The number of published nursing research papers has increased exponentially over the past 20 years, partly due to the pressures placed on academics by universities to ‘publish or perish’. Nursing research has become an end in itself, largely divorced from the aims of theory building and practice development, and research findings are accumulating at an alarming and unwieldy rate. This discussion paper explores some of the possible reasons for this shift in the focus of the academic role and calls for a return to scholarship and a far broader understanding of the purpose and practice of research as a form of intellectual craftsmanship. In order to gain a fuller and deeper understanding of the human condition and human suffering necessary for compassionate care, nurse researchers, practitioners and academics need to develop the ‘nursing imagination’ through reflective writing, collaborative inquiry, the arts, humanities, novels and poetry. We should be guided in our research according to the demands of nursing practice and patient care and work towards creating an academic discipline where our work is valued according to the good it does rather than simply responding to the demands of our higher education employers.
The ramifications of mental ill health are enduring and potentially disabling. This research study focuses on using art to explore children’s understanding and awareness of mental health issues.
To explore the medium of ‘drawing’ as a method of communication by young people for expressing feelings and thoughts about what keeps their minds strong and what makes them happy as children.
Arts-based research was used as a primary mode of inquiry to collect data and conduct analysis.
A total of 16 schools participated, with 10 from the primary school sector (children aged 5–11 years) and six from the post-primary sector (11 + to 18 years). A total of 358 posters were submitted.
Emergent themes suggested the existence of the awareness of stigma, which accompanied mental health issues and social isolation. In addition, perceptions of what makes children happy were also apparent, for example, family and friends. Similarities existed in the relationship between genders of a similar age group, and some differentiations presented between primary and post-primary educational sectors.
Arts-based research offers children an opportunity to recognise and express their feelings. Early identification of a child’s mental health problems may enable mental health nurses to engage in early intervention strategies to promote positive health functioning.
The aim of this study was to develop delirium care pathways (DCPs) useable and relevant for registered practitioners in all care settings: community; acute; and nursing homes. A qualitative approach was adopted to develop the pathways inductively. Focus groups and one-to-one interviews with registered practitioners (n = 45) working as managers, practitioners and clinical nurse consultants were undertaken to develop draft versions of the pathways, which was pilot trialled across 19 clinical settings. The publication of the DCPs was a concise and easily readable document for registered practitioners who required immediate guidance on how to implement evidence-based delirium care for older people and their family carers, including three patient journeys explaining best-practice delirium care in community, acute and nursing home care settings, a webpage resource and printable posters of the pathways' patient journeys to promote the use of the pathways in clinical settings. The work undertaken to develop the pathways was further developed through new policy documents, state-wide initiatives to improve delirium care in hospitals, development of educational resources on delirium care and other knowledge translation projects on this topic.
There have been few attempts to express in words and conceptualise ‘the Internet’ and ‘health’ within a framework. The aim of this study was to present a conceptual framework concerning virtual self-care and online caring. The results show that the concepts of virtual communities, virtual self-care and torrenting frame these very specific interactions and environments and that the concepts of ‘keyboard cowboy’ ‘cyber aid’ and ‘health-interests trader’ stipulate different ways in which to express expertise in cyber nursing. Alongside cyber bullying, cyber nursing is also present in virtual arenas. Nursing researchers need to explore and monitor cyber nursing activities using concepts developed within the field of nursing.
Female-perpetrated family violence is a difficult phenomenon to understand, as it does not easily conform to normative, gendered expectations of women. However, women can sometimes perpetrate family violence against their children and spouses. The aim of this study is to describe and make visible women’s experiences of perpetrating family violence. Nineteen women were interviewed about their experiences of perpetrating family violence. The data were analysed with an inductive content analysis and three categories emerged: the threat of losing the sense of self, acknowledging harming behaviour and challenges in obtaining help. These categories describe women’s conception of self, of their feminine identity and of gender role expectations in a family violence perpetrator context. If female-perpetrated family violence were acknowledged as a part of women’s behaviour this would reflect a shift in society’s notions of gender roles. Results of the study may be used by nurses when encountering women who have perpetrated family violence or in the development of nursing policies aimed at enhancing the wellbeing of the family.
Domestic abuse research can be emotionally challenging, particularly for qualitative researchers who are immersed in sensitive, and sometimes distressing, participant stories. Reflexivity is essential in sensitive research; however, researchers typically focus their reflexive efforts on how their own perspectives may have influenced the data, rather than how they may have been personally affected by the stories they analyse. In this paper, I reflect on how using poetry in domestic abuse research can help to increase researchers’ sensitivity to emotion, heighten their empathic responses to participants’ stories and promote reflexivity. The use of poetry has gained popularity and various poetic forms have been used to collect, analyse and present qualitative data. Using examples from a recently completed study on domestic abuse, I show how tanka poems can be developed from existing qualitative data to draw together researcher and participant perspectives within the same poem. Originating in 7th-century Japan, the tanka is a short, structured poem that conveys strong emotion and authentic voice. To date, tankas are underutilised in poetic inquiry research and, in sharing my own reflections, I advocate tanka poetry as a creative way of engaging with qualitative data and a useful means of reflexivity in domestic abuse research.
Domestic violence is prevalent and harmful for abused women and children and damages women’s capacity to maintain wellbeing and parent effectively. As women’s health is likely to be poor, greater identification and support by nurses for abused women is needed. The aim of this study is to highlight the importance of theory in nursing intervention research on domestic violence and how the application of implementation theory can be used to promote programme sustainability. In particular, we discuss the use of Normalization Process Theory (NPT) in the MOVE (improving maternal and child health care for vulnerable mothers) study, a randomised controlled trial which aimed to increase nurse inquiry, safety planning and referral of abused women. NPT was used in the participatory action research and design stage of the trial, in the implementation and process evaluation phases. In conclusion, the use of implementation theory in nursing research can enhance the uptake of complex interventions, address the knowledge–practice gap and potentially improve outcomes for women experiencing domestic violence.
This study explored women’s experiences of being screened for intimate partner violence and receiving an intervention during perinatal home visits in urban and rural settings in the USA. Twenty-six women were recruited from the DOVE (Domestic Violence Enhanced Home Visit) intervention trial to participate in a nested qualitative interpretive study. Women valued the opportunity to discuss their intimate partner violence experiences and access support. Disclosure was a staged process and home visitor communication style and the development of a trusting relationship were influencing factors. Safety planning was an important feature of the DOVE intervention, whether the abuse was past or ongoing. Women highlighted the need for post-abuse support services. Perinatal home visitors require training in intimate partner violence that supports the development of good communication skills and provides opportunities for experiential learning and feedback with regards to asking about and responding to intimate partner violence. Reinforcement training activities are necessary in order to enhance home visitor’s confidence and comfort, and sustain practice. Rigorous protocols are needed to ensure the safety of home visitors and women.
