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Biomedical subjects

W Lauder

Publications and source records attributed to W Lauder.

18 recordsLinked to original sources

Nurses' judgements of self-neglect: a factorial survey.

Self-neglect can be understood as the failure to engage in those activities which a given culture deems necessary to maintain a socially accepted standard of personal and household hygiene and carry out activities needed to maintain health status. Self-neglect is bound up in a discourse which equates dirt with disease and in which transgressions of self-care norms can be labelled as a medical syndrome. The notion of self-neglect as a social construction is the theoretical perspective which provides the framework for the study reported here. Judgements regarding self-neglect may be social judgements influenced by professional socialisation and cultural values. The belief that different groups of nurses may have different constructions of self-neglect will be investigated and the factors which influence these judgements will be explored in three groups of nurses. The inclusion of nursing students will allow some picture to emerge as to whether judgements develop over time or are relatively constant across the career path, albeit within the limitations of a non-longitudinal design.

Activities of Daily Living↗

Further testing of the Mental Health Problems Perception Questionnaire.

AIM OF THE STUDY: This paper reports a two-part study relating to the further psychometric development of the Mental Health Problems Perceptions Questionnaire. BACKGROUND: The instrument was developed and used originally in a study to investigate the role of district nurses in caring for people with mental health problems, who live in rural settings. It is underpinned by an explicit theoretical framework in which therapeutic commitment, role support and role competency are core concepts. DESIGN: A two-part study is described. Part One used a test-retest method to examine the stability of the instrument on repeated administration. Part Two examined the instrument's internal reliability and construct validity by calculation of Cronbach's alpha coefficients and exploratory factor analysis. RESULTS: Satisfactory internal reliability for a new instrument was demonstrated. Exploratory factor analysis supported the previously proposed theoretical framework. Significant correlations were demonstrated between the scales which constitute the instrument, thereby providing further evidence of construct validity. CONCLUSIONS: The Mental Health Problems Perceptions Questionnaire provides a potentially useful instrument in relation to future educational, clinical and managerial research.

Factor Analysis, Statistical↗

The utility of self-care theory as a theoretical basis for self-neglect.

AIM: This paper sets out to explore the utility of self-care theory in understanding self-neglect. Further theoretical development of both self-care and self-neglect theory and attending core concepts is an important objective. BACKGROUND: The notions of self-neglect and self-care are frequently linked in the literature. The relationship between self-neglect and self-care is not clear and the strengths and limitations in using self-care theory to facilitate a greater understanding of self-neglect will be addressed. Specifically the issues of self-care agency, self-care requisites, objectivity, class and culture, and lifestyle choice will be critically evaluated in the context of self-neglect theory. CONCLUSION: Self-care theory has a useful role to play in furthering our understanding of self-neglect. Self-care theory is able to explain some aspects of self-neglect but not others, although this may be a reflection of the relatively underdeveloped state of self-care theories or alternatively may reflect a more fundamental limitation in our ability to fully explain human behaviour.

Attitude to Health↗

The development and testing of the Mental Health Problems Perception Questionnaire.

This paper reports the development and psychometric testing of the Mental Health Problems Perception Questionnaire. This questionnaire was developed to measure the therapeutic commitment, role support and role competency of non-mental health specialist nurses (generalists) to working with patients with mental health problems who live in rural communities. The instrument was demonstrated to be valid and reliable in this population. The questionnaire was underpinned by an explicit theoretical model which facilitates an understanding of the factors that influence effective psychosocial nursing interventions with this client group.

Clinical Competence↗

A survey of self-neglect in patients living in the community.

Self-neglect is a familiar concept to all community nurses. Nevertheless there have been few empirical studies undertaken in this area over the last 30 years. The study of self-neglect has been hampered by inadequate conceptualization and a lack of theoretical frameworks. This article reports a study of patients who did and did not self-neglect, drawn from district nursing caseloads. Patients with self-neglect had lower levels of operable self-care agency than patients in a comparison group. Only self-neglecting patients had the nursing diagnoses 'ineffective management of therapy' and 'non-compliance'.

Activities of Daily Living↗

The medical model and other constructions of self-neglect.

Nurses frequently encounter patients who neglect their personal hygiene and household cleanliness. Self-neglect is usually understood within the parameters of the medical model, with its need to objectify and categorize. The medicalization of self-neglect obscures the fact that patients and professionals may have different ideas about what self-neglect is and what it is not. This paper explores how the medical construction of self-neglect has come to dominate the self-neglect discourse and will also explore other possible ways of understanding self-neglect.

Humans↗

Constructions of self-neglect: a multiple case study design.

