Dissertations / Theses on the topic 'Army nursing'

There is an abundance of historical and anecdotal material relating to the experiences of the Australian soldier during World War 1. These soldiers were conscious both during and after the war that their contribution was important and that it was recognised as such by Australian society at large. Conversely there is an almost total absence of historical or anecdotal material about the role of the Australian nurse who served during this same conflict. Whether these nurses had the same degree of consciousness, either during or after the war, that their contributions were valued or seen as important by Australian society remains, largely, unknown. This thesis attempts to redress, in part, this absence by telling the story of a nurse, Jessie Tomlins, who served in the Australian Army Nursing Service during this period. At the same time specific aspects of the historical events surrounding World War One will be explored. Jessie Tomlins served, first as a Staff Nurse and later as a Sister, in the 14th Australian General Hospital in Egypt during 1916. At the same time her brother, Fred Tomlins, was already serving in the 1st Australian Light Horse Regiment and spent the entire four years of World War 1 in Palestine and Egypt. At the end of 1916 their younger brother, Will Tomlins, also joined the Army and became a member of the Anzac Mounted Division. The letters, postcards and photographs that Jessie, Fred and Will sent home to their mother and family, as well as Fred's fourteen diaries, form the foundation of this thesis. This thesis provides a meaningful snapshot of one woman from rural Australia who completed her nurse training during the war and then served her country during one of the most brutal periods of humankind. Her own words clearly tell the story of her war time experiences whilst, at the same time, conveying her expectations, prior to, during and after, this event. The development of the Australian Army Nursing Service, as it affected Jessie, over this period is also considered. It will be demonstrated that whilst ordinary men, soldiers, were at the military front line so too were ordinary women, nurses. The thesis will provide support for the contention that the contribution of Australian nurses in World War One, especially that of the ordinary nurse caring for the ordinary soldier, has been poorly recorded and as a result remains under-valued.

Thesis (Ph. D.)--University of Sydney, 2001.
"... The letters, postcards and photographs that Jessie, Fred and Will sent home to their mother and family, as well as Fred's fourteen diaries, form the foundation of this thesis..." -- p. 2. Title from title screen (viewed Apr. 23, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Clinical Nursing, Faculty of Nursing. Includes bibliography. Also available in print form.

The study of stress is limited in professional nursing, but it is nearly non-existent in professional military nursing. The purpose of this study was to explore the relationships among psychological, environmental, biological and demographic factors of stress in new Army nurses during the Army Medical Department’s 8-week Officer Basic Leadership Course (OBLC). Using a descriptive prospective, correlational repeated measures design, 33 study participants completed two psychological stress measures (Perceived Stress Scale [PSS] and the Impact of Event Scale – Revised[IES-R]), an environmental measure (Life Experiences Survey [LES]), a biologic measure (salivary cortisol) and a demographic questionnaire at three different time points during OBLC: at the beginning of OBLC, during the field training exercise and at the end of OBLC. The majority of participants were single, Caucasian females under 30 years of age with no RN experience and no deployment experience. No significant gender differences were detected among study variables. A simple (single-group) repeated measures analysis of the PSS scores, IES-R scores, and salivary cortisol was conducted using the LES score as a covariate. While the PSS scores and salivary cortisol levels did not change significantly over time, the IES-R score did change significantly over time (p = 0.001). The environmental factor (LES score) was not significant as a covariate in any of the three models. The unique baseline findings in this study may provide a springboard for further studies in stress particularly with military nurses who will eventually be deployed and experience a variety of stressful events. Longitudinal research could yield important predictive information related to how the stress response evolves over the course of one’s military career which may include frequent deployments to the combat zone.

