Manuel Crespo Anaya.

Aim. This paper is a report of a concept analysis of letting go within the context of family caregivers and end-of-life care. Background. The term 'letting go' has been used in an informal manner by nurses and other clinicians working with patients and families with terminal illnesses to depict a lack of acceptance of a loved one's impending death. Data sources. The CINAHL, Ovid Medline and PsychInfo databases were searched for the period of 1995-2007 for literature published in English in peer-reviewed journals from a variety of disciplines, using the specific keywords letting go or to let go. Methods. The Walker and Avant method of concept analysis was used, and the study was guided by Zerwekh's family caregiving model of core competencies for hospice nurses. Results. Letting go before the death of a loved one involves a shift in thinking in which there is acknowledgement of impending loss without impeding its natural progression. An emotional attachment and recognition that everything has been carried out usually precede the concept, followed by a peaceful death and acknowledgement of change. Conclusion. The concept of letting go has been explored in many contexts but the core essence of the awareness and work towards the acceptance of an impending loss appears to be a universal domain. Research is needed to further explore and identify patterns of this phenomenon in family caregivers in the context of death of a loved one. [ABSTRACT FROM AUTHOR]

Researching in familiar environments brings about challenges as nurses are learned to tune out their senses to give expert nursing care, and contemporary nursing research using observations has been criticized for being disembodied—not often using senses other than sight. This article draws on experiences from a fieldwork study of palliative and aged care environments to show how a deliberate use of the senses can enhance the richness of nursing research and open up new avenues for investigation. Examples from a reflexive fieldwork journal are presented to demonstrate how sensate experiences was used in a reflexive process that led into areas that otherwise might have remained unexplored. §The authors argue that the interplay between sensate experiences and analytical logic can bring the background to the foreground and provide new ways of making the familiar unfamiliar. In making sense of what residing in health care environments might mean, an embodied research activity is fruitful. [ABSTRACT FROM AUTHOR]

This paper attempts to uncover some of the factors that may have influenced the choice of model for the systematic training of nurses in Denmark. From a historical analysis of selected historical literature, nursing magazines, and archival documents, three themes emerge: the interest from (and of) the medical profession, the strategy on nurse training of the Danish Nurses' Organization, and the societal context of the time. Despite there being a Deaconess Institution in Copenhagen from 1863, it was ultimately the Nightingale model that formed the basis for the training programme. Findings suggest that the Nightingale influence within the medical establishment and among leaders in Danish nursing played a vital role in this choice. As well, the Danish Nurses' Organization actively promoted their preferred 3-year training model, which had strong similarities to the Nightingale model. Changes in family and social life after the 1864 defeat in the Prussian war fostered a growing demand for the liberalization of women's rights and a need for increased professionalization in the nursing and caring function. [ABSTRACT FROM AUTHOR]

The use of virtual environments for the provision of health-care is on the increase, and with each new development brings debates about their impact on care, nursing and nursing practice. Such environments offer opportunities for extending care and improvements in communication. Others believe these developments threaten aspects of nursing they hold sacrosanct. This paper explores the development of an assemblage of computer networks, databases, information systems, software programs and management systems that together work to manage health-care in Australia, namely casemix. We contend that spatial theories on network society show how this assemblage co-ordinates and operates to manage care. We discuss how this assemblage affects care and suggest that changes in organisation may be a part of the shift in how bodily organisation occurs more generally, but more specifically in health-care. We also suggest how nurses are enrolled in and by such networks, leading to transformation in nurses’ practices. Finally, we argue that using spatial forms of analysis allows an interpretation of such assemblages that may account for their strengths and their shortcomings. [ABSTRACT FROM AUTHOR]

This paper describes the changes that were made to a two-semester graduate internship course to facilitate student compliance with Institutional Review Board (IRB) and agency requirements for compliance with the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA). Students now spend the first semester of the internship developing collaborative relationships with the agency and conceptualizing, planning, and developing all aspects of the project, including preparing materials for an IRB review. A series of workshops about the IRB process, the Privacy Rule of HIPAA, and on-line resources have been developed. A password-protected web site and other resources were developed for preceptors. The result of the changes has been primarily positive. By having to conceptualize and develop the entire project at the beginning, students demonstrate a better understanding of program development and evaluation. Their writing has markedly improved. Preceptors like the course revisions, the convenience of on-line resources, and the enhanced course focus on the protection of health care information and of potential participants in health education programs or program evaluation projects. [ABSTRACT FROM AUTHOR]

Highlights the presentation of the research paper entitled "Nurses - A Disappearing Species," Marie-Paule Florin, former President of the French Nurses Association, at the Le Touquet-Paris-Plage, France. Contents of the research paper; Problems of the nursing sector commented by Florin in the research paper; Need to create structures of nursing and to integrate present structures with levels in planning.