Rising rates of obesity are becoming a major problem in the Western world, with multiple implications for individuals’ health and also health service resources. Physical activity can positively influence weight loss and weight loss maintenance; however, levels are low among obese individuals. The aim of this study was to identify the barriers faced by obese individuals which prevent them from engaging with physical activity. A rapid evidence assessment was undertaken based on the framework provided by Bettany-Saltikov. Studies were identified from an electronic database search using key words, reference list search and manual searching of current journal issues. Identified studies were screened for relevance, appraised for quality and relevant data were extracted in order to identify themes for five qualitative and one mixed methods. Several barriers were identified relating to three main themes: physical, psychological and external barriers. Due to the variety of barriers faced by obese individuals it is important to treat each person as an individual and identify the barriers perceived by them, in order to provide targeted support to overcome these barriers.
The aim of this study was to investigate patients’ perceptions and preferences of their participation in nursing care during hospitalisation in Greece. The sample consisted of medical and surgical patients (n = 300). A questionnaire was developed to measure patients’ perception of participation, including an open question and the control preference scale. Descriptive and inferential statistics were used for quantitative data analysis and content analysis for qualitative data. Participation was described as ‘information receiving and responsibility’ and ‘ability to influence’. One-third of the respondents preferred a collaborative role with the nurses, while 77.2% rationalised patient participation with the themes ‘strengthening patient’s role’, ‘improve hospitalisation’ and ‘collaborative relationship’. The meaning of participation seems to support shared information, patient responsibility and motivation during nursing care. Patients were aware of the positive effects of their involvement in care and were willing to assume, at least to some extent, an active role in their own care. Changes in nursing care organisation, nurses’ communication skills and additional educational strategies need to be developed and implemented in clinical practice to optimise patient participation.
This discussion paper argues for understanding nursing care as a commodity within capitalist relations of production, ultimately as a product of labour, whose use value far exceeds its exchange value and price. This under-recognised commodification of care work obscures the social relationships involved in the contribution to the social reproduction of labour and to capital accumulation by nursing care work. This matters, because many care workers give of themselves and their unpaid overtime to provide care as if in a ‘gift economy’, but in doing so find themselves in subordinate subject positions as a part of the social reproduction of labour in a ‘commodity economy’. Thus they are caught in the contradiction between the ‘appearance’ and reality. A focus on the individual moral character of nurses (e.g. the UK’s 6Cs), may operate as a screen deflecting understanding of the reality of the lived experiences of thousands of care workers and supports the discourse of ‘care as a gift’. The commodification of care work also undermines social reproduction itself. Many nurses will not have tools of analysis to critique their subject positioning by power elites and have thus been largely ineffectual in creating change to the neoliberalist and managerialist contexts that characterise many healthcare and other public sector organisations. The implications of this analysis for healthcare policy and nursing practice is the need for a critical praxis (an ‘action nursing’) by nurses and nursing bodies, along with their allies, which may include patient groups, to put care in all its guises and consequences central to the political agenda.
Conditions for nurses’ daily patient education work are unclear and require clarification. The aim was to develop and validate the Nurses’ Patient Education Questionnaire, a questionnaire that assesses nurses’ perceptions of appropriate conditions for patient education work: what nurses say they actually do and what they think about what they do. The questionnaire was developed from a literature review, resulting in the development of five domains. This was followed by ‘cognitive interviewing’ with 14 nurses and dialogue with 5 pedagogical experts. The five domains were identified as significant for assessing nurses’ beliefs and knowledge; education environment; health care organisation; interdisciplinary cooperation and collegial teamwork; and patient education activities. A content validity index was used for agreement of relevance and consensus of items by nurses (n = 10). The total number of items in the final questionnaire is 60, consisting of demographic items, what nurses report they do and perceptions about patient education in daily work. The questionnaire can be used by managers and nurses to identify possibilities and barriers to patient education in different care contexts.
The purpose of this study was to explore the effects of music relaxation video on pain severity, opioid utilisation, and anxiety experienced by women with gynaecological cancer undergoing intracavitary brachytherapy. A two-group randomised controlled trial was conducted in an academic comprehensive cancer centre. Sixty women were randomly assigned to either an experimental group (n = 31) that watched a 30-minute music relaxation video four times (total 120 minutes) or a control group (n = 29) that received standard nursing care during the first 44 hours of the intracavitary brachytherapy. Data were collected to evaluate the effects on pain severity, opioid utilisation and anxiety between groups. Pain scores were measured before and after patients watched the 30-minute music relaxation video and anxiety scores were measured following the video. The amount of opioid consumption was recorded during the 44-hour treatment. Data were tested using ANOVA and t-test. Perceived pain reduction was statistically significant in the experimental group (p = 0.027), but this did not translate into lower total consumption of opioids between the two study groups. Anxiety level reduction was statistically significant in the experimental group (p = 0.001). Music relaxation videos hold promise to be used in conjunction with standard pharmacologic therapy to reduce perceived pain and anxiety levels during the treatments.
To establish the drivers for smoke-free homes among current daily smokers.
A cross-sectional study employing interviews (adults) and self-completed surveys (schoolchildren).
Children aged 12 and 14 in schools in four cities in China, India, Mexico and England. Adults in the community.
Knowledge, attitude, beliefs and behaviour relevant to second-hand smoke in home.
None.
A total of 8994 adults and 14,756 children were surveyed. Knowledge of some of the effects of tobacco is high, but other effects are poorly understood in all cities. In Thiruvananthapuram, there is a lack of awareness of the addictiveness of tobacco, and Hangzhou has poor knowledge in general.
Messages about reducing tobacco usage are effective in support of smoke-free homes in the city with poorest knowledge (Hangzhou) but other factors are more important where knowledge is high.
