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Free accessEditorialFirst published March, 2000pp. 3-3
Free accessResearch articleFirst published March, 2000pp. 4-14his article presents and discusses the results of a study where the focus is on the characteristics of learning in the skillslaboratory, and on how the learning of practical skills take place. The data are collected from three sources: Interviews with groups of students, diary notes from the project-teachers and observation done by the project-counsellor. The sample is not done to make generalizations, but for analytical aims. The datamaterial is analyzed by using the tools of grounded theory. In this article the importance of stress and safety for learning practical skills is discussed. The results show that the students have different concerns regarding stress and safety in this relation. The students are concerned about beeing secure in performing the practical skills. The students express feelings of stress and unsafety when learning practical skills, and they are concerned about the importance of a safe learning climate when learning practical skills. Safety and security are phenomenons of importance in learning practical skills. But to a certain amount unsafety and stress can contibute to stimulate the students to improve their efforts and work, and prepare them for their future profession as nurses. It seems important to contribute to safety and security by supporting and encouraging each student, and by promoting an open and secure climate in the group. It seems also important to allow unsafety and insecurity to a certain amount in order to promote learning and prepare the students for their future role.
Free accessResearch articleFirst published March, 2000pp. 9-14In a preliminary study, summarised here, the theoretical implications of the concept of confirmation were studied, through concept investigation. The present empirical study was then conducted, to study the implications of the concept, describe how confirmation may be experienced, both generally and specifically within nursing supervision, and describe how confirmation may provide a working tool. Fourteen students and eight teachers (supervisors) from a supervision programme at the healthcare college were interviewed. The findings from the previous study were used in the introductory letter sent to study participants. Results showed that confirmation is an important concept in nursing supervision. The supervisor strives for a confirmatory style through body language, and their attention to students. In this study, the supervisors' methods of clarifying, summarising and documenting the supervision showed some variation. Three methods were noted: two guided by students' responses, as individuals or groups, and one guided by the supervisor. The same supervisory measure could be experienced by students as both confirmatory and not, the most prominent measures being continuity, structure and the supervisor's management of problem formulation. A connection was evident between the concept investigation of the preliminary study and the results of the empirical study. If students are exposed to process-oriented supervision, and thereby experience confirmation, this enhances their potential to understand and confirm patients once they become nurses.
Free accessResearch articleFirst published March, 2000pp. 15-21The total duration of lactation was studied in mothers of preterm infants in our NICU at the National Hospital in Oslo, Norway (comparable to level III nurseries in USA). The duration of lactation was studied also in subgroups of mothers (grouped according to infants' birthweight).
Feeding at breast (partial or total) and/or feeding mother's expressed milk.
108 mothers were included, and 59.3% had a Caesarian Section. The infants stayed median 46.5 days at the hospital, their gestational age at birth was median 30.5 weeks (23–36 weeks), and their birth weight was median 1447.5 g (600–2480g). 68% of the infants needed oxygen supply for median 12 days, and 50% of the infants needed ventilator-connection for median 5.5 days. Twenty-seven percent of the infants had a birthweight of 1000 g or below.
A structured interview based on open-ended questions was used at the time of the infants' discharge. The mothers were asked following main-questions: Do you have breastmilk for your baby? If not, how long did you have breastmilk? Phone calls were used later to those mothers who still lactated at their infant's discharge. Existing sources of data were used for infant variables as birthweight, and a registration-schedule was used for close contact, as initial sucking and skin to skin holding. The Wilcoxon Rank Sum test (Z) was used to test differences between subgroups. The Spearman Rank Correlation test (rs) was used to test relationship between variables.
The mothers lactated for a median of 122 days (= 4 months) (mean 168.3 days = 5.6 months, variation 2 – 713 days). Mothers who had previously breastfed, continued lactation significantly longer than those who had not (p= 0.029). Mothers who smoked post birth had a significantly shorter lactation period compared to nonsmoking mothers (p= 0.0006), respectively median 53 and 153 days. A longer lactation period showed a significant relationship with early skin to skin holding of infants (p= 0.0055), and with increasing length of education (p= 0.0001). A shorter period of lactation showed a significant relationship with low gestational weeks (p= 0.0001), and with low birthweight (p= 0.0001). Lactation in 4 groups of mothers (grouped according to infant birthweight) were as follows: group A (infants to and including 999 g): median 56 days (= 1.8 months), group B (1000 – 1499 g): median 72.5 days (= 2.4 months), group C (1500 – 1999 g): median 273 days (= 9.1 months), and in group D (2000 – 2499 g): median 227 days (= 7.5 months).
Mothers who smoked during pregnancy (n= 37) delivered their infants at a significantly lower gestation week (p= 0.026) (difference: median 2.5 week), and their infants had significantly lower birth weights (p= 0,038) (difference: median 195 g), compared to mothers who did not smoke (tables and figure in English).
Free accessResearch articleFirst published March, 2000pp. 22-26Prolonged labour is a common delivery complication, which causes considerable suffering both for the mother and the child.
The aim of the study was to illuminate the experience/ feelings of childbirth among mothers with prolonged labour.
Four mothers with prolonged labour were interviewed, one month after delivery. The interviews were analysed using a content thematic analysis.
The narratives about giving birth were interpreted as a struggle in uncertainty. Themes such as An unsure start and A slow and painful beginning illustrate the feelings connected with prolonged labour. The lack of strength to give birth expresses a painful and destructive process. Themes like When strength is insufficient and To lose control relate to the poor uterine activity and describe the difficulties of the childbirth experience. When the strength to give birth is lacking the experience of becoming a mother ends in a physical and psychological exhaustion. Relief from the pain is overwhelming and An unsure and a careful beginning are themes expressing the immediate sense of becoming a mother.
