Home About us Contact
|
Home About us Contact | ||
|
|
||
Field Notes (field + note)
Selected AbstractsTraditional Chinese medicine in cancer care: perspectives and experiences of patients and professionals in ChinaEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2006W. XU md, msc Although traditional Chinese medicine (TCM) is widely used in Chinese cancer centres, it is a brand new area for formal scientific evaluation. As the first step of developing a research programme on clinical evaluation of TCM for cancer patients, we conducted a qualitative study to explore the perspectives and experiences of Chinese cancer patients and TCM professionals. Twenty-eight persons participated in two cancer patient focus groups and one professional focus group. Semi-structured interviews were audiotaped, transcribed and translated. Textual transcripts and field notes underwent inductive thematic analysis. We found that patients' decision to use TCM for cancer is a self-help process with a deep cultural grounding, which is related to the traditional Chinese philosophy of life. Participants perceived TCM to be an effective and harmless therapy. They highly valued the fact that TCM is tailored to patients, and believed it was the basis of an optimal and safe treatment. Participants also highlighted the long-term positive effects, the benefit of group interventions and the low cost as important features of TCM. Subjects believed that conducting clinical research would be crucial for the recognition and dissemination of TCM in Western countries. The findings of this study are expected to contribute to the knowledge base on the current TCM use for cancer in China, and to provide useful information for developing future clinical research in this area in Western countries. [source] Range dynamics of small mammals along an elevational gradient over an 80-year intervalGLOBAL CHANGE BIOLOGY, Issue 11 2010REBECCA J. ROWE Abstract One expected response to observed global warming is an upslope shift of species elevational ranges. Here, we document changes in the elevational distributions of the small mammals within the Ruby Mountains in northeastern Nevada over an 80-year interval. We quantified range shifts by comparing distributional records from recent comprehensive field surveys (2006,2008) to earlier surveys (1927,1929) conducted at identical and nearby locations. Collector field notes from the historical surveys provided detailed trapping records and locality information, and museum specimens enabled confirmation of species' identifications. To ensure that observed shifts in range did not result from sampling bias, we employed a binomial likelihood model (introduced here) using likelihood ratios to calculate confidence intervals around observed range limits. Climate data indicate increases in both precipitation and summer maximum temperature between sampling periods. Increases in winter minimum temperatures were only evident at mid to high elevations. Consistent with predictions of change associated with climate warming, we document upslope range shifts for only two mesic-adapted species. In contrast, no xeric-adapted species expanded their ranges upslope. Rather, they showed either static distributions over time or downslope contraction or expansion. We attribute these unexpected findings to widespread land-use driven habitat change at lower elevations. Failure to account for land-use induced changes in both baseline assessments and in predicting shifts in species distributions may provide misleading objectives for conservation policies and management practices. [source] The UCLan community engagement and service user support (Comensus) project: valuing authenticity, making space for emergenceHEALTH EXPECTATIONS, Issue 4 2007Soo Downe BA (Hons) RM MSc PhD Abstract Objective, To develop and evaluate service user, carer and community involvement in health and social care education. Background, Despite the high policy profile of involvement issues, there appear to be no published accounts of schemes that have used a systematic whole-faculty approach to community engagement in health and social care higher education. Focus of this paper, The set up and early development of a faculty-wide community engagement project. Setting and participants, Staff from the faculty of health in one University, local service users and carers and community group project workers and local National Health Service (NHS) and public sector staff. Design, Participatory action research including document review, field notes, questionnaires and interviews. Analysis, Thematic analysis. The emerging themes were tested by seeking disconfirming data, and through verification with stake-holders. Results, Prior to the study, there were examples of community engagement in the participating faculty, but they occurred in specific departments, and scored low on the ,ladder of involvement'. Some previous attempts at engagement were perceived to have failed, resulting in resistance from staff and the community. Despite this, an advisory group was successfully formed, and project framing and development evolved with all stake-holders over the subsequent year. The four themes identified in this phase were: building accessibility; being ,proper' service users/carers;moving