Dissertations / Theses on the topic 'Conceptions of nursing'

The School Based Youth Health Nurse Program was established in 1999 by the Queensland Government to fund school nurse positions in Queensland state high schools. Schools were required to apply for a School Based Youth Health Nurse during a five-phase recruitment process, managed by the health districts, and rolled out over four years. The only mandatory selection criterion for the position of School Based Youth Health Nurse was registration as a General Nurse and most School Based Youth Health Nurses are allocated to two state high schools. Currently, there are approximately 115 Full Time Equivalent School Based Youth Health Nurse positions across all Queensland state high schools. The literature review revealed an abundance of information about school nursing. Most of the literature came from the United Kingdom and the United States, who have a different model of school nursing to school based youth health nursing. However, there is literature to suggest school nursing is gradually moving from a disease-focused approach to a social view of health. The noticeable number of articles about, for example, drug and alcohol, mental health, and contemporary sexual health issues, is evidence of this change. Additionally, there is a significant the volume of literature about partnerships and collaboration, much of which is about health education, team teaching and how school nurses and schools do health business together. The surfacing of this literature is a good indication that school nursing is aligning with the broader national health priority areas. More particularly, the literature exposed a small but relevant and current body of research, predominantly from Queensland, about school based youth health nursing. However, there remain significant gaps in the knowledge about school based youth health nursing. In particular, there is a deficit about how School Based Youth Heath Nurses understand the experience of school based youth health nursing. This research aimed to reveal the meaning of the experience of school based youth health nursing. The research question was How do School Based Youth Health Nurses’ understand the experience of school based youth health nursing? This enquiry was instigated because the researcher, who had a positive experience of school based youth health nursing, considered it important to validate other School Based Youth Health Nurses’ experiences. Consequently, a comprehensive use of qualitative research was considered the most appropriate manner to explore this research question. Within this qualitative paradigm, the research framework consists of the epistemology of social constructionism, the theoretical perspective of interpretivism and the approach of phenomenography. After ethical approval was gained, purposeful and snowball sampling was used to recruit a sample of 16 participants. In-depth interviews, which were voluntary, confidential and anonymous, were mostly conducted in public venues and lasted from 40-75 minutes. The researcher also kept a researchers journal as another form of data collection. Data analysis was guided by Dahlgren and Fallsbergs’ (1991, p. 152) seven phases of data analysis which includes familiarization, condensation, comparison, grouping, articulating, labelling and contrasting. The most important finding in this research is the outcome space, which represents the entirety of the experience of school based youth health nursing. The outcome space consists of two components: inside the school environment and outside the school environment. Metaphorically and considered as whole-in-themselves, these two components are not discreet but intertwined with each other. The outcome space consists of eight categories. Each category of description is comprised of several sub-categories of description but as a whole, is a conception of school based youth health nursing. The eight conceptions of school based youth health nursing are: 1. The conception of school based youth health nursing as out there all by yourself. 2. The conception of school based youth health nursing as no real backup. 3. The conception of school based youth health nursing as confronted by many barriers. 4. The conception of school based youth health nursing as hectic and full-on. 5. The conception of school based youth health nursing as working together. 6. The conception of school based youth health nursing as belonging to school. 7. The conception of school based youth health nursing as treated the same as others. 8. The conception of school based youth health nursing as the reason it’s all worthwhile. These eight conceptions of school based youth health nursing are logically related and form a staged hierarchical relationship because they are not equally dependent on each other. The conceptions of school based youth health nursing are grouped according to negative, negative and positive and positive conceptions of school based youth health nursing. The conceptions of school based youth health nursing build on each other, from the bottom upwards, to reach the authorized, or the most desired, conception of school based youth health nursing. This research adds to the knowledge about school nursing in general but especially about school based youth health nursing specifically. Furthermore, this research has operational and strategic implications, highlighted in the negative conceptions of school based youth health nursing, for the School Based Youth Health Nurse Program. The researcher suggests the School Based Youth Health Nurse Program, as a priority, address the operational issues The researcher recommends a range of actions to tackle issues and problems associated with accommodation and information, consultations and referral pathways, confidentiality, health promotion and education, professional development, line management and School Based Youth Health Nurse Program support and school management and community. Strategically, the researcher proposes a variety of actions to address strategic issues, such as the School Based Youth Health Nurse Program vision, model and policy and practice framework, recruitment and retention rates and evaluation. Additionally, the researcher believes the findings of this research have the capacity to spawn a myriad of future research projects. The researcher has identified the most important areas for future research as confidentiality, information, qualifications and health outcomes.

The purpose of this descriptive study was to determine: a) similarities and differences between conceptions of second and third year college-based nursing students regarding effective clinical teachers; b) if either groups' opinion was affected by the instructor's contractual agreement; and c) if students' conceptions could provide a theoretical framework for further empirical research into clinical teacher effectiveness. Transcript analysis of the thirty interviews with second and third year students in a three year college based diploma nursing program revealed that students are capable of identifying factors which enhance their learning in the clinical area, although second and third year students differed somewhat in their perceptions of effective clinical teachers. Lastly, a significantly greater number of full-time faculty than part-time faculty were described as most effective [X²=8.66 (df=1) p.<.01].
Education, Faculty of
Educational Studies (EDST), Department of
Graduate

This thesis investigates the following factors concerning student nurses: (1) demographic background and life experiences; (2) motivations to enter and commitment to nursing school; (3) students' conceptions of the role of a nurse; (4) comparison of students' expectations with their ideals and with the realities of nursing. A questionnaire was administered to first year nursing students at three institutions; a four-year baccalaureate degree program and two community college associate degree programs. The two types of institutions were chosen to allow comparison between students on two different career tracks. The findings indicate that contemporary student nurses are older than typical college students, have had a significant number of prior occupational experiences, and in contrast to the 1960's and earlier, are not exclusively female. They were most strongly motivated to be nurses by the desire to help others and conceive of the role of a nurse as challenging, rewarding, and relatively professional. In general, these students had a good understanding of the role of the average nurse, but they would construct the ideal nursing environment somewhat differently than the actual nursing environment. These findings relate to career exploration and motivational processes associated with occupational training. It can be inferred from survey data that initiates to training programs often are quite aware of what the discipline demands. In many cases they have sought out others who are working in the field. These data also reflect the increasing occupational mobility of American society whereby individuals change careers once or more during their lifetimes.

The trend toward increased computerization in Canadian hospitals has profound implications for hospital employed nurses, the majority of whom are educated in community college nursing programs. Educators, in response to this trend, must be attentive to the quality of student learning when planning for computer content in nursing curricula. The purpose of this phenomenological study was to identify how student nurses, enrolled in a community college nursing program, conceptualize the impact of computer use on hospital employed nurses. Students' conceptions were analyzed in relation to their: (a) attitude toward computers, and (b) length of clinical experience. Thirty-five (11 first-year, 11 second-year and 13 third-year) students enrolled in the nursing program at Cariboo College in Kamloops, British Columbia, were interviewed. Three broad, and ten forced-response, questions generated both qualitative and quantitative data, which were reported as primary and secondary findings. Data analysis, through use of the constant comparative method, was carried out on a formative and summative basis. Findings indicated that subjects had little awareness of computer use by nurses today. Their knowledge of how computers may be used by nurses in the future was also limited, and appeared to center around three broad areas: nursing, communication, and administration. Subjects conceptions of the impact of computer use on hospital employed nurses fell into four categories: (a) nursing image, (b) professionalism, (c) patient care, and (d) workload. Their comments on these four categories were further classified into three: sub-categories, indicating whether they felt that the increased use of computers would: (a) enhance, (b) detract from or (c) both enhance and detract from, each category. It was found that subjects' conceptions differed in complexity in direct proportion to the year in which they were enrolled in the program and also the length of their clinical experience. The majority of subjects had positive attitudes toward computer use. In addition, it was found that there was a significant relationship between complexity of conception and attitude. Students enter nursing programs with established conceptions and attitudes. The goal in planning computer programs must be to sequence computer content through the use of a taxonomy of learning outcomes, so that quality of learning is a priority, and positive attitudes are fostered.
Education, Faculty of
Educational Studies (EDST), Department of
Graduate

