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Biomedical subjects

Ian Norman

Publications and source records attributed to Ian Norman.

At least 19 recordsLinked to original sources
PubMed2006

Cultural competence in nursing: new meanings.

Shortages of nurses challenge the provision of health care in developed countries including those in the European Union (EU), but there has been no upward trend in recruitment of nurses from EU countries with a surplus. A remedy is to facilitate migration of nurses around Europe. However, the importance of the concept of cultural competence has been overlooked within EU health care systems. Migrant nurses from EU countries employed in the United Kingdom indicate that they have experienced problems arising from a variety of issues related to cultural diversity. Countries such as the United Kingdom could benefit from introducing enculturation courses for migrant nurses.

Cultural Diversity↗
PubMed2006

Perceived benefits and difficulties experienced in a mutual support group for family carers of people with schizophrenia.

In this qualitative study, the authors explore from the participants' perspective the benefits and difficulties experienced by participants in a mutual support group for Chinese family carers of patients with schizophrenia in Hong Kong. Thirty family carers and 10 patients who had participated in a 12-session mutual support group were interviewed, and the 12 group sessions were audiotaped for content analysis. Three main themes emerged from the data: (a) positive personal changes attributed to group participation, which included enhanced self-identity and acceptance of the caregiving role, increased knowledge of the illness, and adoption of new coping skills; (b) positive characteristics of the mutual support group, including the explicit group ideology and consensus, perceived social climate of the group, and informational support and empowerment; and (c) major inhibitors of group development, specifically low or irregular group attendance, negative pressure from dominant members, and overexpression of intense and negative feelings. These findings contribute to our understanding of the therapeutic components and limitations of mutual support groups for family carers.

Adult↗
PubMed2006

Interprofessional education to improve pain management.

Pain is a prevalent problem in community care and there is evidence that knowledge and understanding of pain management can be lacking among health professionals, leading to under-treatment. This mini-review aimed to assess the effectiveness of interprofessional education on health professionals' pain documentation and on the pain intensity reported by patients. A search of key databases identified two randomized controlled trials and two quasi-experimental studies. Two studies assessed change in pain documentation following interprofessional education; one revealed a statistically significant improvement and another indicated 29% increase in documentation of pain assessments. Two studies demonstrated no significant changes in patient outcomes, while the other revealed significant improvements. However, integration of the results was not possible because of the various methods of measurement used by the different researchers. Although broadly supportive of interprofessional education, the evidence is not helpful in determining the best way of improving pain management in the community.

Attitude to Health↗
PubMed2005

Quality assurance in UK nursing education: public protection in the era of streamlined assessment.

This paper describes recent reforms of quality assurance (QA) for the education of nurses, midwives and health visitors and reports qualitative findings from a study of how they are working out in practice. This study reported whether the stakeholders consider the system to be adequate for the principal aim of public protection. Using a postal survey and interviews, QA in nursing, midwifery and health visiting is compared and contrasted in the four countries of the United Kingdom. Issues of subjectivity versus objectivity in decision making over QA of nursing, midwifery and health visiting education and the extent to which these processes are rigorous arose. There is an inverse relationship between the number of higher education institutions in a country and the extent to which nursing, midwifery and health visiting QA personnel, responsible for conducting QA events, become involved with those institutions in offering advice and support. Generally speaking, where the changes have been greatest, satisfaction with the QA processes is lowest. Dissatisfaction was only expressed with processes and most likely arose from resistance to change but these are early days in the operation of the new QA procedures.

Consumer Behavior↗
PubMed2005

Competence in nursing practice: a controversial concept--a focused review of literature.

The competency-based approach to education, training and assessment has surfaced as a key policy in industrialised nations. Following the transition of nurse preparation to the higher education sector the need to attenuate the tension of interests between employer and educator arose. While the competency-based approach has the potential to fulfil this, the application of competence to nursing is controversial and little consensus exists on definition. This paper synthesises a significant volume of literature relating to the acceptability and definition of the concept of competence with regard to nursing practice. Subsequent to a focused review of literature, problems inherent to the definition and utilisation of the concept of nursing competence are discussed. Because nursing requires complex combinations of knowledge, performance, skills and attitudes, a holistic definition of competence needs to be agreed upon and operationalised. This could facilitate greater acceptance of the concept and also underpin the development of competency standards and the tools required for the assessment of such.

