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Abdul-Razak Abubakari,1 Martyn C Jones,2 William Lauder,3 Alison Kirk,4 John Anderson,5 Devasenan Devendra,6 Ebrahim K Naderali11School of Health Sciences, Liverpool Hope University, Hope Park, Liverpool, 2School of Nursing and Midwifery, University of Dundee, Dundee, 3School of Nursing and Midwifery and Health, University of Stirling, Stirling, 4Department of Sport, Culture and the Arts, University of Strathclyde, Glasgow, 5Homerton University Hospital NHS Trust, Homerton Row, London, 6West Hertfordshire Hosptials NHS Trust, Watford, UKObjectives: This study investigated ethnic differences in diabetes-specific knowledge, illness perceptions, self-management, and metabolic control among black-African, black-Caribbean,and white-British populations with type 2 diabetes. The study also examined associations between demographic/disease characteristics and diabetes-specific knowledge, illness perceptions, self-management, and metabolic control in each of the three ethnic groups.Design: Cross-sectionalSetting: Diabetes/retinal screening clinics in Hackney and Brent, London.Methods: Black-African, black-Caribbean and white-British populations with type 2 diabetes were asked to participate. Questionnaires measuring demographic/disease characteristics, diabetes-specific knowledge, self-management, and illness perceptions were used for data collection. Data for glycated hemoglobin (HbA1c) and microvascular complications were obtained from medical records. Ethnic differences in diabetes-related measures were estimated using analysis of variance/covariance. Multiple regression techniques were used to determine relationships between demographic/disease characteristics and measured diabetes-related outcomes.Results: Three hundred and fifty-nine patients participated in the study. White-British participants had high diabetes-specific knowledge compared to their black-African and black-Caribbean counterparts. Black-Africans reported better adherence to self-management recommendations than the other ethnic groups. Compared to the white-British patients, black-African and black-Caribbean participants perceived diabetes as a benign condition that could be cured. Educational status and treatment category were determinants of diabetes-specific knowledge in all three ethnic groups. However, different demographic/disease characteristics predicted adherence to self-management recommendations in each ethnic group.Conclusion: Clearly, there is disease (diabetes) knowledge-perception variation between different ethnic groups in the UK which may partly influence overall disease outcome. It is plausible to recommend screening, identifying, and dispelling misconceptions about diabetes among ethnic minority patients by health care professionals as well as emphasizing the importance of self-management in managing chronic diseases such as diabetes.Keywords: black-African, black-Caribbean, white-British, diabetes, illness perceptions, self-management

Aim. To establish levels of mental health at a community level and to model the relationship between mental health difficulty, health-related impact and health related quality of life in school pupils aged 11–18 years old. Background. The issue of psychosocial and mental health in school pupils is a topic of considerable academic and public interest. The incidence of mental health problems in children 11–18 years shows marked differences between countries and within countries. Much of the epidemiological literature has focused on diagnostic categories rather than population health. Design. The study employed a cross-sectional survey. Methods. A cross-sectional survey of 1786 school children aged 11–18 years was conducted in Scotland. Participants completed the strengths and difficulties questionnaire and the SF-10 for Children. Results. This group of school pupils had similar levels of mental health needs and psychosocial health status as UK and age-related US norms. They had poorer levels of physical health status. The most important predictors of psychosocial health status were difficulty category, impact, physical health status and chronicity. The most important predictors of impact were difficulty category, chronicity and psychosocial health status. Conclusion. There is a need to tackle psychosocial health problems in schools. Problems are often chronic in nature and whilst still having an impact on the life of pupils may not be severe enough for a diagnosis which would trigger treatment in the conventional sense. Psychosocial health is predicted by physical health therefore nursing interventions which are focussed on both physical and psychosocial health may be needed. Relevance to clinical practice. This study suggests that in some geographical areas in UK targeting of services to ‘high-need’ schools is not necessary and universal services are required. Problems need to be detected before they reach current treatment thresholds. Interventions should be school-based with a focus on impact on classroom learning and family difficulties. [ABSTRACT FROM AUTHOR]

