Psychological care in nursing education and practice: a search for definition and dimensions

The inclusion of cognitive behavioural therapeutic components in the undergraduate nursing curriculum. A systematic integrative review of the evidence

BACKGROUND

Despite the increasing evidence base for the use of cognitive behavioural interventions in nursing, the extent to which therapeutic interventions and their components are included in the undergraduate curriculum in Australia remains unclear.

OBJECTIVES

To explore if and how cognitive behavioural components are being taught to undergraduate nursing students to deliver outcome benefits to students and patients.

DESIGN

An integrative literature review reporting links between CBT components and methods taught in pre-registration nurse education.

FINDINGS AND CONCLUSION

Based on an analysis of current literature, it is suggested that evidence-based cognitive behavioural components are being taught to undergraduate nursing students. The study reports that teaching cognitive behavioural components can bring clinical benefits to positive patient outcome, to student wellbeing and study performance. However, the teaching of cognitive behavioural conceptual models as a therapeutic skill was found to be limited. Recommendations to incorporate a simple, evidence based cognitive behavioural conceptual tool, highlights how nurse educators can address the requirement to teach from the current evidence base.

The use of narrative in the study of caring: A critique

Within nursing and the allied professions there is an extensive and growing literature that aims to uncover the meaning of caring and its application in practice. Review of the literature reveals a wide range of data collection and analysis methods, including measurement and multivariate analysis, concept analysis, content analysis, Q-sort methodology, the repertory grid technique, case study, ethnographic and phenomenological approaches. It is argued that while all approaches make a valid contribution, appropriate methods for nurses of obtaining rich data about the meaning and practice of caring are those which permit the researcher to enter the world of the nurse and explore perceptions as expressed through stories.

Reference is made within this paper to the use of narrative in an ongoing research study which explores nurses' perceptions and experiences of psychological care-giving and the ways in which these develop throughout nurse education programmes. However, the main purpose of this paper is to present arguments for and against the use of the narrative method, concluding with a brief discussion of methodological choice applied to the study of caring.

Helping student nurses to identify and respond to the psychological needs of physically ill patients: implications for curriculum design

It is universally accepted that nursing practice is predicated upon the notion of holistic care, in that nurses need to address not only the physical needs of ill patients but also their psychological, social, spiritual, and environmental needs. However, there is considerable evidence to suggest that nurses often inadequately identify and respond to patients' psychological needs, sometimes with adverse consequences for physical health and recovery. This may be because they do not fully understand the concept of psychological care, or have been inadequately prepared or educated to deliver it in practice. Following a summary of relevant literature and an overview of findings from a larger study of the nature and experience of psychological caregiving, this paper discusses specific findings on preparing nurses for their psychological caregiving role. The paper proposes a curriculum framework designed to enhance awareness, knowledge, and skill in effective psychological caregiving in nursing practice, to the ultimate benefit of physically ill patients. For the purposes of this paper, psychological care is taken to mean one element of the broader concept of care, rather than being synonymous with it.

The psychological needs of patients receiving chemotherapy: an exploration of nurse perceptions

This study explored the perceptions of a group of registered oncology nurses about the psychological needs of patients with cancer receiving chemotherapy and how the nurses meet these. Eight nurses who provided chemotherapy and were working in a local oncology centre participated. A semi-structured interview was used to explore nurses' perceptions, and how they meet these patients' needs. The analysis of interview transcripts revealed that these nurses agreed that patients with cancer receiving chemotherapy had psychological needs. Moreover, they were conscious that some of the physical side-effects could have a psychological impact on the patients. Although nurses did not use any assessment tool for psychological assessment, they identified two main stages during the treatment when patients needed more psychological support: at the beginning and at the end of the chemotherapy. They explained how they tried to meet patients' psychological needs but they also mentioned several factors that influenced the psychological support that patients received.

Living theory: enhancing the psychological support of patients

This article explores how nurses, involved in a research project incorporating teaching psychological theories and counselling skills to enhance the psychological support of patients with wounds, had, one year on, changed their professional practice. This inquiry was framed by living theory, a concept previously only used in education, which is based on the integration of known knowledge, newly taught knowledge and increased self-awareness. The major principle of living theory is that one's values are questioned, modified, clarified and sometimes changed completely in striving to improve one's professional practice. This research showed nurses creating their own living theories, aspiring to really care for the whole person by developing strong, meaningful relationships with patients. The steps that participants took from first using the enhanced way of working with patients with wounds, to using it to support all patients psychologically, are demonstrated.