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Biomedical subjects

Cecily M Begley

Publications and source records attributed to Cecily M Begley.

11 recordsLinked to original sources
PubMed2004

'Add women & stir'--the biomedical approach to cardiac research!

In conditions shared by women and men, the biomedical model of disease assumes that illness-symptoms and outcomes are biologically and socially 'neutral'. Consequently, up until a decade ago, white middle-aged men were the model subjects in most funded cardiac trials, with the assumption that whatever the findings, the results would also hold true for women. This 'add women and stir' approach has resulted in imbalances in cardiac care and an image of coronary artery disease, which portrays a middle-aged male as its victim. Moreover, cardiac health care has been designed with the male anatomy and male experience of illness in mind, and health promotional measures have been targeted towards men. Women have received these health promotional messages to protect the hearts of men, and have been less likely to modify their own lifestyles in a cardio-protective manner. However, the biological and social differences that exist between women and men, must surely invalidate such biased biomedical assertions, and signify a need to delve beyond the realm of biomedical reductionism for greater insights and understanding. This review examines how scientific reductionism has failed to explore the impact of coronary artery disease on the lives of women and how the gendered image of this disease has privileged the normative frame.

Attitude to Health↗
PubMed2004

Irish nursing students' changing levels of assertiveness during their pre-registration programme.

BACKGROUND: Stress and bullying have been found to be common problems in a number of studies of Irish nursing and midwifery. Victims of bullying need high levels of assertiveness to enable them to withstand the stress of victimization. It was deemed important to measure nursing students' level of assertiveness prior to, and near completion of, their pre-registration education programme. Aim. To ascertain nursing students' perceived levels of assertiveness prior to, and nearing the completion of, their three-year pre-registration programme. METHODS: Ethical approval was given. The students commencing general nurse education programmes in two schools in Southern Ireland agreed to take part (n=72). A questionnaire adapted from a number of assertiveness scales, and tested for validity and reliability in this population, was used to collect data. RESULTS: In general, students' reported assertiveness levels rose as they approached completion of their three-year education programme. DISCUSSION: The resource constrained health service of the 21st century requires nurses who are assertive to meet the needs of its users. Nursing students' assertiveness skills could be augmented through concentrated efforts from nurse educationalists and clinicians to reduce the communication theory practice gap in nurse education today. To address the multi-dimensional nature of assertiveness, strategies to increase assertiveness should operate at the individual, interface and organisational level. CONCLUSIONS: The students in this study reported an increase in levels of assertiveness as they approached completion of their three-year education programme. To function as effective, safe practitioners registered nurses need to be assertive, therefore education in assertiveness should be an integral part of their preparation. The precise composition and mode of delivery of this education requires exploration and evaluation.

Adolescent↗
PubMed2004

How many do I need? Basic principles of sample size estimation.

BACKGROUND: In conducting randomized trials, formal estimations of sample size are required to ensure that the probability of missing an important difference is small, to reduce unnecessary cost and to reduce wastage. Nevertheless, this aspect of research design often causes confusion for the novice researcher. AIM: This paper attempts to demystify the process of sample size estimation by explaining some of the basic concepts and issues to consider in determining appropriate sample sizes. METHOD: Using a hypothetical two group, randomized trial as an example, we examine each of the basic issues that require consideration in estimating appropriate sample sizes. Issues discussed include: the ethics of randomized trials, the randomized trial, the null hypothesis, effect size, probability, significance level and type I error, and power and type II error. The paper concludes with examples of sample size estimations with varying effect size, power and alpha levels. CONCLUSION: Health care researchers should carefully consider each of the aspects inherent in sample size estimations. Such consideration is essential if care is to be based on sound evidence, which has been collected with due consideration of resource use, clinically important differences and the need to avoid, as far as possible, types I and II errors. If the techniques they employ are not appropriate, researchers run the risk of misinterpreting findings due to inappropriate, unrepresentative and biased samples.

Data Interpretation, Statistical↗
PubMed2004

Methodological rigour within a qualitative framework.

AIM: This paper discusses the literature on establishing rigour in research studies. It describes the methodological trinity of reliability, validity and generalization and explores some of the issues relating to establishing rigour in naturalistic inquiry. BACKGROUND: Those working within the naturalistic paradigm have questioned the issue of using validity, reliability and generalizability to demonstrate robustness of qualitative research. Triangulation has been used to demonstrate confirmability and completeness and has been one means of ensuring acceptability across paradigms. Emerging criteria such as goodness and trustworthiness can be used to evaluate the robustness of naturalistic inquiry. DISCUSSION: It is argued that the transference of terms across paradigms is inappropriate; however, if we reject the concepts of validity and reliability, we reject the concept of rigour. Rejection of rigour undermines acceptance of qualitative research as a systematic process that can contribute to the advancement of knowledge. Emerging criteria for demonstrating robustness in qualitative inquiry, such as authenticity, trustworthiness and goodness, need to be considered. Goodness, when not seen as a separate construct but as an integral and embedded component of the research process, should be useful in assuring quality of the entire study. Triangulation is a tried and tested means of offering completeness, particularly in mixed-method research. When multiple types of triangulation are used appropriately as the 'triangulation state of mind', they approach the concept of crystallization, which allows for infinite variety of angles of approach. CONCLUSION: Qualitative researchers need to be explicit about how and why they choose specific legitimizing criteria in ensuring the robustness of their inquiries. A shift from a position of fundamentalism to a more pluralistic approach as a means of legitimizing naturalistic inquiry is advocated.

