The meaning of hope in nursing research: a meta-synthesis

The aim of this study was to develop a meta-synthesis of nursing research about hope as perceived by people during sickness and by healthy people. A meta-synthesis does not intend to cover all studies about hope; rather it tries to synthesize qualitative findings from different contexts, cultures and times to provide a global picture of the phenomenon under study. Noblit and Hare's meta-ethnographic approach was used. The approach is a systematic comparison of studies where each study is translated into the other. Data were 15 qualitative studies published in nursing or allied health journals and conducted in USA, Great Britain, Canada, Australia, Norway, Sweden and Finland. The meta-synthesis resulted in six metaphors that illustrate dimensions of hope. These metaphors permeated the experiences of hope regardless of whether the human being was healthy, chronically or terminally ill. They comprise the complexity of hope and were: living in hope, hoping for something, hope as a light on the horizon, hope as a human-to-human relationship, hope vs. hopelessness and fear: two sides of the same coin, and hope as weathering a storm. Knowing the multidimensionality of hope and what hope means from the patient's perspective might help nurses and other healthcare professionals to inspire hope as Florence Nightingale did when she walked with the lamp through the dark corridors and spread hope and light to the patients. We suggest that nurses working with patients with serious conditions such as cancer reflect on the meaning of the metaphors.     

Enhancing the evaluation of nursing care effectiveness.

Evaluating the effectiveness of nursing care is necessary for developing a sound knowledge base to guide practice. Several studies have been conducted to evaluate the effectiveness of nursing care or interventions in producing the desired outcomes. While the results of these studies are encouraging, they do not provide a comprehensive and realistic evaluation of the contribution of nursing. Factors related to patient characteristics and implementation of care are not accounted for. The outcomes selected do not reflect the direct benefits of nursing care or interventions. In this paper, research methods for conducting effectiveness research in a way that would identify the unique contribution of nursing care delivered under the conditions of the real world of everyday practice are discussed. Examples are provided to illustrate the points of discussion.     

The user experience of critical care discharge: A meta-synthesis of qualitative research

Objectives

This review identifies the most significant factors, which impact upon the user experience of progress and recovery from critical illness during the first month after discharge from critical care, and discusses these in relation to the development of effective critical care discharge support strategies.

Design

Meta-synthesis of qualitative primary research.

Data sources

Qualitative research published in English between 1990 and 2009 was identified using online databases: CINAHL, MEDLINE, EMBASE, British Nursing Index, CDSR, ACP Journal Club, Cochrane library, Social Policy and Practice and PsycInfo. Studies of adult patients, relatives/carers/significant others, which focused on experiences after discharge from an intensive care or high dependency unit to a general ward were retrieved.

Review methods

Following screening against inclusion/exclusion criteria, methodological appraisal of studies was conducted using a published framework. Ten studies met the criteria for inclusion.

Results

Five key themes emerged from the meta-synthesis: physical and psychological symptoms; making progress; the need to know; and safety and security.

Conclusions

Findings from this meta-synthesis and other related literature supports the existence of physical and psychological problems in the immediate period following discharge from critical care to the ward, and suggests that patients and their families have a desire for more control over their recovery. However, this desire is countered by a need to feel safe and protected, culminating in an expression of dependence on healthcare staff. Any effective support strategy needs to take account of these findings.     

Cultural caring in nursing practice: a meta-synthesis of qualitative research

The number of qualitative studies regarding the experience of nurses caring for patients from cultures other than their own has increased, yet there remains a limited understanding of the meanings derived from this work. Using the methodology of Noblit and Hare's metaethnographic comparative method, the main themes and concepts from 13 qualitative studies are reduced to six overall themes that describe over 1000 nurses' experience caring for patients from other cultures. The themes include: (a) connecting with the client, (b) cultural discovery, (c) the patient in context, (d) in their world, not mine, (e) road blocks, and (f) the cultural lens.     

开展护理科研工作的做法与成效

为了探讨护理科研管理 ,通过采取提高护理人员科研意识、重视人才队伍培养、抓好学科带头人的作用、采取有效管理和激励机制及发挥护理部职能作用等做法 ,提高了护理人员的科研能力 ,使护理科研工作取得了较好的成绩     

The Cochrane Library can answer your nursing care effectiveness questions.

Systematic reviews help nurses to manage the overwhelming volume of available information by synthesizing valid data from primary studies and summarizing the results of interventions. One reliable source of systematic reviews of healthcare interventions is the Cochrane Library. This paper briefly describes the Cochrane Collaboration and the Cochrane Library. It also encourages nurse clinicians and nurse administrators to use the Cochrane Library and encourages nurse researchers to contribute to the Cochrane Library by conducting systematic reviews in the field of nursing care effectiveness.     