The article presents information on various developments in the field of nursing. The third edition of the "Directory of Nursing Research in Australia" has recently been published by the nursing branch of the Commonwealth Department of Health, Australia. Kenneth Clarke, the minister for health, launched the Asian Mother and Baby Campaign at the Council House in Birmingham on December 14, 1984. Eleven campaign linkworkers are now in investigations into the use and misuse of a washing bowl, and into a routine nursing procedure, the bed bath.

The author discusses the health care needs and the delivery of health care in Kenya, emphasizing in particular the role and contribution of traditional health practitioners. She also identifies the knowledge and continuous education needed by professional nurses and indicates how they should relate with the community at large. The nurse, it is argued, should be clear about her identity and maintain it without depriving the community and others of their rights and privileges. [ABSTRACT FROM AUTHOR]

The article presents information about current news related to nursing published in "Journal of Advanced Nursing." National Nurses Associations discussed their role and the role of the International Council of Nurses (ICN) in relation to the social and economic conditions of nurses during a one day workshop session organized as part of the meeting of the Council of National Representatives, ICN's governing body, held in Kenya 24-28 September, 1979. The Cyprus Nurses Association (founded in 1970) was accepted into membership with the ICN on 24 September, 1979.

This article presents information related to nursing. Members of the nursing profession, not only in Great Britain but throughout the World, lost a great friend earlier this year when Elise Gordon died on February 4, 1977. She possessed a rare mix of scholarship, charm and warmth, and was editor of Nursing Mirror for 25 years from 1937 to 1963 when she retired. Proposals for a radical and new reorientation of WHO's programme budget policy, to enhance its effectiveness in serving the world's neediest people, were endorsed at the 59th session of the WHO Executive Board held in Geneva this year.

The claim by many occupations to professional status has resulted from lack of precision of definition. The characteristics discussed are those which most writers agree are possessed by professionals and include knowledge, authority for action, community sanction, control and the development of a sub-culture. Nursing as an occupation is viewed in the light of these characteristics and found wanting. However, one equally important measurement may be that of the attitudes displayed by the members of an occupation and, if these are considered, nursing may be seen to be nearer to the ideal type. The main problem may be that the term 'nurse' in the United Kingdom includes a wide range of practitioners. [ABSTRACT FROM AUTHOR]

The profession of nursing searches for a theory base for its practice, but there are problems inherent in defining the nature of concepts and in building them into testable hypotheses and theories. Some concepts are derived from everyday experience, some from the conventional wisdom of the profession. Some are developed by deductive methods from related sciences, some inductively from nursing practice itself. Although a few embryonic theories have been developed, little has been developed at the prescriptive level nor has any unifying model satisfied all thinkers. For the present there is a need to isolate concepts from conventional professional wisdom, for factor isolating research, for the testing of hypotheses against nursing practice. [ABSTRACT FROM AUTHOR]

A classification of nursing phenomena (as diagnosed by nurses) and of nursing interventions is included in the Alpha Version of the International Classification for Nursing Practice (ICNP). The third dimension of the ICNP—nursing outcomes—is currently being developed. As in the case of the Alpha Version's classifications of nursing phenomena and nursing interventions, the active participation of nurses around the world is being sought for the development of an improved Beta Version. [ABSTRACT FROM AUTHOR]

This article presents various news items related to nursing. Nurses attending the 19th Congress of the International Council of Nurses in Seoul, Korea, from May 28, 1989 to 2 June, 1989, will try to answer many questions about the future of nursing. Training in Family planning for physicians, nurses, midwives and other health staff appears to be very unsatisfactory in most countries of the World Health Organization's (WHO) European Region, according to a recent report "Training in Family Planning for Health Personnel." The publication based on a WHO meeting held in Paris, France during July 6-11, 1981, has been published by the WHO European Office, Copenhagen.

The article comments on Li H's article published in the "Journal of Clinical Nursing," which discusses issues concerning the important aspect of family care to older people. The author of this article points out that Li's article stimulates debate on the ways in which nurses can engage effectively and constructively with families. The author remarks that Li's article cannot be taken as a definitive account of family responses to the care needs of older person.