from suspicion to trust: mutually respectful partnerships as a basis for sustainable change; and responses to challenge and emergence. Conclusions, Successful and sustainable engagement requires authenticity. Many problems and solutions arising from authentic engagement are emergent, and potentially challenging to organizations. [source] Recognizing Opportunities for Spiritual Enhancement in Young AdultsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2001Roberta Cavendish PhD Purpose. To describe opportunities in the lives of young adults that strengthen or enhance spirituality. Methods. Descriptive, qualitative. Tape-recorded, semi-structured interviews were conducted with 13 well adults the ages 18 to 24. Interview transcripts, field notes, vignettes, and research committee minutes were analyzed to reduce coded data into conceptual categories and themes. Findings. Seven themes emerged from the participant's responses to probes: Beliefs, Connectedness, Inner Motivating Factors, Life Events, Divine Providence, Understanding the Mystery, and Walking Through. Conclusions. The accurate assessment of spiritual needs of young adults may be contingent on the assessment of their developmental needs. Knowing the opportunities that present in the lives of young adults to foster spiritual growth is important for nurses, who often are present when these opportunities occur. Practice Implications. Standardized language is limited for accurate nursing diagnosis of human responses in the spiritual domain. The findings support a new wellness nursing diagnosis, "Readiness for Enhanced Spirituality," to conceptualize a spirituality continuum and support wellness diagnoses. Search Terms: Nursing diagnosis, psychosocial development, religiosity, spirituality, transitions stage [source] The Religious Racial Integration of African Americans into Diverse ChurchesJOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 2 2010Gerardo Marti Recent scholarship asserts that members of racial groups can transcend their ethnic differences, but other research asserts that ethnoracial identities must be reinforced in order to participate in multiracial churches. Analysis of field notes and interview data from a large, black-white Protestant congregation shows that while the core membership of African Americans come specifically for its ethnic and racial diversity, they also look for markers that affirm a distinctive African-American experience. Ethnic reinforcement attracts highly race-conscious participants who eventually move toward processes of ethnic transcendence and congregational integration. The value for researchers is that distinguishing ethnically transcendent and ethnically reinforcing processes encourages the discovery of subtle, racially specific, and continually reinforced affinities that would otherwise remain hidden in seemingly ethnically transcendent settings. [source] Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practiceJOURNAL OF ADVANCED NURSING, Issue 9 2009Cydnee C. Seneviratne Abstract Title.,Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practice. Aim. This paper is a report of a study conducted to uncover nurses' perceptions of the contexts of caring for acute stroke survivors. Background. Nurses coordinate and organize care and continue the rehabilitative role of physiotherapists, occupational therapists and social workers during evenings and at weekends. Healthcare professionals view the nursing role as essential, but are uncertain about its nature. Method. Ethnographic fieldwork was carried out in 2006 on a stroke unit in Canada. Interviews with nine healthcare professionals, including nurses, complemented observations of 20 healthcare professionals during patient care, team meetings and daily interactions. Analysis methods included ethnographic coding of field notes and interview transcripts. Findings. Three local domains frame how nurses understand challenges in organizing stroke care: 1) space, 2) time and 3) interprofessional practice. Structural factors force nurses to work in exceptionally close quarters. Time constraints compel them to find novel ways of providing care. Moreover, sharing of information with other members of the team enhances relationships and improves ,interprofessional collaboration'. The nurses believed that an interprofessional atmosphere is fundamental for collaborative stroke practice, despite working in a multiprofessional environment. Conclusion. Understanding how care providers conceive of and respond to space, time and interprofessionalism has the potential to improve acute stroke care. Future research focusing on nurses and other professionals as members of interprofessional teams could help inform stroke care to enhance poststroke outcomes. [source] The use of conversational analysis: nurse,patient interaction in communication disability after strokeJOURNAL OF ADVANCED NURSING, Issue 3 2009Clare Gordon Abstract Title., The use of conversational analysis: nurse,patient interaction in communication disability after stroke. Aim., This paper is a report of a study to explore how nursing staff and patients with aphasia or dysarthria communicate with each other in natural interactions on a specialist stroke ward. Background., Nursing staff often talk