Annette Jinks

Resilience to care: A systematic review and meta-synthesis of the qualitative literature concerning the experiences of student nurses in adult hospital settings in the UK

AIM The aim of the study was to gain new insights into the experiences and accounts of adult pre-registration student nurse clinical allocations in hospital settings in the UK. DESIGN A systematic review and meta-synthesis of the qualitative literature was undertaken. DATA SOURCES Pertinent papers published from 1990 to 2010 were identified through searches of Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), and the British Nursing Index. Hand and citation searching was also undertaken. REVIEW METHODS Ten relevant papers were identified for review. Quality checks on the robustness of the studies were undertaken. Data extraction included identifying details of the studys settings, sample details, focus of the study, research design, data collection methods, data analysis approaches and qualitative data themes. RESULTS Approximately 40 qualitative data themes were identified and were the subject of a meta-synthesis. Five cross-cutting synthesised data themes were identified including: pre-placement anticipation, the realities of the clinical environment, clinical learning and becoming a nurse. Stress and coping was a concurrent topic area and related to all the synthesised themes. CONCLUSIONS The findings give new insights into the clinical experiences of student nurses of which the stress of learning in clinical environments and the development of emotional resilience is a focal issue. Whilst the majority of students in the UK experience nurturing, caring clinical environments and positive staff relationships, however, some do not. Reports of negative student nurse clinical experiences are shown in this review to have endured through time. Nurse educators should be alert to the possibility that some students may have very negative clinical experiences. The consequences such negative experiences will affect such things as increases to student attrition and the help perpetuate the cycle of negative clinical learning experiences occurring in the future.

Obesity interventions for people with a learning disability: an integrative literature review

AIM This paper is a review of the effectiveness of non-surgical, non-pharmaceutical interventions designed to promote weight loss in people with a learning disability and how qualitative evidence on peoples experiences and motivations can help understanding of the quantitative research outcomes. BACKGROUND The health risks of obesity underline the importance of effective evidence-based weight loss interventions for people with learning disabilities as they are at increased risk of being overweight. DATA SOURCES Papers published from 1998 to 2009 were identified through searches of the Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), PSYCHINFO databases, and the Cochrane Library. REVIEW METHODS An integrative review method was used. Studies included were non-surgical or non-pharmaceutical interventions aimed at weight reduction for people with a learning disability. Synthesis of the findings related to study design, participants, types of interventions, outcome measures and participant perspectives. RESULTS Twelve studies met the inclusion criteria. The most common research design was quasi-experimental pretest and post-test. Few researchers used a clinical trial approach, and there was only one predominantly qualitative study. Interventions were mainly focused on energy intake, energy expenditure or health promotion. Only a few studies incorporated behaviour modification approaches. CONCLUSION Nurses who work with clients with learning disabilities have a key role to play in the management of obesity. Future research needs to focus on qualitative studies of the perceptions of clients and their families, controlled trials investigating the effectiveness of interventions and their costs and sustainability, and longitudinal studies examining weight loss over time.

Qualitative evaluation of a young carers' initiative

This focus of this article is a qualitative, evaluative study of three Crossroads young carers projects. Focus group discussions took place with 24 young people aged 11—16 years. Data were analysed using a thematic content analysis approach. The themes of the research were: experiences of being a young carer, peer support, opportunities for time out and purposeful activities. The personal characteristics of the participants give rise to a number of worrying conclusions, that relatively young people were found to be undertaking primary caring roles over long periods of time. However, the groups were found to provide opportunities for young carers to experience a positive environment, participate in purposeful activities and have the chance to develop new friendships. Nevertheless, the literature suggests that provision of such projects is inadequate and under-resourced, which may disadvantage further a group of young people who are known to come from lower income families.

Initial findings from the TUILIP (Trent Universities Interprofessional Learning in Practice) project.

This paper reports on initial findings from the Trent Universities Interprofessional Learning in Practice (TUILIP) project. The main aim of this project is to develop sustainable models of interprofessional learning (IPL) that will develop and enhance the professional skills of students through collaborative working within practice settings. The project entails the collaboration of two Universities involving NHS Trusts across the Trent Region in the UK, and students from 13 health and social professions. The project plan is to establish eight pilot sites providing a range of IPL opportunities for all students on placement (Armitage et al., 2008). The project is responsive to the work of Barr (2000) who found that workbased IPL was markedly more likely than college-based teaching to improve the quality of service and bring direct benefits to service users. In addition ‘‘Creating an Interprofessional Workforce’’ has recently reported that IPL should be firmly embedded in practice learning. (Department of Health, 2007)

Evaluation of a Family-Centred Children's Weight Management Intervention.

