The purpose of the study was to compare perceived master's level educational needs of baccalaureate educated community health nurses working in developed areas of the world to perceived master's level educational needs of baccalaureate educated community health nurses working in developing areas of the world. Forty subject areas recommended for master's education in community health nursing were identified. A questionnaire to determine the perceived importance of each subject area was administered to a sample population of nurses working in community settings in the United States and in twenty-eight developing countries. Forty null hypotheses were developed. Each hypothesis stated that there was no difference in perceived importance of including-the selected subject areas in master's education identified by community health nurses working in the United States and by community health nurses working in developing countries. Hypotheses were tested using the Chi-square, with the null hypotheses being rejected at the .05 level of significance.FindingsRespondents included 389 baccalaureate educated nurses from the United States and 39 baccalaureate educated nurses from developing countries. The analysis of data identified significant differences in responses of nurses working in the United States and nurses working in developing countries regarding the importance of including the following subject areas in master's education in community health nursing: applied sanitation, tropical diseases, school health practice, obstetric-gynecological practitioner skills, nurse-midwifery, outpatient medical-surgical skills, family coun seling, gerontology, grant writing, management theory, computer skills, medical anthropology, urban sociology, cross-cultural nursing, nursing theory, current issues and trends, research methods, political science, health policy and public speaking, in master's education in community health nursing.Subject areas were also analyzed for perceived importance to the entire population. Subject areas identified as very important to more than fifty percent of the population were community needs assessment, program planning, health education methods, physical assessment of adults, physical assessment of-.children, family counseling, nutrition therapy, gerontology, and current issues and trends.

This Ph.D. by Publication essay organises my work in four sections: Between Practice and Research; Between Practice and Clinical/Operational Management; Between Practice and Policy; and Between Practice and the Public. A context-setting introduction puts the work in the temporal frame of the 1960's through 2001 and announces the point of view taken on nursing: the reason for the existence of the modern health care delivery system is to provide nursing care. In the first section, the publications deal with the development of clinical nursing research methods. My particular effort was to conceptualise the relationship between nursing practice and research. The publications show how that relationship was actualised. The second section contains work done 20 years or so after that reported in the first section, but the work is closely related. Here, the publications deal with the extension of the notion of nursing practice research to clinical/operational management using the rich administrative data produced by casemix (Diagnosis Related Groups - DRGs). This body of work reveals nursing as resource. The third section holds literature review and policy analysis that provide the contexts for nursing practice. Publications deal particularly with the 'expanded role' of nursing as nurse practitioner, nurse-midwife and nurse anesthetist. Research and policy are knit together in this section. In the fourth section, I connect nursing to public forums. The concluding section draws together the themes that have occurred throughout: valuing nursing and making the discipline visible and credible in terms the world understands. The thesis ends with a metaphor that makes research, operations and policy one with public practice: nursing as craft. / This Ph.D. by Publication essay organises my work in four sections: Between Practice and Research; Between Practice and Clinical/Operational Management; Between Practice and Policy; and Between Practice and the Public. A context-setting introduction puts the work in the temporal frame of the 1960's through 2001 and announces the point of view taken on nursing: the reason for the existence of the modern health care delivery system is to provide nursing care. In the first section, the publications deal with the development of clinical nursing research methods. My particular effort was to conceptualise the relationship between nursing practice and research. The publications show how that relationship was actualised. The second section contains work done 20 years or so after that reported in the first section, but the work is closely related. Here, the publications deal with the extension of the notion of nursing practice research to clinical/operational management using the rich administrative data produced by casemix (Diagnosis Related Groups - DRGs). This body of work reveals nursing as resource. The third section holds literature review and policy analysis that provide the contexts for nursing practice. Publications deal particularly with the 'expanded role' of nursing as nurse practitioner, nurse-midwife and nurse anesthetist. Research and policy are knit together in this section. In the fourth section, I connect nursing to public forums. The concluding section draws together the themes that have occurred throughout: valuing nursing and making the discipline visible and credible in terms the world understands. The thesis ends with a metaphor that makes research, operations and policy one with public practice: nursing as craft.