The purpose of this study was to test a hypothesised model linking perceptions of workplace empowerment and psychological capital (PsyCap) to new graduate nurses’ work engagement by integrating theories of empowerment, PsyCap and work engagement. In response to the nursing shortage, efforts are needed to retain nurses by creating empowering work environments that leverage employee PsyCap to foster work engagement. A secondary analysis of data (n = 205) from a study by Laschinger et al. (2012) was conducted to test the hypothesised model. Hierarchical multiple linear regression analysis was used to test the influence of empowerment and psychological capital on new graduate nurses’ work engagement. Measures of structural empowerment (Conditions of Work Effectiveness Questionnaire-II), PsyCap (Psychological Capital Questionnaire) and work engagement (Utrecht Work Engagement Scale) were used. The hypothesised model was supported. The combined effect of workplace empowerment and PsyCap explained 38% of the variance in new nurses’ work engagement. Workplace empowerment and PsyCap were significant independent predictors of work engagement (β = 0.45 and 0.36, p < 0.05, respectively). The results suggest that the combination of personal and organisational resources is related to greater work engagement among new graduate nurses.
The purpose of this cross-sectional study was to identify the stressors and the level of stress as perceived by hospitalised Syrian patients of intensive care units (ICUs). A convenience sample of 150 Syrians who were hospitalised in ICUs located in the Syrian capital, Damascus, were chosen as study participants and were interviewed using a structured interview guide of the Intensive Care Units Environmental Stressors Scale (ICUESS). The findings revealed that physical stressors were perceived as the most stressful ones, whereas psychological stressors were the least stressful. These findings are congruent with the majority of similarly available regional and international literature. It was also statistically noticed that participants with a higher level of education and income were more sensitive in perceiving the stressors than those who had a lower level of education and income. The findings suggested that nurses must utilise effective measures in ICUs to relieve patients' pain and provide a humane ICU environment and atmosphere in which rest is enabled. In conclusion, decreasing the stress level has a positive impact on patients' health outcomes, where adequate attention to patients' physical and psychological domains should equally be considered.
The use of peer teaching has been recognised as a valuable teaching and learning strategy in higher education. It has been used in nursing as an adjunct to lectures and to support learning in clinical practice. Despite a developing literature there is limited understanding of its use for teaching about research. This educational project aimed to increase understanding of the effects of peer teaching of research in an undergraduate nursing programme. A convenience sample of 151 third year student ‘learners’ were recruited from three campuses across a School of Nursing, Midwifery and Health in Scotland. Students were asked to complete a questionnaire evaluating nine peer teaching sessions delivered by seven separate peer ‘tutor’ presenters, i.e. honours students (two students repeated their presentations). Five peer ‘tutors’ participated in a focus group to discuss their experience of teaching and personal learning. Results indicated that the student learners’ understanding of research and its relevance to clinical practice had been enhanced. These findings resonated with the peer ‘tutors’ intentions of helping other students to make that connection through the presentation of their work. In conclusion, peer teaching of research helped undergraduate nursing students learn about research and it assisted the peer ‘tutors’ to consolidate their learning, develop teaching skills and confidence.
Prostate cancer survivors are keen to engage as active partners in the management of their condition but have voiced a number of unmet support needs that make effective self-management problematic. Identifying self-management behaviours and evaluating how self-management changes over time may provide valuable insights into how men can be better supported to self-manage. Our systematic review aimed to identify the self-management behaviours for prostate cancer survivors and to evaluate whether these change over time.
Using the PRISMA statement we performed a systematic review of studies that identified the self-management behaviours of prostate cancer survivors. Databases searched included: DARE, CDSR, Medline, CINAHL, PsycINFO and ASSIA. Studies were classified by levels of evidence and quality assessment.
111 publications were retrieved from the search and 5 publications were included. Men performed a variety of self-management behaviours for psychological and physical problems. Only one study assessed changes in self-management behaviours over time and was limited to men treated by radiotherapy.
Despite the recent political drive for cancer survivors to self-manage, this review has demonstrated the evidence base is under-developed and a wide range of research is needed to address the unmet supportive care needs of prostate cancer survivors. Practically, this review has identified that Dodd’s Self-Care Log was found to have the strongest psychometric properties for additional research in this area.
The major purpose of this study was to describe gender-related cognitive representations of symptoms of acute coronary syndrome and coping responses to the symptoms as correlates to pre-hospital delay. Data were collected from 131 hospitalised Omani patients for acute coronary syndrome (81 men and 50 women) using a structured interview. Statistical analyses indicated that women perceived themselves as less susceptible to acute coronary syndrome than men. They reported the symptoms, shortness of breath and nausea/vomiting, more frequently than did men. Men who reported shorter pre-hospital delay were more likely to be free from diabetes, report neck pain, not experience left arm pain, attribute the symptoms to cardiac origin and not use the coping responses, ‘wait and see’ and ‘attempted to relax’. Whereas, women with shorter pre-hospital delay were more likely to experience sweating, perceive greater overall intensity of the symptoms and not report fear of diagnostic procedures as a barrier to seek healthcare early. The findings of this study suggest that, in women, the emotional aspect of the symptoms dominates the cognitive appraisal process, whereas the pathological aspect of the symptoms dominates the appraisal process in men.
Aim: To investigate the effect of a randomised controlled trial of a nurse-led structured educational programme compared to standard care on patient knowledge when starting anticoagulant therapy with warfarin.
Methods: 45 patients commencing warfarin during an inpatient admission were randomised into either a control group receiving ‘usual’ care, or an experimental group with structured counselling and provision of an educational video. Identical questionnaires assessing knowledge of anticoagulation therapy were applied at discharge and again 3 months later.
Results: Patients receiving a structured educational approach had significantly better knowledge about their therapy both at hospital discharge and at 3 months post discharge (p=<0.001 and p=0.038 respectively). Secondary outcomes measured also showed a higher level of patient satisfaction (p=0.017) and time in target INR range (56.7% versus 48.1%) in the educational arm.
Conclusions: A formal and structured nurse-led educational package at the initiation of anticoagulant treatment with warfarin treatment improves patient knowledge.
Identifying indicators on predominant types of coping with breathlessness may facilitate the possibility for qualified individualised advice on how to live with breathing difficulties. This paper reports the statistical findings on several parameters constituting possible coping-type-specific indicators with the ability to discriminate between four previously identified types of coping with breathlessness. Data were collected from 12 patients with moderate to very severe chronic obstructive pulmonary disease (COPD) in relation to body care during hospital stay and at home. Data consisted of: (a) Bedside forced expiratory volume in 1 s of predicted; (b) scores on the Modified Borg Scale; (c) respiratory rate; (d) peripheral oxygen saturation and (e) use of breaks from activity and break time duration. We found that the following parameters were able to discriminate between the four coping types: COPD severity, intensity of breathlessness, respiratory rate, level of oxygen saturation and the patients’ use of breaks. These findings should be further tested.
