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Major Themes (major + themes)
Selected AbstractsThe Christian Religion in Modern European and World History: A Review of The Cambridge History of Christianity, 1815,2000HISTORY COMPASS (ELECTRONIC), Issue 6 2008David Lindenfeld Volumes 8 and 9 of the Cambridge History, representing the work of 72 scholars, reflect two major recent historiographical trends: 1) the increased attention paid to religion in modern European history, and 2) the increasing importance of Christianity in as a topic in world history. While these volumes serve to summarize the work already done in the first field, with articles on a wide variety of European countries, they should significantly move the second field forward by bringing together the work of specialists on many different parts of the world in a single place. Volume 8 summarizes scholarship on the Western religious revivals of the nineteenth century, both Catholic and Protestant. By integrating religion and politics, it also presents a more complex picture of the formation of European national identities than Benedict Anderson's Imagined Communities suggests. One third of the volume is devoted to the spread of Christianity to the non-Western world. In Volume 9, the European and world history perspectives are more evenly interspersed. Major themes include the papacy, ecumenism, colonialism, Pentecostalism, and the independent churches of Africa and Asia. The 1960s emerge as a turning point, if for different reasons in different parts of the world. This was the decisive period of secularization in Europe, and the final section documents the social and cultural impact of that shift, particularly on the arts. Although there are inevitable gaps in coverage, these volumes will serve as an invaluable research tool for years to come. [source] Recognition of workplace bullying: a qualitative study of women targets in the public sectorJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2006Sian E. Lewis Abstract Workplace bullying is increasingly acknowledged as a major workplace stressor in the UK and Europe. However, identification and recognition of workplace bullying remain problematic, among targets and within organisations. This paper reports a qualitative study which explored experiences of bullying among ten British women targets, all public sector professionals. Data were collected using in-depth interviews and analysed using grounded theory methods. Findings showed how these targets struggled to identify and cope with bullying. Major themes or processes identified from targets' accounts included: minimising interpersonal difficulties; preserving self; maintaining commitments to professional and organisational values and cultures; sickness explanations; and naming the problem. This research has implications for the development of coping strategies by targets and organisations, and raises questions about the type of support needed to facilitate recognition of workplace bullying. Copyright © 2006 John Wiley & Sons, Ltd. [source] Identifying service needs of children with disruptive behavior problems using a Nominal Group TechniqueNURSING & HEALTH SCIENCES, Issue 4 2000Diana R. Keatinge RN, M ADMIN Abstract A recent study used both qualitative and quantitative methods to examine families' perceptions of service needs for children with disruptive behavior problems. Focusing on the qualitative component of the study, the present paper discusses the modified Nominal Group Technique used in focus groups attended by carers living in rural, regional or metropolitan contexts. Three questions posed to each focus group sought to identify families' concerns about health facilities and/or related support services currently available to them, the benefits they perceived in these services and the changes needed to make these services more appropriate or accessible to them. Major themes in the responses relating to each of these questions included concerns about a lack of, or perceived need for, access to help/support, benefits in schools that accommodated the needs of the children, and support from the community. Families' recommendations for change included increased access to health care advice, information and/or support systems. [source] Perceptions of Transitional Care Needs and Experiences in Pediatric Heart Transplant RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2009S. J. Anthony Survival following pediatric heart transplantation (HTx) continues to improve. The transition from pediatric to adult care is becoming a pivotal stage in the ongoing medical management of this population. Published data support enhanced outcomes for adolescent patients with increased attention to transitional care. The purpose of this study was to explore the ,transition experience' of adolescent HTx recipients and families. All teens (12,18 years) and parents at a single-center HTx program were invited to participate in semistructured interviews. Qualitative, phenomenological methodology was used to build theoretical knowledge and guided the data collection and analysis. The study population included 14 patients (7 males) with a mean age of 15.7 ± 1.8 years (11.7,17.8 years) and at a mean of 4.1 ± 3.3 years post-HTx (0.3,9.2 years) at the time of study participation. Major themes identified included: (i) adolescent disinterest and apathy regarding transition to adult care versus parental anxiety about their child's eventual departure from the pediatric transplant center, (ii) perceived differences in pediatric versus adult care and (iii) identification of strategies described as helpful in facilitating the transition. Understanding the experiences and perceptions of adolescent HTx recipients and their parents is crucial to planning effective transitional care and necessary for evidenced-based practice. [source] Reducing redundancy in invasion ecology by integrating hypotheses into a single theoretical frameworkDIVERSITY AND DISTRIBUTIONS, Issue 1 2009Jane A. Catford ABSTRACT Aim, Invasion ecology includes many hypotheses. Empirical evidence suggests that most of these can explain