Biomedical subjects

Valerie Fleming

Publications and source records attributed to Valerie Fleming.

9 recordsLinked to original sources

PubMed2005

Vocational analysis of health care professions as a basis for innovative curricular planning. An analysis and prognosis of the development of the professional competencies of midwives--cornerstones of innovative curricula in tertiary education.

This article describes current and future tendencies in the development of curriculum planning for health care professions in Germany, using the example of midwifery education. In particular, it discusses 'output-based control' of curriculum planning giving consideration to issues related to German education, health policies and professional educational theories with a view to the general international development. The results of this analysis constitute the starting point for the conceptual planning of a dissertation at the medical faculty of the Berlin Charité with the goal of developing a competency model for the curriculum planning of midwifery education, thus creating a modern curriculum as a basis for a fundamental reform of German midwifery education.

Competency-Based Education↗

PubMed2005

[A discussion of Gadamer's philosophical hermeneutics in international nursing research].

This paper discusses various phenomenological and hermeneutical approaches within international nursing research. The first part contains an extensive literature review which shows that the Anglo-American debate into qualitative research is based on translated material of German philosophers, which is then interpreted not only according to language but also to culture. Philosophical terms are therefore differently interpreted and used. German nursing research is beginning to influence this international debate. The second part contains a methodological discussion of original philosophical texts and international nursing research and provides the foundation for a research method based on Gadamer's philosophical Hermeneutics. It is concluded that qualitative nursing research can only be justified by reference to a philosophical foundation.

Clinical Nursing Research↗

PubMed2004

Changing perceptions of womanhood: living with Parkinson's Disease.

This study adopted a multiple case study design to develop our understanding of the experiences and adjustments made by women with Parkinson Disease in relation to womanhood. Nineteen women participated in this investigation telling their stories through a combination of individual interviews, group interviews, reflective diaries, reflective tapes and creative writing. Data were analysed using the framework of Intrapersonal, Interpersonal, Extrapersonal and Metapersonal health proposed by Boddy and Rice (Perspectives on Health and Illness, Dunsmore Press, Palmerston North, 1992). Women reported that major changes were required in their lives in each of these aspects of health. In particular women reported labile emotions, changing body images, changing lifestyles, changing relationships with partner, family and friends, increasing dependence, decreasing role fulfillment and the need for support versus increasing isolation. The findings are of particular relevance to nurses and other health professionals involved with women with Parkinson's Disease as well as social services and voluntary agencies.

Activities of Daily Living↗

PubMed2003

Hysterectomy: a case study of one woman's experience.

BACKGROUND: There are many published qualitative studies in the large volume of literature about hysterectomy documenting themes common to the majority of participants, such as social support, feelings of illness and wellness, pain and resumption of normal life rather than events which were unique or exceptional. AIM: This study explores the meaning of the experience of abdominal hysterectomy for one woman. METHODS: Single client case study method was used. An overview of case study is presented and the rationale for its selection as an appropriate methodology for this study given. The participant and her "significant others" are introduced. FINDINGS: Four major themes relating to the participant's experience were identified: doubts and justifications, pain, embodiment and sense of betterness. These are discussed in relation to the participant, the research literature and nursing and medical practice. CONCLUSION: Highlighting the case of one woman and analysing her experience as a single case study has produced a depth of material not previously available in other studies. The findings should be of use to staff working in gynaecological nursing, but could also be used in the education of nursing and midwifery students.

Adaptation, Psychological↗

PubMed2003

Hermeneutic research in nursing: developing a Gadamerian-based research method.

This paper takes the stance that although there are many different approaches to phenomenological and hermeneutic research, some of these have become blurred due to multiple interpretations of translated materials. Working from original texts by the German philosophers, this paper reconsiders the relevance of phenomenology and hermeneutics to nursing research. We trace the development of Gadamer's philosophy in order to propose a research method based in this tradition. Five steps have been identified as a guide for nurse researchers. These are deciding upon a question, identification of preunderstandings, gaining understanding through dialogue with participants, gaining understanding through dialogue with text and establishing trustworthiness.