This thesis describes a three-stage project using a qualitative case study approach. It explores in what way the features of Army life affect the daily lives of Army parents, how aspects of Army life influence the decision-making of mothers, and what support Army mothers expect when their child is unwell after their primary health care centre has closed (called the out-of-hours period). The study was conducted within an Army garrison in England. It occurred during an intense period of overseas operational deployment that left mothers as temporary lone parents for many months. Out-of-hours service provision had changed from an Army clinic within walking distance to an NHS provider located over thirty miles away. Phase One, using focus groups with 24 parents, identified how Army life affected parents and what their expectations were for health care provision in the out-of-hours period. During Phase Two, seven of these parents were interviewed to explore the themes identified in the previous stage in greater depth. Phase Three involved interviews with a further seven mothers who had accessed the out-of-hours clinic when their child had been unwell, to investigate the decision-making process that led to a consultation with a health professional. This study provides a rich and detailed description of how disruption, mobility and enforced separation affect parents living with young children within a garrison in England and the coping strategies that mothers used. It is distinctive as it theorises that emotional vulnerability caused by anxiety and fear during military enforced separation challenges a mother’s fundamental sense of belonging. An algorithm developed from the findings demonstrates that a partner’s presence influences whether the mother calls health care services as a first or last resort. Thus, it makes an important contribution to the development of both civilian and military knowledge regarding a mother’s decision-making behaviour and her expectations for care when her child is unwell, particularly when a lone parent

This is the first monograph to be published on the work of the Queen Alexandra's Imperial Military Nursing Service (QAIMNS) in the Great War. The historiography of British military nursing during this period is scant, and research based monograph are negligible. What exists, does not focus specifically on the work of the Queen Alexandra's Imperial Military Nursing Service, (QAIMNS) the Reserve, (QAIMNSR) or the Territorial Force Nursing Service (TFNS) but tends to concentrate on the work of the volunteer, untrained, Voluntary Aid Detachment (VAD) nurses. Unfortunately, this has resulted in factually inaccurate representations of British WW1 nursing. The mass mobilisation of nurses by professional and voluntary nursing services led to rivalry between the different groups and my research addresses the relationship that develop between the trained and volunteer nurses. Also, my research examines the climatic and environmental conditions that impacted upon the effective delivery of nursing and casualty care and the mismanagement of services and supplies by the War Office and the Army Medical Services. Additionally, the political controversies and scandals over inadequate planning for the care, treatment and transportation of mass casualties is addressed. Furthermore, diseases and traumatic injuries sustained by nurses on active service are examined and, shell-shock, hitherto considered a combatants' condition is cited in relation to mental health issues of nurses on active service. Moreover, my research examines the deaths and disability rates within the ranks of nursing services. My research features individual awards