Patient empowerment: emancipatory or technological practice?

OBJECTIVE: To describe the meaning of the theme of empowerment from research on health promotion in nursing from the perspective of nurses participating in the study. METHODS: Manual data analysis and QSR NUD*IST Vivo were used to analyse the data generated by individual and focus group interviews and the critical incident technique with 32 qualified nurses working in an acute hospital setting in the UK. RESULTS: The participants identified a number of issues related to the theme of empowerment. These included the nurse as patient informer, psychological supporter and rapport builder and the concepts of informed choice/decision making, gatekeeping, coping, patient assertiveness, self-esteem and confidence. CONCLUSION: Empowerment is a complex, multi-dimensional, contested concept which can reflect a broad socio-political agenda, a radical emancipatory process or, as the findings from this qualitative study suggest, pragmatic interventions operating within the confines of a slightly modified medical model. PRACTICE IMPLICATIONS: If the reader deems the findings are transferable to their clinical milieu then the implications for practice relate to the need for careful consideration about empowerment in relation to operational definitions for practice, how terminology and related intervention is contextualised and the relationship between pragmatic empowerment and the medical paradigm

Promoting health

By introducing the theories and practices of health promotion, emergency nurses can become strategic practitioners

How to empower patients, and involve the public

Patient empowerment and patient and public involvement are a focus for NHS policy, with an emphasis on patient decision making and representation as core features of a patient-focused NHS. Patient empowerment and patient and public involvement imply a rebalancing of power in the nurse-patient relationship. In reality this is complicated by wider issues of power and control in a complex health service influenced by professional agendas, healthcare leadership, government targets and a developing business culture. Despite these ideological and organisational constraints, there are many ways in which nurses can support aspects of individual patient empowerment and patient and public involvement

Community empowerment for health visiting and other public health nursing

This paper explores the community empowerment aspect of health promotion, where social experience is a key indicator of health, from the perspective of health visiting and other public health nursing. This contemporary model of practice is put into a health promotion context by use of a slightly modified framework and by the inclusion of examples of methods and outcomes of practice that link conceptually with the health assets model and aspects of 'Big Society' thinking. Community development, social capital and capacity building are discussed as key elements of community empowerment with a 'bottom-up' agenda driven by community members. This concerns micro-population health gain, where the process, the quality of the public health nurse-community relationship, is as important as outcome

Conceptual frameworks and terminology in doctoral nursing research

Aim: To define conceptual frameworks and their inherent dichotomies, and integrate them with concomitant concepts to help early nursing doctoral researchers to develop their understanding of and engage with discourse further, so that nursing can demonstrate its ability to contribute to the meta-theoretical debate of doctoral research alongside other practices and theory-based disciplines. Background: Conceptual frameworks are central to nursing doctoral studies as they map and contextualise the philosophical assumptions of the research in relation to paradigms and ontological, epistemological and methodological foundations. They shape all aspects of the research design and provide a structure for theorising. They can also be a challenge for researchers and are under-discussed in the literature. Review methods: Literature review. Discussion: The key aspects of the conceptual framework debate in terms of objectivist, subjectivist paradigms and the wider paradigm debate, including retroduction and abduction, are reviewed here together with consideration of how these apply to nursing doctoral research. Conclusion: Conceptual frameworks are pivotal to nursing doctoral research as they clarify and integrate philosophical, methodological and pragmatic aspects of doctoral thesis while helping the profession to be seen as a research-based discipline, comfortable with the language of meta-theoretical debate. Implications for research/practice: Conceptual frameworks should form the methodological foundation for all nursing doctoral research

Gestational diabetes

Gestational diabetes mellitus (GDM) is defined as hyperglycaemia that is diagnosed for the first time in the second or third trimester of pregnancy. It occurs in 1 in 7 pregnancies worldwide and is associated with increased risk of adverse perinatal outcome, in particular, infant birth weight that is large for gestational age, increased infant adiposity, preeclampsia and preterm delivery, and increased delivery by caesarean section. This review focuses on the controversy regarding screening and diagnosis of GDM following development of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines and the National Institute of Clinical Excellence (NICE) 2015 guidelines. It reviews the most recent research in to diet and exercise modification in prevention and management of GDM, pharmacological management and post-partum management to delay and/or prevent progression to type 2 diabetes

Evaluation of visual implant elastomer and alphanumeric internal tags as a method to identify juveniles of the freshwater crayfish, Cherax destructor

Abstract In the last few years there has been an increasing interest in using traditional animal breeding techniques to improve important traits such as growth rate in freshwater crayfish. However, a major impediment to such programs is an inability to reliably identify individuals or family groups for long periods because of the non-retention of external tags through ecdysis. Visual implant Ž . Ž . elastomer VIE and visual alphanumeric VIalpha internal tags have proven useful in identifying finfish and amphibians. We evaluated the suitability of these two internal tags as a method to Ž . identify yabby Cherax destructor juveniles. Both tags proved useful in identifying juveniles Ž between 0.1 and 4.6 g, with the VIE having the higher retention rate of the two tags up to 92%, . as opposed to 79% for the VIalpha tag . Mortality, as a direct consequence of tagging juveniles with the VIE and VIalpha tags was 13% and 11%, respectively. The ability to reliably identify C. destructor juveniles will increase the efficiency of selective breeding programs for this species by allowing individuals and family groups to be pooled in growth experiments, thereby decreasing the impact of confounding environmental effects. q 2001 Elsevier Science B.V. All rights reserved. Jerry et al.r Aquaculture 193 2001 149-154 15

Patient empowerment within a coronary care unit: insights for health professionals drawn from a patient satisfaction survey

The aim of this exploratory study was to investigate coronary care patients’ perceptions of their care and interventions related to empowerment and strengthening patient choice. The study, conducted in one acute National Health Service (NHS) Trust in Cambridgeshire, England, and completed in 2002, employed a prospective survey design. The research used a self-completion, pilot, postal questionnaire, including closed, open and scaled questions as the main method of data collection. From a total of 200 eligible patients, an unselected, consecutive sample of 142 in-patients consented to participate, of whom 103 returned the questionnaire—–a response rate of 73%. In contrast to much published literature, this study demonstrated that empowerment issues involving the rights of coronary care patients to be primary decision makers, managers of their illnesses and ultimate arbiters of their treatment and care were of minimal concern to all but a few. Almost 90% of patients were content to entrust their care exclusively to health professionals based on their confidence in the clinical expertise of the medical and nursing staff. Findings suggested that, while respondents were well-satisfied with their care, the ethos of patient empowerment was of peripheral concern and readily abdicated in the face of acute illness