The Art of Supervision: Canvas, Song, and Dance

The author's theory papers were selected as the ACPE Theory Papers of the year

Reliability Of Aukamp\u27S Knowledge Scale For Diagnosing Knowledge Deficit Of Third Trimester Pregnant Women

This methodological study addressed the question: What is the reliability of Aukamp\u27s Knowledge Scale (1986) which is used in the identification of a defining characteristic for the nursing diagnosis of knowledge deficit among women in the third trimester of pregnancy? The purpose of this study was to add to the knowledge base for nursing diagnosis by ascertaining the reliability of an instrument to be used in the identification of a defining characteristic for the nursing diagnosis of knowledge deficit of women in the third trimester of pregnancy. This study was based on two conceptual frameworks: American Nurses’ Association’s Nursing: A Social Policy Statement and Aukamp’s (1986) conceptual framework which included R u b i n ’s (1984) theory for maternal identity and maternal experience. Aukamp’s Knowledge Scale was a 14-item test based on the topics of common discomforts, nutrition and weight gain, length of pregnancy, complications of pregnancy, exercise, and fetal behaviors. The Knowledge Scale was completed by 140 women who were 18 years or older and in their 30th to 37th week of pregnancy. Internal consistency reliability of the Knowledge Scale was ascertained by obtaining Cronbach’s alpha correlation coefficient. Childbirth Education Questions and selected demographic data were included in the study to determine if they had an effect on the Knowledge Scale score mean. In this study, a Cronbach’s alpha of .4830 was obtained for Aukamp’s Knowledge Scale. Childbirth Education classes, pregnancy risk status, and race had a significant effect (p_ \u3c .05) on the Knowledge Scale score mean. Three conclusions are drawn: Aukamp’s Knowledge Scale in its present form is not a reliable instrument to identify a defining characteristic for the nursing diagnosis of knowledge deficit in the third trimester of pregnancy ; the Knowledge Scale should be lengthened, refined, and retested for validity and reliability; and childbirth education classes do provide relevant information for third trimester pregnant women

Single Mothers by Choice: Mother–Child Relationships and Children’s Psychological Adjustment

Fifty-one solo mother families were compared with 52 two-parent families all with a 4 –9-year-old child conceived by donor insemination. Standardized interview, observational and questionnaire measures of maternal wellbeing, mother– child relationships and child adjustment were administered to mothers, children and teachers. There were no differences in parenting quality between family types apart from lower mother– child conflict in solo mother families. Neither were there differences in child adjustment. Perceived financial difficulties, child’s gender, and parenting stress were associated with children’s adjustment problems in both family types. The findings suggest that solo motherhood, in itself, does not result in psychological problems for children.This project was supported by a Wellcome Trust Senior Investigator Award

'What Does Donor Mean to a Four-Year-Old?': Initial Insights into Young Children's Perspectives in Solo Mother Families.

This study reports on the questions, thoughts and feelings of children aged 4-9 conceived by donor insemination to single mothers. Fifty-one mothers and 47 children from the same families were each administered a semi-structured interview. Mothers generally reported that while children either lack understanding, or have not yet been told, about their donor conception, they may be thinking and talking about the absence of a father. Most children did not mention either donor conception or father absence and reported positive feelings about their families and friendships. Possible explanations for the discrepancy between mothers' and children's reports are discussed.Wellcome Trust (Grant ID: 097857/Z/11/Z)This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/chso.1218

Streaming primary urgent care: a prospective approach

Aim: To identify the appropriate service provider attendees of emergency departments (EDs) and walk-in centres (WiCs) in North East London and to match this to local service provision and patient choice. Design: An anonymous patient survey and a retrospective analysis of a random sample of patient records were performed. A nurse consultant, general practitioner (GP) and pharmacist used the presenting complaints in the patients’ records to independently stream the patient to primary care services, non-National Health Services or ED. Statistical analysis of level of agreement was undertaken. A stakeholder focus group reviewed the results. Subjects and setting Adult health consumers attending ED and urgent care services in North East London. Results The health user survey identified younger rather than older users (mean age of 35.6 years – SD 15.5), where 50% had not seen a health professional about their concern, with over 40% unable to obtain a convenient or emergency appointment with their GP. Over a third of the attendees were already receiving treatment and over 40% of these saw their complaint as an emergency. Over half of respondents expected to see a doctor, one-quarter expected to see a nurse and only 1% expected to see a pharmacist across both services, although WiCs are nurse-led services. More respondents expected a prescription from a visit to a WiC, whereas in the ED a third of respondents sought health advice or reassurance. Conclusion: A number of unscheduled care strategies are, or have just been, developed with the emphasis on moving demand into community-based services. Plurality of services provides service users with a range of alternative access points but can cause duplication of services and repeat attendance. Managing continued increase in emergency and unscheduled care is a challenge. The uncertainties in prospective decision making could be used to inform service development and delivery