with patients in a functional manner, using minimal social or affective communication. Little nursing research has been carried out with patients who have communication difficulties. Conversational analysis, used in other healthcare settings, is a way to explore these interactions in depth in order to gain further understanding of the communication process. Method., An observational study was carried out in 2005 and the data were 35·5 hours of videotape recording and field notes with 14 nursing staff and five patients with aphasia or dysarthria. The recordings were analysed using conversation analysis. Findings., Nursing staff controlled the conversations by controlling the topic and flow of conversations, creating asymmetry in all interactions. Patients had very little input because of taking short turns and responding to closed questions. These behaviours are related to the institutional context in which they occur. Conclusion., In rehabilitation, the focus for interaction may be thought to be patient goals, worries or plans for the future, but in this study nursing staff controlled the conversations around nursing tasks. This may be because they do not have the confidence to hold conversations with people with communication problems. Nursing staff need to receive training to reinforce communication rehabilitation programmes and to engage more fully with patients in their care, but also that a wider institutional culture of partnership is developed on stroke wards. [source] Individualized care: its conceptualization and practice within a multiethnic societyJOURNAL OF ADVANCED NURSING, Issue 1 2000Kate Gerrish BNurs MSc PhD RGN RM DN Cert Individualized care: its conceptualization and practice within a multiethnic society This paper reports on the selected findings from a larger ethnographic study of the provision of individualized care by district nurses to patients from different ethnic backgrounds. Undertaken in an English community National Health Service (NHS) Trust serving an ethnically diverse population, the study comprised two stages. First, an organizational profile of the Trust was undertaken in order to analyse the local policy context. Data were collected by means of in-depth interviews with managers and a review of policy documentation and caseload profiles. Second, a participant observational study was undertaken focusing on six district nursing teams. Purposive sampling was used to identify four teams with high minority ethnic caseloads and two teams with predominately white ethnic majority caseloads. Interview transcripts and field notes were analysed by drawing upon the principles of dimensional analysis. This paper focuses upon aspects of the second stage, namely how the nurses' conceptualized and practised individualized care. Six principles underpinning the philosophy of individualized care expounded by the nurses were identified: respecting individuality; holistic care; focusing on nursing needs; promoting independence; partnership and negotiation of care; and equity and fairness. Each is examined in turn and consideration given to how they were modified in their transformation into practice. Some implications for patients from minority ethnic backgrounds of the nurses' conceptualization and practice of individualized care are discussed. The lack of internal consistency within the nurses' discourse, the impact of policy directives on care delivery and the influence of factors outside the nurses' control, served to illuminate the complexity whereby the ideals of individualized care were adjusted and reworked in the realities of everyday nursing practice. This in turn raised questions about the appropriateness of the current interpretation and practice of individualized care in a multi-ethnic society. [source] The essentials of Advance Care Planning for end-of-life care for older peopleJOURNAL OF CLINICAL NURSING, Issue 3-4 2010Sarah Yeun-Sim Jeong Aims and objectives., The aim of the study was to investigate the phenomenon of Advance Care Planning and the use of Advance Care Directives in residential aged care facilities in Australia. The objectives were to: ,,investigate the implementation process of Advance Care Planning and the use of Advance Care Directives; ,,investigate the outcomes of Advance Care Planning and experiences of people involved in Advance Care Planning and Advance Care Directives, including residents, families and nursing staff. Background., Benefits of Advance Care Planning for older residents are considerable given their degenerative health-breakdown and minimal chance of recovery. To date, the use of Advance Care Planning and Advance Care Directives is limited and models of service delivery and processes are needed to enhance best practice with Advance Care Planning and positive outcomes for older Australians. Design., Case study. Methods., The study conducted using multiple sources of evidence to enrich understanding of the phenomenon of Advance Care Planning. The researcher engaged in data collection over six months involving participant observation, field notes, semi-structured interviews and document analysis. The findings contribute to the limited knowledge of options currently available to older adults and their families in their decision-making about