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Biomedical subjects

J R Boore

Publications and source records attributed to J R Boore.

At least 19 recordsLinked to original sources

The health behaviours of Chinese people with chronic illness.

This study was undertaken to elucidate the type and range of health-promoting behaviours that Chinese people with chronic illness perform to enhance their health. Eight people with a diagnosed chronic illness were interviewed using a semi-structured interview schedule. From the perspectives of these subjects, health behaviour comprises three dimensions: physical, psychosocial and spiritual. The results of this study clarify health behaviours amongst Chinese people with a chronic illness and illustrate the important influence that culture has upon such activity. Additionally, exploring the health behaviours of these Chinese people can be used to inform and enable nurses to adjust their practices to relate more appropriately to patients' perspectives.

Adaptation, Psychological↗

The evolving concept of health in nursing research: 1988-1998.

This article concerns the evolution of the concept of health, as reported in selected nursing journals, over the last 10 years. It builds on an analysis reported by Reynolds [Reynolds CL. The measurement of health in nursing research. Adv Nurs Sci 1988;10(4):23-31.] who initially investigated the concept of health and the means by which it was measured during the period 1977-1987. Using the same journals as Reynolds, the methodology of systematic review is used to analyse the way in which health is defined, the frequency with which it is investigated and the means by which it is measured, and these data are compared with Reynolds findings. The results indicate that; three times as many studies have been conducted in the last 10 years, a more holistic concept of health has emerged, and the instruments used are becoming more sophisticated. These findings are discussed and the implications for patient education and health care professionals considered.

Chronic Disease↗

Exploring caring using narrative methodology: an analysis of the approach.

The investigation of caring in nursing practice and the need to explicate what it is nurses do when they care present a challenge for nurse researchers. This is due largely to the complex and nebulous nature of caring as a concept and the contextual elements that influence its perceived meaning. Consequently, the use of qualitative methods in the exploration of caring is the method of choice, with researchers employing a variety of such approaches. In particular, the use of stories as a primary way of making sense of an experience has gained attention in the literature and the narrative method is being seen increasingly as a valid means of tapping into the patient experience. However, the use of narratives is complex with a diversity of approaches often being presented. This paper discusses the use of narratives in the exploration of caring, focusing specifically on an approach developed by Donald Polkinghorne. Issues associated with the collection and analysis of narrative data using this approach are examined.

Data Collection↗

Development and definition of the role of the operating department nurse: a review.

In the current cost-conscious National Health Service (NHS), the role of the nurse during anaesthesia and surgery is one that has interested health service managers keen to know what happens behind the closed doors of the operating department. It is clear that if nurses working within this specialized setting are to secure a future in providing care for surgical patients, then it is important to clarify and articulate exactly what it is that their role involves. The aim of this paper is to examine the role of the operating department nurse. First, it will illustrate how the role of the nurse has evolved alongside medical and technical advances in surgery, particularly in the last century. Second, it will highlight that while definition of the role has received attention in the North American literature, references in the British literature as to what it is that operating department nurses do, are scant. Finally, it will address the evolving role of the contemporary perioperative nurse highlighting the changes and challenges that nurses who work within this setting are currently facing. It is suggested here that nurses need to engage in role definition in order to be clear about their direction for the future, particularly within the fast changing, technologically driven environment of the operating department.

Forecasting↗

Fatigue in persons with renal failure who require maintenance haemodialysis.

Fatigue is a highly prevalent symptom experienced by persons who live with chronic illness, including those with renal failure who require maintenance haemodialysis. Fatigue, however, is a non-specific and invisible symptom and is a phenomenon that is poorly understood by health care professionals. This study examined the symptom of fatigue as experienced by a group of 39 adult haemodialysis patients. The theory of unpleasant symptoms formed the conceptual framework for the study. A descriptive correlational design was utilized to examine fatigue from an inductive approach, considering relevant physiological, psychological and situational variables based on a review of the literature. Data were collected using a structured self-report questionnaire and biochemical data from retrospective monthly blood tests. The results of the study indicated that high levels of fatigue are experienced, with correspondingly low levels of vitality, in all the areas measured - general fatigue, physical fatigue, reduced motivation, reduced activity and mental fatigue, by adult haemodialysis patients. Individual variation was noted in the dimensions of fatigue predominantly expressed. Fatigue was significantly associated with the presence of symptoms such as sleep problems, poor physical health status and depression. No associations between fatigue and the biochemical and situational variables measured were noted. Further examination of the data revealed complex relationships between the physiological and psychological factors examined. Depression was significantly associated with physical health status, sleep problems, symptoms and anxiety. Correlations were also noted between symptoms and poor physical functioning, sleep problems and depression. Based on the results, a revised version of the theory of unpleasant symptoms relating to fatigue is presented.