for acts of bravery and mentioned in Dispatches. On the Home Front the politics of nursing are addressed. Nurses campaigned for professional recognition and many were supportive of universal suffrage and they argued for both professional and personal liberation. The struggle for professional recognition led to divisions within the civilian nursing leadership because they failed to arrive at a consensus on the content of the Nurse Registration Bill. Also, the supply of nurses for the war effort was consistently problematic and this led the Government to establish the Supply of Nurses Committee. Before it had its first sitting it had already become contentious and controversial. The issues are discussed. Using extensive primary sources, the monograph moves away from the myths, and uncritical and overly romanticised views of WW1 military nursing. It is hoped that by examining the personal, professional and political issues that impacted upon nurses the monograph will make a significant contribution to the historiography of WW1 military nursing and to the history of the Great War more generally.

Aim: This thesis aimed to explore community nursing middle manager role enactment in managing change within Community Health Partnerships (CHPs) in three regions of Scotland from 2008-2011. Background: CHPs were established to play a key role in shifting care from the acute to the community setting. Within this context the community nursing workforce has been adapting roles in response to Scottish Government (SG) directives. However literature review demonstrated there has been very little research into the role of Community Nurse Middle Managers (CNMMs) in the midst of this change. This investigation sought to address this deficit in the literature. Design and Methodology: The study was conducted in four distinct phases comprising of the reflexive, foundational, recursive and expansive. A total of 42 semi-structured interviews were conducted over the period of investigation. The investigation was qualitative and phenomenological in character. A hermeneutic approach was adopted, broadly based on Heideggerian philosophy. More specifically this study drew on the Interpretative Phenomenological Analysis (IPA) approach of Jonathan Smith (1996). Main findings: In general CNMMs perceived that their jobs had become more complex, with the pace and intensity of work having increased. They held a wide range of responsibilities managing the challenges of driving change within a hierarchy and professional bureaucracy. Opportunities for education and learning were felt to have reduced. A small but significant proportion had left and some were considering leaving the NHS service. A primary motivation for CNMMs was maintaining an implicit connection with service users. They were proud to be members of the nursing profession and aligned their identity with their career history. This was perceived to influence their management and leadership style. In overcoming some of the personal challenges they faced they identified protective factors or “assets” to counteract stress. The application of a salutogenic perspective emerged as important in supporting this. Conclusion: The study has addressed a knowledge gap in literature. It contributes to understandings of NHS community nursing, middle management, role, change and Community Health Partnership literature. In particular it gives a voice to the perspectives of community nursing middle managers in Scotland. It suggests that much more attention needs to be paid to the needs, constitution and sustenance of middle managers in Scottish community nursing and that this has policy, practice, education and research implications.