end-of-life care options. Permission to conduct the study., Prior to commencement of the data collection, ethics clearances from the University of Newcastle and the regional Area Health Service were achieved. Permission to access the residential aged care facilities to undertake the study was obtained from the relevant residential aged care facility ethics committees or designated authorities. The researcher undertook several strategies to ensure all the ethical principles were considered and adhered to while conducting the project. Results., The research identified the components and factors involved in the Advance Care Planning process and in attaining desired outcomes. The conceptual framework developed elaborates how Advance Care Planning should be implemented and what may constitute successful implementation of Advance Care Planning in residential aged care facilities. The four main elements (input, throughput, output, feedback), and 20 sub-elements were requisites for nurses to initiate and implement the Advance Care Planning. Conclusion., The essential components for end-of-life care are identified in the implementation processes of Advance Care Planning in residential aged care facilities. The study contributes to greater awareness of the processes needed for ,dying well' and highlights the need to explore experiences of ,successful dying' and the way nurses contribute to these events. Relevance to clinical practice., The case study identified four determinative requisites for successful implementation of Advance Care Planning in aged care facilities: the expert nurse, discussion, education and involvement of a multidisciplinary team. Nurses should take these factors into account and use person-centred approach in formalised processes to encourage participation in plans for end-of-life care. [source] A theory of meaning of caregiving for parents of mentally ill children in Taiwan, a qualitative studyJOURNAL OF CLINICAL NURSING, Issue 1-2 2010Wen-Jiuan Yen Aims and objectives., The aim of this study is to generate a theory of meaning of care-giving for parents of mentally ill children in Taiwan. Background., Studies indicate that the meaning of care-giving plays an important role in the psychological adjustment of care-givers to care-giving. With a positive meaning of care-giving, care-givers can accept their roles and adapt to them more readily. Design., The research employs the qualitative method of grounded theory, the inquiry is based on symbolic interactionism. Methods., Twenty parental care-givers of children with schizophrenia were recruited at a private hospital in central Taiwan. Semi-structured interviews were conducted. A comparative method was used to analyse the text and field notes. Results., Responsibility (zeren) emerges as the core category or concept. Responsibility expresses broadly the behavioural principles that are culturally prescribed and centred on familial ethics and values. Related concepts and principles that influence caregiver actions and affections include a return of karma, challenges from local gods and fate. By maintaining their culturally prescribed interpretations of care-giving, parents hope to give care indefinitely without complaints. Conclusions., The findings clearly suggest that the meaning of care-giving is determined through a process of internal debate that is shaped by culturally specific concepts. The paper attempts to explain some of these culturally specific determinants and explanations of care-giving behaviour. Relevance to clinical practice., The theory contributes knowledge about the meaning of care-giving for parents of mentally ill children in Taiwan. It should be useful reference for mental health professionals, who provide counselling services to ethnically Taiwanese care-givers. [source] Protocol-based care: the standardisation of decision-making?JOURNAL OF CLINICAL NURSING, Issue 10 2009Jo Rycroft-Malone Aim., To explore how protocol-based care affects clinical decision-making. Background., In the context of evidence-based practice, protocol-based care is a mechanism for facilitating the standardisation of care and streamlining decision-making through rationalising the information with which to make judgements and ultimately decisions. However, whether protocol-based care does, in the reality of practice, standardise decision-making is unknown. This paper reports on a study that explored the impact of protocol-based care on nurses' decision-making. Design., Theoretically informed by realistic evaluation and the promoting action on research implementation in health services framework, a case study design using ethnographic methods was used. Two sites were purposively sampled; a diabetic and endocrine unit and a cardiac medical unit. Methods., Within each site, data collection included observation, postobservation semi-structured interviews with staff and patients, field notes, feedback sessions and document review. Data were inductively and thematically analysed. Results., Decisions made by nurses in both sites were varied according to many different and interacting factors. While several standardised care approaches were available for use, in reality, a variety of information sources informed decision-making. The primary approach to knowledge