1,721,106 research outputs found
Helping people with advanced cancer and their care givers manage conflict over food
No full textBackground: Conflict over food can be aproblem as end of life approaches (Holden, 1991; Meares, 1997). This paper is the first to describe strategies that patients with advanced cancer and their caregivers use to manage eating related conflict.Method: The research was an in-depth case study of weight loss and eating difficulties in people with advanced cancer. The study participants included 32 patient-caregiver pairs receiving palliative home care in the South of England in either 2003 or 2005. Methods of data collection included semi-structured interviews that were analysed using both content and thematic approaches. An emergent theme was ‘conflict’. This paper reports an analysis and interpretation of the conflict data.Findings: Conflict over food had arisen between 26 of the patient-caregiver pairs. There were four different pathways to the conflict: ‘battle for control’, ‘competing goals’, ‘competing understandings’ and ‘feeling uncared for’. Strategies used to manage life with conflict over food, such as ‘education’, could lead to conflict resolution. When conflict resolution had been achieved, the conflict could be seen as acatalyst that aided adaptation to life with eating related problems. In other words, conflict could be beneficial.Conclusions: Facilitating resolution in conflict over food may be an important role for cancer care nurses. A follow-on study is now in progress. This study will test an intervention intended to help patients and their care givers manage eating related conflict
Book Review: Qualitative research practice
No full textThis is a book for researchers. I love it, but I'm a professional nurse-researcher!The book is an anthology. It is about putting research methodology and method into practice. Each chapter has a different author who presents an issue in their particular area of research expertise. Typically, the author explores the issue by drawing on examples of how it has been problematic in their own research and how they have found a pragmatic solution.For example, Chapter 6: Narrative Research, is written by four narrative researchers; Molly Andrews; Shelley Day Sclater; Corinne Squire; and Maria Tamboukou. Although they have worked closely together for years, they could not reach a consensus view on narrative research for the purpose of writing the chapter. They illustrate their lack of consensus by each presenting their own research story. This demonstrates that the many forms of narrative research can all generate useful and relevant insights.The book is full of authoritative voices from the world of qualitative research. It has utility for research students wanting to familiarise themselves with issues faced by practicing researchers. I can envisage it being referenced in many nursing doctoral theses in the future. It is also useful for people like me, who have to find solutions to these authors' challenges in my everyday working life as a nurse-researcher. I learned a lot from reading about how the contributors practice their craft.I found this textbook a really engaging read, although a little too big and heavy to carry around in a handbag
Book review: Focus on solutions, by Kidge Burns
No full textThe book is about solution focused brief therapy (SFBT): a talking intervention intended to support patients in finding their own solutions to problems. It is written for practitioners, including nurses.The author is a speech and language (SLT) therapist in the United Kingdom. The majority of examples of delivering SFBT are taken from her own practice and are persuasive in illustrating how it can complement traditional SLT interventions for speech problems. The book begins with an account of SFBT, which draws on sources written by the pioneers of the therapy. The titles of chapters 2 and 3 imply that they explore the application of the intervention in acute and home care settings, respectively. These chapters do give examples of using SFBT in acute and home care settings, but also include other interesting but tangential information. For example, chapter 2 'Clients in the acute setting', includes a section about training students. Chapters 4 and 5 are the most valuable. These chapters provide transcripts of therapeutic encounters between the author and clients. The transcripts are supported by a description of the SFBT techniques illustrated through the dialogue and how these were therapeutic. The final chapters look at the use of SFBT with groups, as opposed to individuals. Throughout the book, a limitation is its signposting. I read from beginning to end, then I tried to return to those topics that interested me most. This book is difficult to navigate.Traditional health care provides solutions for clients' problems. Solution focused therapy takes a different approach. It is based on the assumption that the client has the solution to their problem, but needs help to discover it. The emphasis is on empowerment. Integrating this approach with traditional service delivery presents many challenges. These challenges include a cultural shift in the understanding of what a healthcare professional does. Integrating SFBT with biomedical interventions and traditional care is not simple. It is disappointing that the book does not include a discussion of the contextual obstacles to delivering SFBT and how these have been overcome in the author's experience.This text is a brave attempt to disseminate an innovation in SLT practice. I am uncertain that it would enable a nurse to practice SFBT, but it could ignite interest in the approach and provide impetus for similar innovation in general nursing practice