Humans↗
PubMed2003

Irish nursing students' changing self-esteem and fear of negative evaluation during their preregistration programme.

BACKGROUND: Studies on Irish nursing and midwifery professions have demonstrated that stress and bullying are frequent problems that may lead to depression and low self-esteem. Self-esteem is linked to social anxiety and is therefore related to fear of negative evaluation. It is important to study nursing students' feelings about self-esteem and negative evaluation, and to assess whether or not both these constructs change as students progress through their preregistration education programme. AIM: This study explored nursing students' perceived levels of self-esteem and their fear of negative evaluation prior to, and nearing the completion of, their 3-year preregistration programme. METHODS: A descriptive, quantitative, comparative survey design was used. All students in the first intake of 1995 in two general nursing schools in Southern Ireland agreed to take part (n = 72). A questionnaire developed from the Rosenberg Self-esteem Scale and the Watson and Friend Fear of Negative Evaluation Scale was used to collect data at the start of their programme and again 2 months before completion. RESULTS: In general, students' reported self-esteem rose as they neared the end of their education programme and their fear of negative evaluation decreased; however, their overall self-esteem levels at their highest were only average. CONCLUSIONS: Many of the studies examining self-esteem have produced contradictory results. An examination of the organizational factors that contribute to self-esteem may increase our understanding of the phenomenon. Self-esteem is a complex, multifaceted phenomenon. While there is no single factor that can increase or decrease a person's self-esteem, this study has explored the potential impact of the fear of negative evaluation on self-esteem. Nursing students' self-esteem might be increased by expansion of intrinsic job characteristics, improving their job satisfaction and providing frequent positive feedback.

Adaptation, Psychological↗
PubMed2002

'Great fleas have little fleas': Irish student midwives' views of the hierarchy in midwifery.

BACKGROUND: Many studies have investigated the world of the student nurse, but there is little work into the lives and experiences of student midwives. Studies of Irish midwives' provision of care have demonstrated that they are not fulfilling their complete role, and research into their education was deemed to be necessary. AIM: To explore the opinions, feelings and views of student midwives as they progressed through their 2-year education programme in Ireland. METHODS: Both quantitative and qualitative methods were used and the qualitative sections of the study were guided by the phenomenological approach. Ethical approval was granted. All students in the first intake of 1995 in all seven midwifery schools in Southern Ireland agreed to take part (n=125). Individual and group interviews, diary-keeping and questionnaires collected data. RESULTS: The findings presented in this paper describe the students' views of the hierarchical structures in midwifery, and the role and behaviours of the 'Matron'. The data describes a subculture of nursing/midwifery subordination. DISCUSSION: One reason for the hierarchical nature of the midwifery profession may be because it is an almost totally female-dominated profession, with the female hierarchy exercising control over other women within a male-based power structure. Many hospitals preferred to employ their own students as staff, ensuring a continuation of the hierarchical regime. CONCLUSION: The recurring nature of this problem may be because midwives now fear change more than they desire it. Further research is required to ascertain whether the reason for the strong hierarchy is because of the continuation of midwifery from the male-dominated profession of nursing, to the existence of the industrial/economic model of maternity care or to the impact of the medicalization of childbirth.

Attitude of Health Personnel↗
PubMed2002

Irish diploma in nursing students' first clinical allocation: the views of nurse managers.

AIM OF THE STUDY: To ascertain the views held by some Irish general nurse managers of the Diploma in Nursing students' first clinical allocation. RATIONALE: Until 1994, nurses in Ireland were trained under a 3-year apprenticeship system and were employed throughout their clinical experience. In March 1997, the first intake of Diploma in Nursing students into one Dublin university were scheduled to commence their clinical placements. As this was the first time that supernumerary students were to be placed in the clinical areas, it was important to discover how effective the whole process was in terms of nurse managers' experiences. RESEARCH METHODS: A grounded-theory approach, using unstructured interviews, explored Irish nurse managers' views of the impact of supernumerary students in the workplace. Ethical approval was granted. All available nurse managers in three general teaching hospitals linked with the university agreed to take part (n = 10). RESULTS: Three themes emerged from the data, entitled 'Structure', 'Students' and 'Support'. In general, the managers believed that staff had had sufficient preparation for this change and that the whole process had been well handled. The respondents were pleasantly surprised by the students' abilities and interest in nursing. Minor problems were dealt with successfully at the local level and the support received by the students was found to be excellent. DISCUSSION: Preconceptions of the students as more intellectual and less able for practical nursing were found to be untenable. The students' presence was welcomed and their questioning attitude, enthusiasm and application of knowledge was praised. Strong clinical support was required and students benefited from giving care, rather than just observing care given. CONCLUSION: It is recommended that supernumerary students should be encouraged to give full care under supervision, in order to learn and to become proficient in all clinical skills. The next phase of change, transition to degree status for students from 2002, will benefit from lessons learned in the past 7 years since transition from certificate to diploma education.

Clinical Competence↗
PubMedDate not supplied

Hypersexuality and dementia: dealing with inappropriate sexual expression.

Sexuality is always a difficult and challenging issue for nurses to address with older patients. This is particularly the case in relation to responding to incidents of hypersexuality or inappropriate sexual expression as a result of dementia. Although research suggests that hypersexuality is a rare occurrence, when it happens it has the potential to jeopardize the quality of life of all concerned. The focus of this article is on exploring the literature on hypersexuality in people with dementia in the residential care setting. Information and principles of care are offered that may help nurses respond in a sensitive manner that protects the rights, dignity and autonomy of all concerned.

Adaptation, Psychological↗