exchange and acquisition was person-to-person; decision-making was a social activity. Rarely were standardised care approaches obviously referred to; nurses described following a mental flowchart, not necessarily linked to a particular guideline or protocol. When standardised care approaches were used, it was reported that they were used flexibly and particularised. Conclusions., While the logic of protocol-based care is algorithmic, in the reality of clinical practice, other sources of information supported nurses' decision-making process. This has significant implications for the political goal of standardisation. Relevance to clinical practice., The successful implementation and judicious use of tools such as protocols and guidelines will likely be dependant on approaches that facilitate the development of nurses' decision-making processes in parallel to paying attention to the influence of context. [source] Nurse practitioner,client interaction as resource exchange in a women's health clinic: an exploratory studyJOURNAL OF CLINICAL NURSING, Issue 5 2003Rebecca K. Donohue PhD Summary ,,Empirical research has thoroughly documented the success of nurse practitioners (NPs) in terms of patient satisfaction and cost-effectiveness. What is missing is the in-depth knowledge of the interactive process through which this is accomplished during a clinic visit. ,,The aim of this study was to understand the special nature and processes of NP and client encounters in the ambulatory primary care context using a resource exchange perspective. ,,An exploratory descriptive design was used to address the following research questions: (i) What do midlife female clients expect in terms of resources to be exchanged prior to a visit with a NP in an ambulatory clinic visit? (ii) What resources are actually exchanged during the clinic visit? (iii) To what extent is there congruence between a woman's expectations and what she is actually receiving from the clinic visit in terms of resources exchanged? ,,The participants included two women health NPs and eight midlife female clients. ,,Data for the study were comprised of audiotaped pre- and postencounter interviews with the clients, audiotapes of the entire clinic visits with the NP and field notes recorded by the researcher of the client visits. Content analysis was conducted using ETHNOGRAPH software. ,,Findings indicated that clients of both NPs had surprisingly similar expectations of receipt of services as well as actual receipt of services. Resources expected and received from the visits included some combination of services, health information, trust, self-disclosure, support, affirmation, time, acceptance and respect. ,,Results of this study suggest that resource exchange theoretical formulations can be applied to NP,client interactions to understand and explain the specific nature of resources the clients expect and receive from a NP during a woman's health clinic visit. [source] Nurse,client processes in mental health: recipients' perspectivesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006R. COATSWORTH-PUSPOKY rn mscn An ethnonursing method was selected to explore and describe nursing support relationships, from the perspectives of recipients, within the mental health subculture. Data sources consisted of three semi-structured client interviews (n = 14) and field notes. When nurses were described as nice and friendly, and validated the client as a person by listening, three overlapping phases of development emerged from the data. These included: a glimmer of help, exploring and problem solving, and saying goodbye. When clients had negative experiences with nurses, they felt a lack of trust towards nurses and felt that their feelings were left unexplored. As a result, the relationships deteriorated. Deterioration began immediately in the first phase called withholding, and continued through the phases of avoiding and ignoring, and struggling with and making sense of. These findings raise healthcare providers' awareness about developing and deteriorating nurse,client relationships, and support the value of the therapeutic relationship as an instrument to restore and promote clients' health. [source] Caring for people in the ,virtual ward': the practical ramifications for acute nursing workJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2003M. DEACON, ba (hons) m.phil rmn srn enb(810) This paper discusses an aspect of data analysis arising from an ethnographic study of acute mental health nursing conducted in an inner city psychiatric unit. The data were collected in the form of field notes. These were made during and following episodes of participant observation on one acute ward and on a psychiatric intensive care unit over a period of 20 months. Acute wards have been subject to continuing criticism as both sites of care and treatment for mentally ill people and of nursing work. However, the practical operations of this social world remain largely unexamined. It is argued that without this understanding, mundane work methods will always be regarded as an impediment to work that is regarded as ,therapeutic' and therefore, of importance. The focus will be on phenomena named the ,virtual ward'. The research has demonstrated that the boundaries of nurses' responsibility