The perception of nurses and doctors on a care bundle guideline for management of pain in critical care

Objetivo: el objetivo de este estudio fue explorar la percepción de las enfermeras y los médicos sobre el uso de un paquete de aten- ción como una guía para el manejo del dolor en cuidados críticos. A pesar del desarrollo de guías y protocolos para el manejo del dolor en cuidados críticos, basados en la evidencia, el dolor sigue siendo un problema importante. La introducción de un paquete de atención para cuidados críticos ha mejorado el manejo de los pacientes ventilados. Un paquete de atención en el manejo del dolor tiene como objetivo reducir las variaciones en la práctica. Método: el estudio tiene un diseño prospectivo cualitativo desarrollado mediante una entrevista en profundidad y semi-estructurada de 23 enfermeros y médicos en una unidad de cuidado crítico. Resultado: cuatro temas principales surgieron: 1 ) la adecuación al escenario de cuidado crítico, 2) la aplicabilidad al escenario de cuidado crítico, 3 ) la propiedad del Paquete de Atención al Dolor, y 4) la necesidad en la práctica actual. Los resultados mostraron una pobre aceptación del paquete por parte de los profesionales de la salud en el manejo de dolor agudo en los enfermos críticos. Conclusión: el estudio encontró que las enfermeras y los médicos no percibieron el paquete de atención al dolor como una herramienta útil para mejorar el manejo del dolor, con pruebas que apuntan a una brecha entre la práctica del manejo del dolor, tal como se describe por el paquete de atención, y la práctica real.</jats:p

Shifting the focus: sequential methods of analysis with qualitative data

The purpose of this article is to illustrate both the processes of data analysis and the methodological development involved in adopting the sequential use of two data analysis methods applied to the same data set. Understanding of the phenomena of interest was sought through examining both the content and the form of nurses’ accounts of practice experiences. Initially, a method of thematic content analysis was applied to understand what the nurses said about their experiences. The core theme of nurses’ change agency derived from this analysis was examined further through a method of narrative analysis. In the second analysis, the focus was shifted to how the nurses accounted for their experiences. The innovative use of iterative, sequential methods of analysis revealed greater complexity and depth of understanding of the phenomena than would have been achieved with one method alone

Observational cross sectional pilot study of adherence with antipsychotic medication in people with schizophrenia or schizoaffective disorders in prisons

This pilot project has aimed to: • Estimate the point prevalence of non-adherence to (typical/atypical) antipsychotic medication in population of people with schizophrenia or schizoaffective disorder in prison. • Determine prisoners’ satisfaction with and beliefs and attitudes towards antipsychotic medication. • Determine predictors of adherence in prisoners with schizophrenia or schizo-affective disorder. • Compare the prevalence of adherence with a community sample of individuals with schizophrenia. • Explore patients’ current and previous subjective experiences of medication (embedded qualitative element of project

What is the place of generalism in the 2020 primary care team?

Primary health care is a domain of reform and change. To maintain a cost-effective, equitable and accessible health care system, policy and strategies must address growing health system complexities. These include workforce shortages, technological advances, an ageing population, rising rates of chronic disease, increases in co-morbidity and growing multi-morbidities. A single-disease focussed approach is not sufficient. Should the generalist be developed to address these multiple issues? What is generalism and its place within the 2020 primary health care team?The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

The development of an interdisciplinary theoretical framework for Forest School in the United Kingdom

A growing evidence base has demonstrated the value of Forest School as an outdoor learning approach which supports a range of benefits including improved physical, social and mental wellbeing, increased confidence and self‐esteem and the development of problem‐solving skills. However, critics of Forest School have argued that a lack of theoretical coherence and detail risks the misinterpretation of Forest School and its pedagogy by both practitioners and researchers. This paper responds to these concerns, establishing a comprehensive and detailed theoretical framework for Forest School. Through a thorough examination of evidence supporting Forest School delivery, we examine the theoretical keystones of this pedagogical approach to inform an interdisciplinary theoretical understanding of Forest School. We argue that Forest School is a particular socially constructed approach to outdoor education, which is informed by social constructivist experiential learning theory. This is driven by two core components. First, play‐pedagogy, which includes the opportunity to experience risk and be creative. Next, biophilic interaction, which examines the human innate desire to be in nature. This is informed by the cultural origins of Forest School development as underpinned by Nordic notions of friluftsliv and by theories of place attachment. Taken together, this theoretical framework considers the breadth of knowledge that underpins Forest School and recognises its growing evidence base, which positions it as a rich and valuable pedagogical approach

The development of an interdisciplinary theoretical framework for Forest School in the United Kingdom

A growing evidence base has demonstrated the value of Forest School as an outdoor learning approach which supports a range of benefits including improved physical, social and mental wellbeing, increased confidence and self-esteem and the development of problem-solving skills. However, critics of Forest School have argued that a lack of theoretical coherence and detail risks the misinterpretation of Forest School and its pedagogy by both practitioners and researchers. This paper responds to these concerns, establishing a comprehensive and detailed theoretical framework for Forest School. Through a thorough examination of evidence supporting Forest School delivery, we examine the theoretical keystones of this pedagogical approach to inform an interdisciplinary theoretical understanding of Forest School. We argue that Forest School is a particular socially constructed approach to outdoor education, which is informed by social constructivist experiential learning theory. This is driven by two core components. First, play-pedagogy, which includes the opportunity to experience risk and be creative. Next, biophilic interaction, which examines the human innate desire to be in nature. This is informed by the cultural origins of Forest School development as underpinned by Nordic notions of friluftsliv and by theories of place attachment. Taken together, this theoretical framework considers the breadth of knowledge that underpins Forest School and recognises its growing evidence base, which positions it as a rich and valuable pedagogical approach

Service user involvement in giving mental health students feedback on placement: a participatory action research study

Background Although the drive to engage service users in service delivery, research and education has mainstream acceptance, it is not easy to achieve meaningful involvement. The contribution that could potentially be made by users whilst accessing services is often overlooked. Objectives and Participants This study involved stakeholders (mentors, service users and a lecturer) working together to design, evaluate and refine a system enabling students to seek feedback from service users. The feedback concerned mental health students’ interpersonal skills and occurred whilst on practice placement. This research aimed to explore the experiences of those concerned when nine students attempted to learn from rather than about service users. Design A 2-year study, encompassing five cycles of participatory action research (PAR). Setting A small island community in the British Isles, adopting UK standards for pre-registration nurse education. Methods Data came from interviews with service users and mentors and a series of reflective group discussions with students who volunteered to try out the feedback mechanism. The deliberations of the PAR stakeholder group informed the research cycles and added to the data, which were subject to thematic analysis. Findings Findings indicated that service users volunteering to give feedback had unanimously positive experiences. Students’ experience lay on a continuum: those with a stronger sense of self were more willing and able to ask for feedback than less confident students. Cultural adjustment to the role change needed was challenging, requiring self-awareness and courage. Over time, all students achieved deep learning and, for some, learning appeared transformative. Conclusion Although contextual, the study concluded that the feedback initiative encouraged the development of more equitable relationships, in which mental health nurses respected the expertise of service users. This potentially benefits student development, recovery-orientated practice, service users and HEIs searching for meaningful ways to involve service users in learning and formative assessment