This paper seeks to highlight the challenges facing researchers when recruiting vulnerable patients to a research study. We explore the difficulties experienced in gatekeeping for a project involving people with dementia, intellectual disabilities and mental health problems who are also having treatment for cancer. It is argued that the challenges in identifying and recruiting vulnerable participants extend beyond ethics committees and governance to the perceptions and judgements of health care professionals in ‘allowing’ access to particular patient groups. These positions and judgements appear to be embedded in certain construction(s) of cancer and discourses surrounding dementia, intellectual disabilities and mental health.
The study aimed to clarify the notion of patient-centred professionalism through consultation with the public, stakeholders and professionals in order to develop a thematic template within nursing. The paper also examines innovative methodology informing eight template themes developed qualitatively. Patient-centred professionalism has had little coverage in nursing literature, whilst ‘patient-centredness’ is supporting patients through holistic care according to needs and expectations. The study took place in Wales, UK, between October 2009 and September 2010. Data collection entailed consultation workshops with newly qualifying nurses (13 participants), community nurses (nine participants), nursing stakeholders (six participants) and the public (six participants). Analysis involved summative and thematic approaches. Result were revealed through template themes, identified in rank order of significance: the patient, nursing ethos, community nurse as a person, knowledge and skills, working relationships, service delivery, training and information and environment. The patient comes first for nurses and was the major theme of the analysis. This almost goes without saying for nurses, whilst for patients this is a surprise, as they see themselves as marginalised. The patient in patient-centred professionalism has multiple identities, many of which contradict one another – recipient and object of care, a force of resistance and a focus of negotiation. In conclusion, a clearer understanding of the concept should play a central role in policy development for optimal care, informing education and training, and methodological strengths could be explored further by other researchers, across a wide range of contexts.
Aim: This paper reports a study that explored the experience of people living with chronic illness among a group of Irish patients.
Background: Chronic conditions affect the lives of millions of people around the world. Understanding their experience and how they cope with chronic illness can help nurses develop appropriate plans for their patients. To date no study on the experience of chronic illness in Ireland was found.
Design: A qualitative descriptive design using focus group interviews was used in this study.
Method: Two focus group interviews with a convenient sample of 19 people with chronic illness were carried out and data collection took place in 2008.
Findings/results: Although the participants’ chronic conditions were varied, a number of common themes were evident from their narratives. These were: ‘a sense of loss’, ‘feelings of anger and frustration’, ‘uncertainty and stress’ and ‘adapting to a new life’. Financial loss and the fragmented nature of health care for people with chronic illness were particularly felt by this group of Irish participants.
Conclusion: It was clear that chronic illness affected their physical, psychological and social lives. They identified a number of personal losses, but felt strongly that they had to continue to make changes in their lives as they struggled to adapt to a new life. The contribution of partners and family members were crucial in this process of adaptation. Service providers need to assess the extent to which their services meet the needs of people with chronic illness in an integrated way.
Many patients experience sleep disturbances and a reduced quality of sleep while hospitalised. Studies have shown that a person with a disease and/or a bodily injury has an increased need for sleep. Patients' experiences of sleep should govern how sleep disturbances should be managed. It is thus necessary to focus upon and describe patients’ needs and experiences. The aim of this study was to explore and describe patients’ experiences of sleeping in hospital. This study is based on qualitative semi-structured interviews with 10 consecutively included patients. The interviews were conducted between October 2010 and March 2011 and were audio recorded and transcribed verbatim. Collected data were analysed by qualitative content analysis. The participants reported physical and psychological experiences that had affected their sleep. Their experiences were categorised using four themes: bedside manner, physical factors, being involved and integrity. Patients considered that experiencing some degree of control, feeling involved and preserving one’s integrity affect sleep during hospitalisation. Several factors have an impact on patients’ sleep. It is not only physical factors but also psychological factors such as bedside manner and having the opportunity to influence and be involved. The patients’ accounts provide a new perspective and open the door to changes in nursing care regarding patients’ sleep.
Nurse conflict has numerous detrimental outcomes for healthcare organisations, patients and nurses themselves. Although past literature has advanced general understanding of conflict and aggression, much of it is limited in its explanation of negative interactions between nurses themselves. To address this, we used a mixed-method approach to identify and describe characteristics of conflict between nurses using content analysis of qualitative descriptions and associated quantitative ratings from practicing registered nurses over 12 weeks of a weekly work experience survey administered online. We found six reliable themes describing the nature of nurse conflict including such characteristics as feeling unfairly treated, others’ irresponsible behaviours and work disagreement. Conflicts containing perceived unfair treatment as well as negative emotion and rude behaviour between nurses were rated very negatively. Results suggest that a comprehensive workplace conflict prevention strategy should include multiple types of policies tailored to address each aspect of nurse conflict. Our findings reinforce the idea that healthcare organisations seeking to reduce nurse conflict should pay attention to promoting fair and courteous treatment among nurses as well as adopt policies to improve features of the work environment such as staffing and training.
The recognition and treatment of paediatric pain in sub-Saharan Africa brings many challenges and barriers for health professionals to overcome. This paper aims to give a unique insight into the world of the health professional through a dynamic cycle of interpretation via Interpretative Phenomenological Analysis. In-depth interviews with six health professionals were conducted and revealed four main themes: a burden-filled workload, mythology, lack of education and pharmacology. Findings showed how working in this field affects health professionals personally; the task of treating children who suffer unnecessary pain is emotive and potentially damaging. The way in which parents, health professionals and children view pain in terms of their everyday existence and within the context of their culture seems fundamental to gaining a better understanding of the barriers to providing pain relief to children in sub-Saharan Africa.
The well-established Institute of Medicine report entitled To Err is Human: Building a Safer Health System highlighted the importance of preventative errors in medicine, suggesting interruptions are a contributing factor. Patient safety organisations, such as The Joint Commission, acknowledge that interruptions contribute to preventable medical errors. The aim of this research is to examine the most frequently observed interruptions experienced by nurses administering medications and evaluate an intervention designed to reduce those interruptions. The primary intervention consisted of a White Vest worn during administration stating: ‘Please do not interrupt while passing medications’. A quasi-experimental design was employed. Nurses were observed for 2 weeks during routine administration of morning medications. The vest was then introduced and worn during administration for 2 weeks for post-intervention data collection. The hospital unit, date, time, duration, and description of the interruption were recorded. Data collection was conducted in four hospital units sequentially. A content analysis revealed the most frequently observed interruptions were comments/questions by hospital staff, phone calls, and seeking supplies. As hypothesised, the overall number of interruptions during medication administration (MA) declined after implementation of the intervention. This study illustrates implications and policy changes with regards to nursing practices and MA.