reach far beyond the ward's spatial environment, both physically and communicatively. The complexity of the work that takes place within the virtual ward and the skills required for its successful completion are taken for granted, but are also a practical source of frustration. Anonymized examples from the practice site studied are used to illuminate the discussion. Working within the virtual ward is part of the messy reality of nurses' work. It is argued that understanding and respecting this reality is necessary if we are to be seriously and consistently ambitious about practice development. [source] National Board Certification (NBC) as a catalyst for teachers' learning about teaching: The effects of the NBC process on candidate teachers' PCK developmentJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 7 2008Soonhye Park Abstract This study examined how the National Board Certification (NBC) process, especially the portfolio creation, influenced candidate teachers' pedagogical content knowledge (PCK). In a larger sense, this study aimed to construct a better understanding of how teachers develop PCK and to establish ecological validity of the National Board assessments. Qualitative research methods, most notably case study, were utilized. Participants were three high school science teachers who were going thorough the NBC process. Data sources included classroom observations, interviews, teachers' reflections, and researcher's field notes. Data were analyzed using the constant comparative method and enumerative approach. Findings indicated that the NBC process affected five aspects of the candidate teachers' instructional practices that were closely related to PCK development: (a) reflection on teaching practices, (b) implementation of new and/or innovative teaching strategies, (c) inquiry-oriented instruction, (d) assessments of students' learning, and (e) understanding of students. © 2008 Wiley Periodicals, Inc. J Res Sci Teach 45: 812,834, 2008 [source] Teaching paediatric residents about learning disorders: use of standardised case discussion versus multimedia computer tutorialMEDICAL EDUCATION, Issue 8 2005Carolyn Frazer Bridgemohan Background, We developed a standardised case-based educational exercise on the topic of childhood learning disorders, and a multimedia computerised adaptation of this exercise, as part of a national curriculum project based on the Bright Futures guidelines. Objective, To explore resident perceptions of the facilitated case discussion (FCD) and the computerised tutorial (CT). Design, Quasi-randomised comparison of two educational interventions. Setting, Preclinic teaching conferences at a large urban children's hospital. Participants, A total of 46 paediatric residents years 1,3 assigned to either FCD (n = 21) or CT (n = 25). Interventions, FCD residents met in groups of 8,12 with a trained facilitator for a structured case discussion, while CT residents worked in groups of 2,3 at a computer station linked to an interactive website. Outcome Measures, Participant responses during semistructured focus group interviews. Analysis, Focus group transcripts, field notes and computer logs were analysed simultaneously using qualitative grounded theory methodology. Results, Residents experienced CT as fun, offering flexibility, greater auditory and visual appeal and more opportunities for active learning. FCD allowed greater contact with expert faculty and made the material more relevant to clinical practice. FCD participants emphasised the clinical skills gleaned and stated that the learning experience would change their future patient management. Both groups reported that case discussion was more interactive than computer learning. Median time spent on learning was slightly shorter for the CT group. All groups of learners arrived at the correct final diagnosis. Conclusions, FCD and CT stimulate different types of learning among paediatric residents. Future studies are needed to determine how to integrate these two techniques to meet the learning needs of residents in diverse settings. [source] Finding the Best Fit: A Grounded Theory of Contraceptive Decision Making in WomenNURSING FORUM, Issue 4 2004APRN-BC, Joanne Noone PhD PROBLEM. Half of the pregnancies in the United States that occur annually are unintended, and of these, half occur among women using contraceptives. METHODS. Interviews with 16 women, field notes, and memos were analyzed using constant comparative analysis and the methods of open, axial, and selective coding were used until saturation occurred. FINDINGS. The core category that describes the process of contraceptive decision making in women is "finding the best fit." Women choose a method or methods to prevent pregnancy based on their knowledge, experience, and evaluation of what would be the best fit within the context of their current life situation. CONCLUSIONS. It is important that nurses obtain a thorough contraceptive history, and realize that women may have different perceptions and knowledge level of methods. [source] The importance of knowing the patient in weaning from mechanical ventilationNURSING IN CRITICAL CARE, Issue 6 2009Cheryl Crocker ABSTRACT Aim: The aim of the research was to understand how nurses used technology to wean