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Biomedical subjects

K A Luker

Publications and source records attributed to K A Luker.

18 recordsLinked to original sources
PubMed1992

Evaluating computer assisted learning for renal patients.

Healthcare professionals have become increasingly concerned with evaluating the impact of their interventions. Consumerism, quality initiatives and financial constraints have contributed in large measure to this concern. Consequently, the focus of many studies which involve the introduction of new and untried techniques is often on demonstrating their relative usefulness. This study sought to evaluate the usefulness and acceptability of computer assisted learning (CAL) for use in the education of renal patients on continuous ambulatory peritoneal dialysis. However, several problems were encountered which limited or impaired the evaluation process. We describe these problems and use them to illustrate the difficulties inherent in evaluative research.

Adult↗
PubMed1992

An exploratory study of the sources of influence on the clinical decisions of community nurses.

This paper reports a small exploratory study which identifies what community nurses consider to be the scope of their practice and the sources of influence on their clinical decisions. The study was stimulated by the emergence of the nurse prescribing initiative, which is likely to bring clinical decision making to the centre of professional debate. The study was carried out over a 5-month period and data were collected from 47 community nurses in four district health authorities. A qualitative method was employed and field work involved observation of 40 home visits and five nurse-run clinics, individual interviews and group discussions with the nurses, and scrutiny of nursing records. The data were content analysed and classified, and the categories were validated by practitioners. Findings suggest that although community nurses consider that a large proportion of their work requires a scientific basis, their practice is largely founded on experiential knowledge, and on the whole they are not positively disposed to research knowledge. The findings are discussed in the context of nurse prescribing. Questions are raised about the nature of a 'professional' knowledge base and the reclassification of scientific knowledge as nursing or experiential knowledge once it has diffused into practice.

Attitude of Health Personnel↗
PubMed1991

Nurses' opinions of the introduction of computer-assisted learning for use in patient education.

Computers have only recently begun to find a place in the everyday work of health care staff. The use of computer-assisted learning (CAL) in patient education is in its infancy. However, the medium appears to offer several advantages to patients. The successful integration of the medium into clinical practice requires the acceptance and support of staff members. Little research exists to date which examines staff responses to the introduction of CAL into their workplace. This small study (n = 14) aims to explore the reactions of staff to the introduction of an experimental CAL package for use in the education of renal patients on continuous ambulatory peritoneal dialysis (CAPD). The opinions of staff members to CAL are probed and their views ascertained regarding the usefulness of CAL to both staff and patients. Results suggest that, despite their initial reservations about CAL, staff were generally positive about the medium.

Adult↗
PubMed1991

The development of the health visitor-client relationship.

The aim of this paper is to explore the health visitor-client relationship as it emerged in an indepth qualitative study of health visiting practice. Despite the emphasis in health visiting practice on developing relationships with clients, there is little empirically based knowledge as to how health visitors develop relationships with clients and what effect relationships have on clients' health outcomes. Forty-five experienced health visitors were interviewed and asked to discuss cases where they felt they had had a positive effect and cases where they thought they had not had any impact. The interviews were tape-recorded and later transcribed. A detailed analysis of the processes involved in developing relationships is described. The data from this study suggest that health visitors develop relationships with clients in an attempt, not only to provide services to clients, but also to ensure access to clients over time. This study makes a contribution to our understanding of the processes involved in everyday health visiting practice.

Attitude of Health Personnel↗
PubMed1990

Staff interaction with vocally disruptive demented patients compared with demented controls.

This study addressed the effect of social isolation on vocally disruptive demented patients (V); the results center on the amount of time patients spent in interactions, and the differences in type and time of staff-patient interaction (IA), compared to controls (C). Semi-structured observations were collected (1100 hours) for 37 vocally disruptive patients and 37 controls, all residents of psychogeriatric wards. Quantitative analysis revealed a low frequency of interactions, elicited mainly for procedural matters and short duration of most interaction episodes. Multiple regression analysis showed a significant difference in the type of interaction: there was more correction of undesired behaviour for vocally disruptive patients than for controls. The results show that social isolation is part of the institutionalized demented patients' life. The dominance of short interaction episodes could contribute to overstimulation. The only significant difference found was the frequency of corrective interactions in the group of vocally disruptive patients. We conclude that this is not the cause of their behaviour, but it may reinforce it. Other factors that might cause and maintain this behaviour require investigation.