Delay seeking medical assistance for ischemic stroke symptoms is common worldwide, yet existing literature does not provide an adequate understanding of experiences at stroke onset. An explanatory narrative inquiry using a holistic-content approach to data was conducted to gain understanding of women’s experiences between symptom onset and hospital arrival. A holistic-content analysis retains the temporal dimension of each individual’s story so that the parts within the story are interpreted in relation to other parts of the story and the outcome of the story. The aim of this paper is to present the procedures for holistic-content analysis, address the trustworthiness of this form of narrative analysis and appraise the utility and limitations of the approach. It was concluded that holistic-content analysis is congruent with the philosophical underpinnings of narrative methodology and it is well suited to examine phenomenon that have a strong temporal dimension. The use of this approach alone to narrative data does not enable researchers to draw naturalistic generalisations and a structured comparison of the narrative accounts resulting from a holistic-content analysis is needed to identify similar and dissimilar characteristics of participants’ experiences.
Background: There has been a long-standing debate over the definition and nature of the quality of healthcare and factors that influence and enhance quality. Within nursing, the challenge is to identify the outcomes that are measurable and amenable to change as a result of nursing care. Arising originally from concerns over potential nurse staffing shortages and nurse retention within the United States, an extensive literature has developed in the acute sector, exploring nurse staffing and its consequences. All of these studies raise the generic question of what potential causal mechanisms might link nurse staffing levels and skill mix to issues of patient safety and outcome.
Objectives: To generate a tentative logic model to understand existing findings and to elucidate possible ways in which nurse staffing and skill mix may affect patient and nurse outcomes.
Methods: This study was grounded within the principles of realist evaluation, realist review and logic modelling. The existing literature was reviewed to bring to light the underlying rationale suggested by the authors of this study on how nursing care might affect patient outcomes. A step-by-step process was followed to demonstrate the generation of a tentative logic model of how nurse staffing might influence patient, and nursing, outcomes.
Results: The final logic model depicts staffing adequacy as having a complex link with patient outcomes. This is mediated at a general level through factors in the process of care (for example, nurse surveillance, clinical judgement, level of education, level of nurse training and length of nursing experience) and tasks left undone. These operate in conjunction with working with other nurses who are clinically competent, having good nurse–physician relationships and communication, supportive nurse manager/supervisor and good teamwork.
Conclusions: This study extends the understanding of the mechanisms through which nurse staffing levels may result in adverse patient outcomes in the acute sector. Key intervening variables are the application of nurse intuition, operation of clinical judgement and missed nursing care/tasks left undone. The tentative logic model can be used to draw up areas and hypotheses to guide the direction of future research and to aid interpretation of existing research.
The purpose of this paper is to describe, and reflect upon, a number of methods deployed to facilitate sick children to have a voice within an acute health care setting. Using an ethnographic approach to investigate the nature of communication between children and health professionals, multiple modes of data collection were employed to engage children's interest, motivation and facilitate child empowerment in the process. The simultaneous use of semi-participant observations, informal interviews and participatory activities ensured that the diverse abilities, interests and preferences of children were acknowledged. Multiple data sources permitted the portrayal of a comprehensive picture which we believe enhanced the trustworthiness of the data. However, as with all data collection methods, researchers need to be critically aware of strengths and weaknesses and these will be reflected upon. Ultimately, it was crucial to use participatory activities in context and have continuous dialogue with the participating children. The goal was to achieve a balance between creative instruments and commonplace conversation. We believe the unstructured and flexible approach, and variety of data collection methods, utilised in our study enhanced its accuracy, truthfulness and reduced the subjectivity of children's responses. In sharing our experiences, we endeavour to assist other researchers in conducting research with children.
Aim: This paper is a report of a study of conflict management styles used by nurses in Jordan.
Background: There are five main styles used to deal with conflict. At present research into their utilisation is dominated by reports from Western countries. This research is the second to investigate their use by nurses in an Arab country and it illustrates similarities with the earlier work, allowing an initial profile to be constructed which may be applicable to the larger Arab world of healthcare.
Methods: Cross-sectional quantitative survey of nurses in Jordan using the Rahim Organisation Conflict Inventory (ROCI II) questionnaire.
Results/Findings: The nurses were most likely to prefer an integrating style of conflict management, followed in rank order by compromising, obliging, dominating and avoiding.
Conclusion: A tentative model of the styles which nurses in Arab countries prefer to manage conflict is proposed, which suggests that they are likely to provide stable workplaces.
This research identifies the views of senior community nurses (Grade 7, often known as District Nurse Team Leaders) in relation to the different service descriptions of pressure ulcer preventative care for older people. The discrete choice experiment (DCE) approach was employed. Scenarios were developed based on: ease of treatment management, impact of treatment on patient lifestyle, affordability of treatment, strength of current evidence and speed for obtaining the equipment. These scenarios were identified from focus discussions and incorporated into a self-administered questionnaire. This questionnaire was posted to 124 nurses in Wales, UK and regression analysis was applied to 85 consistent responses. The results demonstrate that the most preferred treatments are affordable, evidence-based and manageable, and use readily obtainable equipment. The impact of treatment was not significant for this experiment. The usefulness of the DCE approach in the nursing context is discussed in relation to this study.
This descriptive correlational study was conducted to identify perceived parental needs of critically ill infants in Neonatal Intensive Care Units (NICUs). Jordanian parents who were visiting their infants admitted in NICU (N = 170) composed the study sample. Participants completed the demographic data sheet and the NICU Family Needs Inventory. Findings showed that parents ranked assurance, information and proximity as the most important needs, while comfort and support were ranked the lowest. The primary concern of parents was to be assured and informed about the progress of their infant. In addition, the results indicated that the mother’s perceived needs for support, information and proximity were significantly more important than the father's. Accordingly, nurses should establish a rapport with family members and provide them with understandable and honest information. Furthermore, the provision of quality, holistic, family-centered nursing care that relies primarily on early and comprehensive needs assessment, which correlates with infants’ outcomes, is imperative.