Clinical Competence↗
PubMed2005

A randomised controlled trial comparing low dose vaginal misoprostol and dinoprostone vaginal gel for inducing labour at term.

OBJECTIVE: To compare the efficacy of low dose vaginal misoprostol and dinoprostone vaginal gel for induction of labour at term. DESIGN: A single-blind randomised controlled trial. SETTING: Antenatal and labour ward of a UK district general hospital. PARTICIPANTS: Two hundred and sixty-eight women requiring induction of labour at term (>37 weeks of gestation) with no significant fetal or medical condition, no previous uterine surgery and no contraindication to prostaglandin. METHODS: Misoprostol 25 microg (one-quarter of a 100 microg tablet) was inserted into the posterior vaginal fornix every 4 hours (to a maximum of six doses) or dinoprostone vaginal gel 1-2 mg 6 hourly (maximum of 3 mg in 24 hours). MAIN OUTCOME MEASURE: Induction-to-vaginal delivery interval. SECONDARY OUTCOME MEASURES: Requirements for oxytocin, mode of delivery, number of women delivering < 24 hours, incidence of uterine contraction abnormalities, incidence of abnormal cardiotocograph (CTG) recordings, 5-minute Apgar scores, umbilical cord pH recordings, analgesia requirements, admission to NICU and blood loss at delivery. RESULTS: There were no significant differences between the two groups in induction-to-vaginal delivery interval, mode of delivery, number of women delivering within 24 hours and neonatal outcomes. The incidence of uterine contraction abnormalities (tachysystole and hyperstimulation) and the incidence of abnormal CTG recordings were also similar for both groups. CONCLUSION: Low dose vaginal misoprostol is as effective as dinoprostone gel for inducing labour at term. There would be substantial cost savings, estimated at around 3.9 million UK pounds per annum, for maternity services if low dose misoprostol became the agent of choice for inducing labour in the UK.

Administration, Intravaginal↗
PubMed2004

Barriers to research utilisation among forensic mental health nurses.

This study used a cross-sectional, descriptive design to identify barriers to research utilisation among forensic mental health nurses. A postal questionnaire was sent to the total population of 88 registered nurses working in a forensic mental health hospital in the UK. Forty-seven responded representing a response rate of 53%. Results showed that the greatest barriers to research utilisation were those related to the characteristics of the setting in which nurses work or the personal characteristics of nurses themselves, which seems to be consistent with previous studies undertaken in the area. However, the nurses reported it especially difficult to trust what research shows because they feel that it is not always possible to apply those findings to their particular work environment. The main implications for policy are a need for an increase in support from management, programmes of advanced education to provide nurses with research skills, an improvement in accessibility and availability of research reports and an increase in time available to read and implement research. The main suggestions for future research are that qualitative studies should be carried out to attain a better understanding of mental health nurses' attitudes towards research utilisation.

Adult↗
PubMed2004

A randomized controlled trial of a mutual support group for family caregivers of patients with schizophrenia.

This randomized controlled trial examined the effectiveness of a 12-session mutual support group conducted over 3-months for Chinese family caregivers of a relative with schizophrenia compared with routine family support services in Hong Kong. Forty-eight family caregivers from two psychiatric outpatient clinics were allocated randomly to an experimental (mutual support and usual outpatient care) group (n = 24) or a control (usual outpatient care only) group (n = 24). Data were collected prior to, 1 week and 3 months after the intervention. Families allocated to the mutual support group experienced decreased levels of family burden and increased family functioning and these changes were significantly greater than those of the controls at both post-intervention time points. The experimental group also showed a significant decrease in the duration of patient re-hospitalization (the total number of days of psychiatric hospitalization) at 3 months compared with the control group. This suggests that the mutual support group provided a more responsive service for patients than standard care. However, there was no significant difference in family service utilization between the two groups. The findings indicate that a mutual support group can provide benefits for family caregivers of people with schizophrenia that go beyond those provided by routine family support.

Adult↗
PubMed2004

NHS cadet schemes: student experience, commitment, job satisfaction and job stress.

