Robin M. Ion

The British reaction to dementia praecox 1893-1913. Part 1

Emil Kraepelin introduced the concept of dementia praecox in 1893. The eventual acceptance of the concept brought a degree of clarity and order previously unknown to psychiatric nosology. The pre-Kraepelin era had been dominated by concepts such as mania, melancholia and adolescent insanity. After Kraepelin these ideas were abandoned in favour of the two great concepts of dementia praecox and manic depressive insanity, both of which remain active within modern psychiatry in the fonn of schizophrenia and bipolar disorder. This two-part study focuses on the early British reaction to Kraepelins concept, from 1893, when he first introduced it, to 1913 when it gained general recognition. It examines the struggle experienced by the proponents of dementia praecox before the concepts acceptance by most British psychiatrists in 1913. It argues that both clinical/professional and linguistic factors influenced the British response to dementia praecox. Part 1 of this study describes the backdrop to the development of Kraepelins ideas and examines the response to the concept in the British psychiatric textbooks and journals of the period. Part 2 will explore reaction to the concept in the professional meetings of the period, and will also examine and evaluate the key issues arising from the debate. 1. In this paper, unless otherwise stated, all references to Kraepelins work are to the English translations of his books.

Willis and the generic turn in nursing

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Accounting for actions and omissions: a discourse analysis of student nurse accounts of responding to instances of poor care

AIMS To explore how nursing students account for decisions to report or not report poor care witnessed on placement and to examine the implications of findings for educators. BACKGROUND Concern has been raised about the extent to which cases of poor care go unreported. Failure to report cases may have serious consequences for patient safety. DESIGN Semistructured interviews were conducted with 13 undergraduate students at a UK university during 2013. They were asked to consider their response to episodes of poor practice witnessed on placement. METHODS Data were transcribed verbatim and categorized according to whether or not students reported concerns. Cases were analysed in accordance with Potter and Wetheralls version of discourse analysis to identify the discursive strategies used to account for decisions to report or not report poor practice. RESULTS Participants took care to present themselves in a positive light regardless of whether or not they had reported an episode of concern. Those who had reported tended to attribute their actions to internal factors such as moral strength and a commitment to a professional code. Those who had not or would not report concerns provided accounts which referred to external influences that prevented them from doing so or made reporting pointless. CONCLUSION This study provides information about how students account for their actions and omissions in relation to the reporting of poor care. Findings suggest ways educators might increase reporting of concerns.

Exploring the compassion deficit debate

Several recent high profile failures in the UK health care system have promoted strong debate on compassion and care in nursing. A number of papers articulating a range of positions within this debate have been published in this journal over the past two and a half years. These articulate a diverse range of theoretical perspectives and have been drawn together here in an attempt to bring some coherence to the debate and provide an overview of the key arguments and positions taken by those involved. In doing this we invite the reader to consider their own position in relation to the issues raised and to consider the impact of this for their own practice. Finally the paper offers some sense of how individual practitioners might use their understanding of the debates to ensure delivery of good nursing care.

Factor validation and Rasch analysis of the individual recovery outcomes counter

Abstract Objective: The individual recovery outcomes counter is a 12-item personal recovery self-assessment tool for adults with mental health problems. Although widely used across Scotland, limited research into its psychometric properties has been conducted. We tested its’ measurement properties to ascertain the suitability of the tool for continued use in its’ present form. Materials and methods: Anonymised data from the assessments of 1743 adults using mental health services in Scotland were subject to tests based on principles of Rasch measurement theory, principal components analysis and confirmatory factor analysis. Results: Rasch analysis revealed that the six-point response structure of the individual recovery outcomes counter (I.ROC) was problematic. Re-scoring on a four-point scale revealed well-ordered items that measure a single, recovery-related construct, and has acceptable fit statistics. Confirmatory factor analysis supported this. Scale items covered around 75% of the recovery continuum; those individuals least far along the continuum were least well addressed. Conclusions: A modified tool worked well for many, but not all, service users. The study suggests specific developments are required if the I.ROC is to maximise its’ utility for service users and provide meaningful data for service providers. Implications for Rehabilitation Agencies and services working with people with mental health problems aim to help them with their recovery. The individual recovery outcomes counter has been developed and is used widely in Scotland to help service users track their progress to recovery. Using a large sample of routinely collected data we have demonstrated that a number of modifications are needed if the tool is to adequately measure recovery. This will involve consideration of the scoring system, item content and inclusion, and theoretical basis of the tool.

Much more than a mishap

The Nursing and Midwifery Council (NMC) Code makes it clear that registrants are to prioritise the care and safety of patients.

Teaching ethics: intersectionality, care failure and moral courage

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Developing the social media presence of @NurseEducToday by using Twitter

The use of social media (SoMe) has increased significantly over the last ten years. Twitter, one example of the SoMe was developed in 2006 aimed to communicate with small groups. Since its inception Twitter has been embraced as an important professional communication platform by clinicians, academics, educators, students and researchers. Tweets are increasingly used to build collaborative relationships, showcase research and communicate innovative clinical and educational information.

Poor care and the professional duty of the registered nurse

Concerns have been raised in recent years about standards of care in the UK. Notable failures have been identified in the care of vulnerable older adults. This article identifies and discusses some logical steps which might be taken to minimise the risk of individual and systemic care failure in settings for older adults. These steps include frank discussion about ageism to promote empowerment and respect for older people; ensuring robust policies are in place that support and encourage the reporting of poor care; and ensuring that registered practitioners are aware of their accountability for their actions and also their omissions should they witness poor care. In addition to reducing the risk of poor care, these steps could contribute to having a more confident, competent and empowered workforce.

Student life - Helping nurses to speak up.

How we respond to students who raise concerns is important because the experience will shape their future practice. Students often worry about what they might experience when they return to the practice environment, so need to be reassured they are doing the right thing.