Introduction: Building a safety net, leadership and containing quality, are some of many responsibilities that comes with the profession nursing. To maintain health care of highest quality knowledge about patient safety is important. Patient safety means prevent medical errors that may cause the patient physical or psychological damage or in worst case scenario, death. Aim: To describe Vietnamese nurses’ conceptions of patient safety. Method: The study had a qualitative design. Data were collected from interviewing nurses at Hué University Hospital with open-ended questions. The collected data has been transcribed and condensed to categories through content analysis to find key sentences which explained Vietnamese nurses’ conception of patient safety. Result: Data analysis regarding Vietnamese nurse´s conception of patient safety resulted in seven categories which affect patient safety in Hue University Hospital, Equipment effecting the patient safety, Knowledge to provide safer care, Procedures used to increase patient safety, Infections in relation to poor patient safety, Nurses´ conception of communication, Documentation effecting patient safety and Inadequate number of nurses. Conclusion: This study shows that lack of good hygiene, insufficient equipment and the great number of patients are the most common factors to affect the patient safety in a negative way in Vietnam. The study shows that the nurses are well aware of what factors affecting the patient safety as well as how to improve patient safety.

Doctor of Philosophy (PhD)
Abstract Clinical teachers’ experiences of nursing and teaching Clinical nurse teachers’ experiences of nursing and teaching undergraduate nursing students on clinical placement are explored in this thesis because of concerns about the quality of nursing students’ learning outcomes. The aim was to identify variation in clinical teachers’ conceptions of nursing and their conceptions of, and approaches to teaching undergraduate nursing students. The study was significant because clinical teachers’ conceptions of nursing and approaches to clinical teaching have not been researched previously. Underpinning the study was a phenomenographic perspective on learning and teaching. This perspective views learning and teaching in terms of how they were experienced. Experience of nursing and clinical teaching, for example, can be understood in terms of related ‘what’ and ‘how’ aspects. The ‘what’ aspect concerns how nursing and clinical teaching were understood. The ‘how’ aspect is concerned the ways nursing and clinical teaching were approached. Experience of nursing and clinical teaching were described and analysed in terms of the separate ‘what’ and ‘how’ aspects and are understood in terms of the relationship between each of the aspects. Data from semi-structured interviews with twenty clinical teachers were analysed using phenomenographic research techniques (Marton & Booth, 1997) in order to identify variation in how nursing and clinical teaching were experienced. To extend the description, the research also sought to identify the empirical relationships between each of the aspects investigated. Key aspects of variation in clinical teacher experiences of nursing and clinical teaching and associated relationships have been identified. The results suggest that clinical teachers who adopted a student-centred approach to teaching conceived of nursing and clinical teaching in complex ways. The phenomenographic approach provides for an experiential and holistic account of clinical teaching: a perspective absent in nursing education research literature. The research findings extend knowledge that will assist with preparation and support of clinical teachers.

This study investigates the conceptions of information literacy held by student nurses on a BSc Nursing Studies course and asks whether the information skills sessions taught are successful from the students’ viewpoint. Additionally, it compares attitudes to, and use of information literacy within the artificial environment of the university and the ‘real world’ of the nurse as perceived by participants on their clinical and community placements. The inquiry introduces the concept of information literacy and charts its development before discussing it in relation to the changing context of nurse education and evidence-based practice. The research adopts the interpretive paradigm with phenomenography as its methodology. It uses focus groups and twenty-one individual interviews to obtain rich data from a purposive sample of students across the three years of the course. Such data were analysed to produce categories of description representing the collective experience of information literacy across the sample. The thesis questions whether learning to nurse effectively is best achieved through training along traditional lines, education, or a combination of both. For the latter it is imperative to find an appropriate balance between academic and clinical skills. The findings reveal a tension between the academic and clinical aspects of learning to be a nurse which some students struggle to resolve. The study concludes that while information literacy is perceived as part of a nurse’s professional role in supporting evidence-based practice, participant observations suggest that its use is context dependent and variable. The thesis recognizes that the adoption of evidence-based practice may depend on the presence or absence of particular personal and organisational barriers. Suggestions for further research include the relationship between academic and clinical learning, the importance and influence of informal learning, and the nature of the transition from student nurse to autonomous practitioner.

Introduction: Healthcare associated infections (HAIs) are a global problem and lead to a large burden for the patients, healthcare systems and society. In low and middle-income countries the burden and prevalence is higher than in high-income countries. It is possible with good prevention to reduce the prevalence and burden of healthcare associated infections. Aim: Investigate Vietnamese Nurses’ and Nursing students’ conceptions about healthcare associated infections and their role in prevention of healthcare associated infections. Method: Qualitative research with a cross-sectional design and the data was collected through eight semi-structured interviews and unstructured observations. The data was analyzed by content analysis. Results: Four categories were identified in the data analysis: Understanding and conceptions about HAI, Hinders for the prevention of HAI, How to work in a preventive way for HAI, Responsibility for patient safety. Conclusion: The study showed hinders for the nurses to perform their work correctly, limitations in the environment, lack of time, and equipment and supplies. The need for improvements are more nurses, make equipment and supplies more available and more rooms for patients. The participants acknowledge about responsibility and the importance of following guidelines at the hospitals are identified in the result.

In the UK, lecturers in nursing normally have an extensive clinical background accumulated in the National Health Service. They arrive in the Higher Education sector with little experience of university cultures and practices. The transition into this new world can be traumatic as experienced nurses strive to develop their educational capabilities. This thesis focuses on conceptions of being a lecturer in nursing within higher education. Data was collected for the study through video recorded interviews for each of ten lecturers in nursing based at universities across England and Scotland. For each, a semi-structured interview, a tutorial with a student, and a video stimulated recall and reflect interview took place. The data collection design aimed to get beyond espoused identities by collecting rich data including observation and reflection on practice. A phenomenographic approach was used to analyse semi-structured interview data to identify different ways of being a lecturer in nursing. This resulted in five categories of description of identities in the outcome space: nurse; teacher; academic scholar; researcher; and academic leader. Bourdieusian analysis of how identities are negotiated during tutorials indicated that lecturers in nursing had developed new identities within the field of higher education whilst maintaining their core identity as a nurse. Currently, it appears that there is little provision to support lecturers in nursing during the journey from transition to experienced lecturer in nursing. It is proposed that conceptions of identity are discussed through induction, mentorship and in formal development structures. As lecturers of nursing, the participants in this study occupy boundary-crossing roles on the margins of higher education. The super-complex identities of the lecturers revealed in this study provide useful insight into the life of a contemporary academic. In addition to lecturers in nursing, this study and its findings may be relevant to those in other health professions who move between the NHS and Higher Education. The findings may also transfer to other professions where individuals move sectors, such as between public and private, where further research would be required.