Patients who neglect personal hygiene, household cleanliness and their own health are familiar to most nurses. Despite this familiarity, self-neglect is a poorly conceptualized and little researched phenomenon. This multiple case study design uncovers the perceptions of self-neglect held by professionals, patients and relatives. The assumptions which underpin Orem's Theory of Self-Care and the medical model construction of self-neglect are explored and it will be suggested that there are limitations in understanding self-neglect using these theoretical frameworks.

Activities of Daily Living↗

Transfer of knowledge and skills: some implications for nursing and nurse education.

The construct of transfer has enormous importance to nursing as it begins to highlight potential problems in the transfer of knowledge and skills from the campus to the clinical area, from one part of the clinical area to another (e.g. surgical to medical), and from community to the clinical area. Thus, any adequate conceptualization of transfer must account for problems of practice-practice transfer as well as theory-practice transfer. These potential problems are the concern of educators, students and managers who have a responsibility for agency nurses and bank nurses who may find themselves in different specialities on a regular basis. Transfer has relevance to a whole raft of other issues ranging from the application of theories to nursing practice, through to the validity of claims that courses which develop intellectual skills prepare nurses for lifelong learning.

Clinical Competence↗

Course-related family and financial problems of mature nursing students.

In recent years there has been a significant change in the type of student entering nurse education. There has been a move towards widening access, and as a result, more mature students have gained entry to courses. What seems less clear is the types of course-related problems experienced by mature students. The study reported in this paper investigated the financial and family problems that mature students experience as a direct result of undertaking a course in nursing education. It was found that most mature students experience financial, childcare, relationship and family problems. It was also found that a large number of mature students thought about leaving the course as a result of these problems. It may be necessary, in the light of the findings, to consider how future course designs can accommodate mature students and their particular experiences.

Adaptation, Psychological↗

Constructing meaning in the learning experience: the role of alternative theoretical frameworks.

Student nurses actively interact with their experiences and construct theories about nursing in an attempt to make sense of their experiences. These alternative theoretical frameworks (ATFs), it will be suggested, do not conform to the types of structures that are thought to be the hallmark of formal theories but instead the knowledge of students can be understood as a series of narratives. The relationship between ATFs and the formal theories presented by educators may create difficulties for both students and teachers.

Cognition↗

Beyond reflection: practical wisdom and the practical syllogism.

The relationship between the way nurses think and the actions they perform is one of the key debates within the nursing profession. It has been assumed that the thinking that precedes and follows nursing actions has been described within the reflective practitioner doctrine. It is suggested that this is not so, as the reflective doctrine has not only failed to explicate the link between theory and practice but some reflective theorists have perpetuated the theory-practice gap by separating thought and action. Instead it is argued that Aristotle's conceptions of Practical Wisdom and the Practical Syllogism provide a framework in which the link between thinking and doing are described. Practical wisdom is a form of knowledge that can be claimed by those who purport to deal with human good. Unlike theoretical knowledge, practical wisdom ends not in an intellectual conclusion but in the actual performing of some action designed to produce good for fellow humans. These actions are taken only after the practically wise person decides, consciously or unconsciously, the most effective and morally right option. The practical syllogism is that particular feature of critical thinking that links theory and practice in practice professions. The practical syllogism describes the means-end considerations that underpin all actions undertaken by nurses. It is not suggested that all the deliberations of those with practical wisdom is syllogistic in nature but that this is a central feature of the way in which nurses approach the care they deliver.

Humans↗

An exploratory study of the alternative theoretical frameworks of student nurses.

Alternative theoretical frameworks are the tacit assumptions and logical structures of practical action. Student nurses have alternative theories in which ethical and technical knowledge are combined to form high-level heuristics which assist with understanding and responding to client problems. The alternative theories of student nurses can be observed to guide care giving and therefore the theory-practice gap may not be as wide as is often assumed. The values and beliefs about nursing held by student nurses are broadly similar to those advocated for the profession as a whole.

Health Knowledge, Attitudes, Practice↗

Teaching theoretical nursing.

Nursing science has been described as being either alive or inert. Acceptance of one or the other paradigm has important implications for the way in which theories of nursing are taught in the curriculum. In this paper these conflicting paradigms are discussed and the implications for nurse teachers are outlined. It is suggested that this may involve a reconceptualisation of where nursing theories are derived and a consequent shift of power from nurse teachers to the practising nurse.

Curriculum↗

Health promotion in the elderly.

Too often age is equated with pathology. Health promotion strategies need to be modified for the elderly. They must include social and political action as well as life-style changes.

Aged↗

Auditing clinical placements.

The auditing of clinical areas is an important aspect of evaluating and maintaining standards in the Project 2000 scheme of nurse education. The auditing process brings many unexpected additional benefits, including increased ownership of the course and a developing sense of partnership between clinicians and educators. It is not an endeavour that should be undertaken lightly, and many problems can be prevented by good planning, which may include extensive piloting of the audit tool and process.

Clinical Competence↗