The article focuses on the study on the HIV patients' preference and experiences about the quality of care. The study is supported by the assessment of quality of care received by patients with HIV from nurse specialists, nurse consultants and general practitioners. The questionnaire method used in the study is called QUOTE-HIV. It is a modified version of a scale that is designed to measure patient perceptions of care quality. There were 23 scale items used in the study.

Introduces a series of articles related to nursing.

Comments on the article "Violence in the Care of Adult Persons With Intellectual Disabilities," previously published in the "Journal of Clinical Nursing." Failure of the study to offer any new understanding of abuse towards people with intellectual disabilities; Poor operationalization of the term violence; Opinion that the research paper deals superficially with both the validity and reliability of the questionnaire.

This article presents consultation papers of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. Consultation papers prepared by the working groups are now being given a wide distribution throughout the professions of nursing, midwifery and health visiting. The task of the working groups, in considering comments will be greatly assisted if views on the recommendations and proposals in the consultation paper are channelled back through an appropriate professional organization or trade union. The Council has set up seven working groups. Each working group is looking at a particular aspect of the 1979 Act and the related future responsibilities which the Council will inherit.

The article presents information on the upcoming July 2008 issue of "Journal of Advanced Nursing."

Discusses initiatives of the U.S. Academy of Nursing for the improvement of long-term care in the country. Hindrance to improving long-term care; Role of increased educational and research programs in addressing the long-term care problem; Significance of nurses' commitment to profession and legislative supports for improved long-term care across the country.

The author responds to a commentary about her article "The Ascent to Competence Conceptual Framework: An Outcome of a Study of Belongingness." She considers the suggestion that competence as a concept may be subsumed within capability. She cites indicators that hospitalised patients are sicker. She believes the framework offers an alternative method on competency attainment.

Presents several articles and resource materials that reveals effective ways of nursing older people. Focus of the book "Zen Flesh, Zen bone: A Collection of Zen and Pre-Zen Writings," by Zen and Senzaki; Importance of person-centered caring in nursing older people; Effects of looking for external direction in nursing on person-centered effectiveness.

The article focuses on the study concerning the alternative forms of patient and nurse consultations. The study aims to investigate ways of improving access for patients to practice nurse appointments. The researchers found out that there had been no support for the use of phone or e-mail as alternative to consultation in their general study setting.

Comments on the use of special surface devices for patients identified to be at risk and even for those with an identified pressure ulcer. Factors that influenced crude prevalence rates; Limitations of all risk assessment scales; Support surfaces for pressure ulcer prevention.

Introduces a series of articles related to nursing from the February 15, 2002 issue of the 'Journal of Advanced Nursing.'

Introduces a series of articles on advanced nursing practices from the January 15, 2002 issue of the 'Journal of Advanced Nursing.'

Maturity will be the hallmark of the nursing profession in so far as it is conceded that the art and science of nursing entails complementary relationships between the use of its practitioners' heads, hearts and hands. High levels of nursing scholarship, dedicated service and meticulous practice, in combination, will, without doubt, provide high levels of nursing care and that is what the profession of nursing is all about.

Reports that the International Council of Nurses has announced the names of the speakers for the plenary sessions at the 16th Quadrennial Congress in Tokyo, Japan. Schedule for the said conference; Topics to be discussed at the conference; Names of speakers for the topics.

This article explores interview data from a study of 50 Norwegian generalist nurses' focus group accounts of caring for dying patients in the hospital and care home. An eclectic discourse analytic approach was applied to nurses' accounts of the patient and three discursive contexts of reference to the patient were identified: the ‘taken as read’ patient, the patient paired with particular characteristics and the patient as psychologically present. Talk about the patient falls mainly into the first two contexts, which position the patient in relation to three closely related discursive processes: individualization, anonymization and objectification. The third context presents the patient as a person with a particular identity. The analysis is discussed in a broader philosophical and sociological context in which we return to some of the theoretical work on death and dying of the 1990s and the topic of sequestration. We suggest that nurses' talk about the patient can be heard to participate in a continuing sequestration of the dying patient in healthcare institutions focused on ‘result-oriented’ care. [ABSTRACT FROM AUTHOR]

