An investigation of emotional wellbeing and its relationship to contemporary nursing practice

This paper is an investigation of emotional wellbeing and its relationship to contemporary nursing practice for women community health nurses (CHNs) who are providing palliative care. Palliative care provision has been acknowledged as a source of job satisfaction for many nurses however emotional interactions place increasing strain on nurses' wellbeing. Psychosocial aspects of care are reported as having a personal as well as a professional impact. Work related stress places nurses at increased risk of harm and impaired wellbeing. An emancipatory methodology was chosen for this study. Semi-structured interviews and reflective journaling were the methods used. The data was collected over a 16-month period during 2006-2007. There were fifteen participants. This qualitative study explored Australian rural and urban community nurses' experiences with wellbeing, emotional work and their professional practice. The findings revealed opposing social forces, an inner 'dialectical' tension between the nurses' expectations of their professional practices and what is valued in their practice settings. In terms of emotional wellbeing, two overarching themes will be discussed: feeling balanced and feeling out of balance. Workplace environments that were not always conducive to healing increased the emotional strain on nurses. Nurses' work promotes the healing of others therefore to deny the healing of nurses' is to deny others of healing. The need for further qualitative research investigating the emotional wellbeing and professional practice of community nurses who provide palliative care is necessary.

Self-efficacy and the sense of coherence: narrative review and a conceptual synthesis

In this study, the authors develop an exploratory synthesis of two major health concepts: Antonovsky's sense of coherence and Bandura's beliefs in one's own efficacy. Reinterpretation of each study in the light of the other can lead to greater conceptual development and expand existing knowledge. The mutual themes are presented with an explanation of their contribution to broader conceptual discussions. The existence of some similarities between the two concepts is suggested. Researchers can obtain valuable and additional arguments through cross-fertilization of ideas across presented studies united by shared assumptions. Further research is recommended among various age groups and social backgrounds in order to verify the possible benefits of such theoretical development. Theoretical and practical implications of such a synthesis are presented.

Mind-body medicine: a conceptual (re)synthesis?

The aim of this paper is to review the literature on mind-body medicine (MBM) in a narrative manner. A coherent construct is explored and developed that includes a conceptual synthesis of existing theories that is grounded in qualitative paradigms. Theoretical reflections on MBM are addressed in order to overview its practical implications. The logic and underlying principles of MBM are highlighted with regard to the benefits that this modality is reputed to produce. Its therapeutic and preventive values, as well as strategies for its development and promotion, are also considered. The paper proposes several recommendations for future healthcare practices. These include the need to build a complex, multidimensional model of MBM and the integral practical implications. The core information regarding the essence of MBM is discussed in relation to the existing literature and, in particular, quantum physics.

The importance of emancipatory research to contemporary nursing practice

When considering the significant changes that continue to transform nursing practice, a focus on evidenced-based practice has clearly placed nursing research at the forefront of professional practice. The aim of this paper is to highlight the important contribution that emancipatory research methodologies can make to the ongoing development of contemporary nursing practice. A research example demonstrates how an emancipatory framework was applied to a recent doctoral study undertaken with Australian community nurses who provided palliative care. The research focus was on exploring the relationship between the nurse's emotional well-being and their professional practice. The research was epistemologically located within a critical and feminist framework. Emancipatory research is well situated to address the subjective experiences of nurses and to contribute strongly to the future of nursing practice.

Nurses and palliation in the community: the current discourse

A core component of community nursing practice in Australia is the provision of palliative care, however this area of practice has been minimally researched. We, therefore, undertook a broader review of the contemporary literature in community nursing; palliative nursing; and community nursing palliative care. Literature was searched electronically in OVID, CINAHL and nursing databases and manually in relevant journals. Findings revealed community and palliative care nursing to be both complex and challenging. Community and palliative nurses ideals for care are compromised by competing practice demands. Changing health systems and philosophical views, limited resources and the perceived 'visibility/invisibility' polarity are identified as major job stressors. Therapeutic use of 'self' and interpersonal communication are recognized as contributing to job satisfaction. Community nurses providing palliative care is as an under researched area yet it is a role that arguably requires critical understanding and recognition. Further research is needed into the relationship between emotional well-being and professional satisfaction for community and palliative care nurses providing palliation.