A nursing research is an integral part of the nursing. An implementation of research activities in this field makes a basis for an improving of the nursing care and a development of the discipline itself. For nurses working in a clinical department who should carry out research investigations, there is important a knowledge how to conduct investigations and a support from the hospital management. Without this support they could not put the research results into practice which is currently based more on standard procedures. A theoretical part of the thesis deals with the nursing research, research concepts and its historical development. Then it also discusses ethical principles of the nursing research, nurses´ fundamental roles, evidence-based activities, opportunities of the research funding in the Czech Republic and an evaluation of a scientific work. An aim of the thesis was to establish the awareness, participation and interest of the primary and secondary level management in the nursing research. We have identified four hypotheses which we verified by a quantitative survey. H1: More general nurses with a higher education participate in the nursing research than the nurses who are graduates of the secondary medical school. H 2: General nurses-managers who completed a university education are better prepared for an implementation of the nursing research than nurses-managers with the secondary education. H3: The primary and secondary level nursing management of Hospital in České Budějovice participate in the nursing research more than the management from other hospitals in the South Bohemian Region. H 4: The nursing management which is involved in the nursing research apply the research results into practice. The quantitative survey was made by a questionnaire technique. The research sample consisted of nurses working on the positions of the secondary and primary level managers in the inpatients departments of hospitals in the South Bohemian Region. The investigation was conducted in eight hospitals in the South Bohemian Region. It is possible to say, that the awareness of the nursing research is on a good level, nearly half of the nurses monitor and apply the information and the research results in their clinical practice as well as most nurses are ready to implement either a simple research survey or to participate in the research under a guidance or to prepare and implement an independent research project. We believe that the nurses should be interested in the nursing research, but not as a part of their normal duties which they have in their workplace. For a development in the nursing field it is necessary to increase a further awareness of the nursing research and to encourage the nurses so that they should be interested to conduct this research. Results of the survey will be sent to the primary nurses/directors of the nursing in all of the addressed medical facilities. They may also serve as a basis for further research investigations. The lecture on the topic: ?The importance of the nursing research in the nurse´s work? will serve to raise the awareness of the nursing research.

M.Cur. / The purpose of this research study was to describe guidelines to facilitate a “reflective learning environment” for student nurses in a psychiatric clinical setting. In view of existing problems, such as inadequate preparation of professional nurses for the role of a psychiatric clinical facilitator, inability of student nurses to reflect on their learning and integrating theory into practice, nursing education is faced with a greater need to change from traditional teaching-learning approaches to current student-centred approaches that advocate self-directed learning in student nurses. To achieve this goal in a psychiatric clinical setting, it is necessary to shift the emphasis from instructional teaching to facilitation of reflective learning that results in autonomy and self-reliance in student nurses. Klopper (1994, Monograph 2:24) indicates that the clinical facilitator’s guidance to deep holistic learning is not sufficient on its own. The clinical facilitator should be a reflective practitioner and intentionally facilitate a reflective learning environment for student nurses in a psychiatric clinical setting. The research questions that emerged were: • What is a “reflective learning environment” in a psychiatric clinical setting? • How can a “reflective learning environment” be facilitated for student nurses in a psychiatric clinical setting? To realise the purpose of this research, the following objectives were formulated: • to clarify the concept “reflective learning environment” in a psychiatric clinical setting; • to explore and describe the perceptions of student nurses and clinical facilitators with regard to how a “reflective learning environment” could be facilitated for student nurses in a psychiatric clinical setting; and • to describe guidelines to facilitate a “reflective learning environment” for student nurses in a psychiatric clinical setting. The paradigmatic perspective for this research is adopted from the Theory for Health Promotion in Nursing (RAU 2002:4). The functional approach of Botes (1995:13) was used in this study, since it implies application of knowledge. The research design and method used were qualitative, exploratory, descriptive and contextual in nature. The design was divided into two phases. Phase One involved two steps. Step One included the concept analysis of a reflective learning environment through a literature search of all relevant international and national literature on a reflective learning environment. The method of data collection involved a library search – CD-Rom, the Internet, journal articles, books and subject dictionaries - that were used to arrive at attributes that clarified the concept “reflective learning environment” in a psychiatric clinical setting. Concept analysis was done according to the steps described by Wilson (in Walker & Avant, 1983:39). Content analysis of literature was done using deductive, inductive reasoning strategies, synthesis, and inference as described by Chinn & Kramer (1995:63-67), Mouton (1996: 71, 80, 168) and Walker and Avant, (1983:58-62). Theoretical validity was ensured (Mouton, 1996:117). Step Two included the exploration and description of perceptions using agenda focus group interviews held with student nurses and clinical facilitators. The student nurses and clinical facilitators were selected from a psychiatric clinical setting. Both samples were purposively selected. The results of concept clarification conducted gave direction to the agenda focus group interviews that were held with the student nurses and clinical facilitators during the perception survey. The question for the agenda focus group interview with the student nurses was as follows: What are your perceptions with regard to how a reflective learning environment can be facilitated for student nurses in a psychiatric clinical setting? The question for the clinical facilitators was as follows: What are your perceptions with regard to how you can facilitate a reflective learning environment for student nurses in a psychiatric clinical setting? An audiotape was used to record the interviews for later verbatim transcription. Communication techniques, observation and field notes were used during the data collection. Data from both the student nurses and clinical facilitators were analysed according to the qualitative content analysis, as described by Miles and Huberman (1994:241-243). An independent coder, who was purposively selected, was used independently from the researcher in the categorisation of attributes of a “reflective learning environment” that emerged. To ensure trustworthiness in this qualitative research, Lincoln and Guba’s model (1985:290-314) was used throughout the study to ensure the rigor of the study. Ethical considerations were maintained throughout the research study (Denosa, 1998: 1-6; Burns & Grove, 1993:98-104; De Vos, 1998:27-28). Phase Two consisted of conceptualisation of findings from Phase One. Guidelines were formulated based on concluding statements from conceptualisation of the findings. An evaluation of the study was made. Recommendations related to nursing education, nursing practice and nursing research were indicated accordingly. The study was conducted contextually and no generalisations should necessarily be made.

