Colin Macduff

The problem of measuring change in individual health-related quality of life by postal questionnaire: use of the patient-generated index in a disabled population.

The Patient-generated Index (PGI) is a health-related quality of life (HRQoL) measure which asks respondents to nominate the areas of their lives which are most affected by their health condition, so that they can then rate the severity of the effects and weight their relative importance. It is unusual amongst such measures in that it is designed for postal administration. This study assessed the ability of the revised PGI to measure change in HRQoL in a population of 161 people who had previously been identified as having limiting long-term illness. A questionnaire, including a revised version of the PGI and the developmental version of the SF-36, was mailed at two time points (T1 and T2), 4.5 months apart. The PGI was subsequently assessed in terms of practicality, validity, reliability and responsiveness. At T1, 62% of those who felt that they still had a health problem affecting their life completed the PGI correctly. These people were significantly younger and had spent longer in education than the remaining 38%. Only 19 respondents completed the PGI correctly on both occasions, rendering reliability and responsiveness testing inconclusive. The value of the PGI is significantly diminished by the fact that many people cannot complete it correctly. Future development of the instrument is appraised in the context of related measurement methods.

Bereavement and Bereavement Care in Health and Social Care: Provision and Practice in Scotland

The interview study described here aimed to explore current views of and practice in bereavement care and identify priorities for service development in Scotland. Fifty-nine participants who worked with the bereaved in some way, or whose interest was in bereavement or bereavement care, were interviewed. They represented National Health Service organizations, chaplaincy departments, educational institutions, academic departments, voluntary groups, and other related bodies, such as funeral directors. Transcripts were read repeatedly and initial emerging themes were identified, coded and shared between research team members to reach a consensus for key themes. Priority areas for development were related to raising public awareness, coordination of services, guidance, and professional education.

The Economic Cost of Bereavement in Scotland

Aspects of the socioeconomic costs of bereavement in Scotland were estimated using 3 sets of data. Spousal bereavement was associated with increased mortality and longer hospital stays, with additional annual cost of around £20 million. Cost of bereavement coded consultations in primary care was estimated at around £2.0 million annually. In addition, bereaved people were significantly less likely to be employed in the year of and 2 years after bereavement than non-bereaved matched controls, but there were no significant differences in income between bereaved people and matched controls before and after bereavement.

A national study of selection processes for student nurses and midwives.

BACKGROUND This paper presents the main findings from a project that aimed to evaluate selection processes for the recruitment of student nurses and midwives. OBJECTIVES The main objectives were to: Design The evaluation was designed principally to achieve explanation, with multiple case study methodology adopted as the main approach. Within this ambit mixed methods of data collection involving questionnaires and interviews were used. Participants Seven of the Scotland-based Higher Education Institutions participated in the research, with participation from Admissions Tutors, clinical interviewers, academic interviewers, and students. METHODS The methods included: a scoping questionnaire with follow-on questionnaire to elicit views on the strengths and limitations of chosen selection processes; interviews and focus groups to build on these findings. Analytical approaches were congruent with the chosen data collection approaches. Findings HEIs typically have rationales for their various chosen approaches to selection. However, our findings indicate that there is a lack of evidence for most selection approaches particularly in relation to interviewing. There is a growing evidence-base for the use of multiple mini interviews, and emotional intelligence testing. CONCLUSIONS There is a need to work collectively cross-UK to bring together the evidence-base around selection so that processes and decision-making are as valid, reliable, effective and transparent as possible.

An evaluation of the process and initial impact of disseminating a nursing e-thesis

AIM This paper is a report of a study conducted to evaluate product, process and outcome aspects of the dissemination of a nursing PhD thesis via an open-access electronic institutional repository. BACKGROUND Despite the growth of university institutional repositories which make theses easily accessible via the world wide web, nursing has been very slow to evaluate related processes and outcomes. METHOD Drawing on Stakes evaluation research methods, a case study design was adopted. The case is described using a four-phase structure within which key aspects of process and impact are reflexively analysed. FINDINGS In the conceptualization/re-conceptualization phase, fundamental questions about the purpose, format and imagined readership for a published nursing PhD were considered. In the preparation phase, seven key practical processes were identified that are likely to be relevant to most e-theses. In the dissemination phase email invitations were primarily used to invite engagement. The evaluation phase involved quantitative indicators of initial impact, such as page viewing and download statistics and qualitative feedback on processes and product. CONCLUSION Analysis of process and impact elements of e-thesis dissemination is likely to have more than intrinsic value. The advent of e-theses housed in web-based institutional repositories has the potential to transform thesis access and use. It also offers potential to transform the nature and scope of thesis production and dissemination. Nursing scholars can exploit and evaluate such opportunities.

Editorial: The PhD thesis as a virtual guest house.

PhD theses. Who reads them? Within UK nursing the answer is: hardly anybody, save a few PhD supervisors, students and enamoured academics. Since the millennium, the Royal College of Nursing’s Steinberg Collection of over 1000 hard bound theses has seen around 250-300 episodes of access each year. This low level of thesis usage is also characteristic of university libraries in the UK (Copeland and Penman 2004), where processes for accessing these tombstone-like tomes are often tortuous.