The suffering before the onset of labour and during labour and the ineffective care could only be relieved by the decision to assist delivery.
Free accessResearch articleFirst published March, 2000pp. 27-41A survey study among 288 Norwegian undergraduate nursing educators at 32 nursing colleges from 1996 showed that teachers experienced excessive workloads and that excessive workloads often correlated highly with frequent college reforms. In addition, our data indicated that nursing educators enjoy their work and wish to continue teaching. The purpose of this study was through an interview of 14 nursing educators in one small and two large nursing schools to enhance and deepen our knowledge of the expressive factors relevant to experienced satisfaction and excessive workload among Norwegian nursing educators. This made possible a comparison of data and methodological triangulation of our findings. Both the survey study from 1996 and the interview study from 1997 showed that less than half of the educators experienced excessive workload in their daily work situations. The interview showed that one important contributing factor is related to the fact that many teachers combine work with advanced education, and teachers receive insufficient feedback from colleagues and administrators on their job performance at the college.
Free accessResearch articleFirst published March, 2000pp. 32-41This paper gives a brief review of the knowledge and research on pain. Later research emphasize the fact that the central nervous system as a whole and especially the brain itself plays a crucial role when it comes to understanding the mechanisms of pain perception and pain modulation. Clinical experience and empirical research on phantom limbs and phantom limb pain lay growing evidence on the assumption that the human brain have build in structures of a neural network which consists of loops that integrate the somatosensory talamus and cortex, the limbic system and the association cortex. This network which is in part genetically determined, is suggested to play a substantial role in integrating and modulating the pain experience. Research further indicate that our body perception is not a passive process merely reflecting bodily input. The pain experience and the feeling of pain quality is not primarily a result of sensory input, but rather generated by our brain together with other bodily experiences. This knowledge gives further support to health-professionals view of pain as a subjective and multidimensional phenomenon, where it is substantial to believe the patient when he says he is in pain. Standards of pain management should also be aware of the fact that «pain delivers pain». Therefore it is crucial to treat the pain before it becomes established in the central nervous system.
Free accessResearch articleFirst published March, 2000pp. 36-41Quality of life is an important aspect of health sciences such as nursing science. Traditionally, quantitative methods have been used to assess quality of life, but it has been claimed that these methods are not suitable for describing the phenomenon. Moreover, factors other than methods influence scientific knowledge. The aim of the present paper is to discuss what characterises the quality of life research conducted in the field of nursing science today, and how different factors influence the development of relevant knowledge. The following factors are discussed: truth criteria, language and context, research communities, the dependence of data on theory, methods and descriptions of results. The present paper concludes that it is essential to be cognisant of the above-mentioned factors when conducting empirical studies on quality of life. Both quantitative and qualitative studies have limitations. It is important for quality of life research in nursing science to draw on the methods, which are most appropriate at any given time and in any given context.
Free accessResearch articleFirst published March, 2000pp. 42-45Nursing and humour both contain variables such as physiological, psychological, social-cultural, spiritual and ones of a developmental characteristic. Most researchers in nursing look to the fact that nursing is both a science and an art. «Humour theorists» uphold the same idea, and maintain that humour contains variable from different scientific fields whilst being an art form. The aim of this study is to describe experiences of humour in health service and nursing, as well as to find a possible link between humour and nursing-variables. The study is explorative and is based on a questionnaire survey. The questions requiring open ended answers have been arranged according to their meaning and category. The study covered three groups: patients, employees within health service and nursing and persons with no connection to health service and nursing. Participant (N = 802) were obtained through consecutive choice during a three week period. The question «What do you see as humour?» gave replies which can be divided into the following six categories; jokes, laughter, macabre humour, situation comedy, pun and unexpected situation. The majority, although somewhat lower in the patient group, felt that humour could be used in health service and nursing. Patients were also asked a supplementary question: «Is humour used in the health service?» Only 4 % of the men and 15 % of the women thought this was the case. A majority thought their own sense of humour to be greater than that of other people. Humour is a positive experience, and can be used as protection. The ethical code expressed by ICN must be applied to humour used in nursing.
Free accessResearch articleFirst published March, 2000pp. 46-49With the increasing emphasis on evidence-based health care, the scientific support for various interventions often comes into focus when resources are allocated. For nursing care, it is essential that quality of scientific evidence for various interventions is high. As a pilot project, we reviewed the published literature on one approach to nursing care, namely individual patient care planning. Original observations on this and closely related topics were found to be published in 36 articles. There were no randomized trials, and a comparison of the new method vs. the conventional approach was made only in a minority (16) of the studies. Seven of these used contemporary comparisons. The methodological approach was, with one exception, quantitative. The most frequent end-points concerned the documentation process as such and the attitudes and experiences of the nursing staff, whereas the effects for patients were reported more seldomly. We conclude that there is much room for improvement of the quality of scientific documentation when new nursing care methods are introduced.
Free accessResearch articleFirst published March, 2000pp. 50-55The purpose of this article is to describe research of nursing science in Finland, particulary in the 1990' ies. Research have been done based on different scientific philosophies: positivism, fenomenology and citical theory. By using different approaches research has produced different knowledge and theories. Positivistic research has been commonly utilized in Finland. Since the middle of 1980's a fenomenology-hermeneutical approach has also been widely used. Research based on critical theory is seldom used. The purpose of nursing science is to produce knowledge which develop the science itself and which support nursing practice in developing the quality of care. The integration of theory and practice demands active input from researchers and nurses.