Blodtrycksmätning innehåller många olika moment och studiens syfte var att belysa aktuell forskning kring tre faktorer som kan påverka resultatet vid blodtrycksmätning. Faktorerna delades in i kategorierna kläder (med/utan), arm (höger/vänster), och korsade ben eller ej. För att uppnå studiens syfte ställdes tre frågor; Blir det någon skillnad om blodtrycket mäts med eller utan kläder under blodtrycksmanschetten? Spelar det någon roll om blodtrycket mäts i höger eller vänster arm? Hur påverkar korsade ben resultatet vid blodtrycksmätning? Svaren söktes i 12 vetenskapliga artiklar som granskades, analyserades och värderades vetenskapligt. Inom kategorin kläder påvisades inte resultatet någon skillnad i uppmätt blodtryck beroende på om armen var klädd eller ej. Resultatet visade att det fanns viss skillnad i uppmätt blodtryck mellan höger och vänster arm och därför bör blodtrycket mätas i båda. Resultatet visar även att blodtrycket ska mätas med icke korsade ben i knähöjd. En studie visade att blodtrycket inte steg med benen korsade i ankelhöjd. 

Having a stroke at a younger age has been described as a complex experience that raises specific issues and related serice needs, mainly to do with child care, employment and social life. However, there has been little research into how younger people define what a stroke means for them personally and socially and how they live with it in the long term. This study aims to capture the experience of having had a stroke in people under fifty-five during the first year of their stroke. The purpose is to develop an understanding of the experience and to make this knowledge useful- for other people with this illness, for health care in general- and nursing in particular.

Tyrimo tikslas – įvertinti ligonių, po galvos smegenų insulto, pažeistos rankos funkciją bei reakcijos laiką reabilitacijos eigoje.Tyrimo uždaviniai: 1) įvertinti ligonių, po galvos smegenų insulto pažeistos rankos plaštakos jėgą dinamometru reabilitacijos eigoje; 2) įvertinti ligonių, po galvos smegenų insulto pažeistos rankos funkciją per duotą laiką pagal Frenchay rankos testą reabilitacijos eigoje; 3) įvertinti ligonių, po galvos smegenų insulto pažeistos rankos reakcijos laiką taikant „Liniuotės“ testą reabilitacijos eigoje; 4) nustatyti veiksnius, įtakojančius ligonių, po galvos smegenų insulto pažeistos rankos funkciją bei reakcijos laiką reabilitacijos eigoje.Tyrimo metodika: tyrimas buvo atliekamas Abromiškių reabilitacijos ligoninės neurologijos skyriuje 2009 – 2010 m. Tyrime dalyvavo 21 moteris ir 21 vyras. Tiriamųjų amžiaus vidurkis buvo 63,3 ± 11,8 m. Bendradarbiaujant su reabilitacijos ligoninėje dirbančiais psichologais ir pritaikius atrankos priemonę, trumpą protinės būklės tyrimą (TPBT), tyrimui buvo atrinkti tiriamieji, kurių TPBT buvo ne mažiau kaip 20 balų, nes tolimesniam tyrimui reikėjo, kad ligoniai suprastų komandas ir jas vykdytų. JAMAR® hidrauliniu rankos dinamometru buvo vertinta ligonių rankų raumenų jėga. Frenchay rankos testu buvo vertintas rankos ir plaštakos su pareze miklumas. Ligonių pažeistos rankos reakcijos laiką vertinome „Liniuotės“ testu. Matavimai buvo atliekami 2 kartus: prieš ir po reabilitacijos.Tyrimo išvados: 1) reabilitacijos... [toliau žr. visą tekstą]
The aim of the research - to evaluate the function and reaction speed of the affected hand of the patient after stroke during the rehabilitation.The tasks of the research: 1) to evaluate the strength of the stroke affected hand using dynamometer during the rehabilitation; 2) to evaluate the function of the stroke affected hand in given time using Frenchay arm test during the rehabilitation; 3) to evaluate the reaction time of the stroke affected hand using “Ruler” test during the rehabilitation; 4) to determine the factors that influence the function and reaction of the stroke affected hand during the rehabilitation. Research methodology: the research was executed in Abromiškės rehabilitation clinic, neurology department in 2009 – 2010. 21 men and 21 women participated in it. The average age of the examined people was 63,3 ± 11,8 years. With the help of the psychologists of the clinic and selection method of Mini Mental State Examination (MMSE) patients were selected for the research with MMSE no less than 20 points because it was essential for the patients to understand and follow the commands. The strength of the arm muscles was measured with JAMAR® hydraulic hand dynamometer. The dexterity of the arm and palm with paresis was evaluated by Frenchay arm test. The affected hand reaction time was evaluated by “Ruler” test. The tests were performed twice: before and after rehabilitation.Research conclusions: 1) at the beginning of the rehabilitation the average strength of... [to full text]