Activities of Daily Living↗

Exploratory study of nursing in an operating department: preliminary findings on the role of the nurse.

This study was exploratory and describes how nursing was viewed and practised by nurses who worked in an operating department. It also highlighted factors that might influence the role performance of operating department nurses. The research involved interviews with a sample of 6 nurses working in an operating department, observation of 32 hours of nursing work over 6 operating sessions, in addition to the analysis of various documents, including the nursing care plans of 22 patients. Data were triangulated and analysed by constant comparison. Findings indicated that nurses had difficulty in articulating exactly what it was that operating department nursing entailed, but rather viewed their role in terms of the functions they performed. Observations indicated that the nursing role was primarily orientated toward the physical rather than the psychological aspects of care-giving. Furthermore, it appeared that the medical profession, nursing philosophy/leadership and the characteristics of patients all influenced the manner in which nurses enacted their role. These findings suggest that further research into the role of the nurse within the operating department environment is warranted. Key factors from this study were developed into a framework suitable for guiding future study of the nursing role in this environment.

Anthropology, Cultural↗

Caring: theoretical perspectives of relevance to nursing.

Caring as a central concept within nursing has led to the development of several caring theories, the most well known being Madeleine Leininger's Theory of Culture Care and Jean Watson's Theory of Human Caring, both of which were formulated in the 1970s. This paper explores a total of four caring theories: the two established theories presented by Leininger and Watson, Simone Roach's theory developed in the 1980s, and a recent caring theory developed by Boykin & Schoenhofer. A comparison of these theories is presented drawing on a number of criteria, namely: origin of theory, scope of theory, definition of caring, description of nursing, key concepts of the theory, and goal/outcome. Additionally, simplicity as a central component of internal structure is examined in relation to each. Based on this analysis, similarities and differences are highlighted, concluding with a discussion of the utility of the caring theories within nursing practice.

Clinical Competence↗

Collecting data in the operating department: issues in observational methodology.

The UK literature contains few references to nursing in the operating department and even fewer to methods for researching nursing in what is often a complex and stressful environment. Nursing staff work under intense pressure and this presents a challenge, not only for nurses who work in the operating department, but also for researchers who choose to study nursing within its bounds. This paper focuses on some of the key issues which emerged during one study of nursing in the operating department where an observational methodology was used. The author suggests that observation, as a research method, is an important feature of contextual investigation. However, like other methods of investigation, it requires careful planning and preparation. Furthermore, the author believes that sensitivity and skill are required for the enactment of the observer role when researching nursing within this specialized environment.

Data Collection↗

The influence of psychological factors on the self-management of insulin-dependent diabetes mellitus.

This study investigated the influence of a number of psychological factors upon the practice and outcome of diabetic self-management among young adults with insulin-dependent diabetes mellitus. Health beliefs, perception of control and knowledge were assessed by scales and questionnaires and glycosylated haemoglobin results and clinic attendance records obtained for 263 patients. The results demonstrated that the sample members perceived that they were responsible for the control of their diabetes, that the benefits of following treatment were greater than any barriers and that they were knowledgeable about their diabetes. However, these factors were not predictive of the outcome variables of metabolic control or clinic attendance according to multiple regression analysis. Implications of these results for nursing practice and for future research are discussed.

Adolescent↗

Caring: dealing with a difficult concept.

The concept of caring is the focus of this paper, in which an attempt is made to clarify the meaning of caring in nursing using one method of concept analysis. The decision to complete an analysis on caring was made following a substantial review of the literature, from which a concise definition of the concept remained elusive. Concept analysis as described by Walker and Avant (1995) is utilised and this paper demonstrates the various steps involved in this approach.

Adult↗

Knowledge and diabetes self-management.

This paper discusses the role of knowledge in the self-management of diabetes mellitus and addresses limitations in the measurement of knowledge in studies which have been undertaken. In addition, the findings of a recent investigation related to knowledge of diabetes in young adults with the condition are reported. The results showed high levels of knowledge and glycosylated haemoglobin values which were acceptable when length of time with diabetes was considered. However, no relationship between knowledge and level of glycaemic control was demonstrated. In the light of recent research confirming the need for tighter metabolic control, the implications of these findings in relation to future research and the education of health care professionals are considered. Although this paper related to diabetes mellitus many of the issues raised are equally applicable to the wider forum of chronic illness management.

Adolescent↗

Postgraduate education in nursing: a case study.

