Journal of advanced nursing
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Comparative Study
Examining the correspondence of breastfeeding and bottle-feeding couples' infant feeding attitudes.
Examining the correspondence of breastfeeding and bottle-feeding couples' infant feeding attitudes This report focuses on the comparison of infant feeding attitudes within breastfeeding (n = 126) and bottle-feeding (n = 101) couples and their socio-demographic details. The findings from this study reinforce the view that socio-demographic factors are associated with the mothers' choice of feeding method. However, this study highlights the influence of maternal and of paternal knowledge and attitudes which distinguish between breastfeeding and bottle-feeding couples. ⋯ Furthermore, breastfeeding mothers when compared with their partners were more supportive towards breastfeeding. Fathers of both bottle and breast feeding babies were also found to be more embarrassed than their partners about mothers in general breastfeeding in front of nonfamily members. It seems that bottle-feeding mothers and all fathers could be better prepared in many aspects of breastfeeding by the nursing professions to allay the many misconceptions and the social embarrassment associated with breastfeeding, by providing appropriate information and support.
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Cultural challenges in end-of-life care: reflections from focus groups' interviews with hospice staff in Stockholm During the past few decades, Swedish society has changed from a society with a few ethnic groups to one with over a hundred groups of different ethnic backgrounds, languages and religions. As society is becoming increasingly multicultural, cultural issues are also becoming an important feature in health care, particularly in end-of-life care where the questions of existential nature are of great importance. However, cultural issues in health care, especially at hospices, have not been studied sufficiently in Sweden. ⋯ A discussion guide was developed with the following themes: 1) post-training experiences of working with patients with multicultural background; 2) experiences gained by participating in the course of multicultural end-of-life care; 3) post-training reflections about one's own culture; 4) ideas or thoughts regarding work with patients from other cultures arising from the training; and 5) the need for further training in multicultural end-of-life care. One of the study's main findings was that to better understand other cultures it is important to raise awareness about the staff's own culture and to pay attention to culture especially in the context of the individual. The findings from focus groups provide insight regarding the need for planning flexible training in cultural issues to match the needs of the staff at the hospice units studied.
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The patient and the primary care team: a small-scale critical theory For increasing the understanding of team-based delivery of primary care, ratings of care satisfaction and stimulated-recall interviews were used to compose a small-scale critical theory. Three teams and 24 patients at a community health care centre participated in the study. It was found that the multiprofessional team was vulnerable to discrepancies between the health service policy and the available care resources. ⋯ Simultaneously, when the teams are led to solve the health problems without involving the patients in the process, the team members convert these to their own personal distress when they fail. The conclusion is that the discrepancy between care policy and factual resources is an important cause of imbalance in patient-primary care team interaction. If service strategy and team organization and resources are not continuously adjusted to each other, the effects will continue to obstruct communication during consultations.
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Interprofessional relations between doctors and nurses: perspectives from South Wales This paper discusses findings from a study of interprofessional relationships between doctors and nurses in medical wards in three provincial general hospitals in south Wales. The aim of the research was to investigate the changing nature of doctor-nurse relations, and in particular, how far the notion of the doctor-nurse game, as developed by Leonard Stein (Stein 1967, 1990), remains relevant to contemporary hospital work. The present paper concentrates on a subset of the findings concerned with doctors' and nurses' accounts of the hospital division of labour and the extent of any overlap in their work activities. ⋯ Inductive analysis of the data indicated that, whilst doctors and nurses perceived their roles in largely traditional terms, there was some recognition of blurring of occupational boundaries, especially when considering work pressures, working at night and differences in practice in more specialized clinical areas. Although nurses were generally reluctant to challenge doctors' authority, some used the notion of patient 'advocacy' to frame and justify their questioning of particular decisions. Whilst doctors valued 'experience' in nurses and saw experienced nurses as the group who might most legitimately move into doctors' territory, nurses valued formal education and saw advanced nursing qualifications as the route to role expansion.
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The role of nurses in AIDS care regarding voluntary euthanasia and assisted suicide: a call for further dialogue Because of the nature of their work, nurses are directly involved with terminally ill patients and the problems associated with the decision to hasten death through voluntary euthanasia or assisted suicide (VE/AS). An anonymous survey delivered to nurses working in HIV/AIDS settings in Canada was used to analyse nurses' experiences and attitudes regarding VE/AS. An emergent analysis of 22 nurses' responses to an open-ended prompt appearing at the end of the survey reveals that nurses: support death-hastening practices; believe that legislation for these practices needs to be established; are wary of the potential abuse of VE/AS; and believe that further discussion on end-of-life issues is imperative. Their caring role in the health care setting places nurses in key positions to stimulate discussion in this area.