the success of some invaders to some degree in some circumstances. If they all are correct, what does this tell us about invasion? We illustrate the major themes in invasion ecology, and provide an overarching framework that helps organize research and foster links among subfields of invasion ecology and ecology more generally. Location, Global. Methods, We review and synthesize 29 leading hypotheses in plant invasion ecology. Structured around propagule pressure (P), abiotic characteristics (A) and biotic characteristics (B), with the additional influence of humans (H) on P, A and B (hereon PAB), we show how these hypotheses fit into one paradigm. P is based on the size and frequency of introductions, A incorporates ecosystem invasibility based on physical conditions, and B includes the characteristics of invading species (invasiveness), the recipient community and their interactions. Having justified the PAB framework, we propose a way in which invasion research could progress. Results, By highlighting the common ground among hypotheses, we show that invasion ecology is encumbered by theoretical redundancy that can be removed through integration. Using both holistic and incremental approaches, we show how the PAB framework can guide research and quantify the relative importance of different invasion mechanisms. Main conclusions, If the prime aim is to identify the main cause of invasion success, we contend that a top-down approach that focuses on PAB maximizes research efficiency. This approach identifies the most influential factors first, and subsequently narrows the number of potential causal mechanisms. By viewing invasion as a multifaceted process that can be partitioned into major drivers and broken down into a series of sequential steps, invasion theory can be rigorously tested, understanding improved and effective weed management techniques identified. [source] GOVERNANCE AND CHARITIES: AN EXPLORATION OF KEY THEMES AND THE DEVELOPMENT OF A RESEARCH AGENDAFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 1 2009Noel Hyndman The concept of governance has been widely discussed in both the business and non-business sectors. The debate has also been entered into within the charity sector, which comprises over 169,000 organizations in the UK. The UK-based Charity Commission, which describes itself as existing to ,promote sound governance and accountability', has taken a lead in this debate by promoting greater regulation and producing numerous recommendations with regard to the proper governance of charitable organizations. However, the concept of what is meant by governance is unclear and a myriad of ideas are placed under the umbrella of ,good governance'. This paper explores the major themes that form the basis of much of this discussion, examining both the theoretical underpinnings and empirical investigations relating to this area (looking from the perspective of the key stakeholders in the charity sector). Based on an analysis of the extant literature, this paper presents a broad definition of governance with respect to charities and outlines a future research agenda for those interested in adding to knowledge in this area [source] "THE FARTHER REACHES OF HUMAN TIME": RETROSPECT ON CARL SAUER AS PREHISTORIAN,GEOGRAPHICAL REVIEW, Issue 4 2002DAVID R. HARRIS ABSTRACT. Carl Ortwin Sauer (1889,1975) is widely regarded as one of the most influential geographers of the twentieth century, admired particularly for his studies in cultural and historical geography. His contribution to the study of prehistory is less widely acknowledged, but, between 1944 and 1962, he published a series of speculative yet scholarly papers that contain many prescient insights into humanity's remote past and the relationships of our ancestors to the environments they occupied,and modified. In this essay, based on the Carl O. Sauer Memorial Lecture given at the University of California, Berkeley, in October 2001, I reflect on Sauer's contribution to the science of prehistory by examining, in the light of recent advances in knowledge, two major themes of Sauer's work: the early dispersal of Homo sapiens in the Old World, and the origins and prehistoric spread of agriculture. [source] The health, social care and housing needs of lesbian, gay, bisexual and transgender older people: a review of the literatureHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2009Samia Addis MSc Abstract This paper reports the findings of a literature review of the health, social care and housing needs of older lesbian, gay, bisexual and transgender (LGBT) adults undertaken in 2006 for the Welsh Assembly Government. Peer-reviewed literature was identified through database searches of BNI, PubMed, CINAHL, DARE, ASSIA and PsychInfo. Follow-up searches were conducted using references to key papers and journals as well as specific authors who had published key papers. A total of 187 papers or chapters were retrieved, of which 66 were included in the study; major themes were identified and the findings synthesised using a meta-narrative approach. The main themes that emerged from the review were isolation, health behaviours, mental health and sexual health behaviours. The literature indicates that the health, social care and housing needs of LGBT older people is influenced by a number of forms of discrimination which may impact upon the provision of, access to and take up of health, social care and housing services. Understanding of the health, social care and housing needs of older LGBT people is limited and research in this area is scarce. The research which exists has been criticised for using small samples and for tending to exclude participants from less affluent backgrounds. The focus of research tends to be on gay men and lesbians; consequently, the needs of bisexual and transgender people remain largely unknown. Additionally, research which does exist tends to focus on a narrow range of health issues, often related to the health needs of younger LGBT people. Discrimination in various forms has a major impact on needs and experiences, leading to marginalisation of LGBT people