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Biomedical subjects

A Farrington

Publications and source records attributed to A Farrington.

At least 19 recordsLinked to original sources
PubMed1998

Mental health services--maintaining strategic direction.

UNLABELLED: AIM AND KEY ISSUES: This article reviews the theoretical basis of strategic management in an attempt to provide managers with a better understanding of the underpinning concepts and consequent actions they need to take to avoid loss of control and ultimate failure. BACKGROUND: The authors argue that community care for the severely mentally ill is failing and that in part the reason for this perceived failure is a closer allegiance to primary care that has shifted the focus away from mental illness. Such a shift, coupled with poor management and a desire by Community Mental Health Nurses (CMHNs) to retain a broad focus and maintain the 'autonomy' they gain when not held in the gravitational grasp of Consultant Psychiatrists, has resulted in strategic drift. The authors suggest 10 possible reasons to explain why CMHNs currently fail to meet the needs of the severely mentally ill. Among these are a lack of explicit strategic implementation plans, professional ambivalence and self-interest, poor management of resources and conflicting demands from key interest groups. CONCLUSION: It seems that mental health services in this country have reached the point where resistance to change should be crumbling in the face of perceived failure to deliver the required services. Whilst it could be argued that a major and potent source of internal change is performance gaps, few things force change more than sudden and unexpected information about poor organizational performance.

Community Health Nursing↗
PubMed1994

Cancer, emotional responses and cognitive behavioural psychotherapy.

Cancer and its treatment is known to have a substantial psychological morbidity and, while adjuvant psychological therapy (APT) is well established, relatively little work has been done to investigate the effectiveness of psychotherapy, particularly cognitive behaviour therapy (CBT), for patients with cancer. This article focuses initially on emotional responses to the diagnosis of cancer, individual vulnerability and the prevalence of psychological problems in patients with cancer. The use of cognitive behaviour therapy is then described, together with key issues in its application and specific problems. The work concludes by considering differences in applying CBT to patients with cancer compared to patients with other physical illnesses and the notion of 'relapse inoculation'.

Adaptation, Psychological↗
PubMed1994

The fourth paradigm: a new model of leadership for managing nurse education.

Over 20 years ago Toffler suggested that 'tomorrow's individual will have to cope with even more hectic change than we do today' and that for education the lesson is clear, 'its prime objective must be to increase the individuals 'copeability'--the speed and economy with which he/she can adapt to continual change and the faster the rate of change, the more attention must be devoted to discerning the pattern of future events' (Toffler 1970). Knowledge and understanding about what produces change in education is often unclear, however, many theories exist to account for change, which has been described as 'the most recalcitrant subject in the social sciences' (Clark 1983). This work considers change and process and includes types of change, the process and management of change, and models of organization. The integration of colleges of nursing into higher education and university departments is then discussed before the article concludes, by putting forward a new model of leadership for nurse education--the fourth paradigm.

Adaptation, Psychological↗
PubMedDate not supplied

Transcultural psychiatry, ethnic minorities and marginalization.

Cultural and racial bias has been woven into the fabric of Western psychiatry in its historic development. Western psychiatry emphasizes the medical model as being fundamental to the discipline. Many communities in large cities and industrial areas have become multicultural and multiracial. Culture-bound syndromes are not specific to non-Western ethnic minorities. Black people are overrepresented among psychiatric patients in institutions. Mental health services for ethnic minorities have been haphazard and inconsistent. Cultural experiences and the practical realities of racism are overdue their recognition.

Cross-Cultural Comparison↗
PubMedDate not supplied

Intuition and expert clinical practice in nursing.

The quest for the essence of nursing in the UK continues unabated. Similarly, the concept of what constitutes expert clinical practice and the problem of how it can be achieved are topical issues. This article considers the notion of a developmental process in nursing and the concept of reflective practice, and examines the idea of intuition as a key component in the functioning of the expert nurse.

Clinical Competence↗
PubMedDate not supplied

Stress and nursing.

This article looks at definitions and models of stress and examines sources of stress in nursing and the assessment and measurement of stress factors.

Absenteeism↗
PubMedDate not supplied

Shared governance: developing a British model.

This article will examine the concept of shared governance and describe the development of a model for a British NHS trust. The philosophy of shared governance will be related to a decentralised style of management and the consequences that this will have for managers and staff nurses. The introduction of shared governance in the USA has realised many benefits. However, limitations have also been illustrated and these will be discussed in relation to the proposed model for Leicester General Hospital.

Decision Making, Organizational↗
PubMedDate not supplied

Models of clinical supervision.

This article describes several schools of practice in relation to clinical supervision and discusses models of supervision, particularly an integrative approach to clinical supervision in mental health practice. While it is recognised that clinical supervision is more likely to occur in mental health nursing, the article concludes by suggesting a broader application of the underlying principles described.

Humans↗
PubMedDate not supplied

Suicide and psychological debriefing.

The death of a patient by suicide is one of many upsetting experiences that nurses face. However, psychological debriefing after such an event is not commonly available.

Attitude of Health Personnel↗
PubMedDate not supplied

The failure of community care for the severely mentally ill.

For the past 10 years or more there has been an ongoing debate about community mental health (CMH) nursing. It is clearly important in any discourse about CMH nursing to begin by examining where this branch of nursing is at present, i.e. what route it has taken, as well as considering where it is destined to travel. The views expressed in this article are supported by a literature review undertaken as part of a research study into CMH nursing. The first and quantitative stage, which was completed in late 1995, and the second qualitative part of the study has now reached the data analysis stage. The preliminary findings from this study are discussed in this article.

Community Health Nursing↗
PubMedDate not supplied

Strategies for reducing stress and burnout in nursing.

Three models of stress-the stimulus model, the response model and the cognitive-phenomenological-transactional (CPT) model-have been described in detail elsewhere (Farrington, 1995), and the notion of accepting occupational stress as an industrial disease has been suggested (Nursing Times, 1995). This article focuses on the nursing experience of stress and describes strategies for reducing stress and burnout on a personal and organizational level. It concludes by presenting a small-scale research study which examined the nature and impact of events perceived by postregistration nurses to cause personal psychological distress. The findings of the research show that certain stimuli are consistently perceived as being psychologically traumatizing in the daily working life of the student nurse. Nursing clearly remains an emotionally demanding occupation and more work is needed to examine the way in which events and microstressors are cognitively processed by nurses.

Adaptation, Psychological↗