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AIM AND OBJECTIVE: The purpose of this qualitative study was to describe nursing home residents' perceptions of the significance of relationships with peer residents to their experience of thriving. BACKGROUND: Interactions between nursing home residents are limited. Knowledge about the importance of peer interactions to the residents' experiences of thriving is scarce. DESIGN AND METHOD: The study had a descriptive exploratory design and included 26 mentally lucid residents in two nursing homes. Data collection methods included field observation and interviews. RESULTS: To contribute to an experience of thriving, peer relationships had to be experienced as positive and meaningful. A personal relationship to peer residents was not essential to an experience of thriving among all the residents. Some of the thriving residents who had not managed to establish a personal relationship expressed wishes for being involved with peers. The caregivers' role as facilitators in the development of meaningful interactions contributing to thriving was essential. CONCLUSIONS: Nursing home residents have varied wishes, expectations and capacity to interact with peer residents and the significance of peer relationships to thriving also vary. A personal relationship to peer residents is not essential to the experience of thriving among all residents. RELEVANCE TO CLINICAL PRACTICE: Caregivers in nursing homes have a great impact on how social gatherings intended to develop positive peer interactions and on whether the social gatherings fulfil their intentions. Skilled caregivers can secure pleasant and meaningful social gatherings in nursing homes contributing to an experience of thriving. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: To develop local stroke services by involving, in a meaningful way, those affected by stroke in identifying and prioritising service development issues. BACKGROUND: Consideration should be given to including the views of service users in the evaluation and re-design of services. In stroke, the involvement of patients and carers in the development of services has generally been at a consultative level. There is a need to explore strategies to engage patients and carers more fully with the service development agenda. DESIGN: Action research. METHODS: Within the Reflection Phase of this action research study patients' and carers' experiences of stroke services were explored by semi-structured interviews and focus groups. In the Planning and Action Phases, externally facilitated workgroups comprising patients, carers and professionals used a synthesis of the data to identify a range of service development priorities, which informed the development of action plans. RESULTS: Information provision, preparation for transfer of care and the integration of social and leisure activities appear to be priorities for the development of stroke services from the perspective of patients and carers. These findings informed the work of four collaborative workgroups to lead developments in the stroke pathway as follows: stroke prevention and immediate care, early and continuing rehabilitation, transfer of care and long-term support and information provision. CONCLUSION: Stroke patients and carers played a key and meaningful part in the identification and prioritisation of service development issues. External facilitation ensured progress with service development and maintaining patient and carer participation. Several pragmatic recommendations for enhancing the local delivery of stroke services were made. RELEVANCE TO CLINICAL PRACTICE: With external facilitation it is possible for stroke service users to take a meaningful role in service developments that moves beyond consultation. [ABSTRACT FROM AUTHOR]

Aim. To understand student nurse–patient interaction better and to assess the effectiveness of a teaching and learning resource consisting of tapes and transcriptions of actual nurse–patient interaction. Design. Applied conversation analysis and analysis of semi-structured lecture evaluation forms. Background. Little research discusses interpersonal skills (IPS) of student–nurses, even though policy initiatives and literature internationally promote patient-centred communication as being an indicator of high-quality healthcare. Literature also suggests that nursing education is often far removed from the realities which students experience during clinical practice. Methods. Phase 1 of the study saw 10 student nurse–patient interactions audio recorded and transcribed and the data subjected to conversation analysis. Phase 2 saw tapes and transcripts of similar interactions used as a teaching resource with the same cohort of students ( n = 48), student evaluations of the lecture were quantitatively and qualitatively analysed. Results. Phase 1 demonstrated that, in variance to ‘best-practice’ recommendations, student nurse–patient interactions were task-centred and bureaucratically organized. In phase 2, after listening to and reading a transcript of similar interaction, students were able to identify the limitations of undertaking such an approach with patients, strongly suggesting that classroom-based knowledge is not always easily transferred into clinical practice. This teaching approach was positively evaluated, with written evaluations emphasizing the effectiveness of bringing the realities of clinical practice into the classroom. Conclusion. This study suggests that students have difficulty in transferring the principles of ‘good’ communication from the classroom into their own interactions with patients. Students’ written and spoken evaluations were reminiscent of the previous work performed in discussing the concept of a ‘hidden curriculum’ in professional training. Relevance to clinical practice. The use of empirical data in the practice of IPS teaching is recommended as a means of closing the theory-practice gap. Student nurses and mentors need to consider the effect of the hidden curriculum on their IPS. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To test the effectiveness of an education and counseling intervention on reducing environmental hazards in the homes of older women. DESIGN: Secondary analysis from a randomized, controlled trial with two arms: fall prevention program and health education program (control). Environmental hazards were assessed at baseline and immediately posttreatment (12-weeks). SETTING: Participants' homes. PARTICIPANTS: Two hundred seventy-two community-dwelling women aged 70 and older at risk for falling. INTERVENTION: The fall prevention program involved a comprehensive fall risk evaluation, exercise, education, individualized counseling, and referrals. The health education program included topics unrelated to fall prevention. With the exception of the fall risk evaluation conducted by a nurse practitioner, baccalaureate-prepared nurses carried out the interventions. MEASUREMENTS: Summed and individual scores for hazards related to the bathroom, floor surfaces, lighting, furniture, stairways, and storage areas. RESULTS: Environmental hazards were found in all homes, with a baseline mean±standard deviation of 10.7±2.6 total hazards and range of four to 17 hazards. Analysis of within-group changes indicated that the fall prevention group had significantly fewer bathroom, lighting, and total hazards after the intervention, whereas the health education group had significantly fewer bathroom hazards but more floor hazards. At follow-up, the fall prevention group had significantly fewer lighting hazards and total hazards than the health education group. CONCLUSION: Education and counseling have only modest effects in helping older women make recommended home modifications. To be most effective in reducing environmental hazards, fall prevention programs may need to provide and install safety devices. [ABSTRACT FROM AUTHOR]