This paper describes the integrated postgraduate programmed recently introduced by the University of Ulster which includes the first Doctor of Nursing Science (DNSc) programme in Europe. It has three exist points: with a Postgraduate Diploma in Advanced Nursing or Midwifery, a Master of Science in Advanced Nursing or Midwifery or the DNSc. It aims to develop nurses who have the necessary knowledge and skills to function as advanced practitioners and, concurrently, to prepare nurses able to undertake high quality research which will contribute to the knowledge and theoretical base of nursing. Some of the issues which influenced the planning are discussed and demographic characteristics, expectations of the course, and comments of the first two cohorts of students are presented. Anticipated benefits for nursing knowledge and practice as well as potential difficulties with such a programmed are identified.

Adult↗

The evaluation of a nursing model for long-stay psychiatric patient care. Part 2--Presentation and discussion of findings.

A nursing model selected by a population of ward managers was implemented on a long-stay psychiatric ward in Northern Ireland using an adapted action research approach within a quasi-experimental design. A range of dependent variables were appraised at one pre-test and two post-test evaluation points on an experimental (Ward X) and a control ward (Ward Y). A thorough review of the literature and methods used can be found in Part 1 (McKenna et al., 1995, Int. J. Nurs. Stud., 32, 79-94). The findings and their interpretations are presented here. Results indicate that on the experimental ward there were statistically significant improvements in "Psychiatric Monitor", patients' and staff's perception of ward atmosphere, patient satisfaction, staff's views about nursing models, and patient dependency levels. No significant changes were noted in nurse satisfaction levels nor nurses' perception of patients' behaviour. Particular emphasis is placed on the possible threats to the internal and external reliability of these findings and on the attempts made to control these threats.

Attitude↗

The evaluation of a nursing model for long-stay psychiatric patient care. Part 1--Literature review and methodology.

A modified action research approach was used to implement a selected nursing model on a long-stay psychiatric ward. Within a broader quasi-experimental design, specific quality of care indicators were appraised before and after the implementation of the model. These dependent variables were also monitored on a control ward and data were collected on both wards at one pre-test and two post-test points. This paper presents a comprehensive overview of the literature and the methodology for the study. Planned change theory was used as a guiding framework for the implementation of the model and this process is described in detail.

Evaluation Studies as Topic↗

Self-management of chronic illness: implications for nursing.

Health problems and disease have changed during the last century with an increase in the numbers of people with chronic illness. Literature reveals the role of patients changing from passive to active participation in care management. A study of factors influencing self-management using both quantitative and qualitative methods was carried out. Selected results, with the major focus on the qualitative data, are presented to support discussion of a number of issues related to self-management of diabetes. However, many of the implications of the results also apply to those with chronic illness.

Adaptation, Psychological↗

Expectation and evaluation of occupational health nursing services, as perceived by occupational health nurses, employees and employers in the United Kingdom.

A structured questionnaire was used to investigate the relationship between expectation and evaluation of occupational health nursing services as perceived by providers (nurses) and receivers (employers and employees) in the United Kingdom. The response rate was 66.55% (254) from nurses, 51.32% (194) from employees and 44.97% (170) from employers. Data from 144 triads of nurse, employer and employee were used to test 13 null hypotheses, which were all rejected. The strong positive correlation between nurses', employers' and employees' expectations and evaluations indicates that, on the whole, their expectations were met. However, there were differences in the extent to which this was so and the level of expectation varied between groups. Nurses perceived themselves as not meeting their high expectations as well in non-traditional (care-supportive) as in traditional (care-orientated) services. On the whole, employers had significantly lower expectations than nurses, except in the area of care and treatment. Employees had high expectations of preventive services, but their lower evaluations indicate that these were not met. Discussion of these and other findings suggests that employers need education on the value and scope of occupational health nursing, and a model may assist nurses' conceptual understanding of it.

Adult↗

Acquired immunodeficiency syndrome: knowledge and attitudes of nurses in Northern Ireland.

The number of people suffering from conditions associated with HIV infection is growing steadily. These people require care from nurses who should be well trained to undertake all the various aspects of nursing care. Surveys have indicated that health professionals associate AIDS with minority groups such as homosexuals, drug-abusers and prostitutes. Incidents of sub-optimal nursing care of AIDS patients, or suspected AIDS patients belonging to these minority groups, have been well documented. Surveys have revealed much ignorance and confusion among the general public as well as among health professionals with regard to this controversial syndrome. This study aimed to measure nurses' knowledge and attitudes towards homosexuals, drug-abusers and prostitutes, who through their lifestyle are at increased risk for HIV infection. Questionnaires were distributed to a random sample of 800 nurses in Northern Ireland. The sample was stratified by several demographic variables. A response rate of almost 60% was achieved. Nurses appeared to have a moderate knowledge of issues related to HIV infection, but there were large gaps in their knowledge of the terminology used in HIV infection. Nurses were not extremely worried about AIDS itself. However, homosexuals, prostitutes and drug-abusers were seen to be at least partly responsible for their own illness. Implications for nursing care and for nurse education are discussed.

Acquired Immunodeficiency Syndrome↗