The first year post-qualifying as a nurse or midwife is often seen as a key transitional period. Flying Start NHS is the national development programme for all newly qualified nurses, midwives and allied health professionals in NHS Scotland. It is designed to support the transition from student to newly qualified health professional through supporting learning in everyday practice. It is a web-based or CD-ROM programme which seeks to increase the confidence and competence of newly qualified nurses and midwives during their first year of employment following registration. The aims of this study were to establish levels of self-report competency, self-efficacy, job demands and career intentions in newly qualified nurses undertaking Flying Start NHS programme in Scotland. The aims were met by conducting a cross-sectional survey of Flying Start NHS students. Newly qualified nurse participants (n = 97) comprised a convenience sample of newly qualified nurses who were registered as undertaking the Flying Start NHS on-line programme during Autumn -- Winter 2007. Most newly qualified nurses intend to remain in the NHS although a small but important number may leave. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to measure health visitors' professional judgements on 'good enough' parenting and identify what factors and combinations of these are important when making such judgements. Background. The relationship between parenting and child health is unclear. Whilst agreement exists that 'good enough' parenting requires boundary setting, consistency and putting the child's needs first, attempting to define 'good enough' parenting in precise terms is complex. When faced with a complex situation, practitioners rely on relatively few factors to form judgements. Design. Factorial survey methods were employed using vignette techniques. Methods. Vignettes were constructed using previous research on those variables, which may influence nurses' judgements, for example, accommodation and child dentition. The level of factors was randomly varied. Two thousand vignettes were administered to a sample of 200 health visitors in two Health Boards who then made a judgement about this scenario. Analysis. Data were analysed through multiple regression with dummy variables and one-way analysis of variance. Regression equations for both good enough mothering and good enough parenting are reported. Results. The models used are significant predictors of parenting and mothering. Significant predictors on health visitor judgements' were boundary setting in sleep behaviours, type of housing inhabited and health behaviours. Although parenting and mothering are often conflated, health visitors appear to separate these aspects when making judgements based on type of housing. Conclusions. Most professionals can articulate what makes a 'good' parent, equally they may have strong views regarding what constitutes 'poor' parenting. The difficulty is in determining when parenting is 'good enough' to provide a child with a nurturing environment. Relevance to clinical practice. This study suggests that practitioners move their thresholds of what is 'good enough' depending on a narrow range of factors. Awareness of the factors, which influence individuals' judgements is important in safeguarding children. [ABSTRACT FROM AUTHOR]

Aim: To develop a theory that explains the 'realities' of part-time nursing.Background: While little is known about the phenomenon of part-time nursing, increasing numbers of nurses work in part-time employment.Methods: Grounded theory.Results: The problem that part-time nurses shared was an inability to achieve their personal optimal nursing potential. Motivators to work part-time, employment hours, specialty, individual and organizational factors formed contextual conditions that led to this problem. Part-time nurses responded to the challenges through a process of adaptation and adjustment.Conclusion: Harnessing the full productive potential of part-time nurses requires support to limit the difficulties that they encounter. The developed theory provides a valuable guide to managerial action.Implications for nursing practice: Nurse Managers need to consider the developed substantive theory when planning and managing nursing workforces. [ABSTRACT FROM AUTHOR]

Aims and objectives. This element of the larger Scottish evaluation aimed to explore differences between access routes, cohorts and higher education institutes (HEI) (universities and colleges) in levels of self-efficacy, student support and self-reported competence in a nationally representative sample of student nurses and midwives. Background. This paper reports findings from the National Review of Pre-Registration Nursing and Midwifery Programmes in Scotland. Fitness for practice curricula have been the heart of many recent developments in nurse and midwifery education. Fitness for practice set out to map out the future direction of preregistration nursing and midwifery education with the aim of ensuring fitness for practice based on healthcare need. There have been no national evaluations of the effectiveness of this strategic objective. Previous major evaluations in the 1990s suggested that students may not have had the skills needed to be fit for practice. Design. The study design was a cross-sectional survey of a stratified random sample of student nurses and midwives ( n = 777). Data collected included demographic information, generalised perceived self-efficacy, student support and self-reported competency. Results. Students reported high levels of self-reported competency. There were no significant differences between two cohorts or between students with different access routes. Students rated support from family and friends highest and support from HEI lowest. There was a significant difference in support levels between HEI. Self-efficacy scores were similar to other population means and showed small-moderate correlations with self-report competence. Similarly, self-reported competency appears to be at the higher end of the spectrum, although older students may have a more realistic perception of their competence. However, support from HEI was seen as less satisfactory and varied from one institution to another. Conclusions. This study portrays a relatively positive picture of preregistration fitness for practice curricula. Questions are raised about the relative value students place on support from educationalists and mentors and whether support from family and friends and from peers needs to feature more prominently in curricula. The study provides modest support for social cognitive theory. Relevance to clinical practice. The major drivers for changes in preregistration curricula stemmed from fears about the competence of students. This study did not provide support for this viewpoint, and students' self-reports suggest that curricula are, in this respect, meeting their objectives. Nevertheless support from mentors and from educational institutes may need to be improved. [ABSTRACT FROM AUTHOR]