both in the provision of health and social care services and neglect of these groups in public health research. [source] Knowledge management in enterprises: a research agendaINTELLIGENT SYSTEMS IN ACCOUNTING, FINANCE & MANAGEMENT, Issue 1 2005Konstantinos Ergazakis Knowledge management (KM) is an emerging area, which is gaining interest by both enterprises and academics. The effective implementation of a KM strategy is considering as a ,must' and as a precondition of success for contemporary enterprises, as they enter the era of the knowledge economy. However, the field of KM has been slow in formulating a universally accepted methodology, due to the many pending issues that have to be addressed. This paper attempts to propose a novel taxonomy for KM research by co-instantaneously presenting the current status with some major themes of KM research. The discussion presented on these issues should be of value to researchers and practitioners. Copyright © 2005 John Wiley & Sons, Ltd. [source] Boredom in the workplace: More than monotonous tasksINTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 4 2009Lia Loukidou Boredom is an emotional state that has a long history in organizational research. Despite recent changes in technology and the organization of work, boredom remains a part of the experience of work. The available evidence indicates that boredom is associated mainly with negative individual and organizational outcomes. The authors organize the review of the antecedents of boredom around four major themes in the literature: boredom in relation to jobs; individual differences; social context; and goals and coping. The authors conclude that the major challenge for researchers is to provide an integrative account of boredom which subsumes multiple areas of research, and that one most promising avenue for future research requires further attention to boredom in relation to coping processes, pursuit and attainment of personal goals. [source] Promoting breast health: older women's perceptions of an innovative intervention to enhance screeningINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 2 2006Robin Y. Wood EdD Aims and objectives., This study is a continuation of prior funded research in which we tested the use of age and ethnically sensitive video breast health kits to increase knowledge about breast cancer and enhance the screening practices of breast self-examination and mammography among older Caucasian and African-American women. Background., Breast cancer is the most frequent cancer in women worldwide and accounts for 23% of all cancers. Mammography is currently the best procedure available for mass screening of breast cancer. However, underutilization of mammography is a problem among older women in the United States. Elders are at the greatest risk for developing and dying from breast cancer but they are the least likely group to be screened routinely with mammograms or to practice breast self-examination, particularly if they are African-American. Design., Participatory qualitative evaluation focus groups were used to assess the overall impact of the video kit intervention programme and to elucidate the quantitative findings of the original study. Methods., Four focus groups were conducted in two diverse settings with a purposive sample of 23 participants (N = 23). The overall sample was predominantly African-American (87%) with mean age of 71 ± 7.9 years and mean education completed of 12 ± 3.4 years. Results., Five major themes emerged from group discussions: usability and appeal of the intervention, fear and empowerment, personal relevance and intergenerational sharing, impact on screening behaviours, and story telling. Conclusions., Analyses suggest that customized media materials constructed especially for older African-American women empowered participants in this sample to action regarding their own breast health. Relevance to clinical practice., These findings may translate to global populations where risk is increasing but screening programmes are not widely available. Given that older women are historically difficult to access and impact, further design and evaluation of innovative and sensitive educational programmes such as the one described here are recommended. [source] Barth's ,Other' Doctrine of Election in the Church DogmaticsINTERNATIONAL JOURNAL OF SYSTEMATIC THEOLOGY, Issue 2 2007SUZANNE McDONALD This article contends that more consideration needs to be given to the presence of this earlier understanding of election in CD I/1 and 2, both with regard to its influence on the presentation of key loci within these volumes and to the tensions created in the unfolding of major themes before and after his christological reorientation of the doctrine. [source] ,People Is All That Is Left to Privatize': Water Supply Privatization, Globalization and Social Justice in Belize City, BelizeINTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 3 2009DAANISH MUSTAFA Abstract This article presents the findings of an extensive survey on public and policy level perceptions of the failed water supply and sanitation system privatization in Belize City. Drawing upon the burgeoning critical geographical literature on the commodification and privatization of water, we formulate a conceptual framework for analyzing the ethnographic data on perceptions and experience of privatization by Belize City water users. The experience of water supply privatization was largely negative. Residents complained bitterly about an increase in water tariffs and excessive disconnection rates by the privatized Belize Water Supply Limited (BWSL). Many policy makers also accused BWSL of front-loading profits and not making strategic investments in infrastructure. But the symbolic significance of water privatization for the residents of a small Caribbean country like Belize exceeded its practical implications. We argue that the major themes to emerge from the ethnographic data collected for the study can be synthesized into three ,popular privatization narratives' (PPNs). The first was based on the perception that poor governance led to