Journal of Research in Nursing最新文献

Aim: To explore how nurses understand and make sense of multiple definitions of nursing practice.

Methodology: The study used ethnomethodology to explore how nurses in an acute hospital ward shape, construct and sensemake nursing practice in their everyday worlds. Multiple data sources were used to triangulate different constructions of reality and generate a broader understanding, including non-participant shadowing of nurses during eight shifts, semi-structured interviews with six registered nurses and a review of the nursing section of the hospital's Electronic Patient Record system. Data were collected in two surgical wards in an acute hospital (2019-2020). Data were iteratively coded and refined through all stages of the study.

Findings: Nurses make sense of conflicting expectations by creating multiple realities which they apply in different situations to structure how they deliver care. This finding suggests that nurses move seamlessly and unknowingly through these created realities, supported by using specific but discrete languages that they can effortlessly adopt. A consequence is that no single model or theory contains all the realities.

Conclusion: This study goes some way to explain the described difference between work-as-imagined and work-as-done. Failure to acknowledge the multiple realities constructed in practice during pre-registration education may explain the theory-practice gap that many new graduates experience and why anticipated outcomes described in research projects might not be realised in everyday practice.

Implications: Nursing practice is not governed by a single theory or model, and nurses make pragmatic transitions between different expectations. Recognition of this is critical to effective planning and leadership of the nursing resource. Using electronic records as a single measure of nursing work has the potential to create a bias towards one reality and thereby render other aspects of nursing value invisible. Failure to embrace the totality of nursing practice may impede the delivery of anticipated patient outcomes and system efficiencies.

Background: COVID-related clinic shutdowns mandated the use of a day 1 telephone follow-up the day after routine cataract surgery rather than clinic attendance. We investigated to see if this is a safe alternative to standard care.

Methods: Ninety-nine patients who underwent a routine cataract extraction between 22 April 2020 and 19 August 2020 at our Hospital were included in this audit. On post-operative day 1, a standardised questionnaire which screened for ocular symptoms and the observance of correct post-operative procedure was administered. Additionally, an ophthalmic nurse delivered a set of instructions. Patients were then reviewed at our clinic on post-operative day 30. Complications and subsequent clinical management were recorded at this consultation.

Results: The complications found were largely in line with international data and included: prolonged anterior chamber inflammation, cystoid macular oedema, refractive surprise and phimosis. Management at 1-month patient review was in all cases expectant, and there were no complications requiring urgent attention.

Conclusions: A nurse conducted telephone questionnaire on post-operative day 1 appears to be a safe alternative to traditional follow-up. With its implementation, ophthalmic nurses can help relieve strain on ophthalmology departments.

Background: Sexual and gender minority (SGM) individuals experience elevated rates of depression due to exposure to unique social stressors associated with membership in a stigmatised minority group. Coping style has been shown to buffer or exacerbate responses to stress. To date, little is known about the risk or protective influence of coping styles on the relationships between stressors and depression in SGM populations.

Aims: To examine the moderating effects of coping styles on the relationships between stressors and depression in Thai SGMs.

Methods: This cross-sectional descriptive survey was conducted between March and August 2018 using in-person and online surveys. Convenience and snowball recruitment strategies were used. Standardised measures were selected according to the Minority Stress Model. Bivariate and multivariate analyses were conducted. Hayes's PROCESS macro was used to test for significant interactions.

Results: Of the 411 participants, 40% of the participants reported symptoms of depression that were associated with multiple stressors. Problem-focused coping was reported by most participants (95.8%), followed by social support (83.1%) and avoidance (49.1%) coping. Problem-focused coping weakened the relationships between stressors and depression, whereas avoidance coping strengthened the relationships between depression and stress, loneliness and discrimination. Social support coping was negatively related to depression, with no statistically significant moderating effects.

Conclusions: Problem-focused coping served to mitigate the influence of stressors on depression, whereas avoidance coping strategies exacerbated the impact. Nursing interventions aimed at improving problem-focused coping may reduce the negative consequences of stressors on the mental health of SGMs.

Background: Heart failure (HF) patients can experience poor appetite and intense thirst. The Thirst Distress Scale for HF (TDS-HF) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are tools used to assess these symptoms. However, these questionnaires are not currently available in Thai.

Aims: To translate the TDS-HF and SNAQ into the Thai language and to evaluate the reliability and validity of these translated instruments.

Methods: The TDS-HF and the SNAQ were translated from English to Thai using a forward-backward method. Their face and content validity, their internal consistency and test-retest reliability, were assessed with a sample of 20 HF patients recruited from a single supra-tertiary hospital in Thailand.

Results: Participants reported that the TDS-HF and the SNAQ had face validity. The content validity was assessed as adequate by the expert panel. The Cronbach's alphas of the TDS-HF and the SNAQ were 0.91 and 0.71, respectively. The intraclass correlation coefficients of the TDS-HF and the SNAQ were 0.91 and 0.91, respectively.

Conclusions: The Thai versions of the TDS-HF and the SNAQ demonstrate adequate validity and reliability. These tools hold significant potential for supporting clinical practice, particularly for nurses involved in HF management by helping to assess thirst and appetite effectively.

This opinion paper addresses the role of nurses and the relevance of models and theories, both nursing and infection prevention and control (IPC), to visitor restrictions that were widely enforced in many countries during the COVID-19 pandemic, with a focus on person-centredness. It outlines the social utility of nursing, reflecting on whether what happened during this period has made nursing theories more less relevant. It suggests that IPC guidance, rooted in a historic biomedical model, has had a tendency not to consider the impact that the precautionary measures it recommends, rather than the infections themselves, might have on the quality of life of people receiving healthcare. A key driver of the visitor restrictions seemed to be the pursuit of this biomedical model across the health system that was at odds with the person-centred theories of nursing. The paper questions the limitations of focusing on a biomedical logic for guiding the ethics of nursing. The IPC community working with the nursing profession, recapturing some of the theoretical principles of person-centred approaches, could help build a blueprint for compassionate IPC decision-making for the future. The paper outlines seven policy, practice and research considerations that might address the issues raised.