Aged↗
PubMed1990

Gaining access to clients: the case of health visiting.

The aim of this paper is to explore the concept of gaining access to clients as it emerged from an in-depth qualitative study of health visiting practice. The study was conducted using a grounded theory approach to data collection and analysis. Forty-five experienced health visitors were interviewed using a semi-structured interview guide. The interviews were tape recorded and later transcribed. A detailed analysis of the processes involved in 'entering' into client situations to begin health visiting work is presented. Entry into the client/family situation is a process which involves both obtaining access to the client in the environment where health visitor and client meet and 'entering' into the client situation more fully to continue the health visiting work. The data from this study would suggest that the work involved in entering client situations involves many strategies to ensure entry and re-entry. This process is influenced by many factors within the client, the health visitor, and the health visitor-client encounter. This paper makes a contribution to our understanding of the processes involved in everyday health visiting practice.

Attitude to Health↗
PubMed1990

Reluctant collaborators: do patients want to be involved in decisions concerning care?

Against the background of the popularity of the concept of 'patient collaboration' in care, this paper describes, from the frame of reference of the patients, how they perceive being involved in decisions concerning their own treatment and nursing care. A convenience sample of 12 patients were selected. The data collection and analysis were informed to some extent by the approach known as grounded theory. Although only 12 in-depth interviews were conducted, one major theme emerged from the data and that was named 'toeing the line'. The data suggests that some patients are more concerned about doing what is right, that is, pleasing the nurse, than participating in decisions concerning care. It is contended that if nurses adopt practices which encourage involvement they may unwittingly coerse patients to comply. It is argued that patients will accept this situation even if they do not wish a collaborative role. Despite the small sample size, interesting questions are raised concerning the underlying rationale of patient involvement. The conclusion is drawn that promoting individualized care is not necessarily synonymous with active patient involvement as advocated in much of the literature.

Attitude to Health↗
PubMed1989

The referral process in health visiting.

The aim of this paper is to explore the concept of referral as it emerged from an in-depth qualitative study of health visiting practice. The study was conducted using a grounded theory approach to data collection and analysis (Glaser and Strauss, 1967). Forty-five experienced health visitors were interviewed using a semi-structured interview guide. The interviews were tape recorded and later transcribed. A detailed analysis is presented of the processes involved in referring. This includes working up the client for referral, working up the agency, third party referrals, and issues of control in the referral process. The outcome of referral in terms of the effect on the client is also discussed. This paper makes a contribution to our understanding of the microprocesses in everyday health visiting practice.

Community Health Nursing↗
PubMed1987

The elderly at home: service needs and provision.

This paper arises from research to develop a profile of the elderly living in the community. Data are presented from interviews with a stratified random sample of 1406 elderly people living in the Trafford area of Greater Manchester. The findings suggest that in reality community care for the elderly means care by lay carers. Assistance with all tasks ranging from intensely personal care, for example bathing and dressing, to the practical household tasks, such as cooking and cleaning, was more often provided to the elderly by spouses and daughters/daughters-in-law than by the statutory services.It is suggested that some form of eligibility criteria may be used either consciously or unconsciously by general practitioners and other health care workers when referring elderly people to the nursing and social services which may mean that the statutory services do not complement the care given by lay carers. Furthermore, the presence of a lay carer may prevent the situation coming to the attention of the primary health care team.

Aged↗
PubMed1979

Measuring life satisfaction in an elderly female population.

The study described in this paper was undertaken as part of the pilot work for a main study, which attempts to evaluate the effectiveness of health visitor intervention on an elderly female population in Scotland. The Life Satisfaction Index A (Neugarten et al. 1961) was modified by the researcher and tested on a female Scottish population and is subsequently being used as one of three outcome measures of health visitor intervention.

Aged↗
PubMedDate not supplied

The development and evaluation of computer assisted learning for patients on continuous ambulatory peritoneal dialysis.

This article briefly describes the development and evaluation of six computer assisted learning (CAL) packages for use with renal patients on Continuous Ambulatory Peritoneal Dialysis (CAPD). The factors influencing the choice of CAL as the teaching medium are detailed, and some of the difficulties facing nurses involved in patient education highlighted. An outline of the development of program content is given and the methods to be used in the evaluation are briefly explored. Since data collection has only recently commenced, no conclusions can be drawn. However, the authors' anticipation that the study may help to make inroads into exploring the acceptability of CAL to patients and patient educators is expressed.

Adult↗