Aim. The aim of this critical care sleep assessment pilot study was to evaluate the usefulness of three sleep assessment tools to identify which, if any, provided the closest comparison between the nurses' judgement and the patients' experience of their sleep. The study objectives were to: (i) compare patients' and nurses' assessment of sleep using three different rating tools. (ii) Ascertain patients' preferences with non-interventional, user friendly, practical tools in critical care. (iii) Recommend changes and improvements to the way that sleep is assessed and documented. Background. Sleep is important for promoting critical care recovery and sleep disturbance is known to cause irritability, aggression and increased stress levels. The availability and use of valid critical care sleep assessment tools is limited. Design. A descriptive comparative study using three sleep assessment-rating scales were constructed to provide easy to understand tools for completion by both patients and nurses in critical care. Methods. Structured interviews were undertaken with 82 patients and 82 nurses using a convenience sample from four multispecialty critical care units in one large teaching trust. Patients were included in the study if they met a list of pre-defined criteria to obtain responses from lucid orientated patients. Results. No tool produced a close association between the nurses' assessment of the patients sleep and the patients' assessment of their sleep. Patients found two of the three tools easy to use when rating their sleep. Discussion. Objective invasive measurements of sleep as well as complex subjective tools appear inappropriate to be used as a part of daily critical care practice. The application of simple rating scores has a high degree of error when nurses assess patients' sleep, even though high levels of patient observation and assessment are practiced in critical care. Conclusions. More research is needed to examine the assessment of sleep in critical care, particularly linking rating scales to alternative methods of physiological assessment of sleep. Findings indicate nurses are unable to accurately assess critical care patients' sleep using rating assessment tools. However patients were found to prefer two sleep assessment tools, one banded in hours to assess sleep quantity and one as a comparison against normal sleep to assess sleep quality. Relevance to clinical practice. This study reviews the importance of sleep assessment and the diverse methods available for assessing sleep focussing on the critically ill patient. More noteworthy it highlights how nurses sole judgements of patients sleep is not a reliable method in clinical practice, however it provides some indication on the application of 'easy to use' tools to assist in the patients assessments of their sleep. [ABSTRACT FROM AUTHOR]

Qualitative nursing researchers have long recognized that reflective practice (RP) seems to be a valuable tool in nursing care. The aim of the present meta-study was to analyse current qualitative research on RP in nursing care, in order to create and synthesize the knowledge and the understanding of registered nurses' RP. Using a meta-study synthesis approach, embedded assumptions were identified in qualitative studies that have influenced the way researchers have interpreted and made sense of RP in nursing care. Despite empirical focus in research on RP in nursing care, it was found that assumptions about RP were predominantly based on theory. The reflective movement within the practice of nursing care has mainly a constructivist epistemology, based on learning from experience. The individual nurse's RP capability is essential in providing and improving ethical and holistic nursing care. [ABSTRACT FROM AUTHOR]