Purpose – The purpose of this paper is to conduct an in‐depth quantitative and qualitative evaluation of a family‐based weight loss and healthy life style programme for clinically obese children in England.Design/methodology/approach – The mixed method case study evaluation used included obtaining pre and post measurements of anthropometry and a range of attitude and behavioural attributes. The qualitative phase of the study involved in‐depth interviews and focus groups.Findings – The programme is demanding and resource intensive and designed as an intervention for children needing most help with their weight. Participants included the families of five referred children (n=18 individuals) and the intervention team (n=7). All but one child had reduced BMI centiles at the end of the programme. There were also improvements to a number of self‐report aspects of healthy eating and levels of activity and quality of life, self‐esteem and levels of depression indicators. The qualitative evaluation generated a num...

Research engagement and attitudes to teaching research to healthcare students: a questionnaire study of healthcare educators

The evidence‐based practice agenda in many healthcare professions has increased the importance of teaching research skills to students in these professions. However, concern exists that many healthcare educators may be reluctant to teach research. This study investigated potential barriers to their adoption of this role. A questionnaire was distributed to 111 healthcare educators within the Faculty of Health of a post‐1992 university in the north‐west of England. Items enquired about career activities, and included 20 attitude statements concerning research teaching, with a 5‐point Likert scale for responses. The final sample comprised 72 respondents (55 female: 65% response rate). Males rated themselves more likely to volunteer to teach research than did females. A principal components analysis and varimax rotation on attitude responses yielded three factors explaining 54.792% of variability. It was concluded that the development of a positive commitment to research teaching by healthcare educators was an important priority in delivering evidence‐based curricula, and consequently for patient care. However, vigilance was required to prevent gender disparities developing in research teaching.

Endotracheal suctioning in children with severe traumatic brain injury: a literature review

AIM This paper aims to present an overview of the literature relating to the effects of endotracheal suctioning (ETS) in children and adults with severe traumatic brain injury (TBI). BACKGROUND TBI is the leading cause of death in children worldwide and continues to result in widespread mortality and morbidity. In intensive care, ETS is an essential nursing procedure that is undertaken but is known to produce some adverse effects in children. METHOD A comprehensive literature search was undertaken using a Parahoo and quality of reporting of meta-analyses (QUOROM) approach. A range of databases was searched to identify published papers with key search terms. The databases searched included Cochrane Library, Medline, PubMed Central, CINAHL, Proquest and Science Direct. FINDINGS This review is based on 21 papers (with 433 patients in total), but specific papers in paediatric head injury children were extremely limited, and the evidence was largely dated and inconclusive. Although the majority of papers demonstrate an increase in intracranial pressure (ICP) with ETS, there are contradictory results with regard to recovery times. CONCLUSIONS Further research is needed specifically into the effect of ETS on ICP and cerebral perfusion pressure of children with severe TBI, taking into account all the known confounding variables.

The impact of blame culture on paramedic practice: A qualitative study exploring English and Finnish paramedic perceptions

Purpose The purpose of this paper is to explore English and Finnish paramedic perceptions of the healthcare blame culture, its relationship to complaints, the use of defensive practice and if this impacts on paramedic practice and clinical care. Design/methodology/approach Participants were recruited from English and Finnish ambulance services that have similar organisational and professional scopes of practice. The aim was to gain insight into the similarities and differences between the countries regarding the existence of a blame culture in paramedic practice. Semi-structured focus groups and interviews involving 20 English and Finnish paramedics were undertaken. Qualitative perceptions concerning the reality of a blame culture in paramedic practice and its impact on professional roles were sought. Findings Three major themes that were identified in the thematic analysis included: blame culture and its influences; the impact of complaints against paramedics; and the use of defensive practice within their roles. These data themes were similar for both groups of participants. The majority of participants thought the healthcare blame culture to be widespread and believed that this was likely to directly influence paramedics’ working practices. Originality/value Whilst the impact of blame culture and complaints on the medical profession has previously been examined, this study makes an important contribution by exploring the factors that impact on paramedics’ lives and their practice, within two European countries. The inappropriate use of social media by some members of the public in both countries was a disturbing issue for many participants and was identified as an area for further research.

Improving influenza vaccination uptake among frontline healthcare workers

Vaccination of healthcare workers against seasonal influenza is recommended to protect staff, their families and patients. This study reports the findings of a survey conducted to explore how to improve uptake of influenza vaccination among staff at a specialist NHS hospital Trust. Responses to the survey were received from 376 members of staff (a 38.6% response rate). Reasons reported by respondents for not being vaccinated included lack of access and beliefs about the efficacy of vaccination. The findings suggest that uptake could be improved by ensuring convenience and flexibility in vaccination provision.

Student life - Support for research: Annette Jinks and Mair Ning look at the challenges nurse lecturers face when teaching research skills

Students may be turned off by research language and consider it a complex and difficult subject, so teaching it can be challenging.