Thursday, 13 October 2016

Nurses do not see role modelling healthy behaviours as a reasonable professional expectation

Roger Watson, Editor-in-Chief

Should patients and the public expect nurses to be good role models for healthy behaviours? Apparently not - according to nurses.  This surprising finding comes from a UK study by Kelly et al. (2016) titled: 'Should nurses be role models for healthy lifestyles? Results from a modified Delphi study' and published in JAN which aimed: 'To explore the expectation that nurses should be role models for healthy behaviours'. The study involved: 'practising nurses, nursing students, service users, policy makers, workforce development leads and stakeholders working in nurse education' in telephone interviews and a questionnaire. I have to declare that I was one of the respondents.

The authors concluded: 'This study has shown attitudes towards role modelling healthy behaviours different from the views expressed in nursing literature. Behaviour change was thought much more complex than simple imitation; contesting the assumption that role modelling can effect behaviour change. The ‘ideal’ role model proffered by stakeholders was someone who had struggled with unhealthy behaviours but eventually successfully changed the behaviour. Apart from the service user group, stakeholders felt that the healthy role model conceptualized in policy and professional guidance as best placed to encourage behaviour change was unhelpful and unrealistic'.

You can listen to this as a podcast


KELLY M., WILLS J., JESTER R. & SPELLER V. (2016) Should nurses be role models for healthy lifestyles? Results from a modified Delphi study. Journal of Advanced Nursing doi: 10.1111/jan.13173

Friday, 7 October 2016

Caring for ebola patients

Roger Watson, Editor-in-Chief

Ebola is not new and appeared in the pages of JAN over a decade ago in an article by Locsin and Matua (2002).  However, what is new is the more recent extent to which it spread across some parts of Africa and the ensuing death toll.  Of course, it 'hit the headlines' in the UK following the unfortunate case of the 'ebola nurse' Pauline Cafferkey. Ebola has resurfaced in the pages of JAN in a study from Sweden by Andertun et al. (2016) titled: 'Ebola virus disease: caring for patients in Sierra Leone – a qualitative study' and published in JAN. 

The aim of the study was to: 'describe Norwegian healthcare staffs’ experiences of participating in care of patients with Ebola virus disease in Sierra Leone'.  Eight nurses and one doctor were interviewed and the results provided some insight into the experience of these health professionals. Various themes came across about conquering fears and taking safety precautions and living with death.  The authors concluded: 'Our findings revealed that Ebola workers were relying highly on safety and used strategies to minimize risks of contagion. Safe care was central in working with Ebola patients, but the caring relation was challenged. They were constantly reminded of death and had to defeat their fears, but nevertheless they found their experiences of the hazardous work as meaningful and an important motivator.'

You can listen to this as a podcast


ANDERTUN S., HÖRNSTEN A. & HAJDAREVIC S. (2016) Ebola virus disease: caring for patients in Sierra Leone – a qualitative study. Journal of Advanced Nursing doi: 10.1111/jan.13167

Locsin, R. C. and Matua, A. G. (2002) The lived experience of waiting-to-know: Ebola at Mbarara, Uganda – hoping for life, anticipating death. Journal of Advanced Nursing, 37: 173–181. doi:10.1046/j.1365-2648.2002.02069.x

Improving outcomes of surgery on children for children and parents

Roger Watson, Editor-in-Chief

Having a child go through surgery can be difficult for parents, as well as the child. If the problems of lack of knowledge about what the child is going through and the stress associated with that and problems such as post-operative pain for the child are not alleviated, the outcomes from surgery can be made worse. This study from Canada by Chartrand et al. (2016) and published in JAN titled: 'The effect of an educational pre-operative DVD on parents’ and children’s outcomes after a same-day surgery: a randomized controlled trial' aimed to: 'examine the effect of a pre-operative DVD on parents’ knowledge, participation and anxiety and on children’s distress, pain, analgesic requirements and length of recovery after same-day surgery.'

Several outcomes were measured in this study including post-operative pain in the children who, along with their parents, watched the DVD and those who did not.  Outcomes for the parents in the DVD group were positive, including knowledge and pain in the children in this group was reduced. The authors concluded that the DVD intervention was useful in helping parents to help their children in the immediate post-operative period but that the effect may not, necessarily, be sustained.

This article is available open access and you can listen to this as a podcast


CHARTRAND J., TOURIGNY J. & MACCORMICK J. (2016) The effect of an educational pre-operative DVD on parents’ and children’s outcomes after a same-day surgery: a randomized controlled trial. Journal of Advanced Nursing doi: 10.1111/jan.13161

Decreasing depression in caregivers of people with dementia

Roger Watson, Editor-in-Chief

Depression amongst those who care for people at home with dementia is a significant problem. The adverse effects of the burden and the stress of care can have adverse psychological consequences which, if they are not alleviated, can then have an adverse effect on the person with dementia: their carer will become unable to care for them. This problem is addressed in a study from Taiwan by Kuo et al. (2016) titled: 'A randomized controlled trial of a home-based training programme to decrease depression in family caregivers of persons with dementia' and published in JAN.

The aim of the study was: 'to explore distinct trajectories of caregivers’ depressive symptoms and the effects of a training programme on these trajectories over 18 months after the programme'. As explained by the authors: '(t)he experimental group received the training programme with telephone consultation and the control group received written educational materials and social telephone follow-ups'. The intervention worked to alleviate the depressive symptoms of the carers.  The authors concluded: 'The results of this study can provide a reference for healthcare providers who regularly deal with persons with dementia and their caregivers to identify high-risk groups and to reduce family caregivers’ depressive symptoms by providing the individualized family caregiver training programme. Our study can also serve as a model for future studies on trajectories and related interventions for family caregivers’ depressive symptoms.'

