Terminally ill patients and their families describe hospital care as nonsupportive to their needs during the final phase of life. Nurses generally are not comfortable with a supportive role when caring for the dying and tend to adhere to a curative role. The purpose of this descriptive, correlational study therefore was to describe the attitudes of general staff nurses working on medical-surgical units in hospitals towards the care of the dying and to ascertain the relationship between these attitudes and the education and experience of the nurses. An adaptation of the model for role episode, conflict, and ambiguity by Kahn, Wolfe, Quinn, Snoek and Rosenthal (1964) was the applied theoretical framework. The sample consisted of 197 randomly selected registered nurses employed full or part-time on general adult medical-surgical hospital units in British Columbia. The majority of the sample were married, Protestant females, between the ages of 26 and 45 years who were prepared at the diploma level in nursing. The mean length of time worked as a nurse was 8.5 years with a mean of 7.5 years on medical-surgical units. Attitudes towards the care of the dying were generally ambiguous, neither negative nor positive as measured by scores obtained on the ‘Questionnaire for Understanding the Dying Person and His Family’. Additionally, half the respondents did not believe that nurses should be the primary health care professionals equipped to deal with the emotional reactions of the dying yet three-quarters of the sample believed that patients turned to nurses to discuss such emotional issues. Data revealed that close to two-thirds of the respondents had received structured death and dying content in their basic nursing education yet less than half furthered their death and dying education since graduation. Overall death education for the sample was low. A small positive correlation (r=-0.26) was found between respondents' death education and their attitudes towards the care of the dying; no significant association was found between respondents' level of general nursing education and their attitudes. Although there was variability in the amount of professional and personal death experience, over half of the respondents experienced between one and three terminally ill patient deaths on their medical-surgical units per month. Additionally, the majority of respondents had experienced the death of an immediate family member. Overall death experience was low to moderate. A small, but significant positive correlation (r=0.24) was found between overall death experience and attitudes' towards the care of the dying; no significant association was found between general experience and attitude. Findings suggest that supportive nursing care is not being demonstrated with dying patients and their families. However, the influencing natures of death education and death experience on nurses' attitudes are positive, thereby providing the nursing profession with two possible ways of positively influencing nurses' attitudes to the care of the dying. / Applied Science, Faculty of / Nursing, School of / Graduate

This study describes hospital nurses' experiences caring for patients with AIDS. A modified version of Speigelberg's phenomenological approach was used which explored the nurses' experiences from their perspective. A total of eight nurses who had cared for patients with AIDS were interviewed. The findings indicated that caring for these patients is stressful. The researcher identified sources of stress as both internal and external. Internal stressors included: (1) fear of contracting AIDS; (2) homophobia; and (3) caring for dying AIDS patients. The two external stressors were patient variables and societal views. Lack of perceived emotional support from nursing administration further increased the stress. These nurses believed this form of support was essential. In order to cope with these experiences, the nurses utilized their usual coping strategies. Common ones were being physically active, relaxing, and talking with others. Different coping strategies were used to deal with the specific stressors. These were identified by the researcher as: (1) rationalization; (2) knowledge-seeking; (3) withdrawal; and (4) involvement. This study's findings emphasize the need for support for all nurses caring for patients with AIDS. Implications for nursing education, practice, and research were identified. / Applied Science, Faculty of / Nursing, School of / Graduate

