Verpleegkunde最新文献

Few reliable data are available about nursing care in the Netherlands, whereas pressure from society to support the contributions of the discipline of nursing to health care delivery increases. This paper presents an information model to support analytical access to nursing labour and services. This model, the nursing information reference model (Dutch acronym 'VIRM') focuses on the structure to achieve congruence between data from the primary process of nursing care and data derived from that process for clinical practice, management, research, and policy purposes. The model is based on the 'collect-once/use-often' principle of data collection and management, which emphasizes single collection and registration through the patient record for multiple subsequent uses and purposes. In this paper core elements of the VIRM are being discussed. Determination of data from the primary process of nursing care to be provided for certain aims is currently being conducted by the Dutch Nursing Minimum Data Set (VMDNS) initiative. The article at issue should be understood as a starting point in the discussion about the development of a Nursing Minimum Data Set in the Netherlands.

This article describes the experiences of nurses concerning the activities related to euthanasia of patients with aids. The nurses were employed in departments where relatively young, mature people wanted to arrange their own death. Our findings are based on six in-depth interviews with experienced nurses, that are part of a qualitative study into the experiences of nurses in taking leave of terminal patients with aids. The research strategy was based on the Grounded Theory. In order to analyse the experiences of the nurses, four phases were distinguished: set date and time unto application of lethal agent; application unto becoming unconscious; unconsciousness to death; death until transferring the body from the unit. Feelings that occur when taking leave of the patient, if not already taken care of at an earlier instant, play a major role in the phase from application to becoming unconscious. The fact that a deadly agent is being administered can generate feelings of guilt and anxiety. The period from unconsciousness to death is one of waiting. During this period nurses feel alienated and alone. The nurses indicated explicitly that an adequate preparation, evaluation and support are extremely important.

The primary question in this survey was: Is it possible for a panel of experts, by means of existing measurement scales, to weigh and rank criteria in order to get a more refined judgement of quality. For this purpose 134 criteria were presented to a panel of experts using the Delphi-method. In two Delphi-rounds the panel selected 28 most important and 18 least important criteria by means of the VAS and the Coombsscale. This resulted in a selection of 34% of the original number of 134 criteria. The results proved it to be possible, to rank and weigh criteria by means of the VAS and Coombsscale in a Delphi-survey. If it is desired that a numerical value be attributed to criteria which differ little on a notional continuum, the Coombsscale appears to be most suitable. The VAS is not adequate in reaching 70% consensus in regarding least important criteria in a group of existing criteria.

Based on a review of the literature on prediction and prevention of pressure sores, a conceptual scheme is introduced. The three determinants--pressure, shearing force and tissue tolerance--are discussed.

This article describes an investigation of relationships between work characteristics and worker reactions in three elderly homes of a Dutch foundation. Moreover, main effects as well as moderating effects of some relevant individual variables were studied. Variables were measured by means of questionnaires; 144 subjects from the caring and household departments took part in the study. From the results it appeared that social support, growth opportunities and work pressure are related to work satisfaction, work motivation and health complaints. The individual variables need for autonomy and coping strategies showed main effects as well as moderating- (buffer-) effects. On the basis of the findings practical consequences for the management of personnel and work have been formulated.

For different reasons interest for the subject 'quality of care' has increased the last couple of years. One of those reasons is a greater emancipation of the patient, who, just like the insurers, will ask for quality guarantees in the future healthcare system. In this context the relation between the quality of the nursing care (process-variable of the quality of care) and perceived stress and satisfaction of patients and the satisfaction of nurses with their work (outcome-variables) has been investigated. In this investigation a positive relationship has been found between the coordination of care (a dimension of the nursing care quality) and the stress experienced by patients. Also a positive relationship between two dimensions of the nursing care quality (the instrumental and expressive dimensions) and the satisfaction of patients has been found. Finally it is indicated that a negative relationship exists between the instrumental-technical dimension and the satisfaction of nurses.

This paper is concerned with a qualitative study about feelings of powerlessness of community nurses involved in caring for cancer patients suffering pain. From semi-structured interviews the following causes of feelings of powerlessness appeared: discommunication with patients and the general practitioner, dilemmas concerning physical care and opiates and a discrepancy between pain management goals and reality. Main strategies for reducing feelings of powerlessness were: sharing feelings with the patient and colleagues, increasing knowledge and skills and standing back from the situation.

Compliance has been the subject of a discussion between several branches of science. This discussion is mainly focused on questions of terminology and definition. Common usage of terminology and prevailing definitions have the disadvantage that they tend to stress the subordinate position of the patient in relation to the health expert. In this article an attempt is made to fit compliance into Orem's 'self-care deficit theory of nursing'. Compliance is a part of self-care; noncompliance can be seen as a self-care deficit. In contrast with self-care, compliance is not always performed on behalf of maintaining health and well-being. Whereas a self-care deficit is always a threat to health and well-being non-compliance is not.