The potential impact of gender stereotypes for nursing research

The move towards evidence-based health care has meant an increasing pressure on paramedical professionals to become more research aware and research active However, despite various initiatives designed to encourage research, there remains within nursing a notable paucity of relevant published research While numerous explanations have been put forward in an attempt to account for this shortfall, they have tended to focus on structural/organizational barriers rather than difficulties located at the individual level However, Hicks, in studies of midwives and nurse managers suggests that one critical perspective may be the stereotypes and assumptions associated with the nursing profession, these being so diametrically opposed to the core skills required of researchers that they operate as a natural deterrent to research activities of any sort Embedded within this theory is the notion of gender roles, which are archetypally feminine for nursing yet archetypally masculine for research However, Hicks'studies, which were both variants of Asch's Central Trait Theory, focused on women both as the hypothetical subject of the exercise involved and as participants If research is bound up with gender attributions in the way she suggests, it would be necessary to ask if this is still relevant when the gender of the hypothetical figure at the centre of the study is changed To this end, the present study was conducted which, apart from the modification just highlighted, was a replication of Hicks'earlier studies In brief, two groups of participants rated a hypothetical male candidate for a nursing post along 15 bipolar dimensions The candidate had been described by his referee using six adjectives, of which five were identical for each group However, the final phrase used to describe the first group's candidate was'good clinician'while for the second group it was ‘good researcher’ The ratings given by the two groups along the 15 dimensions were then compared It was found that the male applicant described as a good researcher was assumed to be more successful, more ambitious, more confident and more ruthless than one described as a good clinician The implications of these results are discussed in relation to gender theories and nursing research     

康复护理ADL量表的有效性研究

目的　研究康复护理ADL量表在ADL评测中的有效性。方法　对 6 0例患者采用改良BI指数和康复护理ADL评定两种量表进行测评 ,用pearson分析计算入院、出院、出入院改变值及改变值之间相关性 ,对康复护理ADL量表各项目计算组内相关系数。结果　两量表在出入院评测结果有较高相关性 ,入院时r =0 .94 7,P <0 0 0 1,出院时r =0 .94 4 ,P <0 .0 0 1。出入院改变值呈显著相关 ,r =0 .890 ,P <0 .0 0 1。MBI出入院改变值 32 84± 13.2 4 ,RNADL39.0 3± 14 .2 7。两次测评各项目间相关系数r =0 .92 4～ 0 .96 8,P <0 .0 0 1。结论　康复护理ADL量表重测信度高 ,内部一致性较好 ,是一种有效性较好的ADL评定量表     

Creating a new structure for research on health care effectiveness.

Effectiveness research (a term we use in preference to the more confining and difficult health services or outcomes research) evaluates the clinical setting and the health care system on which it depends. It uses a variety of health care assessment techniques and the practical clinical trial to inform clinical practice, quality interventions, and health policy decisions. Effectiveness research had not had sufficient public or private funding to produce the information needed to facilitate evidence-based health care improvement. However, recent trends, such as the likelihood for continued substantial increases in health care costs and concern regarding the quality and safety of the US health care system, are among the important arguments for increasing its funding and capacity. We propose a new entity, a public-private consortium to expand and offer new capability and resources in this area. The consortium would consist of all relevant public and private entities. It would be organized into an executive committee, which would identify research priorities and panels to design requests for proposals. Competitive peer-reviewed proposals, transparency and balance of forces in choice of topics, conduct of research, and interpretation of results would be important features. Metrics for success would be use of the data derived from consortium projects in medical decision making and benefit design. The consortium would provide balance and potential mediation of conflicting or competing interests in which all stakeholders will be present to establish the rules. Broad representation of all interests would serve to avoid the economic, policy, and political issues that have bedeviled past efforts. Models for the consortium include the Health Effectiveness Institute, the Centers for Education and Research on Therapeutics, and the Transportation Research Board.     

Use and effectiveness of psychiatric nursing care plans

Nursing administrators require that bedside nurses should use nursing care plans, which also serve the purposes of auditors, educators and others. They are time consuming, they are not uniformly liked by bedside nurses, and they are not used with equal rigour everywhere. Their efficacy as enhancers of quality of care given has seldom been investigated and never demonstrated. In an attempt to repair this deficiency, the author documented 158 transactions between psychiatric nurses and their patients over a 5-month period. In each instance, the quality of the care given was judged and scored. Subsequently, the author determined whether nursing care plans existed and, by comparing them with the transactions, determined whether or not they had been followed. These nurses did not generally follow the care plans, though usually they thought they had. Transactions done where a nursing care plan existed were not better than those done in the absence of nursing care plans. In transactions following an existing nursing care plan, the quality of care given was judged to be lower than in those where an existing nursing care plan was not followed, a result which was statistically highly significant. These findings are discussed, and the author notes the clear implication of this study that nursing care plans are less than helpful to bedside nursing.     

规范护理科研管理的实践与体会

目的探讨规范护理科研管理的方法,加快护理学科的发展.方法成立护理科研管理小组,建立健全护理科研管理制度.结果我院自2001年对护理科研工作进行规范化管理以来,极大的激发了护理人员学科学、研究科学的创新意识和科研积极性,论文见刊数量逐年上升.2003年发表论文总数是2000年的3.3倍;先后有5项护理成果获得军队系统、中华护理学会、上海护理学会的科技进步奖;主编、出版专著6部.结论规范化的护理科研管理,是提升护理质量、推动护理学科发展的重要手段.