/library/oar/handle/123456789/44154 2026-06-14T22:08:24Z /library/oar/handle/123456789/111270 Title: Nursing power : an ethnography Abstract: Nurses are portrayed in the literature as working according to the institutional conditions that are determined by the medical and managerial professions. Thus, the aim of this study was to explore the institutional possibilities that existed for local nurses to exercise their own power in a Maltese medical ward setting. A practitioner's ethnography that collected data by participant observation and ethnographic interviewing was adopted for this inquiry. Nine staff nurses and two nursing officers working in a medical ward participated in this study. Interviews with the three departmental nursing managers and the two directors of nursing overseeing this ward were also carried out. Furthermore, Six medical firms consented for the observation of ward rounds, and interviews with one consultant and four house officers were also done. Two themes emerged from this study; 'Nursing roles and structure', and 'Nursing relationships in the context of institutional change'. The role of clinical floor nurses' was determined by their own perceptions of nursing and the expectations of others within the hospital. These nurses considered their relationship with patients as leverage in resisting management and medical firms from imposing changes on their practice. The multidisciplinary approach to care was dysfunctional, due to inter-professional conflicts among managers, doctors and clinical floor nurses in this ward. Clinical nursing staff felt that managerial instrumental rationality and decreased subsidiarity discouraged clinical staff from cooperating with nursing management. This study thus suggests that a managerial culture that does not work towards the devolution of managerial authority and responsibility disempowers nurses in the ward. Policies, multidisciplinary meetings and educational initiatives, are recommended to help mitigate issues of conflict among professional groups. Description: M.SC.NURSING 2012-01-01T00:00:00Z /library/oar/handle/123456789/68222 Title: Managing diabetes in young persons : continuous subcutaneous insulin versus multiple daily injections Abstract: 0.1. Overview of the topic: Tight metabolic control during the pre-pubertal and pubertal years has been found to reduce diabetes-related complications later in life. Different forms of intensive insulin therapies, including multiple daily injection and continuous subcutaneous insulin infusion are available which offer the hope for an improved glycemic control. 0.2. Research question: Is continuous subcutaneous insulin infusion therapy (CSII) more effective than multiple daily injection therapy (MDI) , for the management of type 1 diabetes, in children and youths? 0.3. PICO elements: Population -children and youths aged between 18 months and 21 years with TlDM, Intervention- CSII, Comparison- MDI, and Outcome- improved management of glucose levels/control. 0.4. Inclusion criteria: Studies published from 1990 onwards, comparing CSII with MDI in TlDM, considering toddlers, children, adolescents and young adults as a population, investigating metabolic control as outcome measure and classified as randomized controlled trials (RCT's), Systematic reviews, Matched pair studies and Multicentre studies. 0.5. Exclusion criteria: Studies not in English, considering adults and neonates as a population, investigating only cost effectiveness and quality of life as outcome measure and classified as retrospective chart reviews and descriptive studies. 0.6. Outcome of the search: Titles and abstracts of 72 articles were reviewed for relevance. Ultimately, 14 articles were appraised, 9 of which were RCT's, 1 was a systematic review and 4 were matched pair studies, 1 of which also had a multicentre approach. 0.7. Methods of appraisal used: CASP tools for RCT's and systematic reviews 0.8. Main results: CSII is at least as effective as MDI but no more so in achieving glucose control or in preventing complications. Nevertheless, there seems to be higher treatment satisfaction and an increased flexibility in lifestyle when using CSII. 0.9. Conclusion, implications and recommendations: Since CSII has been found to be at least as effective as MDI but no more so in achieving glucose control or in preventing complications, it may be offered to individuals who would prefer this method of insulin delivery for personal reasons such as convenience. However, further research is needed to identify candidates who would benefit most from this therapy. Description: B.SC.(HONS)NURSING 2012-01-01T00:00:00Z /library/oar/handle/123456789/68124 Title: Pressure sores and patient comfort in spinal immobilisation : the vacuum mattress and the spinal board Abstract: Overview of the topic: Spinal immobilisation in patients with spinal cord injuries reduce further risks of spinal injuries during pre-hospital care and transportation, however, the risk of developing pressure sores and patient discomfort are increased when using the equipment. Different equipment is available for spinal immobilisation, including the vacuum mattress and the spinal board. Research Question: Does the use of a vacuum mattress in patients with suspected spinal cord injury result in less pressure sores and increased patient comfort than the spinal board? PICO elements: Population - adults over the age of 18 years with spinal trauma. Intervention - Vacuum mattress. Comparison - Spinal board and outcome- reduction in pressure sores and increase in patient's comfort. Inclusion Criteria: Adult patients with back trauma, requiring spinal immobilisation during pre-hospital care. Exclusion Criteria: Patients under the age of 18 years and studies in which the language of publication is not in English. Outcome of the search: 13 articles were retrieved, but only 9 were relevant. These articles consisted of 2 systematic reviews, 2 randomised controlled trial, and 5 observational studies. Methods of appraisal used: CASP tools Main Results: A vacuum mattress results in less pressure sores than the spinal board, and also increases patient's comfort. Conclusion, implications and recommendations: Since the vacuum mattress has been found to decrease pressure sores and increase patient's comfort, it should be introduced to the ED nurses by hands on practice, and supported with guidelines and protocols. However, further research is needed to reduce the risks of pressure sores. The vacuum mattress is faster to apply than the spinal board. Moreover, the vacuum mattress was superior at immobilization of the torso, whereas the backboard provided better immobilization of the head. Description: B.SC.(HONS)NURSING 2012-01-01T00:00:00Z /library/oar/handle/123456789/68095 Title: Nurses' perceptions towards patients with a homosexual lifestyle Abstract: A number of studies have been carried out in health care to investigate issues related to homosexuality and nursing. Many of these studies concluded that nurses are generally positive in their attitudes towards homosexual patients however, there are various gaps in their knowledge regarding the topic. The present study was conducted to obtain a general view of nurses' perceptions towards patients with a homosexual lifestyle. The objectives focused on; exploring nurses' perceptions about caring for homosexual patients, to determine whether nurses believe of any specific needs of homosexual patients and to investigate nurses' perceptions about their knowledge regarding homosexuality and the homosexual lifestyle. A descriptive, non-experimental design was used for this study and was achieved by means of a questionnaire which was randomly distributed to male and female nurses working on general medical wards in a local state run general acute hospital. From a response rate of 74% and following manual, content and statistical analysis with the use of SPSS, the results obtained showed that although most nurses know people who are homosexual they are still relatively uninformed about homosexuality and the homosexual lifestyle especially regarding lesbian women. Additionally nurses are not aware of the specific needs that homosexual patients might have, and thus they are consequently unsure of how to give holistic care to homosexual patients. Therefore, the need arises for providing courses to staff nurses on dealing with homosexual patients, evaluating nursing courses to highlight the importance of sexuality as part of nursing care and encouraging nurses to offer support to patients who are open about their homosexuality. The study presented with various limitations and thus the results obtained cannot be generalized. The major limitation of this study was the relatively small sample size administered, had a la1ge1 sample been taken, mote 'o-rclations wuld have been made and the results would have given a better insight of the actual situation on the local medical wards. Several recommendations based on the findings of this study were drawn up, one of them being to conduct a similar study including all other health care professionals working on general medical wards to investigate whether there are any differences in the perceptions towards homosexual patients between different disciplines. Description: B.SC.(HONS)NURSING 2012-01-01T00:00:00Z