patients from mechanical ventilation. Background: The literature concerned with the development of critical care centres on the role of technology with little emphasis on the nursing contribution. Design: An ethnographic approach was used to understand how nurses used technology to wean patients from mechanical ventilation. Methods: Data were gathered by participant observation and interviewing over a 6-month period. In total, 250 h of field notes were recorded. Results: Data were analysed by the content analysis method. Knowing the patient was a central theme identified. Three sub-themes were identified: ways of knowing, continuity of care and the role of the patient in the weaning trajectory. Conclusion: ,Knowing the patient' was implied during the interviews as essential to the delivery of patient-centred care. There were two main factors that needed to be present in order for nurses to know their patients: continuity of care and expertise. ,Ways of knowing' was reliant on gaining information about the patient. The role of the patient was a passive recipient of treatment. Implications for practice: Knowing the patient has been defined as a characteristic of expert nursing. To be truly patient-centred nursing needs to address the barriers that prevent nurses from getting to ,know' their patients. [source] Psychological Interventions in the Context of Poverty: Participatory Action Research as PracticeAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2010Laura Smith What innovations of socially just psychological practice exist for mental health professionals working in the context of poverty? This article argues for participatory action research (PAR) as a new horizon not only with regard to the creation of knowledge but as a community-based practice/action that promotes the emotional well-being of people surviving poverty and other forms of oppression. After the presentation of this argument, an ongoing PAR project in a poor urban community is described. This article explores its impact on all participants through observations from field notes along with the results of a focus group in which community co-researchers contributed their experiences of PAR. Finally, key practice-related considerations and other implications for mental health practitioners are proposed. [source] Getting Your Feet Wet: Becoming a Public Health Nurse, Part 1PUBLIC HEALTH NURSING, Issue 1 2004D.N.Sc., Lee SmithBattle R.N. Abstract While the competencies and theory relevant to public health nursing (PHN) practice continue to be described, much less attention has been given to the knowledge derived from practice (clinical know-how) and the development of PHN expertise. A study was designed to address this gap by recruiting nurses with varied levels of experience and from various practice sites. A convenience sample of 28 public health nurses and seven administrators/supervisors were interviewed. A subsample, comprised of less-experienced public health nurses, were followed longitudinally over an 18-month period. Data included more than 130 clinical episodes and approximately 900 pages of transcripts and field notes. A series of interpretive sessions focused on identifying salient aspects of the text and comparing and contrasting what showed up as compelling, puzzling, and meaningful in public health nurses' descriptions. This interpretive analysis revealed changes in understanding of practice and captured the development of clinical know-how. In Part 1, we describe the sample, study design, and two aspects of clinical knowledge development,grappling with the unfamiliar and learning relational skills,that surfaced in nurses' descriptions of early clinical practice. In Part 2, which is to be published in the next issue of Public Health Nursing (SmithBattle, Diekemper, & Leander, 2004), we explore gradual shifts in public health nurses' understanding of practice that led to their engagement in upstream, population-focused activities. Implications of these findings for supporting the clinical learning of public health nurses and the development of expertise are described. [source] Arab American Adolescent Perceptions and Experiences with SmokingPUBLIC HEALTH NURSING, Issue 3 2003Anahid Kulwicki R.N., D.N.S. Abstract The purpose of this pilot study was to gather information on Arab American adolescent tobacco use behavior. This information was used to modify the Project Toward No Tobacco Use cessation program so that it would reflect the cultural values of Arab American youths. Focus group interviews were conducted to collect qualitative data from 28 Arab American adolescents between the ages of 14 and 18 years. The number of participants in the focus groups ranged from three to eight; four sessions were conducted. A moderator, fluent in Arabic and English, facilitated the group's interactions. Each group addressed five interview questions. Discussions were audiotaped and transcribed with the expressed permission of study participants. Qualitative analysis consisted of careful reading of the transcripts and of the field notes for the purpose of identifying recurring themes around tobacco use. Those that emerged were Being Cool; Being able to "Nshar ma'a al shabab" (hang out with the guys); Present Orientation; Smoking feels good, tastes