A replication of Reilly's study (1980) was conducted in order to describe the attitudes of community health nurses who work with parents and children toward child abusers; to determine the relationship between the attitudes of the community health nurses and selected social and professional variables; to compare the attitudes of these nurses to the attitudes of the registered nurses studied by Reilly (1980); to compare the attitudes of the community health nurses in the randomly selected group with the attitudes of the community health nurses in the convenience group; and last, to describe the data presented by the community health nurses in regard to their experiences with child abuse. The population consisted of community health nurses. One sample population of one hundred and fifty-seven subjects was randomly selected from the community health nurses employed by the British Columbia Ministry of Health. A second sample population of fifteen subjects was self-selected from the community health nurses employed in two of the Health Units of Metropolitan Health Services of Greater Vancouver. The attitudes of the community health nurses toward child abusers were measured by a Likert-type Attitudinal Instrument developed by Reilly (1980). Information regarding the selected social and professional variables was obtained by a biographical data sheet also developed by Reilly (1980). Data regarding the community health nurses' experiences with child abuse were collected by open-ended questions. The correlated data from the attitude scores and the background data sheet were analyzed through the process of inferential analysis and descriptive statistics. Data regarding the subjects' experiences with child abuse were summarized by the process of content analysis and descriptive statistics. The results of the study revealed that the community health nurses' attitudes toward child abusers were more favorable than unfavorable. This finding substantiated Reilly's (1980) finding regarding registered nurses' attitudes toward child abusers. In addition, it was shown that the variable, whether the subjects have seen an abused child, significantly affected the attitude scores of the community health nurses in the randomly selected group. The study did not support Reilly's (1980) findings that the subjects' present level of education and whether the subjects have met an abusing parent or detected a case of child abuse significantly affected the attitude scores. The study also found that community health nurses experience a multitude of frustrations in the management of child abuse. In addition, it was found that a significant percentage of the nurses expressed a need for further instruction regarding the treatment of child abuse. / Applied Science, Faculty of / Nursing, School of / Graduate

Public health nurses are required to communicate important communicable disease and preventative health information to an increasing number of immigrants and refugees accessing the American public health system. They must also obtain information on a broad scope of topics about clients and/or their children. Little attention has been paid to the study of intercultural communication between public health nurses and their diverse clientele. The purpose of this study was to identify barriers affecting communication between public health nurses and their immigrant and refugee clients. The Developmental Model of Intercultural Sensitivity developed by Milton Bennett provided a conceptual framework for review and analysis of study results. Data were collected using semi-structured formal interviews with a network sample of 17 nurses. Analysis of the data indicated four major themes: (1) common use of a Western- European, ethnocentric communication style; (2) insufficient recognition of how the dominant culture's values, beliefs, and behaviors affect those from non-dominant cultures; (3) inadequate or irrelevant prior diversity training; and ( 4) lack of available and competent interpreters necessary for translation of information during interviews. These categories capture the essential barriers preventing effective communication with culturally diverse clients. From the perspective of the nurses, communication barriers due to cultural or language differences result in difficulty obtaining compliance with public health mandates such as childhood immunization and medication regimens, and limit understanding of preventative healthcare practices. The results of this study provide information and insight for the development of intercultural sensitivity training for public health nurses. A training program that demonstrates cultural training theory, methods, and suggested sequencing is included. An additional sample training outline follows that offers public health nurses culture specific information regarding Hmong refugees.