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Interpersonal violence by firearm projectile reaches young people around the world and this event may trigger physical and psychological trauma that can change in a negative way the quality of life in this population. This exploratory descriptive study aimed at evaluating the quality of life of victims of interpersonal violence by firearm projectile aged 18 to 39 years and interned at Hospital of Goiânia (HUGO) and identify the presence of symptoms for screening Disorder Post-Traumatic Stress (PTSD). We interviewed 95 victims of gun violence in HUGO interned with the aid of the WHOQOL-Bref and the PCL-PC. Data were subjected to descriptive statistical analysis with p <0.005. The majority (94.7%) were male, mean age 24.6 + / - 5.5 years, 58.9% are black or brown, 66.3% have no steady partner and 73.7% in income between one to two minimum wages. 89.5% of the violent events occurred between 20:07 hours, 52.6% on weekends and holidays, 48.4% of victims had drunk alcohol or drugs before the event and 78.9% had witnessed or were victims of violence before. 74.7% of them said that the violence caused physical and emotional changes (57.9%). the average value assigned in the self-assessment of quality of life was 3.03 and 2.72 for satisfaction with health. The dimensions obtained higher mean scores were the domain of social relationships (52.84) and psychological (50.98). The physical domain and the environment had an average 48.26 and 44.71 respectively. In the physical domain, the facets with an average of less than 3.0 were related to work (2.75), satisfaction with sleep (2.81), difficulties with mobility (2.86), pain (2.89) and dependence on medical treatment (2.94). The environmental domain had scores below 3.0 on the facets related to the feeling of safety (2.27), money (2.76), satisfaction with transportation (2.61), leisure opportunities (2.85) satisfaction with living quarters (2.87). It was observed that the perceptions of individuals frenteaos aspects analyzed in each dimension of WHOQOL-bref, is fairly homogeneous. 60% of the victims showed symptoms and screening for vulnerability to PTSD. It is concluded that the victim of armed violence undergoes changes in their quality of life evidenced by the low values ​​assigned to all dimensions, especially those related to the physical realm and environment that can guide the professional actions and policies for this population. The vulnerability for developing PTSD may have influenced the assessment of quality of life and indicates the need of immediate professional intervention in order to help victims return to their daily activities.
A violência interpessoal por projétil de arma de fogo atinge jovens em todo mundo e tal evento pode desencadear traumas físicos e psicológicos que podem alterar de maneira negativa a qualidade de vida desta população. Este estudo descritivo exploratório teve por objetivo geral avaliar a qualidade de vida das vítimas de violência interpessoal por projétil de arma de fogo com idade entre 18 a 39 anos e internadas no Hospital de Urgências de Goiânia (HUGO) e identificar presença de sintomas para rastreamento de Transtorno de Estresse Pós-Traumático (TEPT). Foram entrevistadas 95 vítimas de violência por arma de fogo internadas no HUGO com auxílio do WHOQOL-Bref e do PCL-PC. Os dados foram submetidos à análise estatística descritiva com p<0,005. A maioria (94,7%) é do sexo masculino, com idade média de 24,6 +/- 5,5 anos, 58,9% são negros ou pardos, 66,3% não tem companheiro fixo e 73,7% em renda entre 1 a 2 salários mínimos. 89,5% dos eventos violentos ocorreram entre 20 e 7 horas, 52,6% nos finais de semana e feriados, 48,4% das vítimas ingeriram álcool ou drogas antes do evento e 78,9% já tinham presenciado ou foram vítimas de violência anteriormente. 74,7% delas declararam que a violência causou alterações físicas e emocionais (57,9%). o valor médio atribuido na auto-avaliação da qualidade de vida foi 3,03 e 2,72 para a satisfação com a saúde. As dimensões que obtiveram maiores médias nos escores foram o domínio relações sociais (52,84) e psicológico (50,98). Os domínio físico e meio ambiente obtiveram média 48,26 e 44,71 respectivamente. No domínio físico, as facetas com média inferior a 3,0 foram as relacionadas ao trabalho (2,75), satisfação com o sono (2,81), dificuldades com locomoção (2,86), dor (2,89) e dependência de tratamento médico (2,94). O domínio meio ambiente obteve escores inferiores a 3,0 nas facetas relacionadas à sensação de segurança (2,27), dinheiro (2,76), satisfação com o transporte (2,61), oportunidade de lazer (2,85), satisfação com o local onde mora (2,87). Observou-se que a percepção dos indivíduos frenteaos aspectos analisados em cada dimensão do WHOQOL-bref, é bastante homogênea. 60% das vítimas apresentaram sintomas para rastreamento e vulnerabilidade ao TEPT. Conclui-se que a vítima de violência armada sofre alterações na qualidade de suas vidas evidenciadas pelos baixos valores atribuídos a todas as dimensões, principalmente as relacionadas ao domínio físico e meio ambiente , que podem nortear as ações profissionais e políticas públicas para esta população. A vulnerabilidade para desenvolvimento do TEPT pode ter influenciado na avaliação de qualidade de vida e indica a necessidade de imediata intervenção profissional de maneira a auxiliar as vítimas a retornarem às suas atividades cotidianas.