Coping with breathlessness is a complex and multidimensional challenge for people with chronic obstructive pulmonary disease (COPD) and involves interacting physiological, cognitive, affective, and psychosocial dimensions. The aim of this study was to explore how people with moderate to most severe COPD predominantly cope with breathlessness during daily living. We chose a multi-modal grounded theory design that holds the opportunity to combine qualitative and quantitative data to capture and explain the multidimensional coping behaviour among people with COPD. The participants’ main concern in coping with breathlessness appeared to be an endless striving to economise on resources in an effort to preserve their integrity. In this integrity-preserving process, four predominant coping types emerged and were labelled: ‘Overrater’, ‘Challenger’, ‘Underrater’, and ‘Leveller’. Each coping type comprised distinctive physiological, cognitive, affective and psychosocial features constituting coping-type-specific indicators.
In theory, four predominant coping types with distinct physiological, cognitive, affective and psychosocial properties are observed among people with COPD. The four coping types seem to constitute a coping trajectory. This hypothesis should be further tested in a longitudinal study.
The aim of this study is to assess the prevalence of pediculosis capitis in one district in Jordan, and to determine the knowledge, attitudes and practices of parents/guardians regarding head lice. The study was performed in Jordan’s Umm el-Jimal district from February 2010 to May 2010, and involved the surveying of 105 randomly selected households containing a total of 213 children. The households’ parents were interviewed for their knowledge, attitudes and practices regarding pediculosis, and afterward their children’s hair was checked for head lice via a 5-min visual scalp examination. Chi-square testing was used to analyse the data, with statistical significance assumed at p < 0.05. The prevalence rate of pediculosis among the 213 children was found to be 14.6%. Parental knowledge of head lice was found to be very limited; only 35.2% of the parents/guardians correctly answered 10 of the 20 questions (50%), and only 17.1% correctly answered 14 questions (70%). More than 94% of the parents reported feeling shame upon learning that their children were infested with pediculosis, and nearly 90% felt too ashamed to ask for help from a healthcare provider. Many parents used traditional/local techniques that they believed to be effective in managing pediculosis; 61% of the parents applied kerosene to the scalps of infested individuals, 39.9% used medical shampoo and 37.6% used special combs. There is a clear deficiency in Jordanian parents’ knowledge of, and practices concerning, pediculosis capitis. It is recommended that the Jordanian Ministry of Health and local health departments work together to ensure the dissemination of accurate and consistent head lice information to families.
Aim: This paper is a report of a study of the ongoing support needs of individuals with long-term conditions who have attended self-management programmes.
Background: Clinical research and policy developments have placed increased emphasis on self-management as a strategy for dealing with people with long-term conditions. These strategies have focused on a range of different interventions of which self-management programmes are one. Such programmes are often time limited, highly structured courses, which have been widely researched and shown to be effective. However, what happens to individuals after they have attended these programmes and what their ongoing support needs are, has received less attention.
Methods: An exploratory qualitative design using focus groups and telephone interviews was used to collect data. The sample consisted of 24 participants. Telephone interviews were offered to all participants to follow up on themes from the focus groups. In total three people participated in these. The data were collected between May and July 2011 and analysed using thematic content analysis.
Findings: Five themes were identified: (1) accessibility, (2) companionship, (3) being and feeling valued, (4) empowerment, and (5) the limits of the medical model.
Conclusion: To facilitate self-management, healthcare professionals need to understand the value of peer-to-peer interaction. Healthcare practitioners, as well as those who organise and deliver self-management programmes have an important role in signposting people with long-term conditions to services within local communities which can offer ongoing support.
Aim: This paper reports on the development, implementation and evaluation of the Alcohol Intervention Training Program (AITP) designed to enhance nurses’ capacity to work with farming men and women who misuse alcohol.
Background: In rural and regional areas where alcohol-related behaviours and problems are relatively elevated, nurses may be the key health professionals dealing with individuals who misuse alcohol. However, they are often ill-equipped to do this, have low confidence in their ability to do so, and perceive numerous barriers. Training is required for these nurses.
Methods: We developed the AITP to enhance nurses’ capacity to work with people with alcohol-related problems. The data were collected during 2010. An intervention group of 15 rural nurses completed the AITP. Nurses’ perceived barriers, attitudes, and perceived performance in working with clients with alcohol problems, and the frequency of engaging with this client group were evaluated. Scores on these measures were compared to those of a control group of 17 nurses’ pre-treatment, post-treatment and at 3-month follow-up.
Results: Participation in the AITP resulted in initial improvements in attitudes to working with alcohol problems, but no change in perceived barriers to doing so. The level of engagement with clients having alcohol-related problems increased, as did perceptions of work performance.
Conclusion: The AITP enhances the ability of rural nurses to address the alcohol and associated health issues of clients in rural and regional areas. However, the program needs refinement and further evaluation.
The purpose of this study was to examine the significance of cognitive representations of symptoms of acute coronary syndrome (ACS) and coping responses to the symptoms, as elements of a consequential process of health care seeking behaviours, in predicting prehospital delay. Data about prehospital delay, cognitive representations and coping responses were obtained from 112 Omani patients hospitalised for acute coronary syndrome during a 6-month period using an interview technique. Indicators of cognitive representations of symptoms of ACS and coping responses to the symptoms significantly explained 42% of the variance in prehospital delay. Shorter prehospital delay was more likely among patients who reported greater chest pain intensity, sweating, persistent symptoms with greater overall intensity, did not perceive fear of being diagnosed with a dangerous disease as a barrier to seek care early, used ‘asked someone to take me to the hospital’ but not ‘attempted to relax’ coping responses. Indicators of cognitive representations of ACS symptoms, as well as coping responses to the symptoms significantly predicted prehospital delay. Educative-counseling programs to shorten prehospital delay should focus on informing individuals at high risk for acute coronary syndrome skills necessary to promote adaptive coping as well as accurate interpretation of the symptoms.
Aims: This paper compares the results of two studies conducted by the same researcher into the attributes and characteristics of clinical leaders.
Background: The two studies used an almost identical questionnaire; however, they were conducted 6 years apart, in different counties, with different health care staff (nurses and paramedics), made up of very different gender ratios. The initial study was larger and focused on more than describing clinical leader attributes; however, this was the principle focus of the second study.
Findings: The findings from both studies offer very similar results and describe clear insights into the attributes health professionals seek in clinical leaders. The research findings are remarkably similar given the differences in professional group, gender variations, country differences and time span.
Conclusions: Leaders are followed because there is a match between the leaders values and beliefs and their actions. People identify with the leaders values and follow them if they are reflected in the leaders’ actions. Clinical leader characteristics are approachability, clinical competence, being supportive, acting as mentors or role models, being visible in practice, directing and helping people, inspiring confidence, having effective communication skills and behaving with integrity. Vision and creativity were less evidently sought or identified as a clinical leader characteristic.
