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Biomedical subjects

S Latter

Publications and source records attributed to S Latter.

12 recordsLinked to original sources
PubMed2001

Consumerism in health care: the case of medication education.

BACKGROUND: The United Kingdom government's policy documents spanning the last decade clearly envisage the patient as a consumer of health care. In this context this paper discusses recent research findings related to the health-promotion practice of medication delivered by nurses in England in a variety of health care settings. Literature exploring consumerism in health care highlights a number of principles which were used to develop a framework to evaluate the data collected in this study. METHOD: Non-participant observation and audio-recordings of nurse-patient interactions about medications were collected in seven different contexts focusing on adults, older people, mental health and community nurse settings. Post-interaction interviews with nurse and patient participants were conducted to explore views on quality, satisfaction with, and intended outcomes of, the interactions. FINDINGS: Generally, the findings demonstrated that the espoused theory and practice reality regarding the carrying out of consumerist principles are incongruous. Interactions contained relatively simple information, were dominated and led by nurses and offered little opportunity for patient choice. Patients, however, expressed a satisfaction with minimal information and involvement. CONCLUSION: The findings are discussed with reference to a number of different contextual factors: acuity of illness, perceived balance of power, information gaps, patterns of contact and nurse-patient relationships, and patient-centred care.

Attitude of Health Personnel↗
PubMed2001

Nurses' educational preparation for a medication education role: findings from a national survey.

Nurses have a potentially important contribution to make to educating patients about medications. This nursing role is likely to acquire increasing significance as the number of nurses independently prescribing medicines grows, in addition to those nurses occupying autonomous and extended roles that involve ongoing assessment and monitoring of patients' medicine-taking behaviour. As part of a study(1)commissioned to evaluate nurses' educational preparation for, and practice of, medication education, a national survey of nurse education institutions was undertaken. A postal questionnaire was distributed to identified individuals within 51 education institutions in England. Respondents were asked about a number of curriculum design and delivery factors related to subjects central to medication education: pharmacology, patient education and communication skills. Analysis highlighted a number of themes: the teaching of pharmacology is generally integrated within other curricular modules; respondents were dissatisfied with insufficient curricular time devoted to taught pharmacology; the importance of lecturers' ability to apply theory to practice; a lack of clarity concerning pharmacology learning outcomes applied to medication education; and respondents' perceptions that opportunities for integrating pharmacology knowledge, patient education and communication skills were available within practice settings. The significance and implications of the findings are discussed in the context of current educational policy.

Communication↗
PubMed2000

Nursing, medication education and the new policy agenda: the evidence base.

Current social and demographic trends, combined with 'the new policy agenda', highlight the importance of nurses' role in educating patients about medication. In the absence of previous research investigation, this study set out to explore nurses' current contribution to medication education and the clinical contextual factors that influence current practice. The evidence base for effective medication education was established from reviews of literature and focus groups with key informants. Nurses' practice was investigated using a case study approach in seven clinical areas representing adult, care of the older person, mental health and community nursing contexts. Methods used to collect data were: audio-recordings (n=37) and observation (n=48) of nurse-patient interactions about medication, post-interaction interviews with nurses (n=29), post-interaction interviews with patients (n=39), analysis of relevant written documentation and researcher observation and field notes. Data sources within each case were subjected to systematic content analysis in order to identify current practice and contextual influences within each case. Cross-case analysis was also employed in order to identify explanations for any differentiation in practice. Findings indicate that nurses' contribution to medication education is commonly limited to simple information giving about medicines, involving the name, purpose, colour, number of tablets and the time and frequency that medications should be administered. Nurses' practice in two of the seven clinical areas was characterised by interactions that more closely demonstrated features of what is known to constitute more comprehensive and effective medication education. Analysis of contextual influences within and between cases allowed explanations to be derived for the types of medication education interactions observed. These concerned: patient characteristics, perceived and expressed preferences of patients for information, characteristics of the nurse-patient relationship, lack of time and high workload, and the philosophy of care within the clinical area. In all clinical areas, nurses were not explicitly and judiciously using available evidence to inform their medication-related interactions. The paper concludes with discussion and implications of the findings.

Evidence-Based Medicine↗
PubMed2000

Evaluating educational preparation for a health education role in practice: the case of medication education.

Current health care policy and practice contexts in the UK point to the importance of nurses' ability to make an effective contribution to educating patients about medication, as part of their role in health education and health promotion. Nurses' potential contribution to this important activity will inevitably be dependent on knowledge and skills acquired during preregistration and postregistration programmes of education. Against this backdrop, changes in pre and postregistration nurse education in the UK in the past decade highlight the importance and timeliness of evaluating the adequacy of educational preparation for a medication role. This paper reports on the findings from an evaluation of UK educational preparation for a medication education role in practice. A case study design was used to investigate current educational preparation at three education institutions. Multiple methods of data collection at each site involved focus group discussions with lecturers and practitioners, individual interviews with key personnel, nonparticipant observation of teaching sessions, postobservation interviews with students and curriculum analysis. Findings highlighted the importance of a number of dimensions of preparation for practice of such a role: the need for sufficient taught pharmacology; opportunities for application and integration of prerequisite knowledge and skills; the importance of practice-based learning; the need for an evidence-based curriculum, and the importance of clarifying outcomes and competencies required for a medication education role within pre and postregistration curricula. The paper concludes with a discussion and implications of the findings.

Attitude of Health Personnel↗
PubMed1999

Help or hindrance? Single, unsupported mothers' perceptions of health visiting.