Rheumatoid arthritis is the inflammatory disease of web, which causes progressive inflammation of joints. Rheumatoid arthritis is on the top according to the number of patients who become invalids. The growing number of invalids in Lithuania becomes not only medical problem, but social problem as well. Everything is done to quell the activity of pathological process, its progression and to return and maintain the functions of moving device of the body with the help of prophylaxis, therapy and rehabilitation. The perfect program of treatment is often created for a year or longer period of time to reach good results. Different methods of treatment and their consistency let to reach better results. Physiotherapy is one of the treatments of rheumatoid arthritis, blocking the progress of the disease. The aim of the research – to estimate the effect of physiotherapy on arm functions of patients with rheumatoid arthritis. The goals of the research: to estimate the state of health of investigative and control groups of people with rheumatoid arthritis according to Keitel indicators before and after physiotherapy; to estimate the force of hand muscles of people with rheumatoid arthritis before and after physiotherapy; to estimate the effect of physiotherapy on the pain of hand joints of people with rheumatoid arthritis; to estimate the mobility of hand joints of people with rheumatoid arthritis before and after physiotherapy. 40 patients (5 men and 35 women) with the average age 57.6... [to full text]

Bakgrund: Blodtrycksmätning är en av sjuksköterskans arbetsuppgifter och hon/han ska genom den kunna identifiera patientens hälsostatus. Det finns brister hos sjukvårdspersonal runt om i världen om hur korrekt blodtryckemätning ska genomföras. Syfte: Syftet med litteraturstudien var att undersöka hur 3 olika faktorer påverkar blodtrycksresultatet vid manuell blodtrycksmätning med fokus på korsade ben, mätning över/utan tröjärm samt armposition. Metod: För att finna vetenskapliga artiklar användes databaserna Pubmed, CINAHL och Cochrane. Efter granskning och kvalitetsbedömning återstod det 15 kvantitativa artiklar som användes i denna studie. Resultat: Det  visade sig tydligt att hur patientens arm- och benposition var vid blodtrycksmätningen påverkade  blodtrycksresultatet signifikant. Däremot påverkade inte mätning över tröjärm blodtrycksvärdena nämnvärt. Diskussion: Hjärtläge är inte definerat i svenska rekomendationer. Det behövs tydligare definitioner/rekomendationer i Sverige för att undvika feldiagnostisering. Då mätning över tröjärm inte påverkade mätreslutatet underlättar det för patienter som har svårigheter att ta av sig på överkroppen. Slutsats: Det viktigt att alla som kontrollerar blodtrycket har kunskaper om vilka fel som kan påverka mätresultaten.

The aims of the Lithuanian Health Programme (1998) are to reduce the death rate in patients following stoke, age younger than 65 years old by 15%, and by 10% in patients at age of 65-74 years old, up to year 2010. While trying to enhance the recovery results following the abovementioned disease it is necessary to erect and renew the effective rehabilitation system. The aim is to estimate the effectiveness of The Constrain – Induce Movement Test on arm functions’ recovery of the post - stroke patients. The were two groups of testees, experimental group and control group, each composed of 30 stroke patients. The methods used while writing this study were as follows: the analysis of the used literature sources, and the testing (the evaluation of movements and the Nine Hole Peg Test). The Constrain – Induce Movement Test applied while carrying out this experiment statistically credibly improved the function of the patients’ arms. The average of the evaluation of shoulders arch movements in the control group is 3,13 ± 0,61 points. In the experimental group the average is 4,53 ± 0,97 points. The margin of 1,4 point is statistically reliable (p<0,05). There was also noticed a significant improvement in hand movements in the experimental group. The average of the evaluation of hand movements in the control group is 3,4 ± 0,67 points, while in the experimental group the average is 5,07 ± 0,87 points. The margin is 1,67 points (p<0,05). Analogous results were drawn while estimating... [to full text]

The purpose of this study was to establish an influence on static and dynamic postural control in sitting for voluntary arm movement for children with diplegic cerebral palsy. The investigation was fulfilled with control and experimental groups. The control group included ten healthy children and the experimental group included ten children with cerebral palsy. The age of the children was from 10 to 13 years. Subjects had to perform the same task with a single arm for four times. Every time the demands of postural control were increasing – the distance between objects and outward stability was changing. Task performing time was measured and visual estimation of the quality of postural control was done. The study showed that children with cerebral palsy performed the task slower than healthy ones (P < 0.05). The task performance time in the experimental group increased depending on growing distance between objects (p <0.05) and increased depending on decreasing outward stability (p < 0.05). The task’s time in the control group increased only when the distance was increasing between objects (p < 0.05), though when outward stability was decreasing the task’s performance time decreased (p < 0.05). A connection between task’s performance speed in standard conditions and task’s performance speed when the distance between objects was increased (r = 0.8), outward stability was decreased (r = 0.79), the distance between objects was increased and outward stability was decreased (r = 0... [to full text]