Torra ögon beror på en obalans i ögats tårfilm och påverkar patientens livskvalité, eftersom tillståndet ger symtom i form av ögonsmärta, rinnande ögon och synnedsättning. Tillståndet är kroniskt, progressivt och kräver regelbunden behandling.  Syftet med denna studie var att undersöka patienters uppfattningar av att leva med torra ögon.  Metoden var en kvalitativ design med en fenomenografisk forskningsansats. Patienter från en ögonmottagning i Sydsverige blev enskilt intervjuade.  Resultatet visar på tre beskrivningskategorier: En förändrad tillvaro, Oro kring vad omgivningen tänker samt Att leva på hoppet. Informanterna uppfattar fysiska besvär i form av ögonsmärta och rinnande ögon, och upplever att besvären är obehagliga. Tillståndet uppfattas inverka negativt på livet och upplevs utgöra hinder för ett välfungerande vardagsliv. Informanterna uppfattar en oro kring vad omgivningen tänker om dem när besvären är synliga. De lever på hoppet om att hitta en lösning på besvären och vidtar olika åtgärder för att hantera tillståndets utmaningar.   Slutsatsen är att en ökad kunskap om patienters uppfattningar av att leva med torra ögon, kan leda till bättre stöd och omvårdnad i form av god information och personcentrerad omvårdnad. Det rekommenderas att torra ögon uppmärksammas mer inom omvårdnadsutbildning, och ytterligare forskning inom området rekommenderas.
Dry eyes are due to an imbalance in the tear film of the eye and affect the patient's quality of life, as the condition causes symptoms in form of eye pain, watery eyes and visual impairment. The condition is chronic, progressive and requires regular treatment.   The purpose of this phenomenographic study was to examine patient´s conceptions of living with dry eyes.   The method was a qualitative design with a phenomenographic research approach. Patients from an eye clinic in southern Sweden were individually interviewed.   The result shows three descriptive categories: A changed existence, Concern about what the environment thinks and Living on the hope. The informants perceive physical inconveniences such as eye pain and watery eyes, and experience that the inconveniences are unpleasant. The condition is perceived to have a negative impact on life and is perceived as a hindrance to a well-functioning everyday life. The informants perceive concerns about what the environment thinks of them when the problems are visible. They live on the hope of finding a solution to the problems and take various measures to deal with the challenges of the condition.  The conclusion is that an increased knowledge of patient´s conceptions of living with dry eyes, can lead to better support and nursing in form of good information and person-centered care. It is recommended that dry eyes be given more attention in nursing education, and further research in this area is recommended.

This dissertation focuses on continuity and change in a local knowledge culture, the nursing teacher education in Stockholm, during the years between 1958 and 1999, with a strong emphasis on conceptions of knowledge and learning. Concepts of analysis come from Basil Bernstein, Ludwik Fleck, Reinhart Koselleck and gender theory. The study is based on archived documents and interviews with nursing teacher educators. The results show continuity as well as change of the knowledge culture. The first period, 1958-1974, shows continuity in relation to the space of experience. Methodical knowledge is important. The second time period, 1975-1978, is characterized by great changes, starting with a distinct break when prior conceptions and values are discarded. The focus on important, external knowledge of the earlier period is replaced by the conception that the human being and her inner abilities and characteristics are the most important resources for the profession. Conceptions and values are not completely abandoned during the last time period, 1979-1999. Values connected to personality development remain, but new values appear as a consequence of state governance towards research basis. The spirit of time, new co-workers, changed state governance, the ideological characteristics of values as well as a female dominance within the education allow an understanding of the great change in conceptions and values in the middle of the 1970’s.  A stable staff of nursing teacher educators, the specific ideological and gender coded features of the values and a traditional distinctiveness and separation from other teacher education programs allow an understanding of the stability of the personality development element. The male gender coding of the content during the first period could be understood by the influence of physicians on the education, state governance towards education technology and harmony with the space of experience. During the whole of the studied time period, there are female coded conceptions regarding the work of the nursing teacher educators; collectivity, emphasis on practical action and control of - closeness to the student group.
När praktikgrundad kunskap möter högskolan

Este estudo descreve e analisa o universo da Consulta de Enfermagem (CE) desenvolvida por enfermeiras da Rede de Serviços de Atenção Básica de Saúde de Porto Alegre. Foram analisados 95 serviços de saúde de diferentes origens institucionais como: Unidades de Saúde; Unidades de Saúde da Família; Ambulatórios e Centros de Saúde; Unidades Particulares/Conveniadas e Unidades Mistas, localizadas em diferentes regiões do município de Porto Alegre. O número total de enfermeiras que aceitaram participar foi de 127, correspondendo a 80,9% da população das que atuam na Atenção Básica. Entre os objetivos constam descrever o universo dessa prática assistencial considerando concepções e métodos, o perfil das enfermeiras e sua inserção nos serviços de Atenção Básica de Saúde. O delineamento deste estudo é exploratório e descritivo, transversal, com abordagem analítica quanti-qualitativa. A coleta de dados baseou-se em um formulário e um guia de entrevistas. Revelou um universo heterogêneo, diversificado e multifuncional em relação à prática da CE pelas enfermeiras no cotidiano dos serviços de saúde. Dentre elas, 85,8% das entrevistadas desenvolvem CE, evidenciando essa prática como central na sua atuação profissional. A atuação na CE influencia e é influenciada pelas interações de trabalho; pela composição das equipes de saúde; pelo local de realização da consulta; pelas demandas assistenciais; pelas estratégias de acesso dos usuários ao serviço; pelas exigências e protocolos institucionais através de programas de saúde pública e acolhimento, e pela própria concepção de CE que cada enfermeira dá para a sua prática profissional. Evidenciou-se que a CE configura-se em estratégia assistencial substancial à demanda dos serviços, representada nos quantitativos de atendimentos e na complexidade das situações de saúde e de doença da clientela. Pode-se afirmar que existem diferentes concepções e práticas de CE, sendo definidas por um leque de ações que se estendem da formalidade a informalidade nos diferentes espaços dos serviços. Por fim, constata-se que a prática da CE foi ampliada e fortalecida com a implantação da Estratégia de Saúde da Família na Atenção Básica de Porto Alegre nos últimos anos.
This study describes and analyses the environment of Nursing Consultation (NC) developed by nurses of the Basic Health Attention Service Network in Porto Alegre. Ninety five (95) health services of different institutional origins were analyzed, they are: Health Units; Family Health Units; Policlinic and Health Centers; Private/Covenanted Units; and Mixed Units, located in different regions of Porto Alegre. The total number of nurses who participated was 127, corresponding to 80,9% of the population of the ones who work in the basic attention. Among the objectives of this study there are the description of the universe of the assistance practice which takes into consideration the concepts and methods, the profile of the nurses and their insertion in the basic health attention service. The outline of this study is exploratory, descriptive and transversal, with an analytical quanti-qualitative approach. The collection of the data was based in a form of interviews. After the analysis, the mentioned universe showed to be heterogeneous, diversified and multifunctional in relation to the practice of the NC performed by the nurses in their daily work in the health service. Among them, 85,8% of the interviewees work with NC, they evidence such practice as being core in their acting in this kind of health service. Their acting in NC influences and it is influenced by work interactions; by the composition of the health teams; by the place of the consultation; by the demands of assistance; by strategies of users’ access to the service; and, by the requirements and institutional protocols through programs of public health. It was made evident that NC is a substantial assistance strategy to the demands of the service, which is represented in the high number of consultations and in the complexity of the health situations and patients’ sickness. We can affirm that there are different conceptions and practices of NC. They may be defined by a varied range of actions which go from the formality to the informality in different places which offer health service. It was verified that the practice of NC was amplified and fortified with the implantation of the Family Health Strategy in basic attention which happened in the city of Porto Alegre in the last years.
Este estudio describe y analiza el universo de la Consulta de Enfermería (CE) desarrollada por enfermeras de la Red de Servicios de Atención Básica de Salud de Porto Alegre. Fueron analizados 95 servicios de salud de diferentes orígenes institucionales como: Unidades de Salud; Unidades de Salud de la Familia; Ambulatorios y Centros de Salud; Unidades Particulares/Conveniadas y Unidades Mixtas, localizadas en diferentes regiones del municipio de Porto Alegre. El número total de enfermeras que participaron fue de 127, correspondiendo a 80,9% de la población de las que actúan en la atención básica. Entre los objetivos constan describir el universo de esta práctica asistencial considerando concepciones y métodos, el perfil de las enfermeras y su inserción en los servicios de atención básica de salud. El delineamiento de este estudio es exploratorio y descriptivo, transversal, con abordaje analítica cuanti-cualitativa. La colecta de datos se basó en un formulario-guía de entrevistas. Reveló un universo heterogéneo, diversificado y multifuncional en relación a la práctica de la CE por las enfermeras en el cotidiano de los servicios de salud. Entre ellas 85,8% de las entrevistadas desarrollan CE, evidenciando esa práctica como central en su actuación en ese ámbito de la salud. Esa actuación en la CE influencia y está influenciada por las interacciones de trabajo; por la composición de los equipos de salud; por el lugar donde se realiza de la consulta; por las demandas asistenciales; por las estrategias de acceso de los usuarios al servicio; por las exigencias y protocolos institucionales a través de programas de salud pública y acogimiento. Se evidenció que la CE se configura en estrategia asistencial substancial a la demanda de los servicios, representada en los cuantitativos de atendimientos y en la complejidad de las situaciones de salud y de enfermedad de la clientela. Se puede afirmar que existen diferentes concepciones y prácticas de CE, siendo definidas por un conjunto de acciones que se extienden de la formalidad a la informalidad en los diferentes espacios de los servicios. Se constata que la práctica de la CE fue ampliada y fortalecida con la implementación de la Estrategia de Salud de la Familia en la atención básica de Porto Alegre en los últimos años.