No description available.

A thesis submitted to the Faculty of Commerce, Law and Management, University of the Witwatersrand, in fulfilment of the requirements for the degree of Doctor of Philosophy. September 2018 / Intensive care is a small but complex system; context-specific and continually confronted by dynamic changes and challenges in the environment. Initiatives following the traditional reductionist approach to improve the delivery of intensive care has had limited success. The aim of this research was to develop a systemic framework for the improvement of intensive care delivery. The factors affecting the delivery of intensive care – in South Africa and internationally – were elucidated by a comprehensive review and analysis of intensive care literature. A further understanding of intensive care delivery in South Africa was obtained by “making sense of the mess” using a systems approach. Systemic intervention served as the meta-methodology and methods and techniques from interactive planning, critical systems heuristics, soft systems methodology and the viable system model were employed. Making sense of the mess emphasised the complexity of intensive care delivery, on both a situational and a cognitive level. It became clear that a single methodology would not suffice, but that a pluralist methodology was required to guide improvement in intensive care delivery. Based on this understanding, nine principles were formulated to guide the development of a framework for the improvement of intensive care delivery. Systemic intervention was used as the meta-methodology. Interactive planning was identified as the key methodology, incorporating methods and techniques from critical systems heuristics, soft system methodology and the viable system model to build a systemic framework for the improvement of intensive care delivery. Embedded in the proposed framework are matters relating to systemicity, complexity, flexibility, empowerment, and transformation of intensive care delivery. The proposed framework allows for multiple-perspectives, including that of marginalised stakeholders, the mitigation of multi-vested interests and power relationships. It is both flexible and adaptable to promote learning about the complex problems of intensive care delivery and it accommodates the strengths of various relevant approaches to complex problem solving. The proposed framework aims to facilitate sustainable improvement of intensive care delivery and to ensure the “just-use” of resources to foster distributive justice. It acknowledges the trajectory of intensive care delivery – the patient comes from the community and returns to the community and intensive care delivery functions on a continuum that ranges from basic to highly sophisticated. / E.K. 2019

The purposes of this study were to (a) explore the relationship between the nursing faculty member's perception of the climate for research and the research productivity of nursing faculty members; and (b) identify educational and administrative interventions possessing the potential for increasing research productivity. The questionnaire consisted of a modification of Likert’s <i>Profile of Organizational Characteristics</i> Form S, perceptions of the influence of organizational climate on research productivity, several aspects of institutional support, job-related data, and research productivity for the period June 1980-May 1983. Data were analyzed using Pearson's product-moment correlation coefficient. Descriptive statistics were compared for types of institutional support. Research productivity ranged from 0-40 research publications and presentations in the 3 year period. Twenty-five percent of the faculty produced 80 percent of the research. Almost half of the respondents did no research for the period studied. Organizational climate ranged from System 1 (Exploitative-Authoritative System) to System 4 (Participative Group) with the predominate climate being System 3 (Consultative System). Although faculty perceived components of organizational climate as affecting their research productivity, the finding revealed only a low positive correlation (.173, p <.05) between organizational climate and research productivity. The relationships (p <.05) between two other measures of climate (number of current facilitators and number of additional research knowledge needs) and research productivity were low (.252, -.162 respectively). No relationship was found between other climate measures (number of facilitators needing change and number of types of research training faculty desired) and research productivity. Faculty indicated that primarily monetary-related facilitators and rewards for research were most frequently available and that time-related and knowledge and skill-related facilitators were least frequently available. High producers had some of the same needs as other producers, e.g., workload policy providing time for research. Other needs, particularly knowledge and skill needs, differed by productivity level. Two interventions were suggested: (a) a workload policy with time for research, and (b) educational interventions for faculty with various productivity levels. / Ed. D.