privatization; the second on a preference for national- over global-scale politics, so that objections to privatization were based on nationalism; the third on angst about losing control to the systemic compulsions of neoliberal globalization. Overall the privatization process not only had important (largely negative) material consequences for Belizeans but, given their historical and cultural geography, profound discursive and symbolic consequences for their sense of identity in a condition of neoliberal globalization. Résumé Cet article présente les résultats d'une vaste enquête sur les impressions, de la population et des acteurs des politiques publiques, concernant l'échec de la privatisation du réseau d'approvisionnement en eau et d'assainissement de Belize City. Utilisant les publications géographiques critiques qui se multiplient sur la marchandisation et la privatisation de l'eau, un cadre conceptuel est formulé pour analyser les données ethnographiques sur les impressions et l'expérience de la privatisation émanant des usagers de l'eau de Belize City. L'expérience de cette privatisation a été en grande partie négative. Les habitants se plaignent amèrement de l'augmentation des tarifs et de taux de coupures excessifs par la société privée Belize Water Supply Limited (BWSL). De nombreux décideurs politiques ont également accusé BWSL de prélever les bénéfices sans effectuer d'investissements stratégiques d'infrastructure. Toutefois, la place symbolique de la privatisation de l'eau pour les habitants d'un petit pays de la mer des Antilles comme Belize dépasse les incidences pratiques. Les principaux thèmes dessinés par les données ethnographiques collectées peuvent se résumer en trois ,récits populaires de la privatization'. Le premier repose sur l'impression que la faiblesse de la gouvernance a conduit à la privatisation; le deuxième sur une préférence pour une politique à l'échelon national plutôt que mondial, de sorte que les objections à la privatisation étaient liées au nationalisme; le troisième sur l'angoisse de perdre la maîtrise des pressions systémiques exercées par la mondialisation néolibérale. En général, le processus de privatisation a eu des conséquences matérielles importantes (en grande partie négatives) pour les Béliziens mais aussi, étant donnée la géographie historique et culturelle nationale, de profondes implications discursives et symboliques sur leur sens de l'identité dans un contexte de mondialisation néolibérale. [source] Evidence-Based Practice in Healthcare: An Exploratory Cross-Discipline Comparison of Enhancers and BarriersJOURNAL FOR HEALTHCARE QUALITY, Issue 3 2010Joanna Asadoorian Abstract: In order to improve health outcomes, healthcare providers need to base practice on current evidence. The purpose of this qualitative study was to explore and compare the understanding and experiences with evidence-based practice (EBP) in three different disciplines. Researchers conducted individual interviews with psychiatrists, nurses, and dental hygienists. The majority of study participants demonstrated an understanding of EBP and were able to identify enhancers and barriers to implementing EBP. Using a grounded theory approach, several major themes acting as enhancers and barriers to EBP emerged and revealed both differences and similarities within and across the three health disciplines. While saturation was not attempted, this exploratory research is important in contributing to understanding the cultural practice milieu in relation to individual characteristics in implementing evidence into practice with the overall aim of improving healthcare delivery and outcomes. [source] Insights on Immunizations From Caregivers of Children Receiving Medicaid-Funded ServicesJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2000Deborah B. Evers ISSUES AND PURPOSE. Despite numerous programs aimed at improving immunization rates among American children, under-immunization remains a significant problem. This study was conducted to gain insight into parents' /guardians' knowledge and attitudes regarding childhood immunizations. DESIGN AND METHODS. Thirteen African-American mothers and grandmothers participated in semistructured, audiotaped focus-group interviews. RESULTS. Four major themes emerged: health knowledge and beliefs about immunizations, system barriers that impede obtaining immunizations, facilitators that enhance obtaining immunizations, and suggestions for change. PRACTICE IMPLICATIONS. Immunizations are one of the most important health advantages available to children. Therefore, nurses must become aware of the problem of underimmunization and work to address some of the concerns caregivers have identified in this study. The health and lives of the nation's children depend on it. [source] Women's perceptions and experiences of a traumatic birth: a meta-ethnographyJOURNAL OF ADVANCED NURSING, Issue 10 2010Rakime Elmir elmir r., schmied v., wilkes l. & jackson d. (2010) Women's perceptions and experiences of a traumatic birth: a meta-ethnography. Journal of Advanced Nursing,66(10), 2142,2153. Abstract Aim., This study presents the findings a meta-ethnographic study reporting women's perceptions and experiences of traumatic birth. Background., Childbirth is viewed by many as a life transition that can bring a sense of accomplishment. However, for some women, birth is experienced as a traumatic event with a minority experiencing post-traumatic stress. A traumatic birth experience can have a significant impact on the physical and emotional well-being of a woman, her infant and family. Data source., The CINAHL, MEDLINE, Scopus and PubMed databases were searched for the period January 1994 to October 2009 using the keywords birth trauma, traumatic birth, qualitative research, birth narrative and birth stories. Review methods., A meta-ethnographic approach was used. Quality appraisal was carried out. An index paper served as a guide in identifying particular findings and comparing them with other findings. This ,reciprocal translation' process started with a search for common themes, phrases and metaphors. Results., Ten