Bakgrund: Fetma är ett växande problem världen över, som ger en ökad risk för bland annat hjärt-kärlsjukdomar och diabetes typ 2. Fetmans uppkomst påverkas av olika faktorer som miljö, genetik och livsstil. Sjuksköterskans uppgift är att ge en jämlik vård med respekt för människors lika värde. Studier visar att personer med fetma undviker vården på grund av rädsla för ett dåligt bemötande.  Syfte: Syftet var att undersöka sjuksköterskors attityder till vuxna personer med fetma.  Metod: Allmän litteraturöversikt med nio kvantitativa och en kvalitativ artikel, vilka hittades genom databassökningar i PubMed, Cinahl complete och PsychInfo. Dataanalysen utfördes i fyra steg enligt Fribergs metod.  Resultat: Fem teman växte fram ur resultatet: Fördomar och stereotypa föreställningar, kunskap om fetmans uppkomst och viktkontroll, attityder relaterade till demografiska faktorer, sjuksköterskornas egen vikt och kroppsuppfattning, attityder i omvårdnadsarbetet.  Sammanfattning: Fetma är en komplex sjukdom som påverkas av en rad faktorer. En förenklad bild av sjukdomens uppkomst leder till mer fördomar. Att medvetandegöra samhällets normer om hälsa och kroppar kan sjuksköterskor upptäcka egna fördomar. Fortbildning kan ge sjuksköterskor en bättre kunskap vilket kan påverka deras attityder. En etisk diskussion rörande individens kontra samhällets ansvar samt påverkbara faktorer är av vikt så att sjuksköterskor sätter upp rimliga mål för patienterna. / Background: Obesity is a growing problem worldwide, which increases the risk of, among other things, cardiovascular disease and type 2 diabetes. The onset of obesity is affected by various factors such as the environment, genetics and lifestyle. The nurse's task is to provide equal care with respect for the equal value of human beings. Studies show that people with obesity avoid care due to fear of poor treatment. Aim: The aim was to describe nurses' attitudes towards adult patients with obesity. Method: General literature review with nine quantitative and one qualitative article, which were found through database searches in PubMed, Cinahl complete and PsychInfo. The data analysis was performed in four steps according to Friberg's method. Results: Five themes emerged from the results: prejudices and stereotypical perceptions, knowledge about factors, causation and weight control of obesity, attitudes related to demographic factors, nurses' own weight and body perception, attitudes in nursing care. Summary: Obesity is a complex disease that is affected by a number of factors. A simplified explanation of the etiology of obesity leads to more prejudice. Awareness about society's norms about health and body images, may help nurses to discover their own prejudices. Education can give nurses more knowledge, which may affect their attitudes. An ethical discussion whether responsibility and controllability is placed on individuals or society is important so that nurses sets reasonable goals for the patients.

Thesis (MPH.) --University of Limpopo, 2011 / Objectives: To assess the extent of HIV and AIDS related stigma among health care professionals, to identify factors that cause attitudes and perception towards HIV and AIDS related stigma and to determine if HIV and AIDS influence stigma. Study design: A descriptive cross sectional survey. Settings: Tshilidzini Hospital in Limpopo Province, South Africa. Subjects: A total of two hundred and sixty five health care professionals participated in the study. The study employed convenience sampling, when collecting data. The majority of health care professionals were females (77.7%). The average age of participants was 39.5 years with a standard deviation of 9.6. Outcome measures: Subject’s demographic information was determined by use of questionnaire. Age, gender educational level and race were included. Attitudes and perception towards HIV and AIDS patients were also assessed. Analysis: Data were analyzed by SPSS windows version 15.0. Means and frequencies were calculated. ANOVA and T test were employed to assess the comparison of attitudes between health care professionals. Findings: The results showed that the majority of health care professionals do not have negative attitudes towards people living with HIV and AIDS. Out of 265 health care professionals, 69% agreed that they needed to eliminate shame and rejection associated with HIV and AIDS, and 84% indicated that they needed more training to be more sensitive to the needs of people living with HIV and AIDS.Conclusion: Findings from the study showed high positive attitudes and perception among health care professionals towards people living with HIV and AIDS. Government should make provision of protective clothing a priority to reduce the perceived risk of HIV infection. Government should also introduce HIV and AIDS education at the primary level of health care.

Thesis (M. Cur.)-- University of Limpopo, 2013 / Background: The growing human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) pandemic continues to make a serious impact on all countries throughout the world. Globally, countries have responded to the HIV/AIDS pandemic by investing millions of dollars to help fight the disease, but the impact of HIV/AIDS is even greater in developing countries of Sub-Saharan Africa, including South Africa. Aims: The aims of this study were to describe the perceived problems experienced by professional nurses who provide health care to patients living with HIV/AIDS in public hospitals of Polokwane municipality, Limpopo Province and to identify guidelines to support these professional nurses. Study method: A qualitative, descriptive and contextual method was used in this study. Semi-structured, one-to-one interviews were conducted with professional nurses who participated voluntarily in the study. Tesch’s open-coding method was used for data analysis. Results: Professional nurses who provided care to people living with HIV/AIDS at Polokwane Hospital expressed feelings of frustrations and work overload, treatment delay, lack of knowledge on HIV/AIDS, lack of support systems, poor prognosis and patients presenting with confusion and mental disturbances. Conclusion and recommendations: Despite the fact that the professional nurses expressed negative experiences as they carried out their daily activities, and they still continued rendering care to HIV/AIDS patients, notwithstanding the obstacles they encountered. Recommendations were made with regard to nursing practice and nursing education, staff support by vii management, education and counselling for relatives, reaching out to the relatives and community, and further research.