Using Scotland's national model for older adult care as an example, lessons learned about older adult care and the impact of retirees on rural Scottish communities may have relevance for rural older adult care in the United States. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aims of the study were to (i) investigate age and loneliness, (ii) investigate the association between religiosity and loneliness, and (iii) and explore the relationship between social capital and loneliness. Background. Loneliness is the subjective experience of social isolation and is a risk factor for a wide range of health problems including heart disease and depression. Poor self-rated health, domestic violence and poor economic conditions are associated with greater loneliness. Design. The study was a cross-sectional survey of a random sample of adults aged 18 years and over. Methods. A random sample of 1289 subjects was interviewed by computer-assisted telephone interviewing. This interview included the Loneliness Scale and items from the Social Capital Module of the General Household Survey. Findings. Loneliness is more common in men and people without strong religious beliefs. An income-loneliness gradient is evident. Little support was found for the association between social capital and loneliness. Conclusion. The prevalence of loneliness is relatively stable in this population. Loneliness is linked to income and unemployment and as such pathways between socio-economic factors, loneliness and health need to guide interventions and future research. Relevance to clinical practice. Loneliness is linked to a range of social and economic factors. Current Health Visiting practice recognizes the importance of tackling the effects of poverty and social deprivation and places community building at the core of much Health Visiting practice. This broad community level approach can usefully transfer into all community nursing and health promotion activity. [ABSTRACT FROM AUTHOR]

PURPOSE. To propose a new NANDA diagnosis, self-neglect. DATA SOURCES. Research studies and literature published from a variety of disciplines including nursing as well as primary research. DATA SYNTHESES. This diagnosis can be used to describe a constellation of self-care problems of varying severity and impact on the health and well-being of people who self-neglect. Included are two subtypes of self-neglect based on the degree of intentionality. Clarification of self-neglect is long overdue because self-neglect presents conceptual, identification, and intervention problems for nurses, healthcare workers, and for medicolegal systems across settings and in many countries. CONCLUSION. The proposed diagnosis, self-neglect, fills a gap in current standardized terminology. This diagnosis will contribute significantly to nurses leading the way in the explication of an interdisciplinary and international health concern. PRACTICE AND POLICY IMPLICATIONS. Developing self-neglect as a recognized nursing label is vital to clinicians and policy makers within and across countries. Appreciating less serious/non-life-threatening presentations will give nurses a care perspective to improve the health and well-being of those in earlier stages of self-neglect. Definitions for this phenomenon will contribute to care planning and interventions, leading to consistency in practice and research. [ABSTRACT FROM AUTHOR]

Clinical judgments and decisions are an integral component of nurse work and nurses are increasingly being challenged to account for their judgments and decisions. Nursing research is needed to help explain judgment and decision making in nursing, but most research in this area is almost exclusively characterized by descriptive studies. This article describes the use of the factorial survey method, which combines the explanatory power of a factorial experiment with the benefits of a sample survey. This hybrid technique is an excellent method for studying judgments and decisions across settings, roles, disciplines, and countries. This article outlines the steps of the method and demonstrates its applicability with an exemplar from a study across nurses from 3 countries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Loneliness is associated with an increased incidence of a wide range of physical and mental health problems. The detection, prevention and amelioration of loneliness is an important public health issue for nurses. METHODS: This study reports findings from the 2002 Central Queensland Social Survey. The aims of the study were to (i). establish the extent of loneliness in a community sample; and (ii). to identify the factors that are predictors of loneliness. A random sample of 1241 subjects were interviewed by Computer-Assisted Telephone Interviewing. This interview included the Loneliness Scale formulated by De Jong Gierveld and Kamphuis. FINDINGS: Loneliness is a common phenomenon and risk factors include experience of domestic violence in current relationship, not having recent paid employment, not being married/partnered, and the number of children under 18 years in a household. Loneliness is not associated with higher rates of health care professional consultations. CONCLUSION: Loneliness is a very common problem and should be seen as a major public health issue. Nurses, through a community capacity building framework, have a major role to play in the prevention of loneliness. [ABSTRACT FROM AUTHOR]

BACKGROUND: Self-neglect can be defined as the failure to engage in those self-care actions necessary to maintain a socially acceptable standard of personal and household hygiene and/or a failure to adequately care for one's own health. It is generally acknowledged that research and practice in the area of self-neglect has been hampered by a lack of theoretical development. Socio-psychological theories, such as 'social constructivism' and 'negotiated interactionism' can contribute to a deeper understanding of the phenomenon and to the further development of self-neglect theory. AIMS: This paper seeks to apply social and psychological theories to understanding self-neglect. Self-neglect is an underconceptualized phenomenon, which requires to be studied within a broader theoretical context than is at present the case. IMPLICATIONS: Sociological and psychological theories offer radically different ways of looking at self-neglect, as opposed to the medical model, as they seek to explain and understand, rather than simply classify it as a medical disorder caused by some form of underlying psychopathology. These theories emphasize the dynamic and interpretative nature of self-neglect and illustrate the arbitrary way in which this label is applied. [ABSTRACT FROM AUTHOR]

