International journal of nursing studies
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Internationally the stroke unit is recognised as the evidence-based model for patient management, although clarity about the effective components of stroke units is lacking. Whilst skilled nursing care has been proposed as one component, the theoretical and empirical basis for stroke nursing is limited. We attempted to explore the organisational context of stroke unit nursing, to determine those features that staff perceived to be important in facilitating high quality care. ⋯ Nine themes that comprised an organisational context that supported the delivery of high quality nursing care in acute stroke units were identified, and provide a framework for organisational development. The study highlighted the importance of an overarching service model to guide the organisation of care and the development of specialist and advanced nursing roles. Whilst multidisciplinary working appears to be a key component of stroke unit nursing, various organisational challenges to its successful implementation were highlighted. In particular the consequence of differences in the therapeutic approach of nurses and therapy staff needs to be explored in greater depth. Successful teamwork appears to depend on opportunities for the development of relationships between team members as much as the use of formal communication systems and structures. A co-ordinated approach to education and training, clinical leadership, a commitment to research, and opportunities for role and practice development also appear to be key organisational features of stroke unit nursing. Recommendations for the development of stroke nursing leadership and future research into teamwork in stroke settings are made.
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Social capital, defined as an investment in relationships that facilitates the exchange of resources, has been identified as a possible protective factor for child health in the context of risk factors such as poverty. Reliable and valid measures of social capital are needed for research and practice, particularly in non-English-speaking populations in developing countries. ⋯ The 14-item Arabic SCS was found to be reliable and valid in this sample, with four internally consistent factors. While the tool may not be appropriate for comparing social capital between cultural groups, it will enable clinicians and researchers to address an important gap in knowledge characterized by a paucity of research on childhood chronic illness in low- and middle-income countries such as Egypt.
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The nursing literature is replete with articles on the function of clothing in preventing and controlling infections. However, although contemporary literature demonstrates intimate connections between clothing and identity, there is a lack of studies which illuminate the meanings associated with wearing patient clothing. ⋯ The tension between patient clothing as being practical and comfortable and at the same time enabling feelings of being depersonalised and stigmatised suggests that nursing staff need to balance the practical benefits of these garments with the social and existential meanings they might have.
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Nurses have a professional duty to respect patients' dignity. There is a dearth of research about patients' dignity in acute hospital settings. ⋯ Patients are vulnerable to loss of dignity in hospital. Staff behaviour and the hospital environment can influence whether patients' dignity is lost or upheld.