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Universidade Federal Fluminense. Escola de Enfermagem Aurora de Afonso Costa
A presente pesquisa tem como objetivo analisar a abordagem psicossocial do cuidado de enfermagem às pessoas que sofreram violência por arma de fogo atendida no setor de emergência. A violência nas grandes cidades é um fenômeno social que vem sendo discutida cada vez mais na área da saúde por trazer consequências graves à população. Trata-se de um estudo descritivo de natureza qualitativa que utilizou como instrumento de coleta de dados a entrevista semiestruturada aplicada a equipe de enfermagem da emergência do Hospital Federal de Bonsucesso (RJ). Através da Análise do discurso do sujeito coletivo emergiram três categorias temáticas: Os cuidados identificados no atendimento às vítimas de violência no setor de emergência; as representações da equipe de enfermagem sobre o atendimento as pessoas que sofreram violência por arma de fogo e a abordagem psicossocial de enfermagem às vítimas de violência. Os dados obtidos a abordagem psicossocial ainda é um desafio a ser superado pela equipe de enfermagem. Conclui-se que a abordagem psicossocial de enfermagem na emergência apresenta uma prática que aponta para o cuidado integralizado e holístico é essencial às pessoas que sofreram violência por arma de fogo. O olhar de enfermagem deve ser um cuidado mais integralizado, compreendendo este indivíduo na sociedade, na família, na sua relação com o mundo. Torna-se um desafio permanente, no campo da saúde pública, fortalecer e contextualizar as intervenções psicossociais nas grandes emergências
This study aims to examine the psychosocial approach of nursing care to people who have experienced violence by firearm seen at the emergency room. The violence in big cities is a social phenomenon that has been discussed increasingly in the health of the population have severe consequences. It is a qualitative descriptive study that used the instrument to collect data to semi-structured interviews applied to the nursing staff of the Federal Emergency Hospital Bonsucesso (RJ). Through analysis of the collective subject discourse emerged three themes: care identified in caring for victims of violence in the emergency room; representations of the nursing staff on the care people who have experienced violence by firearms; nursing and psychosocial approach to victims of violence victims of violence in the emergency room, quiet and responsive care; representations of the nursing staff on the care people who have experienced violence by firearms, and the psychosocial approach is still a challenge to be overcome by the nursing staff. We conclude that the psychosocial approach in emergency nursing practice that presents a points paid for the care and holistic is essential for people who have experienced violence by firearms. The look of nursing care should be paid more, including this individual in society, in the family, its relationship with the world. It is an ongoing challenge in the field of public health, strengthen and contextualize psychosocial interventions in major emergencies

The use of research findings in clinical nursing practice has been studied extensively in civilian institutions or with civilian nurses. However, little research utilization study has been done in US military facilities. Everett Rogers' theory on diffusion of innovations posits that a system's social structure and cultural norms affect an innovation's diffusion in several aspects, including innovation decisions, rate of diffusion, and the consequences of innovation (Rogers, 1995). Due to differences in organizational culture between civilian and military facilities, it is difficult to generalize the research done in civilian nursing facilities to the military organization. All nurses working at three US Army Medical Treatment Facilities were asked to participate in the study, of which 313 returned surveys. Use of research findings in practice was measured using an adapted version of Estabrooks' Research Utilization Survey (Estabrooks, 1997). Perception of organizational climate was measured using Mylle's Organizational Climate Index for Military Units (Mylle, 1998). Nurses indicated a generally positive attitude toward use of research for practice, stating that they believed it would enhance patient outcomes and they would use it if they could. There were direct relationships between several factors and research utilization, including attitudes toward research, time to read and implement research, access to research findings and support. Nursing support was directly correlated with all aspects of organizational climate indicators. There were inverse relationships between years worked in nursing and research utilization. Sources of research findings were primarily general nursing journals rather than research journals. The internet is an increasing source of information as unit access to the internet becomes more prevalent. Results of this study describe the influencing factors of research utilization by nurses in US Army hospitals, which can provide information for encouraging use of research findings by nurses and for conducting further intervention studies.

The retention of healthcare personnel, especially in the profession of nursing, continues to remain a critical issue. The ability to adequately and safely staff healthcare facilities to provide inpatient and outpatient care and emergency services is dependent on maintaining a well trained and experienced professional and paraprofessional workforce. This issue is of particular importance to the enlisted members of United States Army Medical Department (AMEDD) and the United States Army Nurse Corps. This qualitative descriptive research study identified many topics influencing the retention of enlisted personnel in the AMEDD. The work environment, economic factors, personal and professional issues were identified as influencing decisions regarding reenlistment. Additionally, the findings of this study indicate that the decision to reenlist was often made as a result of the individual’s perceptions and evaluation of the importance and interactions of the topics. Finally, this study identified that retention can also include the possibility of staff returning to a previous employer. The development of a better understanding of the topics identified and described as important when making the decision to reenlist should support the AMEDD as it continues to assess and refine current reenlistment incentives as well as the identification and development of additional options to improve enlisted soldier retention.