AIM: This paper sets out to explore the utility of self-care theory in understanding self-neglect. Further theoretical development of both self-care and self-neglect theory and attending core concepts is an important objective. BACKGROUND: The notions of self-neglect and self-care are frequently linked in the literature. The relationship between self-neglect and self-care is not clear and the strengths and limitations in using self-care theory to facilitate a greater understanding of self-neglect will be addressed. Specifically the issues of self-care agency, self-care requisites, objectivity, class and culture, and lifestyle choice will be critically evaluated in the context of self-neglect theory. CONCLUSION: Self-care theory has a useful role to play in furthering our understanding of self-neglect. Self-care theory is able to explain some aspects of self-neglect but not others, although this may be a reflection of the relatively underdeveloped state of self-care theories or alternatively may reflect a more fundamental limitation in our ability to fully explain human behaviour. [ABSTRACT FROM AUTHOR]

* District Nurses in rural areas frequently fulfil, in some permutation, the functions of district nursing, health visiting, school nursing, and community midwifery. This complex role can bring them into contact with a wide range of mental health problems.* The extent, nature and type of mental health problems, and their response to these problems, is not well documented in the literature.* The findings of this qualitative study indicate that District Nurses do in fact have contact with a wide range of mental health problems. The role of District Nurses in caring for this client group is more substantial than has been previously recognized.* It is suggested that this role be formally acknowledged and that systems put in place to optimize the effectiveness of District Nursing interventions. [ABSTRACT FROM AUTHOR]

AIM OF THE STUDY: This paper reports a two-part study relating to the further psychometric development of the Mental Health Problems Perceptions Questionnaire. BACKGROUND: The instrument was developed and used originally in a study to investigate the role of district nurses in caring for people with mental health problems, who live in rural settings. It is underpinned by an explicit theoretical framework in which therapeutic commitment, role support and role competency are core concepts. DESIGN: A two-part study is described. Part One used a test-retest method to examine the stability of the instrument on repeated administration. Part Two examined the instrument's internal reliability and construct validity by calculation of Cronbach's alpha coefficients and exploratory factor analysis. RESULTS: Satisfactory internal reliability for a new instrument was demonstrated. Exploratory factor analysis supported the previously proposed theoretical framework. Significant correlations were demonstrated between the scales which constitute the instrument, thereby providing further evidence of construct validity. CONCLUSIONS: The Mental Health Problems Perceptions Questionnaire provides a potentially useful instrument in relation to future educational, clinical and managerial research. [ABSTRACT FROM AUTHOR]

Patients who neglect personal hygiene, household cleanliness and their own health are familiar to most nurses. Despite this familiarity, self-neglect is a poorly conceptualized and little researched phenomenon. This multiple case study design uncovers the perceptions of self-neglect held by professionals, patients and relatives. The assumptions which underpin Orem's Theory of Self-Care and the medical model construction of self-neglect are explored and it will be suggested that there are limitations in understanding self-neglect using these theoretical frameworks. [ABSTRACT FROM AUTHOR]

Self-neglect is a familiar concept to all community nurses. Nevertheless there have been few empirical studies undertaken in this area over the last 30 years. The study of self-neglect has been hampered by inadequate conceptualization and a lack of theoretical frameworks. This article reports a study of patients who did and did not self-neglect, drawn from district nursing caseloads. Patients with self-neglect had lower levels of operable self-care agency than patients in a comparison group. Only self-neglecting patients had the nursing diagnoses 'ineffective management of therapy' and 'non-compliance'. [ABSTRACT FROM AUTHOR]

Student nurses actively interact with their experiences and construct theories about nursing in an attempt to make sense of their experiences. These alternative theoretical frameworks (ATFs), it will be suggested, do not conform to the types of structures that are thought to be the hallmark of formal theories but instead the knowledge of students can be understood as a series of narratives. The relationship between ATFs and the formal theories presented by educators may create difficulties for both students and teachers. [ABSTRACT FROM AUTHOR]

Alternative theoretical frameworks are the tacit assumptions and logical structures of practical action. Student nurses have alternative theories in which ethical and technical knowledge are combined to form high-level heuristics which assist with understanding and responding to client problems. The alternative theories of student nurses can be observed to guide care giving and therefore the theory-practice gap may not be as wide as is often assumed. The values and beliefs about nursing held by student nurses are broadly similar to those advocated for the profession as a whole. [ABSTRACT FROM AUTHOR]