The manual handling of people and objects is integral to the provision of nursing care to patients globally. Despite over 30 years of research intended to guide improvements for nurses’ safety, substantial rates of manual handling injuries persist internationally within the nursing profession. This paper reviews the contemporary international literature regarding manual handling interventions noting the unique context for injury prevention strategies within healthcare. The review includes the recognition of underlying assumptions inherent in the conceptualisation of manual handling and its management, and the preponderance of the post-positivist paradigm in this field.
The complexity of manual handling in healthcare has resulted in a theoretical shift from single factor interventions based on technique training towards an emerging multidimensional approach. However the key elements for sustainable solutions to reduce nurses’ manual handling injuries have not yet been identified and consensus is lacking regarding the implementation and appropriate evaluation of injury prevention programmes. Furthermore, whilst the literature is replete with data derived from surveys or insurance industry records of compensation claims, there is a dearth of literature exploring nurses’ manual handling experiences. The in-depth investigation of nurses’ perspectives on manual handling may uncover new knowledge critical to improvement of the manual handling issues.
The primary purpose of this study was to identify Jordanian nurses’ perceptions of their roles toward the families of hospitalised critically ill patients. Second, to examine the relationship between nurses’ role expectations and perceived role performance toward the families of hospitalised critically ill patients. A descriptive, correlational design was used. A convenience sample of 127 intensive care unit (ICU) nurses was recruited from ICUs located in four different hospitals in Jordan. Data were collected using a demographic data form, a Role Performance Subscale with 19 items and a Role Expectation Subscale with 14 items. Results indicated that Jordanian ICU nurses expected and performed interventions that required more time, emotion and communication skills less than interventions that required less time, emotion and communication skills.
It is claimed that the involvement of mental health service users in research remains fragmented, and expertise in involving service users is still developing. This paper explains how a group of mental health service users and carers formed a Research Development Group in Wales. This is a process paper which describes how the group was established and funded as part of the United Kingdom Clinical Research Networks. It explores the rationale for a Mental Health Service User and Carer Partnership Research Development Group and the challenges experienced in setting up the group, including activities such as a current research project. This project involves collaboration between group members and nurses from a local National Health Service Trust, which is helping to build research capacity. This project is used to illustrate the issues raised, and we provide critical reflections of this process. The power balances that posed challenges to a group of this type are explored and ways to overcome them are suggested. The research group is still in its infancy but has aspirations to move from being a user involvement group to a user-led group incorporating the differing viewpoints and promoting an equal contribution from its members.
Assessing mothers’ knowledge and practices in managing minor illness is very important in order to ensure safe and effective ways of managing minor illnesses and decrease complications and hospitalisation. The aims of this study were to explore mothers' knowledge and practices of managing minor illnesses of children under the age of five and the association between socio-demographic variables of the mothers and their knowledge and practices of managing minor illnesses. This study used a cross-sectional survey design. The survey included true or false knowledge questions related to management of minor illness and related symptoms in children including fever (12 questions), upper respiratory tract infection (seven questions) and diarrhoea (nine questions). Data were analysed by calculating frequencies, distribution, and where appropriate running bivariate correlations and t-tests to determine if significant associations existed between maternal demographic variables and level of knowledge. Findings: A total of 348 mothers who visited the comprehensive health centres in Irbid, Jordan agreed to participate in the study. The mean number of questions answered correctly about fever management was 8.6 (SD = 1.7). The mean score for management of URTI was 4.9 (SD = 1.4) and for diarrhoea was 6.4 (SD = 1.2). There was a significant positive association between the mother’s age, household income, mother’s level of education, and number of children, with knowledge and practices of fever and/or upper respiratory tract infection, p < .05. Nurses and other health care providers could play a significant role in educating women in how to manage their children's minor illnesses.
Many nurse-researchers have considered the question of whether to ‘help out’ with clinical work while undertaking fieldwork. In this study, the nurse-researcher did not ‘help out’ and also positioned herself in an unassuming way. This produced some striking responses from nurse-participants. During the handover she became ‘one of us’ nurses, however, at the bedside the nurses struggled to designate her. Sitting on their group border, they worked either to bring her back into the group as ‘one of us’ or push her off the border to become ‘one of them’. Either way, they moved quickly to categorise this unknown presence in their midst. This categorisation, we argue, was a discursive formation in response to anxiety and illustrates how anxiety continues to function as an organising principle in nursing. The findings have implications for nurse-researchers undertaking fieldwork with hospital nurses, in relation to the question of their position in the field.
Objective: To investigate the longitudinal effectiveness of a brief eating disorder training on primary care providers’ self-perceived knowledge, skills and attitudes regarding eating disorder screening and intervention.
Method: We trained 45 primary care providers (including nurses, nurse practitioners and physicians) practicing in 10 medical sites and measured their self-perceived knowledge, skills and attitudes on eating disorder screening and intervention using a 23-item questionnaire prior to, 1 week and 6 months after the training.
Results: The eating disorder knowledge score and eating disorder skill level score showed pretest to posttest gains that were associated with large effect sizes (d = 1.25 and 1.31, respectively). The significance and magnitude of effects carried over through the 6-month follow-up evaluation. Unlike the eating disorder knowledge and skill scores, there was no significant improvement in eating disorder attitudes from pretest to posttest or from pretest to the 6-month follow-up.
Discussion: Findings show support for the effectiveness of a brief eating disorder training on primary care providers’ reported knowledge and skills for addressing eating disorders in their practice. These results underscore the importance of providing information to primary care providers on how they can more adequately screen and intervene with eating disorders, as part of primary care to their patients.
The purpose of this study was to examine men’s and women’s experiences living with rheumatoid arthritis (RA). Using semi-structured, in-depth telephone interviews, nine women and seven men who were recently diagnosed with RA (disease duration < four years) were interviewed about their experiences adjusting to RA. Line-by-line coding using thematic analysis was used to identify themes. Findings from the qualitative analysis revealed six categories emerging from the data: 1. degree of severity of the impact of the disease, 2. appraisal about what the illness means to me, 3. availability of social support, 4. perception of self-efficacious behaviours, 5. use of coping strategies, and 6. RA’s effect on valued life activities. A number of participants described positive thinking about managing their RA; whereas others described negative thinking. Individuals’ appraisals and perceptions about their illness coupled with how their illness affected their ability to fulfill their role responsibilities were important in their adjustment to RA. Social support was also identified as key in learning to live with RA. For individuals with RA, the impact of the disease on their ability to maintain normal life is important, and as such it is vital that healthcare professionals have a better understanding of the perceptions and experiences that individuals have living with RA.