Neste trabalho, questiona-se a diferenciação de imperativos de carreira entre enfermeiros militares e enfermeiros civis que com formações técnico-cientificas idênticas exercem a sua profissão nas Instituições de Saúde do Exército. O objectivo geral da tese é a análise de metodologias que permitam uma gestão eficaz dos recursos humanos de enfermagem nas Instituições de Saúde do Exército tendo em consideração as especificidades e particularidades da carreira de enfermagem e os imperativos da carreira militar. Procedeu-se a um estudo qualitativo de carácter exploratório e descritivo – Estudo de Caso – com recurso à pesquisa documental e bibliográfica complementada por entrevistas exploratórias por forma a obter uma perspectiva geral do tipo aproximativo da matéria analisada. O objecto de estudo foi enquadrado teoricamente através da abordagem dos aspectos mais significativos da gestão de recursos humanos em saúde, das especificidades da saúde militar, em particular no que se refere à sua missão e às suas instituições, assim como das formas de recrutamento, formação e progressão na carreira dos profissionais de enfermagem. Sendo a saúde militar essencial para o funcionamento e eficácia do sistema das forças militares, em particular no âmbito das organizações internacionais em que Portugal está inserido, concluiu-se ser indispensável levar a cabo o redimensionamento , a articulação e a criação de equidade profissional e económica dos Enfermeiros que servem o Exército, através da optimização de processos e valorização dos recursos humanos. Para o efeito, considera-se ser necessário proceder a um levantamento das competências disponíveis, à identificação de carências, à promoção da formação do pessoal e a um planeamento que assegure níveis de remuneração equivalentes para funções com conteúdos semelhantes.
This work, questions the differentiate between the needs of career military nurses and civilian nurses that with identical technical and scientific training, exercise their profession in the Army Health Institutions. . The overall objective of the thesis is the analysis of methodologies that effective the management of nursing human resources in the Army Health Institutions taking into account the specificities and particularities of the career of nursing and the imperatives of military career. There was an exploratory and descriptive qualitative study - Case Study - using the desk research and literature complemented by exploratory interviews to obtain an overview of the type of matter considered approximate. The purpose of this study was framed theoretically by the approach of the most significant aspects of human resources management in health, the health of specific military, particularly in relation to its mission and its institutions, and forms of recruitment, training and career development of nurses. As the military health essential for the functioning and effectiveness of the system of military forces, in particular in international organizations in which Portugal is included, it being necessary to carry out the reorganization, the articulation and creation of professional and economic equity nurses who serve the Army, through the optimization of processes and development of human resources. To this end, it is necessary to be a survey of skills available, the identification of needs, the promotion of training and planning to ensure levels of remuneration for equivalent functions with similar content.

Text in Afrikaans
This research describes the coats of arms and emblems of hospitals and nursing colleges in the Republic of South Africa, an aspect of nursing's heritage and history have not yet been described. Data were collected by means of questionnaires. An extensive literature review on heraldics and an analysis of the meanings contained in the symbols appearing on these devices were done. The analysis resulted in the following; the uniqueness of the individual devices, the development of nursing and nursing education, the influence of values, norms, ideals, culture, religion and history on the selection of symbols. The heraldic meanings of symbols and the meanings indicated in the questionnaires were compared with the identified core concepts for nursing. The overall finding was that any congruence was purely circumstantial.
Hierdie navorsing beskryf die wapens en embleme van hospitale en verpleegkolleges in die Republiek van Suid-Afrika, 'n aspek van die erfenis en geskiedenis van verpleging wat nog nie vantevore beskryf is nie. Inligting was deur middel van vraelyste ingesamel. 'n Uitgebreide literatuuroorsig oor die heraldiek en 'n ontleding van die betekenisse van die simbole soos aangetref op die wapens/embleme, is gedoen.Uit die analisering is die volgende bevind; die uniekheid van die individuele wapens/embleme, die ontwikkeling van verpleging en verpleegonderrig, die invloed van waardes, norme, ideale, kultuur, godsdiens en geskiedenis op die keuse van simbole. Die heraldiese betekenis van simbole en die betekenis wat in die vraelyste daaroor aangedui is, is met die geidentifiseerde kembegrippe vir verpleging, vergelyk. Die algemene bevinding is dat enige ooreenkoms bloot toevallig is.
Health Studies
M.A. (Verpleegkunde)