Although there have been studies of clients' perceptions of health visiting, the views of single, unsupported mothers about the health visiting service have been under-researched. Therefore, this study investigated their views using semi-structured interviews with 12 single, unsupported mothers identified by health visitors within one National Health Service Community Trust. The data were analysed using Burnard's (1991) thematic content analysis, which enabled a number of identifiable themes to emerge. Findings showed that the participants perceived the health visiting service as being concerned almost exclusively with babies and there was a general lack of understanding about the broader role of the health visitor. Clinics were seen as places to visit to weigh the baby but not as a contact point with a health visitor. Some health visitors were perceived as being judgemental in attitude and not necessarily interested in the clients as individuals. Participants considered that health visitors should be friendly, interested, able to promote their confidence and offer individualized advice. Overall the study suggests that health visitors may not be utilizing all dimensions of their role with single, unsupported mothers and may not be communicating effectively with them about this. The study also shows that single, unsupported mothers wish to be treated in the same way as other mothers but at present some feel that they are stigmatized and treated differently. The paper concludes with an outline of the implications of the findings and recommendations for practice and future research.

Adolescent↗
PubMed1998

Qualified nurse smokers' attitudes towards a hospital smoking ban and its influence on their smoking behaviour.

This study explored the effects of a complete smoking ban in a large British teaching hospital on nurses' smoking behaviour and their attitudes and views on the current policy and compliance with it. Questionnaires were distributed to a convenience sample of nurse smokers and ex-smokers 9 months after the introduction of the smoking ban. A response rate of 64.7% (n = 33) was achieved. The reported reduction in work-time cigarette consumption following the ban was not statistically significant (Wilcoxon test: P = 0.069). No reduction outside work was recorded. Six (21.4%) smokers claimed that the ban had been a reason for them to try to give up smoking. Two of three ex-smokers reported that the ban had played a role in their giving up. The respondents showed considerable agreement with their health educator and role model function. Support for the policy was, however, very limited and compliance with it was reported to be poor among patients as well as staff. Twenty (76.9%) of current smokers indicated their wish to give up, 11 (39.3%) of them believed their own determination to be an effective way to achieve this. These results would seem to indicate that smoking policies currently have limited impact on smoking behaviour. It is suggested that in future policies should aim at strengthening nurses' determination to give up as well as secure their support for the restrictions in order to assist them in changing their smoking behaviour.

Attitude to Health↗
PubMed1998

Implementing health promoting nursing: the integration of interpersonal skills and health promotion.

Health promoting nursing practice is seen as the way forward for the nursing profession. This paper outlines the meaning of health promotion and distinguishes between a traditional and new paradigm approach. The research examining the extent to which a new paradigm approach is practised demonstrates that, to date, nurses predominantly adopt the traditional approach to health promotion. It is argued that the integration of interpersonal skills and health promotion within nursing curricula is crucial in enabling the transfer of theoretical concepts into practice. The ways in which this integration has been approached within one college of nursing are described. The difficulties encountered in attempting this integration and accomplishing a philosophical shift from a traditional to a new paradigm approach to health promotion are discussed and critiqued. Specifically conflicts that occur at an interpersonal, organizational and societal level are identified and proposed as explanations for the slow implementation of health promoting nursing.

Clinical Competence↗
PubMed1992

Health education in nursing: perceptions of practice in acute settings.

A postal questionnaire survey design was utilized to establish a national overview of perceptions of health education practice in general acute ward settings. Questionnaires were sent to individuals identified as the most senior nurse within each district health authority in England (n = 195). Respondents were asked to specify--with the help of their nursing teams--the progress made on wards within their respective district health authorities in relation to a range of health education activities. A response rate of 73% (n = 142) was achieved. The majority of responses reflected the perceptions of senior nurse managers or their deputies. The data showed that respondents felt health education activities generally are a feature of nursing practice on acute wards. However, on the majority of wards, they were seen as only partially included into some areas of nursing practice. On only a small proportion (4%) of wards was health education of any type reported not to be a feature of practice. Of the five specific health education areas explored in the questionnaire, 'patient education' and 'information-giving' were felt to be occurring on a significantly greater number of wards and significantly more frequently than 'encouraging patients and their families to participate in care'. Data analysis also showed that all the activities specified--that is, patient education, information-giving, healthy lifestyle advice and encouraging patient and family participation in care--were positively correlated.

Attitude of Health Personnel↗
PubMedDate not supplied

Nursing and medication education.

AIM: This study set out to explore nurses' current contribution to medication education and the clinical contextual factors that influence current practice. METHOD: Nurses' practice was investigated using a case study approach. Methods used to collect data were: audio-recordings and observation of nurse-patient interactions about medication, post-interaction interviews with nurses and patients, analysis of relevant written documentation and researcher observation and field notes. RESULTS: Findings indicate that nurses' contribution to medication education is commonly limited to giving simple information about medicines, involving the name, purpose, colour, number of tablets and the time and frequency for their administration. CONCLUSION: Nurse-patient relationships, patterns of contact and philosophy of care were all identified as contributory factors to enabling the practice of medication education in clinical areas.

Attitude of Health Personnel↗
PubMedDate not supplied

Perceptions and practice of health education and heath promotion in acute ward settings.

This paper reports on an overview of the findings from a two-year Department of Health-funded research project. The study had two overall aims: to describe the extent to which health education and health promotion had become integrated into nurses' practice in acute-care settings and to identify the facilitative and inhibitory factors involved. The study comprised separate sequential stages of data collection and utilised a multi-method approach. Findings from a survey of ward sisters and from ward-based case studies are presented and discussed. These suggest that nurses have yet to fulfill their potential as educators and promoters of health and that a number of influences interact at ward level to encourage or impede the development of this role.

Health Promotion↗