This thesis examines the present provisions for pre-conception care and the views of the providers of services. Pre-conception care is seen by some clinicians and health educators as a means of making any necessary changes in life style, corrections to imbalances in the nutritional status of the prospective mother (and father) and the assessment of any medical problems, thus maximizing the likelihood of the normal development of the baby. Pre-conception care may be described as a service to bridge the gap between the family planning clinic and the first ante-natal booking appointment. There were three separate foci for the empirical research - the Foresight organisation (a charity which has pioneered pre-conception care in Britain); the pre-conception care clinic at the West London Hospital, Hammersmith; and the West Midlands Regional Health Authority. The six main sources of data were: twenty five clinicians operating Foresight pre-conception clinics, couples attending pre-conception clinics, committee members of the Foresight organisation, staff of the West London Hospital pre-conception clinic, Hammersmith, District Health Education Officers working in the West Midlands Regional Health Authority and the members of the Ante-Natal Care Action Group, a sub-group of the Regional Health Advisory Group on Health Promotion and Preventive Medicine. A range of research methods were adopted. These were as follows: questionnaires and report forms used in co-operation with the Foresight clinicians, interviews, participant observation discussions and informal meetings and, finally, literature and official documentation. The research findings illustrated that pre-conception care services provided at the predominantly private Foresight clinics were of a rather `ad hoc' nature. The type of provision varied considerably and clearly reflected the views held by its providers. The protocol which had been developed to assist in the standardization of results was not followed by the clinicians. The pre-conception service provided at the West London Hospital shared some similarities in its approach with the Foresight provision; a major difference was that it did not advocate the use of routine hair trace metal analysis. Interviews with District Health Education Officers and with members of the Ante Natal Care Action Group revealed a tentative and cautious approach to pre-conception care generally and to the Foresight approach in particular. The thesis concludes with a consideration of the future of pre-conception care and the prospects for the establishment of a comprehensive pre-conception care service.

Bakgrund: Telefonrådgivning har använts som kommunikationssätt sedan 30-talet inom sjukvården. I nutid är telefonrådgivning ett väl etablerat och beprövat kommunikationsalternativ som brukas runt om i Sverige. Dock belyser forskning telefonrådgivning som en komplex arbetsuppgift. Inom oftalmologi finns det vidare sparsam forskning kring just ögonsjuksköterskans uppfattning av telefonrådgivning.  Syfte: Syftet var att undersöka ögonsjuksköterskans uppfattning av telefonrådgivning på ögonmottagning.  Metod: Metoden som användes var av kvalitativ design med en fenomenografisk ansats. Åtta ögonsjuksköterskor från södra Sverige som arbetade på ögonmottagning intervjuades enskilt. En fenomenografisk analysmetod valdes att användas för analysering av data.  Resultat: Analysen resulterade i tre beskrivningskategorier: (1) Relationens betydelse mellan ögonsjuksköterska och patient, (2) Aspekter som begränsar och underlättar bedömningen mellan ögonsjuksköterska och patient samt (3) Betydelsen av kunskap, stöd och erfarenhet för ögonsjuksköterskan. Slutsats: Det framkom olika begränsande och underlättande aspekter som påverkar bedömningen och mötet med patienten. Ögonsjuksköterskan uppfattade relationen med patienten som en central del i arbetet med telefonrådgivning. Likaså uppfattades stöd i olika former samt kunskapsutveckling och erfarenhet kring området som betydelsefullt. Resultatet visar, likt tidigare forskning, att telefonrådgivning är en mycket komplex arbetsuppgift.
Background: Telephone counseling has been used as a means of communication since the 1930s in healthcare. Today, telephone counseling is a well-established and proven communication alternative that is used around Sweden. However, research highlights telephone counseling as a complex task. In ophthalmology, there is also sparse research on the ophthalmic nurse´s perception of telephone counseling. Aim: The purpose was to investigate the ophthalmic nurse conception of telephone counseling at an eye clinic.Method: The method used was of qualitative design with a phenomenographic approach. Eight ophthalmic nurse´s from southern Sweden who worked at the eye clinic were interviewed individually. A phenomenographic analysis method was chosen to be used for data analysis. Results: The analysis resulted in three descriptive categories: (1) The importance of the relationship between the ophthalmic nurse and the patient, (2) Aspects that limit and facilitate the assessment between the ophthalmic nurse and the patient and (3) The importance of knowledge, support and experience for the ophthalmic nurse. Conclusion: Various limiting and facilitating aspects emerged that affect the assessment and the meeting with the patient. The ophthalmic nurse perceived the relationship with the patient as a central part of the work with telephone counseling. Likewise, support in various forms as well as knowledge development and experience in the area were perceived as significant. The results show, like previous research, that telephone counseling is a very complex task.