Community mental health nurses speak out: the critical relationship between emotional wellbeing and satisfying professional practice

The article reports on selected findings of a research study concerning emotional wellbeing and professional nursing practice (Rose 2002). It highlights the relationship between community mental health nurses' and emotional wellbeing, and their capacity to provide satisfying professional nursing practice (Rose 2002). The notion of emotional wellbeing, factors that impacted upon the participants' emotional wellbeing, and the relationship of emotional wellbeing to professional practice were revealed in the study. These findings were based on a qualitative critical feminist research inquiry and specifically, interviews with five women community mental health nurses in Australia. Whilst complex, emotional wellbeing was found to be both implicitly and explicitly linked to the participants intertwined personal and professional experiences. Four key components were identified: the nebulous notion; the stress relationship; the mind, body, spirit connection; and, inner sense of balance. In terms of emotional wellbeing and professional practice, three themes were revealed. These were: being able to speak out (or not); being autonomous (or not) and being satisfied (or not). The authors argue that the emotional wellbeing of nurses working in community mental health settings is critical to satisfying professional practice. Furthermore nursing work involves emotional work which impacts on one's emotional wellbeing and emotional wellbeing is integrally linked to professional practice. It is recommended that health organisations must be pro-active in addressing the emotional needs of nurses to ensure the delivery of health care that is aligned to professional practice. This approach will ensure nurses will feel more recognised and validated in terms of their nursing practice.

Internationalizing nursing: valuing the multiple places and spaces of nursing education

Effective internationalization of nursing education means looking outside one's comfort zone. As Heinrich (1997, 2001) has shown, nurses can reflect on the risks related to maintenance of the status quo and perceptions of nurses' ways of being, and also become heroic in their educational approaches. If nurses are willing to learn from each other, regardless of where they received their nursing education, it is possible to enhance the rich tapestry of nursing actions, experiences, and expertise. The articles in this issue focusing on international nursing education provide greater insights into current research in this discourse and provide nurse educators with further knowledge that will enhance curriculum development and implementation, as well as professional nursing relationships.

Mobile subjectivities: positioning the nonunitary self in critical feminist and postmodern research

Most scholarly work is written from the perspective of the author being a unitary subject occupying a sole, rational, and unified position. This article argues that scholarship may be enhanced by the author adopting multiple subject positions as a methodological framework. Such an adoption is advantageous in working against the romance of the notion of a single truth while also maintaining teleological values congruent with critical and feminist agendas. This article outlines the conceptual development of this methodological framework, the rationale for its development, an explication of the concept of multiple subjectivity, and an exemplar of its application within nursing research.

Taking the Eagleʼs View

Watson's conceptual model of a caring-healing transpersonal understanding of nursing was used to underpin a hermeneutic phenomenological study of the extraordinary and transformational experiences of nurse healers. The 5 essential themes uncovered from the analysis of interviews with 11 nurse healers--Belonging & Connecting, Opening to Spirit, Summoning, Wounding & Healing Journey, and Living as a Healer--are set out, along with the overarching theme "Walking Two Worlds." Foundational understandings of Watson's model as they relate to the findings, and theoretical aspects, are discussed, and potential contributions of this study to the ongoing evolution of Watson's conceptual model are articulated.

Community mental health nurses and their emotional wellbeing: is anyone listening?

This paper highlights some of the findings from a recent study with women community mental health nurses which explored the relationship between emotional wellbeing and professional practice. Specifically, this article addresses the unique meaning of emotional wellbeing, self healing strategies used by participants, and identifies the relationship to professional practice. The findings revealed that the notion of emotional wellbeing whilst complex was explicitly linked to the iritertwining of their personal and professional experiences and situations. It is argued that the implications for failing to meet the needs of our nurses will not only jeopardise the nurses themselves but moreover the clients as recipients of such an essential service.

Reconceptualizing vulnerability: deconstruction and reconstruction as a postmodern feminist analytical research method

Nursing research informed by postmodern feminist perspectives has prompted many debates in recent times. While this is so, nurse researchers who have been tempted to break new ground have had few examples of appropriate analytical methods for a research design informed by the above perspectives. This article presents a deconstructive/reconstructive secondary analysis of a postmodern feminist ethnography in order to provide an analytical exemplar. In doing so, previous notions of vulnerability as a negative state have been challenged and reconstructed.

Studying women nurse academics: exposing workplace violence in Australia: Part 2

This article is the second in a series on workplace violence in academia. The specific findings on women nurse academics' experiences with violence in Australian universities are revealed. Findings indicate that Australian universities are competitive with wide spread violence. Participants revealed they were not supported nor recognised for their workplace contributions. Violence predominated in schools of nursing rather than the broader university. It is argued these findings need public dissemination to improve workplace environments and eliminate violence. It is noted that the results reported are part of a larger research study on progression and professional development of women nurse academics.

Studying women nurse academics: exposing workplace violence in Australia: Part 1

This article is the first in a two part series on research investigating the lived experiences of women nurse academics in Australia. This is part of a larger research study involving participants from Australia, New Zealand, the United States of America and the United Kingdom. The aim of this research was to investigate the participants' professional experiences and progression within their respective school of nursing and university. This article focuses on the literature on workplace violence and research methodology. The importance of storytelling and the relationship between emotional safety and sensitive disclosures is also addressed.