In the context of various policy initiatives concerning widening access to and strengthening recruitment and retention in the health services, cadet schemes--predominantly in nursing--have proliferated over the last few years. As part of a larger national evaluation of National Health Service (NHS) cadet schemes, this paper reports on a survey of senior cadet students across 62 cadet schemes in England and examines their experience of being a cadet on such a scheme. Cadets forming the most senior cohort from each of the 62 schemes (n = 596) were surveyed using a questionnaire. The questionnaire included self-rated measures of job satisfaction, job stress and commitment. A 5% sample of these cadets participated in follow-up telephone interviews. Cadets reported high satisfaction with their courses. One of the most positive aspects of the schemes was the first-hand experience of working in the NHS they provided, whilst also giving cadets the opportunity to gain recognisable skills and qualifications. Cadets scored highly on the job satisfaction scale and, on the job stress scale, showed low stress overall. A significant positive correlation was found between satisfaction and stress, indicating that the cadets who are most satisfied are also more highly stressed. A negative correlation was found between stress and the dimensions of commitment indicating that those cadets who are stressed are less committed to the NHS. A negative correlation was also found between satisfaction and the dimensions of commitment, suggesting that commitment to the NHS is not contingent on high satisfaction. The implications for the findings of the survey are discussed.

Adolescent↗
PubMed2003

Educational needs of families caring for Chinese patients with schizophrenia.

BACKGROUND: Schizophrenia is a disruptive and distressing illness for patients and family members who care for them. As in Western countries more than 20% of people with schizophrenia in Hong Kong are discharged to their homes, but their families are unprepared to care for them. Studies of caregivers' opinions about the information required to supervise patients are limited, particularly for the purposes of optimizing family-centred care. AIM: The aim of this study was to identify the educational needs of Chinese families caring for a relative with schizophrenia. METHODS: A cross-sectional survey was conducted in Hong Kong with a random sample of 204 family members caring for a relative with schizophrenia. A Chinese version of the Modified Educational Needs Questionnaire, validated in a previous study, was used to identify educational needs that family caregivers considered important in caring for mentally ill relatives. FINDINGS: Educational needs perceived as important by caregivers included gaining information about early warning signs of illness and relapse, effects of medication and ways of coping with patients' bizarre and assaulting behaviour. Gender, education level and closeness of the relationship with the patient correlated positively and significantly with need importance. Conversely, the relationship between duration of caring for patient and need importance correlated significantly but negatively, indicating the adverse effect of enduring mental illness on family caregivers' interest in mental health education. CONCLUSION: This study emphasizes the importance of assessing specific family needs in caring for a relative with mental illness. It also raises concern about the negative effects of the length of time of caring for such patients and the role of socio-economic factors on the perceived educational needs of these families.

Adult↗
PubMed2003

Evaluating change in health care practice: lessons from three studies.

Implementation and evaluation of evidence-based practice are high on the policy agenda in the UK National Health Service. Over the last 30 years evaluation of practice in the health services has moved from a (medical) profession-led mode to a politically and managerially led mode in which objectives are pre-set by those who legitimate and fund the services. Against this background we describe three recent evaluations of nursing practice as examples to illustrate challenges encountered when evaluating changes in practice developments in health care. If evaluations are to contribute to improvements in practice, a shift is needed from an over-reliance on one-off outcome evaluations to those that have a cumulative component and take account of context and process as well as outcome. The merits of realistic evaluation are suggested as a solution to the methodological limitations of traditional approaches and to developing generalizable theory.

Clinical Competence↗
PubMed2003

Interprofessional perceptions of health care students.

Effective interprofessional working, which is widely considered as essential to high-quality health care, is influenced by the attitudes of health care professionals towards their own and other professional groups. Relatively little is known, however, about interprofessional attitudes, particularly of students in health care professions. This study aimed to increase our understanding of students' attitudes towards their own and other professional groups on entry to a programme of professional education. Hypothesised relationships between stereotypes, professional identity and readiness for professional learning were tested by means of a questionnaire survey of 933 undergraduate health care students drawn from five health care groups (medicine, nursing, dietetics, pharmacy and physiotherapy) within a multi-faculty UK university. Positive statistically significant correlations were found between stereotypes, professional identity and readiness for interprofessional learning. As predicted, students identified strongly with their own professional group at the start of pre-registration education. They were also willing to engage in interprofessional learning. More unexpected was the positive association found between heterostereotype and professional identity scores. There are potential benefits of introducing active interprofessional education activities at an early stage of professional preparation to capitalise on students' positive attitudes towards their own and other professional groups.

Attitude of Health Personnel↗