Sammanfattning Syftet med litteraturstudien var att beskriva sjuksköterskors inställning till eutanasi. Metoden var en beskrivande litteraturstudie. Av 220 artiklar valdes 14 artiklar med kvalitativ eller kvantitativ ansats. Resultatet visade att eutanasi är en komplex fråga där olika etiska och moraliska aspekter spelar in. Sjuksköterskorna ansåg att eutanasi kunde vara etiskt försvarbart för värnandet av patientens autonomi, vid svår obotlig sjukdom, om alla andra behandlingsmetoder blivit uttömda samt om patienten själv tog upp förfrågan om eutanasi. Argument emot eutanasi var att sjuksköterskan har en livsbevarande roll, att risk för missbruk av eutanasi kan förekomma samt religiösa skäl. Yngre deltagare och de med lägre utbildning var mer positiva till eutanasi medan äldre sjuksköterskor och de med högre utbildning hade en mer negativ inställning. Inställningen till eutanasi skilde sig beroende på vart sjuksköterskorna arbetade t.ex. vid intensivvårds-, palliativ- eller pediatrisk vårdavdelning. De som arbetade inom pediatrisk och palliativ vård var i högre omfattning emot mot eutanasi. Sjuksköterskor som uppgavs sig vara religiösa var mer negativt inställda till eutanasi och till legalisering av eutanasi. I länder där eutanasi är legaliserat pågår diskussioner om sjuksköterskans roll inom eutanasivården och dess beslutsprocess. Slutsatsen är att frågor kring eutanasi är viktigt att undersöka, inte bara allmänhetens inställning utan även olika professioners reflektioner. Debatten kring eutanasi kommer att fortgå.   Nyckelord: eutanasi, sjuksköterskors inställningar, palliativ vård, beslut i livets slutskede / Abstract The aim of this literature review was to describe nurse’s attitudes towards euthanasia. The method used was a descriptive design. Of the 220 hits, 14 was chosen by CINAHL and PubMed (MedLine) and then analyzed. Both qualitative and quantitative aspects were included. The results showed that euthanasia is a complex issue where many ethical and moral aspects come in to play. The nurses felt that euthanasia was ethically acceptable for safeguarding patient autonomy, but also when patients’ suffered from incurable disease and severe pain therefore requested euthanasia. Arguments against euthanasia where directed towards the nurse’s role as lifesaver and preserver of life, the risk of misuse and religious beliefs. The study showed that younger nurses and those with lower formal education where more prone to the use of euthanasia than elderly nurses and those with higher education. Attitudes toward euthanasia differed depending on what type of ward the nurses worked in, for example at intensive care units, palliative care or pediatrics. Those who work in pediatric wards or with palliative care are those who more often oppose the use of euthanasia. Nurses who described themselves as religious often argued against the use of euthanasia and its legislation. In countries where euthanasia is legal there is an ongoing debate about nurses’ role in euthanasia and in its decision processing. The conclusion is that questions regarding euthanasia are important to investigate, not only by exploring the public’s attitudes but also by exploring the reflections of professionals. The debates will continue regarding euthanasia.  Keywords: Euthanasia, nurses’ attitudes, palliative care, end of life decisions