qualitative studies were included in the final sample. Six major themes were identified: ,feeling invisible and out of control', ,to be treated humanely', ,feeling trapped: the reoccurring nightmare of my childbirth experience', ,a rollercoaster of emotions', ,disrupted relationships' and ,strength of purpose: a way to succeed as a mother'. Conclusions., It is evident that a small percentage of women experience a traumatic birth. Although some women who experience a traumatic birth do not necessarily have physical or psychological adverse outcomes, others identify a significant personal impact. Healthcare professionals must recognize women's need to be involved in decision-making and to be fully informed about all aspects of their labour and birth to increase their sense of control. [source] Nurses' experiences with telephone triage and advice: a meta-ethnographyJOURNAL OF ADVANCED NURSING, Issue 3 2010Rebecca J. Purc-Stephenson purc-stephenson r.j. & thrasher c. (2010) Nurses' experiences with telephone triage and advice: a meta-ethnography. Journal of Advanced Nursing66(3), 482,494. Abstract Aims., This study is a meta-ethnography of nurses' experiences with telephone triage and advice and factors that facilitate or impede their decision-making process. Background., Telephone triage and advice services are a rapidly expanding development in health care. Unlike traditional forms of nursing practice, telenurses offer triage recommendations and advice to the general public without visual cues. Data sources., Published qualitative research on telephone triage and advice were sought from interdisciplinary research databases (1980,2008) and bibliographical reviews of retrieved studies. Review methods., Our systematic search identified 16 relevant studies. Two researchers independently reviewed, critically appraised, and extracted key themes and concepts from each study. We followed techniques of meta-ethnography to synthesize the findings, using both reciprocal and refutational translation to compare similar or contradictory findings, and a line-of-arguments synthesis. Results., We identified five major themes that highlight common issues and concerns experienced by telenurses: gaining and maintaining skills, autonomy, new work environment, holistic assessment, and stress and pressure. A line-of-arguments synthesis produced a three-stage model that describes the decision-making process used by telenurses and highlights how assessments largely depend on the ability to ,build a picture' of the patient and the presenting health issue. Conclusion., Telenurses experience a range of common concerns and issues which either impede or facilitate the decision-making process. Although ,building a picture' of the patient is key to making assessments over the telephone, final triage decisions are influenced by balancing the conflicting demands of being both carer and gatekeeper to limited healthcare services. [source] Patients' experiences of hip fractureJOURNAL OF ADVANCED NURSING, Issue 4 2003Graeme Archibald BA MSc RN Background., Hip fracture is a major cause of mortality and morbidity, particularly among older people, but there is little information on how individuals experience this. Aims., This study was conducted to explore the experiences of individuals who had suffered a hip fracture. The aim was not to produce generalizable findings but, rather, to generate a rich description of the experience of incurring and recovering from a hip fracture, to inform nursing practice. Method., Phenomenological methodology was used. A purposeful sample of five older patients was interviewed, following a stay in a community hospital for rehabilitation after surgical repair of a hip fracture. The unstructured interviews were tape-recorded, transcribed verbatim and analysed for significant statements and meanings. Findings., Four major themes emerged: the injury experience, the pain experience, the recovery experience and the disability experience. The injury experience consisted of storytelling, recalling the experience of the injury itself. The pain experience consisted of coping with the pain. The recovery experience involved the operation, beginning the struggle of recovery, and regaining independence. The disability experience consisted of the disability itself, depending on others, and being housebound. Conclusions., Pain management, meeting psychological and physical needs for nursing care, planning for discharge, and ensuring a reasonable quality of life are areas for nursing care development. Consideration of appropriate settings for rehabilitation is needed and there should be further investigation into improving quality of life after discharge. [source] A literature review: factors that impact on nurses' effective use of the Medical Emergency Team (MET)JOURNAL OF CLINICAL NURSING, Issue 24 2009Lisa Jones Aims and objectives., The aim of this literature review is to identify factors, both positive and negative, that impact on nurses' effective use of the Medical Emergency Team (MET) in acute care settings. Background., Outcomes for patients are often dependent on nurses' ability to identify and respond to signs of increasing illness and initiate medical intervention. In an attempt to improve patient outcomes, many acute hospitals have implemented a rapid response system known as the Medical Emergency Team (MET) which has improved management of critically ill ward patients. Subsequent research has indicated that the MET system continues to be underused by nurses. Design., A comprehensive thematic literature review. Methods., The review was undertaken using key words and the electronic databases of Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID/MEDLINE, Blackwell Synergy, Science Direct and Informit. Fifteen primary research reports were relevant and included in the review. Results., Five major themes emerged from the analysis of the literature as the major factors effecting nurses' use of the MET system. They were: education on the MET, expertise, support by medical and nursing staff, nurses' familiarity with and advocacy for the patient and