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Biomedical subjects

Philip Burnard

Publications and source records attributed to Philip Burnard.

17 recordsLinked to original sources

Preparing for loop ileostomy surgery: women's accounts from a qualitative study.

Restorative proctocolectomy has become increasingly the surgical treatment of choice for ulcerative colitis and familial adenomatous polyposis since its inception in 1978 [Parks and Nicholls, 1978. British Medical Journal 2(6130), 85-88]. As Keighley, Grobler and Bain [1993. Gut 34(6), 680-684] point out it not only eradicates disease, it preserves the anal sphincter, so enabling patients to void normally. However, for many patients surgery takes place in stages, with the formation of a loop ileostomy as the first stage. As its use increases, so more nurses (both specialist and general trained) will be involved in providing ongoing care and support both pre and post operatively. Although research is available regarding surgery, ileo-anal pouch formation and function together with possible complications, little is known about the immediate post operative period. This paper reports a study of female patients' accounts of their preparation for, and experiences of such surgery. It was part of a larger study into the quality of life of women following restorative proctocolectomy [Notter, 2002. The Quality of Life of Women Following Restorative Proctocolectomy]. A total of 50 women participated in this study, which used descriptive phenomenology to explore their lived experiences. The surgery proved to be a pivotal period in their lives, with surgery the dream of full recovery had gone. The findings reveal a traumatic time with memories dominated by the issues of pain, the changes to their body and in most cases problems with the loop ileostomy. Most were left with a determination to maintain the pouch at all costs. This study identifies major implications for nurse education and training, regarding all aspects of care during this critical time. Findings show the immense and long lasting impact this type of surgery can have on quality of life.

Adaptation, Psychological↗

Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses.

AIMS: The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK. METHODS: The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey. RESULTS: One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = -0.148, P = 0.050) and the depersonalization subscale (r = -0.220, P = 0.003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization. CONCLUSIONS: The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include - to seek clinical supervision as and when necessary.

Adult↗

Some attitudes towards teaching and learning in Thai nursing education.

This paper offers a discussion of some of the attitudes towards teaching and learning in Thai nursing education. It illustrates the strict, hierarchical set of relationships that exist between people throughout all aspects of Thai society. It then relates these relationships to those between teachers and students of nursing and how those relationships effect the ways in which students receive and deal with knowledge. Other attitudes towards learning, communication and student/lecturer relationships are also noted. It is hoped that the paper helps those, in other cultures, to reflect on their own practices.

Anthropology, Cultural↗

Issues in helping students from other cultures.

This paper reviews some of the research highlighting evidence of problems associated with studying overseas. Issues such as problems with daily living, being in the classroom and dealing with differences in the academic system are identified. The issue of studying in another culture is considered and problems of differences of perceptions between teachers and students are noted. The paper closes with some suggestions of how teachers in universities might improve their skills in helping such students. Given that the paper has to have a 'position', the assumption is that the students, in question, are coming to 'western' countries to study. The principles also apply in many other contexts and the reader must make this adjustment, as necessary.

Adaptation, Psychological↗

Somebody else's heart inside me: a descriptive study of psychological problems after a heart transplantation.

This study describes the psychological problems of heart transplant recipients. Using a qualitative research approach, interviews were conducted with 42 patients(35 men and 7 women). Analysis of the data revealed concerns about the donor's heart and how receiving somebody else's heart might affect the recipient's own personality; feelings of guilt for the donor's death and feelings of gratitude towards the donor's family; and concerns about the recipient's own heart. These findings provide health care professionals with pointers that may aid improved information provision and maximise the use of existing coping strategies.

Adaptation, Psychological↗

Writing a qualitative research report.

A research project in nursing or nursing education is probably only complete once the findings have been published. This paper offers a format for writing a qualitative research report for publication. It suggests, at least, the following sections: introduction, aims of the study, review of the literature, sample, data collection methods, data analysis methods, findings, discussion, conclusion, abstract. Each of these sections is addressed along with many written-out examples. In some sections, alternative approaches are suggested. The aim of the paper is to help the neophyte researcher to structure his or her report and for the experienced researcher to reflect on his or her current practice. References to other source material on qualitative research are given.

Humans↗

Culture and communication in Thai nursing: a report of an ethnographic study.