Facilitating the development of clinical skills in caring for dying people in hospital
No full textResearch shows that diploma level preparation has resulted in newly qualified nurses with clinical skill deficits (e.g. Macleod Clark et al. 1996, Carlisle et al. 1999). Part of the government's current plan to improve the quality of services delivered by the NHS is to address this problem through the introduction of a new nursing role; a role incorporating both clinical practice and teaching (Department of Health 1999). This paper draws data from a phenomenological study of 28 qualified diplomat nurses. It identifies their self-perceived skill deficits in relation of caring for dying people in acute hospital medical wards, and the ways that they believe that they could best be helped to overcome these deficits. On the basis of these findings, strategies are recommended that a practitioner-educator might adopt, with the intention of facilitating skill development in the care of dying people. <br/
Carers' influence on diets of people with advanced cancer
No full textBackground: The Macmillan weight and eating studies 2003-2007 are investigating ways of helping people with advanced cancer live with symptoms of weight loss and loss of appetite. These can cause distress for both patients and carers, and can be a source of conflict between them.Aim: To examine a specific cause of distress (healthy-eating messages), and the implications for nursing practice.Method: Data for this article is taken from a mixed method exploratory case study carried out in 2003 and a pilot study for a trial in 2005.Results: Carers are committed to helping patients and believe it is important to encourage them to eat. However, the influence of healthy-eating messages can lead to inappropriate feeding and cause distress for both groups.Conclusion: Nurses can help by assessing carers’ concerns about patients’ eating habits and providing information about eating well in advanced cancer.<br/
The hidden benefit: The supportive function of the nursing handover for qualified nurses caring for dying people in hospital
No full text• The nursing handover is a key activity for nurses working in acute hospital wards in the NHS. Little scholarly attention has been paid to the use nurses make of the information exchanged during nursing handover or how certain features of the nursing handover might impact positively or negatively on patient outcomes.• This paper draws on data from a phenomenological study of 28 qualified diplomate nurses.• During the course of non-directive semi-structured interviews, some of the participants in this study expressed the opinion that nursing handover was helpful in enabling them to work with dying people in the acute hospital medical wards in which they worked.• The nurses identified two important functions of the nursing handover. The first was as a forum for discussing opinions and expressing feelings. The second was as a source of information on which to base their nursing decisions and actions.• It is proposed that some qualified nurses need help with the emotional labour of caring for dying people and that the nursing handover can assist in emotional adaptation, so enabling the management of troubling thoughts or feelings experienced in the course of caring for someone who is dying.• The role of the nursing handover in providing emotional support for nurses has been little studied and is a potentially useful area of future research, especially if it can be related to patient experiences and outcomes.<br/
Emergency hospital admissions for ill-defined conditions amongst older people: a review of the literature
No full textObjective. To conduct a review of the literature on frequency and characteristics of emergency hospital admissions of older people for ill-defined conditions.Background. Emergency hospital admissions for ill-defined conditions are increasing for older people. Despite concern about this trend little is known about the frequency or characteristics of such admissions in emergency medical settings.Method. Relevant papers were identified by searching Medline, Cinahl, Web of Science and other databases. Papers that met inclusion criteria were selected. A descriptive analysis approach was taken.Results. Eighteen studies met the inclusion criteria for the review, all descriptive, survey or cohort studies. None directly investigated the patient group. Some relevant data were available, particularly in relation to frequency of admissions for ill-defined conditions.Conclusions. There is a paucity of research on the patient group, but the evidence available suggests the incidence of these admissions is high in emergency settings and in many countries. Future research on incidence in specific settings, appropriateness of admissions and patient characteristics is urgently required.Relevance to clinical practice. As the population ages increased numbers of older people will be admitted to hospital for ill-defined conditions. Nursing interventions may contribute to future management of these patients
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