Translation and validation of the Comfort Behaviors Checklist in hospitalized children with chronic diseases

BACKGROUND

Different tools have been developed to measure patients' comfort. This study aims to translate, validate, and apply the Comfort Behaviors Checklist to hospitalized children with chronic diseases.

METHODS

Validity and reliability are assessed using face and content validity, construct validity (known-groups technique and Principal Component Analysis), internal consistency, and inter-rater reliability. The study takes place in a children's hospital in Iran, involving 220 children aged 4 to 6.

RESULTS

The Comfort Behaviors Checklist demonstrates acceptable face and content validity. Construct validity is supported by the lack of correlation between behavioral comfort scores in known groups. The Principal Component analysis results in five components, explaining 70.39% of the total variation. The checklist exhibits acceptable reliability, with a total Cronbach's alpha coefficient of 0.86 and an intraclass correlation coefficient of 0.835.

CONCLUSION

The Comfort Behavior Checklist is a valid and reliable tool for assessing the level of comfort in Iranian children with chronic diseases.

Hospice Attitudes of Physicians and Nurses

The purpose of this study was to gauge the attitudes of internal medicine (IM) physicians and hospice nurses on the hospice programs in a Southeastern US county. A postal survey sought views on the following issues: (1) the level of control that hospice affords dying patients; (2) health care professionals’ education and communication involving the dying process; (3) the hospice referral process; (4) characteristics of a “good death”; and (5) gender versus professional role regarding hospice attitudes. The data revealed that occupational role in hospice care has a more significant function in the development of cognitive attitudes than of gender regarding hospice programs and that professional education needs more emphasis on the study of end-of-life issues, as well as open communication between health care professionals and patients during the dying process. Physicians were less likely than nurses to agree that patient control was important. Additionally, what constitutes a good death was similar to previous studies.

Prevention of Unethical Actions in Nursing Homes

Ethical problems regularly arise during daily care in nursing homes. These include violation of patients' right to autonomy and to be treated with respect. The aim of this study was to investigate how caregivers emphasize daily dialogue and mutual reflection to reach moral alternatives in daily care. The data were collected by participant observation and interviews with seven caregivers in a Norwegian nursing home. A number of ethical problems linked to 10 patients were disclosed. Moral problems were revealed as the caregivers acted in ways that they knew were against patients' interest. We used a theoretical interpretation according to Habermas' discourse ethics on the importance of dialogue when deciding moral courses of action for patients. This theory has four basic requirements: communicative competence, equality, self-determination, and openness about motives.

Communication - a core concept in client supervision by public health nurses

AIM

The aim of this study was to explore public health nurses' reflections on client supervision.

BACKGROUND

Reflection on actions represents a possible basis for constructing and refining assumptions on current theories used in practice thus making knowledge development possible.

METHODS

Transcript-based qualitative content analysis was used to analyse the findings from individual interviews with 13 female public health nurses.

FINDINGS

Communication is a core concept of client supervision by public health nurses and includes the following themes: (1) building a trusting relationship, (2) looking beyond the current situation, (3) creating a partnership and equality and (4) considering the challenge involved in trying to act in the clients' best interests.

CONCLUSIONS

This study shows that public health nurses' reflection and reflecting related to their provision of client supervision revealed one possible assumption regarding their theories-in-use; communication is a core concept in client supervision. Communication is viewed from a hermeneutic perspective--as the meaning of the interaction between the public health nurses and the client in the supervision is reflected upon and interpreted.

Public Health Nursing in Ireland: A Critical Overview*

The World Health Organization have stressed the importance of nurses and midwives as a "force for health" in society's efforts to tackle the public health challenges of our time. The public health challenges are both diverse and complex. Principally, they emanate from a social model of health that takes cognizance of our behavior, our environment, and the historical, political, and cultural structures that facilitate health or militate against it. This paper provides a critical overview of public health nursing in Ireland, toward situating both our contribution to public health and some of the challenges that lie ahead of us. Specifically, it looks at nonquantifiable practice, where, through the presentation of stories, the wealth of public health nursing work is demonstrated in the ordinary voices of public health nurses. The potential risk of ignoring and minimizing the contribution of public health nursing in future developments in primary care in Ireland is discussed. Finally, it is proposed that public health nurses need to get political.

Frames and Perspectives in Clinical Nursing Practice: A Study of Norwegian Nurses in Acute Care Settings

The aim of this study was to investigate the nature of nurses’ clinical practice in terms of what guide their clinical engagement and clinical constructions. Schön (1983) and Argyris, Putnana, and Smith (1985) have demonstrated that practitioners “see” situations differently depending on how they frame the situation. In nursing, there is a lack of knowledge regarding what kinds of frames nurses are using in their clinical work. The research question was: What frames and perspectives guide nurses’ clinical constructions?

The study was based on a descriptive design using a clinical field approach in an acute care setting in Norway. A theoretical sample consisted of 6 registered nurses, 3 from medical wards and 3 from surgical wards. Data were collected through participant observation and in-depth interviews with the nurses, as well as nursing documents about the patients.

The results showed that the nurses’ frame of reference emerged as normality, health, need, trajectory, and action. These are structured on 3 themes: (a) the patient status dimension with a set of 3 frames that are used to consider patients’ current status and condition in terms of normality, health, and needs; (b) the dimension with a frame for judging patients’ situational experiences in relation to hospitalization, (illness trajectory); and (c) the nurses’ action referring to the frame with which nurses consider their actions. These 5 frames form a complex template with which nurses come to arrive at meanings of clinical situations and “design” or engage in their practice. The nurses are moving back and forth between these different perspectives, circulating around the individual patient or patients as a group. The nurses’ practice in this setting tells about the complexity and diversity permeating the assessment, decisions, and performance of nursing care.

Patients' autonomy in surgical care: a comparison of nurses' perceptions in five European countries

BACKGROUND

This report forms part of the results of an international comparative study funded by the European Commission (1998-2001).

AIM

To describe and compare the maintenance of patients' autonomy on surgical wards, from the point of view of nursing staff, in five European countries (Finland, Spain, Greece, Germany and Scotland). Autonomy is defined in terms of information received and decision making by patients.

METHOD

The data were collected using a questionnaire specifically designed for use in this study. Responses (response rate 66%) were obtained from 1280 nurses working on surgical wards. Data analysis was based on descriptive statistics, t-tests, analysis of variance (ANOVA) with posthoc Tukey's HSD test and logistic regression.

RESULTS

There were clear between-country differences in nurses' perceptions, especially on a north-south axis (Finland and Scotland vs. Greece and Spain), regarding the extent to which the autonomy of surgical patients is supported by nursing staff. Training and ethics education, in particular, were associated with nurses' perceptions of the maintenance of patient autonomy in Finland and Greece.

CONCLUSION

Further research is needed to establish whether the results obtained are caused by differences in cultures, nursing practices or roles of health-care personnel or patients in different European countries.