Introduction : La rétroaction sur la performance des personnes étudiantes infirmières lors de l’utilisation de simulateur de patients sur ordinateur contribuerait à l’apprentissage et au développement du raisonnement clinique en supportant la métacognition (Zary et al., 2006). Or à notre connaissance, la forme et le contenu de ce type de rétroaction demeure peu discuté dans les écrits scientifiques. Objectif : Ce projet de recherche comportait trois objectifs. Le premier était de contribuer au développement d’une fonctionnalité de rétroaction dans un simulateur sur écran, le second visait à documenter la perception de son utilité à la suite d’une expérimentation guidée en laboratoire auprès de personnes étudiantes infirmières et, enfin, le troisième objectif visait à décrire l’appréciation générale du simulateur par les personnes participantes. Méthodes : Un devis de recherche descriptif avec méthodes mixtes auprès d’un échantillon de convenance constitué d’étudiantes et étudiants en sciences infirmières d’une université québécoise a été retenu pour cette étude. Le modèle de rétroaction PROMPTED (Rudland et al., 2013) a été retenu pour orienter la conception de la rétroaction dans le simulateur sur écran. L’accès au simulateur s’est fait par un lien web et, par la suite, les personnes participantes devaient compléter un questionnaire web autoadministré pour documenter leur appréciation de la rétroaction fournie pendant la simulation et du simulateur sur écran en soi. De plus, des entrevues ont été réalisées pour enrichir la description de l’utilité perçue de la rétroaction offerte dans le simulateur sur écran. Résultats : La rétroaction intégrée dans le simulateur sur écran selon les principes du modèle PROMPTED a permis de guider et de bien renseigner les étudiantes au cours de l’activité. Les données recueillies suggèrent l’appréciation de l’utilisation de la rétroaction en cours d’activité plutôt que d’avoir seulement un solutionnaire à la fin de l’exercice. Conclusion : En plus d’apporter une plus-value au simulateur sur écran par rapport à ce qui se retrouve sur le marché, ce projet contribue à l’avancement des connaissances sur l’utilité de la présence de rétroaction dans les simulateurs sur écran lors de la formation infirmière.
Abstract : Background: Feedback on nursing students’ performance when using a screen simulator could contribute to the learning and development of clinical reasoning by supporting metacognition (Zary et al., 2006). To our knowledge, the form and content of this type of feedback remains slightly discussed in scientific literature. Objective: This research project had three objectives. The first was to contribute to the development of a feedback functionality in a screen simulator, the second was to document the perception of its usefulness following a laboratory-guided experimentation with nursing students, and finally, the third objective aimed to describe its overall appreciation of the simulator. Methods: A descriptive research design with mixed methods was used with a convenience sample of nursing students of a university in Quebec. The PROMPTED feedback model (Rudland et al., 2013) was chosen to guide the conception of feedback in the screen simulator. Access to the simulator was via a web link and subsequently, the participants had to complete a self-administered web questionnaire of their appreciation of the feedback provided during the simulation as well as the screen simulator per se. In addition, interviews were conducted to enrich the description of the perceived usefulness of the feedback provided in the screen simulator. Results: Feedback integrated into the screen simulator in accordance with the PROMPTED Model has helped to guide and to inform the students during the activity. The data collected suggest the use of reel-time continuous feedback rather than only giving the answers at the end of the exercise. Conclusion: In addition to the value upgrade of the screen simulator compared to what is on the market, this project has contributed to the advancement of knowledge on the usefulness of feedback in screen simulators in nursing education.

Bakgrund: Att vårdas på sjukhus kan för äldre personer ge en upplevelse av minskad autonomi, och förlust av förmågor/funktioner. Den äldre personen efterfrågar att få bli sedd av sjuksköterskan som autonom person och utifrån deras resurser Syfte: Syftet är att beskriva sjuksköterskors uppfattning av arbetet med den äldre personens resurser under vårdtiden på en geriatrisk slutenvårdsavdelning. Metod: Metoden är en kvalitativ intervjustudie med fenomenografisk ansats. Resultat: Sjuksköterskors uppfattning av arbetet med den äldre personens resurser under vårdtiden på en geriatrisk slutenvårdavdelning beskrevs i en övergripande kategori och med fyra kategorier. Den övergripande kategorin var att sjuksköterskor har olika förståelse för begreppet resurser. De fyra kategorierna var; möjligheter ges att låta den äldre personen göra det hen kan själv, arbetet med den äldre personens resurser bottnar i ett personcentrerat tankesätt, den äldre personens resurser kan vara dolda och den äldre personens resurser tas inte tillvara. Konklusion: Sjuksköterskor uppfattar frånvaro av arbetet med den äldre personens resurser trots teoretisk medvetenhet. Genom ett personcentrerat arbetssätt kan den äldre personens resurser tas tillvara. Att som sjuksköterska identifiera resurser är ett sätt att stärka den äldre personens hälsa och livskvalitet.
Background: Hospitalization can bestow a feeling of autonomy deprivation and loss of abilities for the elderly persons. The elderly person expects to be seen by the nurse as an autonomous person and have their individual assets identified. Purpose: Purpose is to describe the nurses´ perceptions of the work with elderly persons´s assets during inpatient stay at a Geriatric ward. Method: Method is qualitative interview study with a phenomenographic methodology. Results: Nurses’ perceptions of the work with elderly person’s assets during inpatient stay at a Geriatric ward can be described in an overriding category and four categories. The overriding category was nurses have different understanding for the term assets. The four categories were; possibilities given to let de elderly person do what him/herself can do, the work with the elderly persons assets is sprung from a person-centered mindset, the elderly persons assets can be hidden and the elderly persons assets is not taken at use. Conclusion: Nurses’ percept an absence of work with the elderly persons assets despite theoretical awareness. Thru a person-centered way of working can the elderly persons assets be taken care of. As a nurse identify assets is a way of strengthen the elderly persons health and quality of life.

Bakgrund: Hjärtinfarkt drabbar årligen 7 miljoner människor världen över och är den enskilt vanligaste dödsorsaken i Sverige. Sjukvården har ett ansvar i omhändertagandet av en patient som drabbats av en hjärtinfarkt. Dels genom ett lugnt och tryggt omhändertagande men också genom stöd och vägledning. Genom personcentrerad vård lägger sjuksköterskan fokus på patientens delaktighet, övertygelser och värderingar och tar hänsyn till att det finns kulturella, sociala och individuella skillnader. Sjuksköterskan behöver undersöka faktorer som kan påverka patientens förmåga att anpassa sig till sjukdomen för att kunna hjälpa patienten att anpassa sig till sin nya livssituation. Livsåskådningar ligger till grund för hur människor tolkar sin omvärld och ser på livet. Hur en människas syn och tankar om verkligheten och sin omvärld ser ut påverkar individens handlande gentemot sig själv och andra. Syfte: Syftet var att belysa livsåskådningens betydelse för patienters anpassning till livet efter en hjärtinfarkt. Metod: En litteraturöversikt gjordes i enlighet med Fribergs metod. Resultatet är baserat på tolv kvalitativa vetenskapliga artiklar som beskriver patienters erfarenheter av att drabbas av en hjärtinfarkt och livet som följer efter infarkten. Artiklarna analyserades genom tematisering och kategorisering. Resultat: Tre huvudkategorier identifierades med tillhörande åtta subkategorier. De tre huvudkategorierna var känsla av kontroll, tankar kring livet och döden och känslor kring en förändrad livssituation. Dessa tre huvudkategorier beskriver patienters erfarenheter av att drabbas av en hjärtinfarkt. Ur resultatet framkom att livsåskådningsmässiga frågor kommer till patienten i samband med en livshotande sjukdom. Diskussion: Resultatet diskuteras utifrån Jeffners definition av livsåskådning och vilken funktion livsåskådningen har för hur människan anpassar sig till en förändrad tillvaro utifrån perspektiv och hanterbarhet. Tydligt framkommande delar i resultatet kopplas till och diskuteras mot de tre komponenterna, teorier om människan och världen, centralt värderingssystem och grundhållning i Jeffners definition.
Background: Myocardial infarction affects seven million people annually all over the world and is the single most common cause of death in Sweden. Healthcare professionals have a responsibility to care for a patient who has suffered a heart attack. Partly through calm and safe caring, but also through support and guidance. As well as person-centered care, the nurse focuses on the patient's involvement, beliefs and values and considers that there are cultural, social and individual differences. The nurse needs to investigate factors that can affect the patient's ability to adapt to the disease in order to help the patient adapt to their new life situation. Conception of life form the basis for how people interpret their surroundings and outlook on life. How a person's vision and thoughts about reality and their surroundings look, and affect the patients´ actions towards themselves and others. Aim: The aim was to illustrate the meaning of conception of life for patients´ adapting to life after a myocardial infarction. Method: A literature review was made in accordance with Friberg's method. The result is based on twelve qualitative scientific articles describing patients' experiences of suffering from a myocardial infarction and life following contraction. The articles were analyzed by thematization and categorization. Results: Three main categories were identified with eight associated subcategories. The three main categories were feeling of control, thoughts about life and death and feelings about a changed life situation. These three main categories describe patients' experiences of suffering a myocardial infarction. The results showed that thoughts about conception of life arise with diagnosis of a life-threatening illness. Discussion: The result is discussed on the basis of Jeffners definition of conception of life and it´s function for how a person adapts to a changed existence from perspective and manageability. Clearly emerging parts of the result are linked to and discussed against the three components, theories of human kind and the world, a central values system and a basic attitude towards life in Jeffners definition.