Humans↗

PubMed2002

Coping with menstruation: understanding the needs of women with Parkinson's disease.

AIMS: To understand how women with Parkinson's disease (PD) experience and cope with menstruation and associated gynaecological problems, and adjustments to womanhood. This paper focuses on menstruation. RATIONALE: Unique hormonal fluctuations are known to affect women with idiopathic PD, however, our understanding of the impact of these changes on daily lives and opportunities for nursing support are limited. METHODS: Descriptive multiple case study design was adopted, and data collection involved a variety of approaches. Including semi-structured interviews, conversational interviews, group interview, reflective diaries and creative writing. A flexible approach was encouraged whereby consenting women chose how and when they wanted to participate. FINDINGS: A total of 19 women participated, 17 were experiencing naturally occurring periods. The majority had been diagnosed around the age of 39 years, and at the time of study participants ages ranged from 34 to 56 years. Three of the women reported no change in the experience of their periods following diagnosis, 15 reported worsening problems which in two extreme situations led to hysterectomy. During the monthly cycle PD symptoms were often exaggerated, medication effectiveness reduced and 'off times' increased. The period itself involved high levels of pain, fatigue and sometimes humiliating experiences when self-care was impossible. CONCLUSIONS: This study offers a unique contribution to our understanding of the needs of young women with PD, and suggests that health professionals need to look beyond the mask of a disease associated with old age. The nursing profession has a responsibility to develop models of best practice to enable women of any age to be themselves and to adapt to the rhythm of their hormones as they live and grow older with PD.

Activities of Daily Living↗

PubMed2002

Measurement of clinical performance of nurses: a literature review.

Despite a 40-year history of researching and developing an instrument for measurement of clinical competence in nursing, there are none that are universally accepted for this purpose. This article presents a critical review of the research, which has been carried out to explore the measurement of nurses' clinical performance. To search the literature in a systematic manner, the criteria stipulated by the Cochrane Research Database were applied. The review showed that assessment tools have been developed using a variety of different methods and several instruments were found to have been developed but nothing that is universally accepted. However, the authors found that the pathway for instrument generation suggested by Smith and Kendall (1963) offers a robust approach to the generation of such a tool regardless of the practice setting. Other methods identified in this literature review also offer interested researchers an opportunity to explore the current role of the nurse, as well as the possibility of developing tools for assessing the performance of students at various stages in their education and nurses at various times after qualification.

Clinical Competence↗

PubMed2002

[Evidence-based midwifery practice in Scotland: a discussion of the problems].

In recent years there has been a drive to base all health care provision upon the most recent, appropriate scientific evidence. This has prompted an interest in research by midwives in clinical practice who want to ensure that they are providing the best possible care. Those midwives who do not use evidenced based practice but instead teach, support and demonstrate ritualistic practices without reference to the substantial research available, are limiting women's choice in maternity care. In a recent trial investigating whether routine suturing of perineal lacerations is required, the trial's outcome was jeopardised because of midwives' beliefs about suturing. The rationale for such ritualistic behaviour is not always easy to understand and using a framework of power and it is examined in this article to determine what concepts are influencing these practices. The article concludes by suggesting that some midwives appear to ignore the results of this trial and other research and demonstrate a paternalistic attitude towards their clients.

Evidence-Based Medicine↗

PubMedDate not supplied

Parkinson's disease: the effects on womanhood.

AIM: To understand how women with Parkinson's disease (PD) experience and cope with menstruation, associated gynaecological problems and adjustments to womanhood. METHOD: In-depth case studies were completed with 19 women who told their stories using a combination of interviews, group interviews, reflective diaries and creative writing. RESULTS: The data revealed that most (n = 16, 83 per cent) of the women associated PD with a worsening of their menstruation problems. There was a general perception that interaction with doctors and nurses focused on drug efficacy and mobility. Distressing practical problems associated with menstruation, relationships and sexual problems were rarely addressed. CONCLUSION: Women in this study experienced emotional exhaustion, physical fatigue, pain and increased severity of menstrual problems after the onset of PD. The findings not only challenge nurses to find new ways of working to ensure best practice, but also to access expert care and support for these women.

Activities of Daily Living↗