nurses' workload. Conclusions., Ongoing education on all aspects of the MET system is recommended for nursing, medical and MET staff. Bringing MET education into undergraduate programs to prepare new graduates entering the workforce to care for acutely ill patients is also strongly recommended. Further research is also needed to determine other influences on MET activation. Relevance to clinical practice., Strategies that will assist nurses to use the MET system more effectively include recruitment and retention of adequate numbers of permanent skilled staff thereby increasing familiarity with and advocacy for the patient. Junior doctors and nurses should be encouraged to attend ward MET calls to gain skills in management of acutely ill patients. [source] An observational study of health professionals' use of evidence to inform the development of clinical management toolsJOURNAL OF CLINICAL NURSING, Issue 16 2008Alison M Hutchinson BAppSc, MBioeth Aim., This observational study sought to investigate the process of evidence use by health professionals during development of evidence-based clinical management tools. Background., Studies conducted to explore the process of research use are scarce and knowledge of this process is essential for our understanding of the influences on research use in practice. Design., A qualitative, non-participant, observational design. Methods., Behaviour and actions of two separate multidisciplinary teams were observed and audio-recorded during a combined total of seven meetings for the development of clinical management tools. Semi-structured, one-to-one interviews were conducted approximately half-way through the development process and following completion of the clinical management tools. Results., Three major themes emerged from this research. First, the process of clinical management tool development and evidence use. Nurses assumed responsibility for coordination of development which focused on describing current practice. Second, the forms of evidence employed during the development process included the use of experiential knowledge, opinions and knowledge of the context, in addition to research evidence. However, reference to research evidence was limited and its incorporation into the instrument was infrequently observed. Third, the use of research evidence emerged with respect to how such evidence was employed. Conclusion., This study focused on real-life discussion and decision-making that occurred between health professionals when developing evidence-based clinical management tools. Health professionals may have a tendency to rely on their professional experience and current practice in preference to seeking and applying relevant research evidence. Relevance to clinical practice., Nurses have an important role to play in the development of multidisciplinary evidence-based clinical management tools, but to actively participate in this process they need to be familiar with the relevant research evidence and have the skills and confidence to integrate the evidence into practice. [source] A best-evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in-patient mental health settingsJOURNAL OF CLINICAL NURSING, Issue 9 2008John A Baker BNurs, MPhil Aims and objectives., This paper aims to synthesise published literature of drug use/administration studies of pro re nata psychotropic medications in mental health wards. Design., The study employed a best-evidence synthesis review design. Background., The administration of psychotropic pro re nata medications is a frequently used clinical intervention in mental health wards. Pro re nata contributes to exposing patients to high doses of antipsychotic medication. Despite the frequent use of pro re nata, there is limited evidence of their effectiveness. Methods., A best-evidence synthesis review. Results., Six major themes emerged from the literature: (i) frequency of administration; (ii) administration during the 24-hour day; (iii) administration associated with length and stage of admission; (iv) rationales for administration; (v) medicines administered (including route of administration); and (vi) effects and side effects of the medicines administered. Conclusions., Overall findings indicate that the administration of psychotropic pro re nata varies radically and appears to be influenced by many variables. Relevance to clinical practice., Patients are most likely to receive a benzodiazepine or typical antipsychotic as pro re nata. Pro re nata is an important and under-researched clinical intervention used in mental health wards. [source] The impact of an ICU liaison nurse: a case study of ward nurses' perceptionsJOURNAL OF CLINICAL NURSING, Issue 6 2005Wendy Chaboyer MN Aims and objectives., To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role. Background., Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit. Design., Case study of one Australian hospital that utilizes an intensive care unit liaison nurse. Methods., Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. Findings., Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education. Conclusions., This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses. Relevance to clinical practice., Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum. [source] Agency nursing work in acute care settings: perceptions of hospital nursing managers and agency nurse providersJOURNAL OF CLINICAL NURSING, Issue 4 2003Elizabeth Manias BPHARM, FRCNA, MNursStud, MPharm Summary ,,There is a paucity of research in investigating agency nursing work from the perspectives of hospital nursing managers and agency nurse providers. ,,This exploratory paper examines the hospital nursing managers' and agency nurse providers' perceptions and experiences of agency nursing work. ,,Individual, in-depth interviews were conducted with three agency nurse providers and eight hospital nursing managers. Because of the lack of previous research in this area, an exploratory, semi-structured interviewing technique was deemed appropriate. ,,Three major themes emerged from interview data: planning for ward allocation, communication and