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Pediatric wards in South Africa are largely occupied by children with AIDS-related illnesses. This study uses qualitative inquiry involving focus groups with nurses into the needs of children, caregivers, and healthcare providers. The findings indicate changes to the nature of nursing practice, knowledge of nursing, and ethics of nursing care.
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This study assessed faculty members' perceived knowledge of medical genetics concepts and conditions, the importance of integrating this content into NP curricula and how this was being done. During a national NP conference, 40 NP faculty voluntarily completed surveys. Participants' perceived knowledge of genetics varied; 35% noted low or very low knowledge, and only 5% reported high or very high knowledge. Most participants (95%) believed genetics is important, but only 10% reported having separate genetics courses in their NP programs. Approximately half of the participants reported personal involvement in genetics NP education, and 50% reported barriers to implementing it into their curricula. Most faculty indicated they did not feel comfortable teaching genetics, nor did they have formal training in the area. Advancing medical genetics into NP curricula will require ongoing faculty development and training to sustain and build genetics skills and competencies for advanced practice nurses.
Health for All by the Year 2000 is a theme developed in 1979 by the World Health Organization. The theme includes oral health and is being promoted throughout the world. The advances in dental research make it possible to improve oral health and, concomitantly, general health. With the appropriate use of science-based, preventive regimens, dental caries and periodontal diseases can be prevented or controlled. Further, major risk factors for oral and lip cancer are known; thus, it is possible to reduce the incidence of these diseases. Available technologies, however, are useful only when they are used by appropriate user groups as recommended. The gaps between what is known about preventing oral diseases and what is practiced are often extensive. This presentation explores differences between scientific knowledge about risk factors for oral diseases and preventive regimens and procedures, public and professional knowledge and practices, and professional support for improved oral health through the application of primary preventive procedures, often referred to as "science transfer". Barriers to the adoption of preventive regimens and practices are discussed. Strategies using health education and health promotion for narrowing these gaps are presented.
Asthma is a chronic illness that affects 5% to 10% or about 5 million children in this country. Morbidity and rising mortality rates are of particular concern in minority children. This study addresses a serious knowledge deficit about the management of asthma in minority children by testing the effect of a school-based asthma education program on psychosocial and health outcomes of 8-13-year-old inner-city minority students. Although the mean scores of the treatment group were higher than the control group on several of the psychosocial measures, these changes were not significant. However, significant differences were found between the groups on health outcomes. Recommendations for future research and clinical practice are discussed.
There has been a drive towards addressing the types of care and therapeutic interventions available to people with serious mental illness, which is reflected in the latest government mental health policy initiatives. Recent evidence strongly supports the implementation of psychological and social interventions for people with psychosis, and in particular the use of cognitive behavioural techniques. Until now, the main focus has been on people living in the community. This study examines the delivery of psychosocial interventions training to qualified psychiatric nurses and unqualified staff on seven acute psychiatric admission wards in London, UK. The approach had the strength of on-site delivery, follow-up role modelling of the interventions and clinical supervision. Despite this, in some cases the training was less successful, mainly because of staffing and leadership weaknesses. The impact of training in these methods and the implications for mental health education and practice development are discussed.
At the request of Native community-based organizations in Montreal, a needs assessment for an HIV and AIDS education and prevention program for urban Natives was initiated. A five-session focus group concerning HIV and AIDS was attended by nine Native persons over a 2-month period. Data was collected using the guidelines of the HIV/AIDS Rapid Anthropological Assessment Procedures (AIDS RAP) developed by the Social and Behavioural Research Unit of the World Health Organization's Global Programme on AIDS. We followed these up with in-depth semistructured interviews with five different members of the Montreal Native community. The data were reviewed by a steering committee to ensure validity. Findings highlight the potential explosive route of transmission of HIV along networks of sexual interaction between persons in urban areas and then to rural partners. Maintaining control over the AIDS program planning within the community permits issues such as traditional values and healing practices to be discussed and taken into account.
This study presents an integrative review of published research articles on positive health practices (PHP) as defined by Muhlenkamp and Brown. Using Cooper's guidelines for accomplishing an integrative review, 29 relevant studies concerning PHP were located, reviewed, and critiqued; theoretical and methodological issues emerging from the studies were identified. Directions for future research on PHP are specified. Implications for nursing practice derived from the research findings are addressed.