Most nurses live and work in multicultural settings. Given the need for all nurses and health-care workers to communicate--with patients, with families and with other health-care professionals--the study of the relationship between culture and communication can help to inform practice. This paper offers the findings from an ethnographic study of culture and communication, carried out in Thailand. The aim of the study was to address the question: 'in what, if any, ways do Thai cultural issues influence interpersonal communication patterns in Thai nursing and Thai nursing education?'. Data were collected from a variety of sources, including direct and indirect observation, interviews and discussions and the literature on the topic. For the interviews, the sample was a convenience and purposive one made up of clinical nurses and nurse educators (n = 14). Those data were analysed with the aid of a computerised, qualitative data analysis program. Findings reported in this paper include those relating to 'Thainess', Buddhism, the nursing profession and nurse--patient/doctor--patient relationships. The report ends with a 'portrait' of Thai nursing communication. It is suggested that understanding the cultural aspects of nursing in various contexts can help nurses, internationally.

Altruism↗

Writing a qualitative research report.

A research project in nursing or nursing education is probably only complete once the findings have been published. This paper offers a format for writing a qualitative research report for publication. It suggests, at least, the following sections: introduction, aims of the study, review of the literature, sample, data collection methods, data analysis methods, findings, discussion, conclusion, abstract. Each of these sections is addressed along with many written-out examples. In some sections, alternative approaches are suggested. The aim of the paper is to help the neophyte researcher to structure his or her report and for the experienced researcher to reflect on his or her current practice. References to other source material on qualitative research are given.

Data Collection↗

Stress, burnout, coping and stress management in psychiatrists: findings from a systematic review.

BACKGROUND: Research into stress among psychiatrists has attempted to identify stressors, which can lead to physical illness and psychological distress. AIMS: The aim of the study was systematically to review the current evidence for the effectiveness of stress management interventions for those working in the psychiatric profession. METHOD: A systematic review of the current literature was conducted into stress and stress management within the profession of psychiatry. RESULTS: Twenty-three international studies were included in the psychiatry section of the review. Psychiatrists report a range of stressors in their work, including stress associated with their work and personal stresses. One personal stress, which psychiatrists find very difficult to cope with is patient suicide. Coping strategies include support from colleagues and outside interests. No studies evaluated the use of stress-management interventions for psychiatrists. CONCLUSIONS: Psychiatry is a stressful profession. Psychiatrists identified several stressors in their professional and personal lives.

Adaptation, Psychological↗

Education for community mental health nurses: a summary of the key debates.

A wide range of post-qualifying education courses exist for community mental health nurses (CMHNs) working in the UK. 'Specialist practitioner' courses emphasize shared learning between CMHNs and members of other community nursing branches. These programmes typically include course content drawing on the social and behavioural sciences, as well as on material more tailored to the clinical needs of practitioners. Such courses and their predecessors have been subject to criticism, however. Courses have been described as anachronistic, and failing to take account of recent advances in treatment modalities. In addition concerns about the generic focus of some programmes have also been raised. Educational alternatives, such as programmes preparing nurses and other mental health workers to provide 'psycho-social interventions' have, correspondingly, become increasingly popular. In this paper we explore some of the debates surrounding the education of CMHNs, and explore the context in which CMHNs work and in which educational programmes are devised. We consider the multidisciplinary environment in which CMHNs practise, the differing client groups with which CMHNs work, the developing policy framework in which mental health care is provided, demands for more user-responsive education, and the relationship between higher educational institutions and health care providers. We conclude the paper with a series of questions for CMHN educators and education commissioners.

Community Health Nursing↗

Self-esteem and student nurses: a cross-cultural study of nursing students in Thailand and the UK.

Self-esteem is a key feature in a person's perception of their own worth. This report is of a study of the reported self-esteem levels of two groups of student nurses: one in Thailand and one in the UK. Purposive samples of 120 Thai students and 101 UK undergraduate nursing students were given the Culture-Free Self-Esteem Inventory (CFSEI-2). The CFSEI-2 is a self-reported inventory, which measures an individual's perception of self. The findings of the study indicate that the perceptions of own self-esteem in undergraduate student nurses in the UK and in Thailand were comparable to the normal ranges of self-esteem as assessed by the instrument. An independent sample t-test revealed that there were no significant differences in mean overall and subscale self-esteem scores between UK and Thai nursing students. There were no indications of differences in levels of self-esteem for UK and Thai nursing students experiencing different parts of their training.

Adolescent↗