Difference still troubles university environments: emotional health issues associated with lesbian visibility in nursing schools

This article addresses some of the findings from a study, which investigated the lived experiences of women nurse academics in Australia, New Zealand, the United States of America and the United Kingdom. Specifically, this article reports on the findings of the experiences of lesbian nurse academics in the study. There were 15 lesbians who participated in this research. The results revealed that lesbian nurse academics are experiencing homophobia and as a consequence were suffering emotional health effects. Emotional health disruptions were irrespective of whether they were 'visible invisible' regarding their sexuality.

Safe sex and student nurses in rural Australia: nurses' knowledge and practices (Part 1)

This article is the first of a two-part series on a research study investigating student nurses' knowledge and attitudes to safe sex in a rural university in Australia. The article begins with a discussion of HIV/AIDS, particularly the current incidence and a discussion of the associated epidemiological data. Health care professionals responses to the disease and examples from relevant Australian literature are briefly explored. The authors then discuss the need for this current research study, reveal the associated ethical process, outline the instrument used and the sample population. The article concludes with a discussion of reliability and validity.

Safe sex and student nurses in rural Australia: nurses' knowledge and practices (Part 2)

In this article, the second in a two-part series on a research study investigating student nurses' knowledge and attitudes to safe sex in a rural university in Australia, the results are revealed. The major findings discussed in this article are focused on sexual preference, the need for safe sex, safe sex practices, the need for educational material regarding safe sex, exploration of sex/sexuality and, the need for study of conflict resolution, negotiation skills, and self esteem building. The article concludes with deliberations on educational recommendations associated with the research.

The dis-ease of nursing academia: putting the vulnerability 'out there' (Part 2)

In this article, the second in a two-part series on research investigating the lived experiences of women nurse academics in australia, the results of the study are revealed. The major findings indicated that the Australian university system remains competitive and non-supportive of women nurse academics. The women who participated in this study had a strong desire to share their stories and reveal their vulnerability associated with their everyday life experiences in universities. Cultural descriptions revealed the complexity of women nurse academics' vulnerability as well as the dimensions of emotional resilience and optimism for their associated emotional healing.

Epistemology at work: the ontological relationship between feminist methods, intersubjectivity and nursing research--a research exemplar

This article explores the importance of strong epistemological and ontological links in nursing research by examining the design and process of a recent research project. The research topic concerns the relationship between self-concept and nursing practice. In this article, the authors demonstrate that commitment to a methodologically consistent process and the necessary associated epistemological and ontological positions provides a depth and structure to nursing research. It is the authors' belief that such consistency within research acts to strengthen the research process, and consequently strengthens nursing's research base and knowledge.

The dis-ease of nursing academia: putting the vulnerability 'out there' (Part 1)

This article is the first in a two-part series on a recent research study investigating the lived experiences of women nurse academics in Australia. This article begins with a discussion on the growing necessity of nurses to care for one another while working in stressful environments. The author then discusses the need to research nurse academics. The majority of the article focuses on the methodological considerations associated with planning and researching the above topic. A comprehensive discussion of research methodology, methods and ethical concerns ensues.

Intimate partner violence screening and intervention: data from eleven Pennsylvania and California community hospital emergency departments

OBJECTIVE

To provide clinical practice recommendations for screening and interventions for intimate partner violence (IPV) in ED settings.

SETTING

Eleven mid-sized community-level hospital emergency departments (20,000 to 40,000 admissions annually) in Pennsylvania and California.

PARTICIPANTS

All women (4641) aged 18 years or older who came to the emergency department during 309 selected shifts.

METHODS

An anonymous survey inquiring about physical, sexual, and emotional IPV was conducted from 1995 through 1997. In addition, medical records were abstracted for every woman (18 years and older) seen in the 11 participating emergency departments during the study period.

RESULTS

The vast majority of both abused and nonabused women supported routine screening for IPV; however, fewer than 25% of women said they were asked about IPV by ED staff. ED screening rates for IPV were higher among women who came to the emergency department because of acute trauma from abuse (39%) than for women who reported that they had been abused within the past year (13%). The prevalence of past year and lifetime IPV was significantly higher when the questionnaire was self-administered than when it was administered by a nurse. More than a third of women who had recently been abused and 76% of women who acknowledged experiencing physical or sexual IPV within the past year reported that they did not come to the emergency department for treatment of an injury. Although the majority of women (76% to 90%) agreed with the concept of health care providers reporting IPV to the police, women abused recently were significantly less likely to support this practice.

CONCLUSION

The study provides evidence supporting standard protocols for routine screening for IPV among women who come to emergency departments and chart prompts for both screening and interventions. These actions are acceptable to the majority of both abused and nonabused women seen in the emergency department and should be considered in systematic repeated training of health care professionals in emergency departments. This information is important for health care providers who are seeking to improve their identification of and care for abused women.