http://hdl.handle.net/2173/31602 Thu, 20 Jun 2013 04:18:18 GMT 2013-06-20T04:18:18Z http://hdl.handle.net/2173/109062 Title: Reconstructing nursing altruism using a biological evolutionary framework. Authors: Haigh, Carol Abstract: AIM: This paper presents a discussion of the role of altruism in development of the discipline of nursing and an exploration of how nursing altruism compares with current thinking in biological evolutionary theory. There is an assumption that the role of the nurse has its foundations in altruistic behaviours; however, the source of this altruism is never analysed or debated. DATA SOURCES: A search of the biological altruism, altruism and health-related literature encompassing the years 1975-2007 was performed using Google Scholar. DISCUSSION: The first element of the study is a brief overview of nursing altruism as a way of establishing the conceptual boundaries. Additionally, the major tenets of biological evolution are explored to clarify the theoretical underpinnings of the hypotheses presented. A key premise of this study is that nursing altruism is not solely a manifestation of disinterested sacrifice for the benefit of others, but is more concerned with ensuring the survival of a clearly defined social group. IMPLICATIONS FOR NURSING: A re-evaluation of altruism as a motivating factor in nursing and as an element of the therapeutic relationship is long overdue. It is time that the nursing profession examined professional driving forces using more than traditional philosophical frameworks. CONCLUSION: Nursing altruism is programmed to ensure the survival of the meme rather than to act in the best interest of patients. Certainly patients reap the benefits of this selfish altruism, but that can be argued to be a side effect rather than a result. Description: Full-text of this article is not available in this e-prints service. This article was originally published following peer-review in Journal of Advanced Nursing, published by and copyright Wiley-Blackwell Publishing Ltd. Tue, 01 Jun 2010 00:00:00 GMT http://hdl.handle.net/2173/109062 2010-06-01T00:00:00Z http://hdl.handle.net/2173/108821 Title: The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes Authors: Body, Richard; Carley, Simon; Wibberley, Christopher; McDowell, Garry; Ferguson, Jamie; Mackway-Jones, Kevin Abstract: Patient history and physical examination are widely accepted as cornerstones of diagnosis in modern medicine. We aimed to assess the value of individual historical and examination findings for diagnosing acute myocardial infarction (AMI) and predicting adverse cardiac events in undifferentiated Emergency Department (ED) patients with chest pain. We prospectively recruited patients presenting to the ED with suspected cardiac chest pain. Clinical features were recorded using a custom-designed report form. All patients were followed up for the diagnosis of AMI and the occurrence of adverse events (death, AMI or urgent revascularization) within 6 months.AMI was diagnosed in 148 (18.6%) of the 796 patients recruited. Following adjustment for age, sex and ECG changes, the following characteristics made AMI more likely (adjusted odds ratio, 95% confidence intervals): pain radiating to the right arm (2.23, 1.24–4.00), both arms (2.69, 1.36–5.36), vomiting (3.50, 1.81–6.77), central chest pain (3.29, 1.94–5.61) and sweating observed (5.18, 3.02–8.86). Pain in the left anterior chest made AMI significantly less likely (0.25, 0.14–0.46). The presence of rest pain (0.67, 0.41–1.10) or pain radiating to the left arm (1.36, 0.89–2.09) did not significantly alter the probability of AMI.Our results challenge many widely held assertions about the value of individual symptoms and signs in ED patients with suspected acute coronary syndromes. Several ‘atypical’ symptoms actually render AMI more likely, whereas many ‘typical’ symptoms that are often considered to identify high-risk populations have no diagnostic value. Description: Full-text of this article is not available in this e-prints service. This article was originally published following peer-review in Resuscitation, published by and copyright Elsevier. Fri, 01 Jan 2010 00:00:00 GMT http://hdl.handle.net/2173/108821 2010-01-01T00:00:00Z http://hdl.handle.net/2173/94424 Title: The who and where of clinical skills teaching: a review from the UK perspective Authors: Borneuf, Anne-Marie; Haigh, Carol Abstract: Over the years, the debate on clinical skill acquisition in Nursing is one that has been subject to constant scrutiny within educational settings, locally and globally. Indeed, the Nursing and Midwifery Council (NMC) have endeavoured to provide some clarity with the publication of the Essential Skills Cluster statements [NMC, 2006. Advance Information Regarding Essential Skill Clusters for Preregistration Nursing Programmes (NMC Circular 35/2006). NMC, London] and the recently updated Standards to Support Learning and Assessment in Practice [NMC, 2008. Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers, second ed. NMC, London]. In this paper, we seek to provide a review of the evidence and debate produced thus far surrounding skills acquisition in general and the role of the nurse lecturer in particular from a UK perspective. Description: Full-text of this article is not available in this e-prints service. This article was originally published following peer-review in Nurse Education Today, published by and copyright Elsevier. Mon, 01 Feb 2010 00:00:00 GMT http://hdl.handle.net/2173/94424 2010-02-01T00:00:00Z http://hdl.handle.net/2173/94419 Title: “When I first started going I was going in on my knees, but I came out and I was skipping”: exploring rheumatoid arthritis patients’ perceptions of receiving treatment with acupuncture Authors: Hughes, Joyce G. Abstract: Objectives To outline rheumatoid arthritis (RA) patients’ experiences of receiving treatment with acupuncture, exploring the impact of practitioner affiliation to a traditional or western theoretical base. Design Qualitative study utilising grounded theory method. Convenience sample of thirteen patients with RA. Data collection, organisation and analysis performed concurrently. In-depth semi-structured interviews were tape-recorded and transcribed. Field notes were also taken. Open, axial and selective coding performed. Emergent categories and themes identified and informed the topics to be discussed in subsequent interviews. Results Patients perceived acupuncture as alleviating a number of RA symptoms including the relief of rheumatic pain and improvements in mobility. Acupuncture was additionally perceived as alleviating a number of consequential secondary symptoms of RA, such as fatigue, depression and sleeplessness. These effects allowed patients to feel normal again and regain their lives, and resulted in improvements in patients’ lifestyle, emotional well-being and self-image. Acupuncturist affiliation impacts on both patient experience and perception of effects. Conclusions Acupuncture elicits a range of effects which contribute to improvements in RA patients’ quality of life. Varied levels of congruence were identified between the intended therapeutic effect of acupuncture [Hughes JG, Goldbart J, Fairhurst E, Knowles K. Exploring acupuncturists’ perceptions of treating patients with rheumatoid arthritis. Complementary Therapies in Medicine 2007;15:101–8] and patients’ perceptions of effects. Acupuncturist affiliation has demonstrable implications for the practice and research of acupuncture. Description: Full-text of this article is not available in this e-prints service. This article was originally published following peer-review in Complementary Therapies in Medicine, published by and copyright Elsevier. Thu, 01 Oct 2009 00:00:00 GMT http://hdl.handle.net/2173/94419 2009-10-01T00:00:00Z