The aim of nursing practice is to provide evidence-based care that ensures quality outcomes for patients, families, healthcare providers and the health care system. This may only occur with increased exposure to nursing research. Nursing education institutions should therefore ensure that students are prepared to provide evidence-based care by participating in and conducting research. The purpose of the study is to explore and describe the challenges faced by nurse educators in teaching research methodology and supervising undergraduate nursing students at a university in order to make recommendations to support nurse educators in teaching research and supervising research projects. Qualitative, explorative, contextual and descriptive research was conducted to explore and describe the challenges experienced by nurse educators. Data were collected through a focus group discussion. Nine nurse educators participated in the research study. Participants acknowledged that they faced challenges in teaching research methodology and supervising research projects. The challenges described pertained to human resources; research experience, competencies and guidelines; physical resources; and a lack of support from their institution’s management. Based on the challenges, recommendations were made to address the lack of specific competencies, research guidelines, student/educator ratios, physical resources and technology issues / Health Studies / M.A. (Health Studies)

A pesquisa em Enfermagem é uma atividade que tem possibilitado avanços na prática assistencial. No Brasil iniciou-se com os programas de pós-graduação, sendo as enfermeiras professoras as detentoras desta prática. As enfermeiras assistenciais têm procurado, ao longo dos anos, superar barreiras de ordem particular e institucional na sua realização. Instituições de ensino e empregadoras de serviços de saúde buscam promover o desenvolvimento profissional das enfermeiras implementando estratégias que incentivem a atividade investigativa no contexto profissional. Seguindo essa tendência a Diretoria de Enfermagem do Hospital Universitário Regional do Norte do Paraná criou em 1999 o Núcleo de Pesquisa em Enfermagem (NUPE), para apoiar as enfermeiras na realização de pesquisas. Tem-se, neste estudo, o objetivo de interpretar os sentidos atribuídos pelas enfermeiras assistenciais na participação em um serviço de incentivo à pesquisa e integrá-los em significados socialmente construídos, por meio da análise interpretativa. O quadro teóricometodológico foi delineado com base em conceitos e princípios educacionais e na cultura organizacional, visando-se interpretar como as enfermeiras constroem a atividade da pesquisa no cotidiano profissional mediante serviço de apoio inserido na instituição hospitalar. Para isso, a etnografia, como método, e o estudo de caso, como estratégia, possibilitaram a aproximação necessária do contexto cultural das envolvidas. Os dados foram coletados em entrevistas individuais e grupais, em depoimentos escritos direcionados por questões e em análise documental. O contexto histórico-estrutural do serviço foi descrito pelo olhar da diretora de enfermagem e secretária do NUPE, em exercício no período de 1999 a 2002. A produção científica nestes anos apresentou 129 projetos de pesquisa e 151 trabalhos científicos elaborados pelas enfermeiras. Destes, 36 foram publicados em periódicos e 6 premiados em eventos científicos. Os artigos, em grande parte, construídos coletivamente e publicados em diversos veículos de divulgação, relacionam-se ao Campo Temático Assistencial e Organizacional. Sobre o processo vivenciado, as enfermeiras aludiram sentidos da atividade investigativa na prática assistencial no que tange à valoração desta, ao papel de aprender por meio dela, além dos movimentos inerentes e ainda, do fato de ser uma tarefa árdua, que demanda empenho pessoal. Os significados, analisados sob o prisma do rito de passagem, evidenciaram os movimentos dos sujeitos e da instituição: no período pré-liminar, pela impregnação do fazer sem questionar; no período liminar, pela inserção das enfermeiras junto ao NUPE; e no período pós-liminar, com sinais de ruptura dos velhos paradigmas e abertura às novas perspectivas. Observou-se, no contexto cultural, o desenvolvimento de estratégias e ações pela mobilização dos atores e da instituição com o despertar para a atividade investigativa, o criar na postura de realizadoras de pesquisa, com repercussões intramuros e extramuros à instituição, percebidas no desenvolvimento pessoal-profissional e na valorização do trabalho desenvolvido. A pesquisa, apoiada pela organização e desejada pela enfermeira, consubstancia-se como estratégia científicopedagógica na formação permanente de enfermeiras assistenciais e agrega repercussões positivas para a assistência prestada. No âmbito de serviços de saúde conceber a realização de pesquisa em favor da produção do conhecimento e desenvolvimento profissional requer uma mudança na cultura organizacional por meio de inovações, tempo e interesse dos envolvidos. / The nursing research is an activity that has advanced in the assistant practice. In