Evaluation of a national educational programme for healthcare workers on prevention and control of healthcare associated infections

This paper presents an overview of key findings from an evaluation of a national educational programme that aims to provide healthcare staff with the skills and knowledge necessary to ensure good practice in preventing healthcare associated infections. The research methods comprised literature review, large-scale questionnaire surveys of students and mentors on the Cleanliness Champions Programme, and 20 key-informant interviews. The educational programme was found to be fit for purpose, but there was a need for some restructuring and modifications. Nurses were found to comprise around two-thirds of all registrants on the programme. The study also provided some illumination of initial integration into practice. Cleanliness Champions typically reported substantial impact on their personal practice and many cited examples of influence on colleagues’ practice. However there is an urgent need to ensure that other occupational groups join with nursing by enrolling on the programme in much greater numbers. If this is accompanied by further investment, a critical mass may form that has sufficient multidisciplinary momentum to make good infection prevention and control practices more embedded clinical realities within Scotland. Key lessons from the evaluation are identified that may usefully inform similar initiatives and/or other national healthcare education programmes.

Decision precision or holistic heuristic?: Insights on on-site selection of student nurses and midwives

Concerns about quality of care delivery in the UK have led to more scrutiny of criteria and methods for the selection of student nurses. However few substantive research studies of on-site selection processes exist. This study elicited and interpreted perspectives on interviewing processes and related decision making involved in on-site selection of student nurses and midwives. Individual and focus group interviews were undertaken with 36 lecturers, 5 clinical staff and 72 students from seven Scottish universities. Enquiry focused primarily on interviewing of candidates on-site. Qualitative content analysis was used as a primary strategy, followed by in-depth thematic analysis. Students had very mixed experiences of interview processes. Staff typically took into account a range of candidate attributes that they valued in order to achieve holistic assessments. These included: interpersonal skills, team working, confidence, problem-solving, aptitude for caring, motivations, and commitment. Staff had mixed views of the validity and reliability of interview processes. A holistic heuristic for overall decision making predominated over belief in the precision of, and evidence base for, particular attribute measurement processes. While the development of measurement tools for particular attributes continues apace, tension between holism and precision is likely to persist within on-site selection procedures.

A thematic analysis of the experience of UK mental health nurses who have trained in Solution Focused Brief Therapy.

Accessible summary What is known on the subject?Solution Focused Brief Therapy (SFBT) is an effective model of brief psychotherapy.Evidence suggests that nurses can be trained to deliver SFBT with only a few days training.It has been argued that SFBT reflects the core values of nursing practice, but no empirical research has been undertaken to validate this assertion. &NA; What does this paper add to existing knowledge?This is the first time the impact of such training on nurses’ sense of professional and personal identity has been explored.Drawing upon data derived from twenty interviews, this paper explores the key themes reported by nurses in relation to their personal experience of training in SFBT.This paper extends our understanding of the lived experience of mental health nurses and facilitates discussion on the preparation and practice of their role. &NA; What are the implications for practice?Training in SFBT can provide a framework for nurses to empower their clients/patients to take control of their own recovery in a shared and trusting relationship.Training in SFBT can enhance nurses’ sense of trust in their clients.Training in solution‐focused interactions may provide a framework for many nurses to provide the type of collaborative, patient‐led care they aspire to. Introduction: SFBT is a psychotherapeutic model that aims to ‘build solutions’ rather than ‘solve problems’. It has evolved into a structured communication framework utilized across a range of disciplines, focusing on the future, as opposed to the past, and on participants strengths and abilities, as opposed to their problems and deficits. There have been no studies exploring the experience of training in SFBT from the perspective of the nurses being trained. Aim: This study sought to explore the experience of nurses who had completed a six‐month training course in SFBT. Methods: Using a qualitative methodology, 20 nurses who had undertaken SFBT training were interviewed at various locations across Scotland. Results: Five main themes emerged from analysis of the 20 interviews. Many of the participants reported increased trust in their clients and enhanced role satisfaction. Implications for Practice: Training in SFBT provides nurses with an alternative model of practice to the dominant ‘medical’ and ‘psychological’ models of contemporary practice. The experiences of the participants in this study suggest that SFBT can be a useful intervention in nursing practice and that nurses can easily incorporate SFBT into their practice.

Harnessing our rivers of knowledge: time to improve nursing's engagement with Electronic Theses and Dissertations

In 2009, India mandated that all theses and dissertations from its universities would be required to be submitted electronically to a new national repository called Shodhganga: http://shodhganga.inflibnet.ac.in. Combining Shodh, the Sanskrit word for research and discovery, with Ganga, the name of the country’s longest and holiest river, produced the striking metaphor of a national river of doctoral and masters knowledge. Although the database is more conservatively billed by its custodians as a reservoir, it is hard for the deskbound academic to resist the splendid vision of a nation’s theses and dissertations, now in electronic formats, rolling forward as a mighty unified force to feed into the global ocean of scholarship. India is not alone in such activity. During the past 10 years Australia, the UK and many other countries have harvested theses and dissertations in electronic formats from the Institutional Repositories (IRs) of individual universities to create excellent national web portals for scholars from all disciplines. Importantly, a guiding principle has been to make these works openly available in full text format whenever possible. In turn there are now several international web portals such as the Networked Digital Library for Theses and Dissertations (NDLTD) that harvest these scholarly works. So, in a relatively short time we have come a long way from the use of white gloves for the single copy unpublished thesis, or the use of microfiche and magnifying glass.