good, and keeps your mind off trouble; Availability and Accessibility of tobacco; and Barriers to Smoking Cessation Programs. The results of the focus group discussions provided valuable information about the tobacco use perceptions and behaviors of Arab American adolescents and the youths' need for a culturally relevant smoking cessation program. [source] The role of collegial interaction in continuing professional developmentTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2007Anna R. Gagliardi MLS Abstract Introduction: Many physicians seek information from colleagues over other sources, highlighting the important role of interaction in continuing professional development (CPD). To guide the development of CPD opportunities, this study explored the nature of cancer-related questions faced by general surgeons, and how interaction with colleagues addressed those questions. Methods: This study involved thematic analysis of field notes collected through observation and transcripts of telephone interviews with 20 surgeons, two pathologists, one medical oncologist, and one radiation oncologist affiliated with six community hospitals participating in multidisciplinary cancer conferences by videoconference in one region of Ontario, Canada. Results: Six multidisciplinary cancer conferences (MCCs) were observed between April and September 2006, and 11 interviews were conducted between December 2006 and January 2007. Sharing of clinical experience made possible collective decision making for complex cancer cases. Physicians thought that collegial interaction improved awareness of current evidence, patient satisfaction with treatment plans, appropriate care delivery, and continuity. By comparing proposed treatment with that of the group and gaining exposure to decision making for more cases than they would see in their own practices, physicians developed clinical expertise that could be applied to future cases. Little collegial interaction occurred outside these organized sessions. Discussion: These findings highlight the role of formally coordinated collegial interaction as an important means of CPD for general surgeons. Investment may be required for infrastructure to support such efforts and for release of health professional time for participation. Further research is required to examine direct and indirect outcomes of collegial interaction. [source] Comanche ethnography: field notes of E. Adamson Hoebel, Waldo R. Wedel, Gustav G. Carlson, and Robert H. Lowie , Edited by Thomas W. KavanaghTHE JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE, Issue 3 2010Abby Wightman No abstract is available for this article. [source] Illegitimate Killers: The Symbolic Ecology and Cultural Politics of Coyote-Hunting Tournaments in Addison County, VermontANTHROPOLOGY & HUMANISM, Issue 2 2009Marc A. BoglioliArticle first published online: 6 NOV 200 SUMMARY Although I have conducted ethnographic research on hunting in central Vermont since 1996, one important issue has remained conspicuously absent from my field notes: organized hunting protest. That all changed one cold February day in 2005 as protesters from a home-grown animal rights group stood along a country road in Whiting, Vermont, to voice their opposition to the first annual Howlin' Hills Coyote Hunt. This coyote-hunting tournament was characterized by a broad assortment of local residents,including hunters,as a morally corrupt departure from traditional hunting ethics and from that day forward Addison County has been caught up in a social drama that may forever change the face of hunting in Vermont. As deep philosophical differences were revealed between not only hunters and antihunters, but between hunters themselves, a small window opened for a more general moral critique of hunting. Drawing on testimony from hunters, animal rights activists, Vermont Department of Fish and Wildlife personnel, and my own experiences at coyote tournaments, I explain the perspectives of the various actors in this drama as they struggle to define the meaning and ethical place of hunting in the 21st century. [Keywords: human,animal relations, symbolic ecology, hunting, rural America, coyotes] [source] Research Beyond the Pale: Whiteness in Audience Studies and Media EthnographyCOMMUNICATION THEORY, Issue 2 2005Vicki Mayer This article examines the role of whiteness as a structuring absence to ethnographic audience research. After ignoring whiteness altogether, media ethnographers have tended to essentialize whiteness within narratives of structural dominance or individual vulnerability. Using poststructuralist theories of language, whiteness, and hegemony, the author argues that these narratives for whiteness can be traced to experiences in the field that are shaped by historical and institutional forces outside of the field. Researchers both perform whiteness in the field, by claiming its privilege and hiding its visibility, and codify whiteness for others to identify outside the field. To illustrate, the author examines "narcissistic whiteness" and "defensive whiteness" as two articulations that are visible in her own field notes, interpreted through unifying narratives and rearticulated through an alternative reading of the notes. [source] | ||||||||||||||||||||||||||||