Brazil it started with pos-graduation programs, with nurse teachers as possessing this practice. The assistant nurses have been looking for many years to overcome barriers of particular and institutional order to get concreted. Education and health service institutions try to promote the professional development of nurses implementing strategies which encourage the research activities in the professional context. Following the tendency of the Nursery Board of Directors of the Regional University Hospital of North Paraná a Nursing Research Nucleus was created in 1999 (NUPE) to support the nurses during their researches. The aim of this study is to analyze the conferred meanings given by assistant nurses in their participation on the research incentive and include them in built social meanings, by interpretative analysis. The theoretical and methodological view was designed from concepts and educational principles and organizational culture, trying to interpret how nurses deal with research activity in their daily professional lives with support service provided in their hospital institution. For this reason, the ethnography as method, and the case of study as strategy, made the necessary approach to the cultural context of the ones involved in the process possible. The data were collected by individual and group interviews, written statements and documental analysis. The historical and structural context of the service was described through the nursing director and NUPE secretary?s view, working in the period from 1999 to 2002. The scientific production in these years present that the nurses created 129 research projects, 151 scientific works. From these, 36 were publicized in scientific newspaper and 6 awarded in scientific events. The articles, in general, were collectively written and publicized in different means, related to the assistant and organizational thematic field. About the experienced process, the nurses mentioned meanings of the research activity in the assistant practice referring to increasing the value in it, the role of learning through it, besides the movements and finality related to it, and furthermore, being a really hard task which demands personal dedication. The meanings, analyzed through the ritual process, show the movements of the subjects and from the institution during the preliminary period, by doing without asking; during the current period by the insertion of nurses into NUPE and during the pos period, with rupture signals to the old paradigms and an opened mind to new perspectives. The development of strategies and actions to mobilize the subjects and the institution were observed in the cultural context with the consciousness to the research activity, the creation of the role of research, the repercussion inside and outside the institution, realized during professional and personal development and having their work developed with an increased value. The research supported by the organization and desired by the nurse, consolidates as scientific and pedagogical strategy in the constant assistant nurse training and adds positive repercussions to the given assistance. In the health area, accepting the research realization in favor of knowledge production and professional development requires changes in the organizational culture through innovations, time and interests of the ones involved.

M.Cur. (Intensive General Nursing) / From the professional ethical perspective the professional nurse is responsible for the treatment and nursing of a patient in acute pain by effectively handling pain in the first 48 hours post-operative following serious surgery. The professional nurse can treat patients optimally only if she has the necessary knowledge and skills with regard to the different methods of handling pain. By making effective handling of pain available to the patient, including the advantages and disadvantages, the professional nurse contributes to maintaining, promoting and restoring health. In this way she facilitates the patient in reaching his objective of obtaining wholeness and she obtains her objective of quality nursing. The aim of this study is to determine which method of handling pain, namely the intermittent bolus dose analgesics and patient controlled analgesics, offers the most advantages to the patient and the professional nurse. A quantitative, contextually descriptive research design was followed in which a survey method and a retrospective analysis of nursing and medical records were completed in order to determine the total amount of analgesic used and to investigate the haemodynamic stability while using analgesics. An analysis was done of the information collected by means of a structured pain control list. Results indicate that those patients using patient controlled analgesics use larger doses of analgesics and are haemodynamically more stable while using analgesics than those patients using the method of intermittent bolus dose analgesics. Following on the conclusion, nursing guidelines were established for nursing practice and recommendations were made for nursing practice, nursing education and further research.