The primary purpose of this study was to identify the way in which two groups, staff nurses and nurse administrators/managers, each conceptualize the ideal and actual role of the registered nurse practicing at the bedside. Data was examined in order to identify similarities and differences in the opinions of the two groups. A questionnaire with 35 items/situations using a Likert scale was developed. Items/situations were worded to conform to a five-point response format ranging from strongly agree to strongly disagree. The role conception items/situations were designed to measure the respondent's perceptions of what the role should be and perceptions of what actually exists in the practice of the nurse role. The sample of 300 non-management nurses was randomly selected using 50 percent of the professional nurses from each unit. Nurse administrators/managers comprised a smaller number than non-managers, therefore, the questionnaire was given to this entire group. Noteworthy findings of the study include that (a) staff nurses and nurse administrators/managers agreed in their perception of what comprises the actual professional role of the nurse practicing at the bedside, (b) both groups also agreed in their perception of what comprises the ideal professional role of the staff nurse practicing at the bedside, (c) the staff nurses and nurse administrators/managers agreed in their perception of what comprised the actual bureaucratic role of the nurse practicing at the bedside, (d) the groups agreed in their perceptions of what comprised the ideal bureaucratic role of the nurse practicing at the bedside, and (e) there is a significant difference between the ideal and actual role conceptions within both the bureaucratic and professional concepts. Simply stated, the respondents of this study do not believe that nursing is being practiced the way nursing should be practiced. Implications of the study are presented and discussed, and recommendations for further study are provided.

The study explored the cultural dynamics of construction of sexual intercourse within gender constructions of masculinity and femininity among the Yoruba people of South western Nigeria. The Explanatory Model Interview Catalogue (EMIC/ETIC) framework, a cultural explanatory social analytic framework with guides to looking at the insiders' perspectives, was used as the theoretical base to the study. The study was conducted to broaden understanding of sexual relationships in order to generate culturally relevant programmes that can promote sexual health, control sexual coercion, sexual violence and reduce the transmission and spread of HIV. It explored information about the conceptions of sexual relationships, social dynamics of sexual negotiations in marital and non-marital relationships, the expressions and process of knowledge acquisition as such translates to sexual behaviour by men and women. The prevalence of consensus, coercive and forced sexual intercourse and sexual morbidity were determined. Perceived link of sexual coercion and sexual violence to HIV transmission was also explored. Traditional practices, including regulatory mechanisms for the control of sexual behaviour of men and women in the culture were also explored. Equally focused in the study were differences in the conceptions of sexual relationships among the study population as moderated by sex, age, educational background and marital status, along with experiences of sexual coercion, forced sex, and sexual intercourse related morbidity. Adopting the ethnographic method, qualitative data from historical review of existing information about the Yoruba people, focus group discussions, in-depth individual interviews and observations were complemented by quantitative data generated through a survey in a sample Yoruba community of lIe-Ife. Findings showed the conception of sexual relationships and sexual intercourse built around the conception and social constructions of active masculinity and passive femininity. Conceptions of sexual relationship evolved as a transitional phenomenon that individuals were expected to learn informally instinctually and as they attain sexual biological maturity through language use and observations of practices among older people. Two typologies of masculinity and femininity were discernible in the study population that also give specifications to social and sexual behaviour of men and women. There appeared a changing conception of femininity especially among young people below 30 years, which is also informing sexual behaviour of young women. Relationships were moderated by age, economic status and marriage, which invariably put women in subordinate position to men either in social or sexual relationships. Behaviour of men and women were dictated by social role assignment of leadership through economic provisions for family and control of sexual act by the man. This was within a contractual relationship of older men with younger women with the primary motive of procreation in traditional orientation. Sexual intercourse was seen as a compulsory act for both men and women especially as it results to procreation though the initiation and control were part of the social responsibility of the man. It was socially approved within marriage but pre-marital and extra marital relationships were tolerated more for men. The act was also used "as a prove of self", for economic gains, to demonstrate love, for enjoyment and as a tool of punishment of women by some men. Knowledge acquisition about sexual relationships and sexual intercourse tended to be inadequate throughout the life span. There was never a time when individuals, even after marriage, have access to correct information about sexual intercourse. There was gross assumption of what sexual partners know about sexual intercourse in the population. Within the context of 13 identifiable topical knowledge areas desirable for sexual health, more than 50% of males and females expressed lack of knowledge. There were significant differences in expressed knowledge by male and female respondents of what sexual intercourse is and the motives of sexual intercourse
Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2005.

Problématique : Les organisations de santé font face à des pressions diverses pour offrir des soins et des services qui répondent aux plus hauts critères de performance et rendre compte de cette performance. Ces pressions proviennent de différents acteurs tels que les usagers du système de santé et les décideurs politiques. En raison de la place importante que prennent les infirmières dans l’offre de services de santé, il existe un intérêt croissant pour la mise en place d’interventions visant à mesurer et à améliorer la performance des services infirmiers. Cependant, dans le cadre de ces processus, les organisations sont souvent confrontées à des visions différentes et conflictuelles de la performance et à diverses approches pour la mesurer. Objectifs : Cette étude qualitative exploratoire a pour but d’explorer les conceptions de la performance des membres de l’équipe d’encadrement impliqués dans la prestation des services infirmiers et des infirmières soignantes et d’examiner dans quelle mesure les conceptions de la performance des deux groupes d’acteurs correspondent ou entrent en conflit. Méthodologie : Des entrevues semi-dirigées ont été conduites auprès de cinq membres de l’équipe d’encadrement et de trois infirmières. Une analyse de contenu a été effectuée à la fois pour faire ressortir l’éventail des conceptions et celles qui sont les plus prépondérantes dans les discours. Le cadre de référence ayant guidé cette analyse est une adaptation du modèle conceptuel de Donabedian comprenant trois dimensions soit la structure, le processus et les résultats (Unruh & Wan, 2004). Résultats : L’analyse des données recueillies auprès des membres de l’équipe d’encadrement fait ressortir dix conceptions distinctes, mais interreliées de la performance qui mettent l’accent sur les éléments de processus de soins infirmiers et de résultats chez la clientèle. Concernant les infirmières, neuf conceptions ont été répertoriées et l’accent a été porté surtout sur les éléments concernant l’adéquation des ressources humaines infirmières et de processus de soins infirmiers. Certaines similitudes et différences ont été repérées entre les conceptions de ces deux groupes d’acteurs. Conclusion : Cette étude permet de mieux comprendre les conceptions de la performance des acteurs impliqués dans l’offre de services infirmiers. Le modèle intégrateur qui résulte de la combinaison de ces différentes conceptions offre un cadre utile pour guider la construction d’outils de mesure de performance directement en lien avec les soins infirmiers et répondre à la demande d’imputabilité par rapport à ces services.
Background : Healthcare organizations face pressure to supply care and services that meet the highest level of performance and to show accountability in regards to this performance. These pressures come from different individuals ranging from the users of the healthcare system to political leaders. Since the nursing staffs occupy an important part in the supply of the healthcare services, there is a growing interest to put in place actions that would increase the performance of the nursing services as well as measure it. However, as part of this process, healthcare organizations often face conflictual notions of what performance is and how to properly measure it. Objectives : This qualitative exploratory study aims to explore the different notions of what performance is as seen by management teams involved in the nursing services delivery and by the field nurses to determine how much these notions are similar to each other or rather in opposition. Methodology: Semi-directed interviews have been held with five management teams’ members and also with three nurses. A content analysis has been made to illustrate the various notions of what performance is and those that show up the most. The framework used in this study is an adaptation of Donabedian’s model which includes three components: structure, process and results (Unruh & Wan, 2004). Findings: Ten distinct but related performance notions that focus on nursing’s process and impact on the users have been identified from data collected from management team members. On the nurses’ side, nine notions have been identified and put the focus mainly on the adequacy of nursing human resources with the nursing process. Some differences and similarities have also been identified between the performance notions of the two groups. Conclusion : This study gives a better understanding of the different performance notions that come from the various individuals involved in the nursing supply. The integrator model that result from the mix of these different notions will be useful in the creation of performance measurement tools directly linked with the nursing services, which will help respond to the accountability demand towards these services.