professionalism. ,,In planning for ward allocation, hospital managers were primarily concerned with maintaining adequate numbers of nursing staff in the ward settings. A major concern for agency nurse providers was inappropriate allocation of temporary staff. ,,Communication was valued in different ways. While hospital managers focused on communication between the agency nurse and other permanent members of the health care team, agency providers were concerned with exchanges between agencies and hospital organizations, and between the agencies and agency nurses. ,,For both groups, responsibility for professional development and the status of agency nursing as a career choice for graduate and experienced nurses were the focal aspects for consideration. ,,A limitation of this study is the small number of individual interviews conducted with hospital nursing managers and agency nurse providers. Nevertheless, the findings represent the views of 11 individuals in senior managerial roles. ,,The findings reinforce the need to enhance collaboration between hospitals and nursing agencies, and to examine how divergent views of agency nursing work could be reconciled , with the aim of providing quality patient care. [source] The challenge of using the low back pain guidelines: a qualitative researchJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2007Rachel Dahan MD MClSc Abstract Purpose, Current low back pain (LBP) clinical guidelines have helped to summarize the scientific evidence and research, but have failed to provide tools and guide family physicians (FPs). The purpose of this study is to identify barriers and facilitators for the implementation of LBP guidelines from family FPs' perspective. Methods, A qualitative focus group study of FPs in the north of Israel. Purposeful sampling was used to recruit participants, all of them board-certified FPs. Four focus groups were created, and discussions were taped, transcribed and analysed for major themes. Results, Focus groups findings have expanded the understanding of the intellectual and mental challenges faced by Israeli FPs caring for LBP patients and highlighted the many obstacles to implementing LBP guidelines. Physicians' decision-making, pertaining to LBP, functions on three levels simultaneously: the physicians' agenda based on familiarity with the guidelines; their need to remain grounded in the context of the specific patient,doctor relationship; and the constraints and demands of the physician's workplace, medical system and environment. Conclusions, Despite an overall positive attitude towards LBP guideline implementation, FPs found it hard to come to terms with the conflicting dimensions of LBP patient care. The patient,doctor interaction determined the outcome of the encounter, whether it complied with the guidelines and whether the encounter leads to a healing process or to a vicious circle of unnecessary utilization of services. [source] An Educational Needs Assessment of Pennsylvania Workforce: Opportunities to Redefine Secondary Career and Technical Education to Meet Food Industry NeedsJOURNAL OF FOOD SCIENCE EDUCATION, Issue 2 2006Larry Napoleon ABSTRACT: This article describes the outcomes of a needs assessment concerning current training needs and performance targets for non-degreed employees in the food industry. Focus groups were used to gather data from 5 food-processing companies: a fresh vegetable company, a canned vegetable company, 2 snack food companies, and a meat company. Focus group participants consisted of 1 senior-level manager each from human resource, production, quality assurance, purchasing, and product development departments within each company. The needs assessment identified 4 major themes that employers indicated as beneficial knowledge and skills for employees to possess: safety training, knowledge of food and production systems, learning and applying mathematical skills, and professional conduct. The authors anticipate that the knowledge of industry needs, with respect to the desired incoming workforce competencies and knowledge, will facilitate the development of integrated curriculum modules for secondary career and technical education programs (high school grades). These integrated curriculum modules will address the growing needs of the food industry and facilitate the development of employment skills required to function and prosper in the new global economy. [source] Understanding and Responding to Patients' Requests for Assistance in DyingJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2003Judith Kennedy Schwarz Purpose: To explore how nurses experience and respond to patients' requests for assistance in dying (AID). Design and Methods: A phenomenological study of 10 self-selected nurses. Findings: Four major themes: Being Open to Hear and Hearing; Interpreting and Responding to the Meaning; Responding to Persistent Requests for AID, and Reflections. When faced with persistent requests for AID, participants provided a continuum of interventions: refusal, providing palliative care that might secondarily hasten dying, respecting and not interfering with patients' or families' plans to hasten dying, and providing varying types and degrees of direct AID. Their responses were context-driven rather than rule-mandated, and they drew a distinction between secondarily hastening and directly causing death. Conclusions: Few nurses in this study unequivocally agreed or refused to directly help a patient die. Most struggled alone and in silence to find a morally and legally acceptable way to help patients who persisted in requesting AID. Regardless of how they responded, many described feelings of conflict, guilt, and moral distress. [source] The Menopause Experience: A Woman's PerspectiveJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2002Sharon A. George PhD Objective: To understand the complexities of the experience of menopause in American women from diverse ethnic and socioeconomic backgrounds. The specific aims of this phenomenologic study were to (a) examine and interpret the reality of the menopausal transition as experienced by American women and (b) identify common elements and themes that occur as a result of the complexities of this experience. Design: Data for this qualitative study were gathered through semistructured interviews with 15 women who experienced natural menopause. Participants: A multiethnic sample of 15 menopausal American women in Massachusetts was selected from a pool of voluntary participants from the Boston area. Data Analysis: The interviews were analyzed to identify themes pertinent to the personal experience of menopause. Those themes, extracted from the similarities and differences described, represent broad aspects of these women's experiences. Results: Three major themes or phases were identified: expectations and realization, sorting things out, and a new life phase. Although some women expressed similar thoughts in particular categories, no two women had the same experience of menopause. Conclusions: The data support the premise that the experience of menopause in American women is unique to each individual and that the meaning or perspective differs among women. The data revealed the complexities of this human experience by explicating personal meanings related to experiences, expectations, attitudes, and beliefs about menopause. [source] Crossing national boundaries: A typology of qualified immigrants' career orientationsJOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 5 2010Jelena Zikic Abstract This qualitative study examines objective,subjective career interdependencies within a sample of 45 qualified immigrants (QIs) in Canada, Spain and France. The particular challenges in this type of self-initiated international careers arise from the power of institutions and local gatekeepers, the lack of recognition for QIs' foreign career capital, and the need for proactivity. Resulting from primary data analysis, we identify six major themes in QIs' subjective interpretations of objective barriers: Maintaining motivation, managing identity, developing new credentials, developing local know-how, building a new social network and evaluating career success. Secondary data analysis distinguishes three QI career orientations,embracing, adaptive and resisting orientations,with each portraying distinct patterns of motivation, identity and coping. This study extends the boundaryless career perspective by providing a more fine-grained understanding of how qualified migrants manage both physical and psychological mobility during self-initiated international career transitions. With regards to the interdependence between objective and subjective career aspects, it illustrates the importance of avoiding preference to one side at the neglect of the other, or treating the two sides as independent of one another. Practical implications are proposed for career management efforts and receiving economies. Copyright © 2010 John Wiley & Sons, Ltd. [source] A preliminary analysis of narratives on the impact of training in solution-focused therapy expressed by students having completed a 6-month training courseJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2010S. SMITH ba (hons) ba pgctlt rmn rnt fhea Accessible summary ,,Students who participated in a six month training course in SFBT reported significant changes in their relationships with clients. ,,They reported increased trust in clients as people, increased confidence in their own professional role, and increased enthusiasm for working with clients. ,,Students demonstrated an in-depth knowledge and understanding of solution focused principles and practice, enabling them to own their practice and respond creatively to individual clients. ,,It is suggested that substantive training in solution focused brief therapy may help to enhance the professional role and cultural identity of participants, particularly those from a nursing background. Abstract Solution-focused brief therapy (SFBT) is a therapeutic approach utilized in a wide variety of settings. Its roots are in systemic and family therapy, and the emphasis in practice is on helping clients identify what their life will be like when they no longer have their problem, and how close they are to experiencing that situation now. The literature suggests that SFBT is at least as effective as other forms of psychotherapy. This pilot-study explored the impact of a training course in SFBT on the nurses who took part. Interviews were carried out with participants (n= 8) and narrative accounts were analysed and grouped according to emerging themes. Three major themes were perceived; Trust in clients, Positivity and Confidence, and these were supported by interconnected minor themes relating to the eclectic use of the approach, the use of language within the approach, and the application of SFBT in wider life. It is argued that training in SFBT may have a positive impact on the therapeutic and professional role of nurses, and that further studies are required to explore the impact of SFBT training on the professional and cultural identity of nurses. [source] Supplementary prescribing: potential ways to reform hospital psychiatric careJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2006A. JONES phd rn The objective of this study was to explore perceptions held by nurses and psychiatrists towards the potential application of supplementary prescribing on acute psychiatric wards. Six focus groups were conducted with 19 nurses and seven psychiatrists who worked on three wards. Two major themes were identified: first, ways in which patients could receive care and treatment through supplementary prescribing and in new forms of partnership and second, ways by which nurses and psychiatrists could be organized to deliver their care through a supplementary prescribing framework. Nurses and psychiatrists were generally positive about the advent of prescribing and offered positive views as to how patient care could be improved and a general willingness for nurses to adapt and work differently. Findings from this exploratory study offer practical solutions to how supplementary prescribing could work on acute psychiatric wards. [source] | |||||||||||||||||||||||||||||||||||||