Patienter med missbruksproblem upptar mycket av hälso- ochsjukvårdens platser och resurser. Det är därmed viktigt attsäkerställa att dessa patienter får god vård och belysa vilkafaktorer som kan inverka på omvårdnaden. Syftet var att belysasjuksköterskors attityder gentemot patienter medmissbruksproblem samt att beskriva hur mötet mellansjuksköterskor och dessa patienter ser ut. Det användes 17vetenskapliga artiklar som grund för detta arbete varav 11 varkvantitativa och sex var kvalitativa. Det framkom attsjuksköterskor ofta uppvisade negativa attityder gentemot patientermed missbruksproblematik och detta inverkade på omvårdnadenav patienterna. Det förekom även stigmatisering, stereotypiseringoch moralisering av patienter med missbruksproblem vilket leddetill att dessa patienter många gånger fick sämre vård.Sjuksköterskans omvårdnadsarbete ska präglas av etisktförhållningsätt och en humanistisk människosyn vilket försummasom negativa attityder gentemot patienter med missbruksproblemfår inverka på vården. Mer kvalitativ forskning gällandesjuksköterskors attityder gentemot patienter medmissbruksproblem efterfrågas. Dessutom krävs det merundervisning i sjuksköterskans grundutbildning och meryrkesrelaterad utbildning på sjuksköterskans arbetsplats gällandeomvårdnaden av patienter med missbruksproblem. / Patients with substance abuse problems occupy much of the bedsand resources of the health care. Therefore, it is important toensure that these patients receive proper care and highlight thefactors that may affect that care. The purpose of this literaturestudy was to illuminate nurses’ attitudes towards patients withsubstance abuse problems and describe the character of themeetings between nurses and these patients. As the basis for thispaper, 17 research articles were used, of them 11 articles werequantitative and six were qualitative. It was found that nurses oftenexhibited negative attitudes towards patients with substance abuseproblems and that this had an impact on the nursing care of thesepatients. Stigmatization, stereotyping and moralization of thesepatients were also detected and this often led to substandard care.Nursing care is characterized by an ethical approach and ahumanistic view that is overlooked if the negative attitudes ofnurses towards patients with substance abuse problems are allowedto affect care. More qualitative research on nurses’ attitudestowards patients with substance abuse problems is prompted.Furthermore, it is required more education in the undergraduatenursing schools and more occupational education at nurses’workplace about nursing care of patients with substance abuseproblems.

The issues of job satisfaction for nurses and nurses' continuing clinical competence have become major concerns for the nursing profession as evidenced by a growing volume of research into these areas. Both job satisfaction and clinical competence of nurses can affect quality of care (of which patient satisfaction is one facet). This study focussed on the concepts of job satisfaction and clinical competence of nurses, and patient satisfaction-their interelationships, and how they were affected by the implementation of a Staff Development Nurse on one nursing unit in an active treatment hospital. A hospital-based Job Enhancement Project provided a unique opportunity to combine a dynamic real-life situation with an additional case study approach to examining the issues though interviews and documentation of the relationships among the nursing staff over an 18-month period of time. Both quantative and qualitative methods were used to gather pertinent information in addressing the research questions. Focus unit nursing staff questionnaires returned initially (13 of 27) and at the one-year mark (six of 27) of the Project, and interviews with six key participant nursing staff were used to survey nurses' perceptions of their own job satisfaction and clinical competence as well as their perceptions of their peers' job satisfaction and clinical competence. The patients admitted to the focus unit during the Project time frame were also invited to complete patient satisfaction surveys. The Staff Development Nurse and the Nursing Unit Manager were interviewed to give their perspectives. The Staff Development Nurse kept a journal of her work for the 18 month period, and so did the researcher. Frequencies, percentages, and content analysis of qualitative data provided the statistical and descriptive information for inerpretation. One finding in this study was that the Staff Development Nurse did have a positive influence on the clinical competence of some of the nursing staff on the focus unit, which may have in turn had a positive influence on nurses' perceptions of job satisfaction. The Staff Development Nurse was an immense support for the Nursing Unit Manager. However, the major finding in this study was that there were many other factors which influenced nurses' perceptions of job satisfaction, many of them which were beyond the control of the SDN. The SDN actually became a mitigating factor or a buffering agent in helping the nursing staff cope with these other factors. This study contributes to the growing body of research on nurses'quality of working life and some of the influecing factors. It may also provide insights into the realtionships between nurses and patients, and the role definition of a nurse educator on one nursing unit. / xiii, 246 leaves : ill. ; 29 cm.