A study of awareness and use of family planning methods among 1188 married women aged 15-40 years, attending antenatal clinic in four different locations, conducted in Ibadan, Nigeria between May to December 1995 is reported. Most respondents (94.3%) were aware of the use of family planning but only 12.0% had ever visited a family planning clinic. Awareness of specific methods was 82.6% for condoms, 75.7% for oral contraceptives, 75.5% for injectable contraceptives and 65.3% for intrauterine device. Current use of family planning methods was low with 10.0% using withdrawal, 8.1% oral contraceptives, 5.2% using intrauterine devices and 4.7% using condoms. Perceived constraints to the use of family planning methods included husband's opposition, fear of complications and perceived insufficient knowledge about family planning methods. It is concluded that there is a knowledge-practice gap in the use of family planning methods among married women in Ibadan, Nigeria. Improved education strategies and better access to services are needed to solve these problems.
There is confusion and misunderstanding about the concepts of knowledge translation, knowledge transfer, knowledge exchange, research utilization, implementation, diffusion, and dissemination. We review the terms and definitions used to describe the concept of moving knowledge into action. We also offer a conceptual framework for thinking about the process and integrate the roles of knowledge creation and knowledge application. The implications of knowledge translation for continuing education in the health professions include the need to base continuing education on the best available knowledge, the use of educational and other transfer strategies that are known to be effective, and the value of learning about planned-action theories to be better able to understand and influence change in practice settings.
Implicit in the evolving role of pharmacy is that its practitioners embrace the concept of quality of life (QoL). In recent years there has been an increased interest in incorporating health-related quality of life (HRQoL) measures into clinical practice, primarily focusing on the physician as the user of this information. Pharmacists may be able to use these instruments in their practices to provide better pharmaceutical care. To explore the feasibility of such an undertaking, questionnaires were mailed to a national sample of community pharmacies. In addition to the questionnaire, the respondents were provided with examples of two instruments: the Duke Health Profile and the QOLIE-10. A definition of HRQoL was provided to the respondents. After two mailings and a reminder postcard, a usable response rate of 27.2% was achieved. The results revealed that over 80% of the respondents currently discuss HRQoL issues with their patients. In addition, 66% reported that they attempt to assess the HRQoL of their patients, albeit usually on a subjective, informal basis. After viewing examples of HRQoL instruments, over three-quarters of the respondents reported a willingness to use HRQoL assessment tools in their practices. However, only 53.7% of the respondents were familiar with the concept of HRQoL. Less than 5% reported familiarity with formal instruments. The self-reported knowledge of pharmacists concerning HRQoL was low and the respondents recognized a significant gap between their current knowledge and the level of knowledge needed to assess the HRQoL of their patients formally. The results suggest a possible role for the pharmacist in HRQoL assessment. However, the use of HRQoL instruments in community pharmacies will require further training and education on the part of pharmacists concerning the concept of HRQoL, the issues involved in its measurement and how they can use HRQoL information in their practices. In addition, a number of unanswered questions must be addressed through the research process in order for HRQoL questionnaires to become clinical tools in the practice of pharmacy.
In the first of two articles, the authors describe the development of outcome measures for nursing older people in a continuing care setting. They describe why such a process was initiated and the framework which guided the project, including current nursing and government policy and theories of knowledge and expert practice. The second article will appear next week.
The campaign for exclusive breast-feeding in a baby-friendly hospital at Prapokklao Hospital, Chanthaburi was increased. The contributory factors was likely due to enforcement of early bonding and attachment, by rooming-in of infants in the materity ward. After cessation of comprehensive intervention exclusive breast-feeding dropped significantly but increased in predominant breast-feeding. This might be due to family influence with the suggestion to give water in addition to breast milk. Data shows that rooming-in is essential in the promotion of breast-feeding. A decreased of abandoned children indicates early bonding. To sustain a baby-friendly hospital, 10 steps to successful breast-feeding must be followed strictly. Intervention activities must be done continuously with cooperation of health providers at all levels. It is felt that breast-feeding should not be considered a maternal instinct but a new behavior that needs to be changed to a point that mothers adopt breast-feeding practices for 4 months after delivery.