by Yung Ha-ping, Hilary.
Questionnaire also in Chinese.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1994.
Includes bibliographical references (leaves 92-101).
ACKNOWLEDGEMENTS
ABSTRACT --- p.ii
LIST OF TABLES --- p.vii
LIST OF FIGURES --- p.viii
CHAPTER
Chapter 1. --- INTRODUCTION --- p.1
Bacground of the Study --- p.1
Significance of the Study --- p.4
Purpose of the Study --- p.5
Chapter 2. --- REVIEW OF LITERATURE AND THEORETICAL FRAMEWORK
Role Conception
Role --- p.6
Role Conception --- p.7
Nursing Role Conception --- p.8
Role Discrepancy --- p.9
Change of Role Conception --- p.10
Socilaisation and Role Conception --- p.11
Socialisation of Baccalaureate Degree Students --- p.12
Socialisation of Hospital-based Certificate Students --- p.13
Nursing and Ethics --- p.14
Ethical Dilemma --- p.15
Code of Ethics --- p.16
Moral Development --- p.17
Moral Reasoning and Moral Behaviour --- p.18
Decision-making Framework --- p.20
Ethical Decision-making in Nursing --- p.21
Ethical Decision-making and Work Environment --- p.23
Ethical Decision-making and Role Conception --- p.24
Ethical Decision-making and Education --- p.25
Learning Climate
Concept of Organizational Climate --- p.26
Organizational Climate and Leadership --- p.28
Ward Learning Climate --- p.28
Ward Teaching and Learning --- p.30
Role of Ward Staff and School Tutor in Ward Teaching --- p.31
Role of ward Sister in Ward Teaching --- p.32
"Relationship among Role Conception, Ethical Decision- Making and Ward Learning Climate" --- p.34
Chapter 3. --- RESEARCH METHODOLOGY
Design of the Study --- p.38
Hypotheses --- p.38
Definitions --- p.39
Subjects --- p.40
Procedure --- p.42
Instruments --- p.42
Analysis Design --- p.50
Chapter 4. --- RESULTS
Demographic Characteristics --- p.52
Differences in Role Conception Types --- p.53
Differences in Discrepancy Role Conception --- p.60
Differences in Ethical Decision-making --- p.63
Differences in Perception of Ward Learning Climate --- p.66
"Relationship among Ethical Decision-making, Role Conception and Learning Climate" --- p.69
Chapter 5. --- DISCUSSION
Differences in Professional Role Conception --- p.75
Differences in Bureaucratic Role Conception --- p.79
Differences in Service Role Conception --- p.80
Differences in Ethical Decision-making --- p.81
Differences in Perception of Ward Learning Climate --- p.83
"Relationship among Ethical Decision-making, Role Conception and Learning Climate" --- p.84
Limitations --- p.87
Chapter 6. --- "CONCLUSION, IMPLICATIONS AND RECOMMENDATIONS"
Conclusion --- p.88
Implications and Recommendations --- p.89
Suggestions for Further Research --- p.90
REFERENCES --- p.91
APPENDICES
Chapter I. --- Code for Nurses --- p.102
Chapter II. --- Letter of Request for Approval --- p.103
Chapter III. --- Questionnaire Instruction --- p.104
Chapter IV. --- Letter to Students --- p.105
Chapter V. --- Consent Form --- p.106
Chapter VI. --- Demographic Data --- p.107
Chapter VII. --- Nursing Role Conception Inventory --- p.108
Chapter VIII(A). --- Opinion About Nursing (Role Conception Questionnaire) --- p.110
Chapter VIII(B). --- Opinion About Nursing - Chinese Version --- p.115
Chapter IX(A). --- Judgment About Nursing Decision (JAND) (Ethical Decision-making Qusetionnaire) --- p.118
Chapter IX(B). --- Judgment About Nursing Decision (JAND) -Chinese Version --- p.125
Chapter X. --- Ward Learning Climate Indicators --- p.132
Chapter XI(A). --- Ward Learning Climate Questionnaire --- p.135
Chapter XI(B). --- Ward Learning Climate Questionnaire -Chinese Version --- p.138
Chapter XII. --- Narrative Responses --- p.140

碩士
大葉大學
運動健康管理學系
104
Abstract The purpose of this research is to investigate relevant factors between health conception and standards of living through sampling different backgrounds, health knowledge, living standards and correlated variables of nurses living in mid district. A cross-sectional study design via questionnaire was conducted to sample individuals with different backgrounds to analyze the correlation between living standards and health conception. A total of 500 samples were done, 420 samples returned with 71 samples unanswered, resultant in 349 samples been analyzed and 83.1% success returned rate. SPSS were used to conduct descriptive analysis, Pearson’s correlation coefficient analysis and multiple regression analysis which came to the following result: The research shows: 1. Adaptive health conception received the highest overall while clinical health conception been the lowest; the overall living standards depending on social relationship is the highest category while physical health been the lowest. 2. The overall health conception within four different facets that have positive associations are: Job, age, education and seniority; marriage facet has a negative association to health conception. The higher the job title, higher level of education and higher seniority has better understanding of health conception. 3. Living standards within four different facets that have positive associations are: Age, level of education and seniority; job title and marriage facet have negative association to health conception. In age category 21-30 and 50 and up, higher level of education and higher seniority has greater perception of living standard. 4. Overall living standards and health conception received positive association, while peace and happiness been the highest category. 5. Health conception within four facets is positively related to peace and happiness which was predicted to be the most important variable. It shows that health conception of peace and happiness can also explain 28.9% of the variations in living standards. In conclusion, this can provide a reference for health care department to assist in reduce work stress and exhaustion of nurses. A positive conscious of health conception can elevate the living standards of nurses. Key words: Overall evaluation, clinical, role function, peace and happiness

碩士
國立屏東科技大學
畜產系
94
The purpose of this study was aimed in the effects of feeding level and nursing days on the body weight and backfat thickness losses of the black sows（12.5% Landrace and 87.5% black）, conception ability after weaning and the performance of piglets growth. Experiment 1 : 40 crossbred sows , 20 primiparous sows and 20 multiparous sows , effects of feeding level of the sows during nursing stage in hot season in southern Taiwan on reproductive performance and piglets growth was conducted to investigate the were randomly alloted to 3.0, 4.5, 5.0 and 5.5 kg feeding level during nursing stage. Results indicated that the body weight loss of the primiparous and multiparous sows of the 3.0 kg groups were significantly higher（P < 0.05）than the other treats, but between other treats had no. The body weight loss of the 3.0 kg multiparous sows were significantly higher than the other and feeding level groups of the multiparous and the 4.5 and 5.5 kg groups of the primiparous（P < 0.05）. No matter the primiparous or multiparous sows, the backfat thickness loss in the 3.0 kg treats were significantly higher than the 4.5 and 5.5 kg treats（P < 0.05）. The estrous rate within 10 days post-weaning of the 4.5 kg feeding level group were higher than the other groups. The piglets weight gain of the 3.0 kg groups were lower than the others during nursing stage , but increased with the feeding level ,and the piglets weaning weight of the multiparous groups were greater than the primiparous groups. There was no significantly effect on the litter size of next parity in the parties within feeding level groups .In Experiment 2-1：56 crossbred 3rd~6th parity sows, 34 original sows and 22 foster sows were used to investigate the effects of nursing days on the reproductive performance of the sows and piglets growth. Results indicated that the body weight losses tended to increase followed the increase of nursing days. Weight loss of the original sows of the Day 21 and Day 28 groups significantly higher than the of that foster sows（ P < 0.05）.The subsequent estrous rates within 10 days postweaning of the Day 7 nursing groups of the original and foster sows were less significantly than the 14Day groups（P < 0.05）. In Experiment 2-2 : 272 piglets were borned to 34 original sows investigate the effects of nursing days on the piglets growth. Results indicated that there was no significant difference between treats. but the body weight gain creased with nursing days increase and the death rate decrease. Body weight gain and weaning weight of the piglets were greater for Day 28 groups than other treats.