Background: Some adoptive parents struggle with depressive symptoms post-placement. Foli’s Mid-Range Theory of Postadoption Depression provided the theoretical context for the analysis.
Research Aim: To explicate connections between adoptive mothers’ unmet/unrealistic expectations and experiences with postadoption depression in the first 24 months of parenting their child(ren).
Methods: Data were collected as part of a web-based study that examined predictors of maternal postadoption depression. A qualitative content analysis of approximately 332 responses, ranging from two words to two pages of text, was conducted using a deductive, unrestrained matrix approach.
Major Findings: Support and refinement of major maternal expectations were attained and new concepts were revealed. Parents reported experiencing depression; they expressed unmet expectations as parents and of their children; they reported wishing they had received more medical and behavioural information about their child; and they reported mixed reactions and support from family and friends. Mothers described trans-racial family characteristics and being an adoptive family as factors in being accepted by society. Finally, the passage of time was described as a contributor to bonding and re-establishing family equilibrium.
Conclusions: The findings refine and expand Foli’s Mid-Range Theory. Nurses render care to adoptive parents and their children in a number of practice settings, and these findings provide evidence to guide nursing care.
Aims and objectives This UK study aimed to generate new ideas about training strategies for healthcare staff caring for people with dementia in the acute hospital setting.
Background A review of related literature exposed topical debate regarding current educational deficits, yet revealed few examples of the implementation of training initiatives for practising healthcare professionals.
Design A descriptive qualitative approach was used.
Methods Data were generated using two focus groups comprised of Staff Nurses (four) and Healthcare Assistants (three) working in a mixed gender acute elderly care unit in the North of England. Dialogues explored individuals’ experiences of delivering care to people with dementia hospitalised with physical illnesses and, usefully, their thoughts about learning in the workplace.
Results Four broad categories emerged from transcript-based analysis: learning about dementia; learning about the person; learning from each other; learning from specialists. Specific recommendations included the improvement of staff preparedness through fundamental training, improved flow of information about individuals, dementia-specialist input for situation-based advice, and structured opportunities to reflect on practice.
Conclusion The National Dementia Strategy for England emphasises the pressing need to improve care for people with dementia when they are admitted to hospital with physical illness, and highlights the importance of staff education in contributing to improved care. This study provides an insider view from a potential target population of such healthcare providers regarding their perceived educational needs.
Relevance to clinical practice The results of this study point the way forward to practical and achievable ways of increasing and improving knowledge about dementia, and enhancing skills in caring for people who are cognitively impaired, among general hospital staff.
As a qualitative research method, Grounded Theory (GT) has had a significant impact on nursing research and has made a major contribution to the development of nursing knowledge. Despite this, conflicting opinions in the literature about methodological issues have contributed to the confusion about how this type of research is best conducted. The purpose of this paper is to present an animated model that illustrates and facilitates an understanding of how the various techniques inherent in the GT method converge to enable data categorisation and the formation of substantive theory. It will explain the key tenets of the research process underpinning GT and provides a guide for navigating the research process. It is hoped that this will facilitate understanding and promote the use of this methodology in nursing when it is appropriate to the research question being posed.
This paper draws lessons from the use of an emic–etic ethnographical technique in a grounded theory study of how New Zealand practice nurses use information. The technique was used to heighten theoretical sensitivity in this study. As a nurse practitioner, I (the lead author) could not step out of my emic perspective to provide an etic perspective of my own general practice. From my emic embodied subjectivity I constructed my work environment to fit with best practice. Conversely, in four other general practices, my lack of personal connection protected an etic sense of disembodiment. New insights into mental models guiding the emic and etic roles of ethnography are suggested. Emic and etic perspectives, along with embodied and disembodied feelings, are not binary opposites but rather sit along a philosophical continuum. Their position on this continuum depends on the role and relationships of the researcher(s) in the social and cultural context of the area of inquiry.
A fear of medical examination and of pain in care procedures is common among children. Young children are particularly sensitive to the way a procedure is carried out. The children will engage and act in the way they understand the situation and what is meaningful for them, which will depend on their experiences, interests and motivation. This study describes the qualitative differences in the complexity of how young children, aged 3–5 years, demonstrated the way they engaged in care procedures involving venepuncture. Video observation captured the young children as social actors in the procedure, and interpretive descriptive analysis was used to seek an understanding of the children’s demonstrated expressions and actions. The identified ways of engagement among the children were as follows: watchful engagement, curious engagement and adaptive engagement, as well as avoidance, forced engagement and resigned engagement. The children could fluctuate between the different ways of engagement during the course of the procedure. The results call attention to the sensitivity and responsiveness shown by the adults, nurses and parents in guiding the young children’s engagement and their ability to become integrated and act through active participation in a sometimes frightening care procedure.
This paper presents an exploration of the validity and reliability of the translated Arabic version of the original English version of the Parental Stressor Scale: Paediatric Intensive Care Unit (PSS: PICU) with a sample of Jordanian parents of children admitted to a paediatric intensive care unit. Three hundred and fifty parents were recruited to the study. The PSS: PICU was completed by parents within 15 minutes. Data were collected from parents (N = 350) from different governmental, private and educational hospitals in Amman, Jordan. Subscales measuring stress from Child’s Appearance, Procedures, Sights and Sounds, Staff Communication, Staff Behavior, Parental Role, and Child’s Behavior and Emotions showed a range of responses and showed good internal consistency. Parents in this study perceived stress from various sources during their child’s hospitalisation. The dimensions ranked most stressful in the PICU were procedures (mean = 3.8, standard deviation, SD = 1.11), the child’s behaviors and emotions (mean = 3.72, SD = 1.04) and child’s appearance (mean = 3.71, SD = 0.75). The least listed stressful items were behaviors of professional staff in the unit (mean = 2.19, SD = 0.73), and staff communication in the unit (mean = 2.25, SD = 0.81). The reported elevated levels of parental stress underscores the importance of ongoing screening for factors impacting on psychological well-being and the inclusion of this information in education and counseling strategies in the inpatient settings. Consideration of areas of parent education regarding stressful ICU environment, and children’s behavioral and emotional reaction to hospitalisation could help reduce stress for Jordanian parents.