OBJECTIVES: It would appear that mothers are the main organisers for their child's immunisation. What do they know about immunisation? What are their reasons for having their child immunised? What are their experiences of the process and the difficulties they encounter? This study focuses on these questions. METHOD: A representative sample (n = 242) of mothers giving birth in southern Tasmania completed two questionnaires post partum, one during the first week and the other at 12 months. RESULTS: Primigravidae women were less well-informed about immunisation than multigravidae women. Almost all the mothers intended to immunise their babies for their child's welfare. However, at 54 weeks only 21% were fully immunised. General practitioners immunised 74% of the babies. Mothers were primarily responsible for arranging and overseeing the baby's immunisation. Problems included: lack of child care and of accompanying adults; post immunisation reactions (80% of babies); and inadequate information about immunisation reactions. Most mothers supported immunisation reminder systems and written records of immunisation. CONCLUSION: The general practitioner, the preferred provider of immunisation, can facilitate the translation of a mother's positive convictions into action important potential strategies include: mother friendly appointment systems; providing more information on immunisation, including possible reactions; general practice based immunisation outreach programs and domiciliary visiting.
AIM: This paper reports on an action research study which raised some questions about the processes of developing a sense of shared ownership in action research in a research environment which does not always have the appropriate mechanisms to support and sustain action research. BACKGROUND: Action research has gained popularity in nursing and healthcare research, offering a way of developing practice-based knowledge, which can assist in changing practice and democratizing inquiry. METHODS: There are other organizational constraints on action research which arise at different levels, and which also require discussion. These can be issues about communication and ownership at a practice level and issues of funding and project management procedures. This paper reports on a study in which these issues came to the fore, and offers some thoughts on how they can affect the processes of action research. CONCLUSION: While the principles of action research appear to offer much towards the development of a practice-rooted body of knowledge for nursing, unless some of the issues of ownership are resolved, it is unlikely to move beyond academic rhetoric. RELEVANCE TO CLINICAL PRACTICE: If nursing is to engage in action research, this must be done critically and reflectively and careful attention paid to developing an inclusive and collaborative approach to knowledge and practice development. Furthermore, to develop in nursing and health care research, it must find ways to meet the requirements of funding bodies.
With increases in life expectancy and increasing numbers of older patients utilising the acute setting, attitudes of registered nurses caring for older people may affect the quality of care provided. This paper reviews recent research on positive and negative attitudes of acute-care nurses towards older people. Many negative attitudes reflect ageist streotypes and knowledge deficits that significantly influence registered nurses' practice and older patients' quality of care. In the acute setting, older patients experience reduced independence, limited decision-making opportunities, increased probability of developing complications, little consideration of their ageing-related needs, limited health education and social isolation. Available instruments to measure attitudes towards and knowledge about older people, although reliable and valid, are outdated, country-specific and do not include either a patient-focus or a caring perspective. This paper argues for the development and utilisation of a research instrument that includes both a patient focus and a caring dimension.
OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in child and adolescent psychiatry. ADHD children are at risk for academic and psychological difficulties. Lack of cooperation between schools, parents and therapeutic institutions inhibits a multimodal treatment program. This study surveys teachers' knowledge and attitudes towards attention deficit hyperactivity disorder. METHOD: One hundred and ninety six elementary school teachers in Shiraz, Iran, anonymously completed a self-report questionnaire on ADHD. RESULTS: Knowledge about ADHD was relatively low. 46.9% of respondents agreed that ADHD is due to biological and genetic vulnerabilities and causation. 53.1%of all the teachers considered ADHD to be the result of parental spoiling. The attitude score towards ADHD children was also low. 64.8% agree that the same disciplinary rules used for all students should also be applied to ADHD children. 77.6% believe that ADHD students experience difficulties in their relations with their classmates. There was a significant correlation between teachers' knowledge of ADHD and their attitude. The main sources of knowledge about ADHD were: Television and radio; friends and relatives; periodical, newspapers and magazines. CONCLUSION: Knowledge about ADHD was sound to be very low. PRACTICE IMPLICATIONS: Health and/or Educational Ministry should promote a special course on ADHD for teachers and education should be part of the curriculum in faculty training. Providing these educational programs on television and radio may be highly effective as they were the most common source of information.