Peu d’écrits décrivent la conception personnelle de la discipline infirmière des étudiants ou son évolution. Pourtant, celle-ci guide la pratique des étudiants (Fawcett, 2002; Pepin, Kérouac, & Ducharme, 2010) et a des impacts sur leur persévérance dans leur formation (Spouse, 2000). Le but de cette recherche était d’explorer l’évolution de la conception personnelle de la discipline infirmière d’étudiants pendant leur formation collégiale. Ce mémoire présente une étude qualitative exploratoire fondée sur un cadre de référence liant le constructivisme radical (Glasersfeld, 1994) et le centre d’intérêt de la discipline (Pepin et al., 2010). Des entrevues individuelles ont été menées auprès de onze étudiants de première, troisième et cinquième sessions (n=11). Les données ont été analysées par questionnement analytique (Paillé & Mucchielli, 2010). Selon les participants, un soin « humain » est préalable aux « soins » de l’infirmier. Ils décrivent que l’infirmier guide une personne unique, détenant des capacités afin qu’elle accomplisse ses activités et prenne soin d’elle-même pour maintenir sa santé mentale et physique ; l’environnement hospitalier ne rejoint pas les conditions idéales identifiées par les participants. La compréhension des concepts centraux devient plus complexe durant leur formation. Les participants attribuent surtout ces changements à leurs expériences de stages. Finalement, la présente étude fournit des pistes aux enseignants afin qu’ils puissent soutenir l’apprentissage des conceptions de la discipline et orienter la construction d’une conception personnelle de la discipline infirmière utile à la pratique des étudiants.
Few studies describe the nursing students’ personal conceptual framework of the discipline nor its evolution though it influence their pratice and their continuation in the educational program (Fawcett, 2002; Pepin et al., 2010; Spouse, 2000). The goal of this research was to explore the evolution of nursing students’ personal conceptual framework during their nursing educational program. This paper presents a exploratory qualitative study inspired by a theoretical framework linking the radical constructivism (Glasersfeld, 1994) and the center of interest of the discipline (Pepin et al., 2010). Individual interviews were conducted with first, third and fifth semester nursing students (n=11). The data were analysed by analytic questioning (Paillé & Mucchielli, 2010). The participants describe « human » nursing as a precondition of the « nursing activities ». They describe the person has unique having abilities. The nurse guide the person to be able to accomplish his activities and to take care of himself to maintain mental and physical health. The hospital environment is not meeting the ideal conditions set by the participants. Throughout their educational program, the comprehension of the central concepts of nursing seems to get more complex and mature. The participants identify the experience gained through clinical placements as the main factor of influence on their personal conceptual framework. Finally, this research provides new knowledge to the nursing teachers facilitating the learning of the nursing theory and orient the construction of a useful personal framework for the future practice of the nursing students.

A tese que se apresenta neste relatório centrou-se no domínio da supervisão clínica em enfermagem (SCE), tomando por objeto de estudo o desenvolvimento de um modelo de SCE que permita responder às exigências do exercício profissional dos enfermeiros, contribuindo para a melhoria da qualidade da sua prática profissional. Emergiu de um percurso de investigação-ação que decorreu no Centro Hospitalar do Médio Ave E.P.E (CHMA), designadamente nas unidades de internamento de Medicina, Obstetrícia e Ginecologia/Bloco de Partos e Pediatria durante cerca de quatro anos, onde se concretizou uma trajetória de mudança. Englobou também um estudo metodológico realizado na Unidade Local de Saúde de Matosinhos E.P.E. (ULSM), de tradução, adaptação cultural e validação de um instrumento que avalia a eficiência e a eficácia da SCE disponibilizada – a Manchester Clinical Supervision Scale® (MCSS®). O paradigma de investigação construtivista alicerçou o desenvolvimento de um modelo de SCE cuja utilidade prática foi evidente no contexto da ação. O seu desenvolvimento visou, essencialmente, os seguintes propósitos: descrever necessidades e resultados sensíveis ao modelo a diferentes níveis e identificar os atores, o processo e as estratégias a utilizar em SCE, tendo como desiderato não só a melhoria contínua da qualidade em supervisão mas também a melhoria contínua da qualidade do exercício profissional dos enfermeiros. O Modelo de Supervisão Clínica em Enfermagem Contextualizado (MSCEC) constitui o contributo principal deste estudo para o conhecimento da disciplina, particularmente no que se refere à identificação e clarificação dos seus eixos (conceção de cuidados, exercício profissional e supervisão) e às relações que se estabelecem entre os intervenientes que atuam no eixo da conceção dos cuidados, do exercício profissional e da supervisão e que possibilitam a retroalimentação do próprio modelo, permitindo que este não se esgote em si mesmo, dada a riqueza de situações que emergem da prática clínica e os desafios em que consistem para todos. O percurso de desenvolvimento do MSCEC consistiu numa iniciativa inovadora, dada a ausência de tradição em SCE e a escassez de estudos neste âmbito no nosso país, nãobstante, não se ter tornado impeditivo da sua realização, pela visão de futuro de todos com quem, por esta via, tivemos a oportunidade de trabalhar e de evoluir do ‘ad hoc a um modelo de SCE em uso’.
The thesis presented in this report focused on the area of clinical supervision in nursing taking as a study object the development of a clinical supervision model in nursing which allows the improvement of the quality of nurses’ professional practice. It emerged from an action - research that took place at the Médio Ave Hospital Center (CHMA), particularly in inpatient units of Medicine, Obstetrics/Delivery Room/Gynecology and Pediatrics for about four years, where a cycle of change took place. We also carried out a methodological study conducted at Matosinhos Local Health Unit (ULSM) for the translation, cultural adaptation and validation of the Manchester Clinical Supervision Scale ® (MCSS ®). A constructivist research paradigm was adopted to develop a clinical supervision model in nursing whose usefulness was evident in the context of action. Its development mainly aimed the following purposes: to describe the needs and supervision sensitive outcomes which result from the model at different levels as well as to identify the actors, the process and the strategies to be used in clinical supervision in nursing, having as desideratum not only the continuous quality improvement in supervision, but also the continuous quality improvement of nurses’ professional practice. The Clinical Supervision Contextualized Model in Nursing constitutes the main contribution of this study to the knowledge of the nursing field, particularly wich regards to the identification and clarification of its axes (conception of care, professional practice and supervision) and the relationships established among the actors working on those axes and the feedback that supplies the model itself, allowing that it does not end in itself, given the wealth of situations that arise in clinical practice and the challenges they consist for all. The development path of the Clinical Supervision Contextualized Model in Nursing consisted in a groundbreaking initiative, given the lack of tradition in clinical supervision in nursing and the scarcity of studies in this field in our country. However, it did not become an obstacle to its achievement because of the vision of all who, this way, had the opportunity to work and evolve from ‘ad hoc to a clinical supervision model in use'.