You can listen to this as a podcast


KUO L.-M. , HUANG H.-L., L IANG J., KWOK Y.-T., HSU W.- C., SU P.- L. & SHYU Y.- I.L. (2016) A randomized controlled trial of a home-based training programme to decrease depression in family caregivers of persons with dementia. Journal of Advanced Nursing doi: 10.1111/jan.13157

Wednesday, 28 September 2016

The power of multiple perspectives: service user involvement enhanced research quality

Nina Helen Mjøsund, Monica Eriksson, Geir Arild Espnes, Mette Haaland-Øverby, Sven Liang Jensen, Irene Norheim, Solveig Helene Høymork Kjus, Inger-Lill Portaasen, Hege Forbech Vinje

Service user involvement enhanced the research quality in a study using interpretative phenomenological analysis – the power of multiple perspectives

Persons with mental illness and their family members possess experiences that when shared can become valuable contributions to nursing research and mental health research. Service user involvement is requested; however, evidence for its quality-enhancing potential in research needs to be examined. Our article emphasises this. In doing so, our envisioned impact is threefold:
  1. to encourage researchers to utilise this experiential knowledge
  2. to remind the health service users of the valuable knowledge they possess
  3. to positively influence attitudes towards patients with severe mental illness
We aimed to examine how service user involvement contributed to the development of interpretative phenomenological analysis methodology and enhanced research quality. Interpretative phenomenological analysis is a qualitative methodology used in health research internationally to understand human experiences that are essential to the participants. Included are some ideas about how to improve breadth and depth of findings when working on interpretation of texts.

We, service users and researchers, shared experiences from four years of collaboration (2012 – 2015) on a qualitative mental health promotion project. Five research advisors either with a diagnosis or related to a person with severe mental illness constituted the advisory team. They collaborated with the research fellow throughout the entire research process, and have co-authored this article. In the project we explored how twelve persons diagnosed with severe mental disorders and with experiences of in-patient care perceived positive mental health. In this article we have described and examined the joint process of analysing the empirical data from interviews. Our analytical discussions were audiotaped, transcribed and subsequently interpreted following the guidelines for good qualitative analysis in interpretative phenomenological analysis studies.

The advisory team became ‘the researcher’s helping hand’. The power of multiple perspectives came across in the interpretation of interview texts. Multiple perspectives gave more insightful interpretations of nuances, complexity, richness or ambiguity in the interviewed participants’ accounts. The interpretative element of interpretative phenomenological analysis was enhanced by the emergence of multiple perspectives in the analysis of the empirical data.

Our conclusion was that service user involvement improved the research quality in our project. We argue that service user involvement and interpretative phenomenological analysis methodology can mutually reinforce each other. The methodology has the potential to make service user involvement meaningful, creative and manageable. The methodology holds features that may benefit from service user involvement in terms of more breadth and depth, as well as validation of findings.

Our research contributes to the ongoing process of improving nursing and health research methodology. These findings should be of value to all qualitative researchers and especially for those who are required by funding bodies to involve service users in their research projects. Our experiences can be included in academic training of nurses and other health professionals as a way of advancing the methodological approaches in qualitative research. We hope this article can inspire nurses in clinical practice and service users to be aware of the synergy and the power of multiple perspectives when service users are brought into decision making in nursing and health care.


Mjøsund N.H., Eriksson M., Espnes G.A., Haaland-Øverby M., Jensen S.L., Norheim I., Kjus S.H.H.,Portaasen I.-L. & Vinje H.F. (2016) Service user involvement enhanced the research quality in a study using interpretative phenomenological analysis – the power of multiple perspectives. Journal of Advanced Nursing. doi: 10.1111/jan.13093

Wednesday, 14 September 2016

Drinking and pregnancy

Roger Watson, Editor-in-Chief

It is generally accepted that drinking alcohol during pregnancy is unwise due to the possibility of adverse consequences for the unborn baby.  This study from Scotland by Symon et al. (2016) titled: 'Peri-conceptual and mid-pregnancy drinking: a cross-sectional assessment in two Scottish health board areas using a 7-day Retrospective Diary' and published in JAN aimed: 'to evaluate the use of a 7-day Retrospective Diary to assess peri-conceptual and mid-pregnancy alcohol consumption.'

Over 500 women participated and, in the light of prevailing health warnings about drinking alcohol in pregnancy, the results are worrying.  As the authors explain: 'Over half the participants admitted to drinking above recommended daily limits at least occasionally in the peri-conceptual period; over a fifth did so weekly' and 'Twenty-eight women said they had drunk more than the recommended two units a day since finding out they were pregnant.' Saturday night was the most common night for drinking and: '196 women drank varying amounts of wine and 177 drank spirits. Six women admitted to drinking on their own peri-conceptually; one also said she drank on her own during pregnancy. All others said they only drank with family and/or friends.'

The authors concluded: 'We found some evidence to confirm the link between pre-pregnancy and pregnancy drinking reported in the wider literature, particularly when infrequent but heavy' and 'Existing alcohol screening instruments do not capture well the complexity of drinking patterns. As we found, some women engage in heavy episodic drinking without exceeding recommended weekly pre-pregnancy limits.'

You can listen to this as a podcast


SYMON A., RANKIN J., SINCLAIR H., BUTCHER G., BARCLAY K., GORDON R., MACDONALD M. & SMITH L. (2016) Peri-conceptual and mid-pregnancy drinking: a cross-sectional assessment in two Scottish health board areas using a 7-day Retrospective Diary. Journal of Advanced Nursing doi: 10.1111/jan.13112