Fathers’ Views and Understanding of their Roles in Families with a Child with Acute Lymphoblastic Leukaemia: An Interpretative Phenomenological Analysis

This study explored how fathers of children diagnosed with acute lymphoblastic leukaemia (ALL) perceived and understood the roles they had within their family over the course of their child’s illness and treatment. In-depth semi-structured interviews were conducted with five fathers. Transcripts were analysed using interpretative phenomenological analysis (IPA). The major themes that emerged were: adjusting to the diagnosis; the experience of maternal gate-keeping; striving for normalization; experiences of giving and receiving support. Overall, the fathers perceived themselves as having significant responsibility in helping their child and family cope with the illness experience. Clinical implications, including the need for professionals to recognize and more openly acknowledge the father’s position, are considered.

Surveying nursing students on their sources of stress: A validation study

This study tested the psychometric properties of a questionnaire that measured sources of distress and eustress, or good stress, in nursing students. The Transactional model of stress construes stress in these different ways and is frequently used to understand sources of stress, coping and stress responses. Limited research has attempted to measure sources of distress and eustress or sources that can potentially enhance performance and well-being. A volunteer sample of final year nursing students (n = 120) was surveyed in the United Kingdom in 2007. The questionnaire measured sources of stress and measures of psychological well-being were taken to test construct validity. This was tested through an exploratory factor analysis. This reduced the questionnaire from 49 to 29 items and suggested three factors: learning and teaching, placement related and course organization; second, it was analysed by testing the assumptions of the Transactional model, the model on which the questionnaire was based. In line with the assumptions of the model, measures of distress related to adverse well-being, and measures of eustress related to healthier well-being responses. The test–retest reliability estimate was 0.8. While certain programme issues were associated with distress, placement-related experiences were the most important source of eustress.

A Census-based longitudinal study of variations in survival amongst residents of nursing and residential homes in Northern Ireland

Background: despite the intensive services provided to residents of care homes, information on death rates is not routinely available for this population in the UK. Objective: to quantify mortality rates across the care home population of Northern Ireland, and assess variation by type of care home and resident characteristics. Design: a prospective, Census-based cohort study, with 5-year follow-up. Participants: all 9,072 residents of care homes for people aged 65 and over at the time of the 2001 census with a special emphasis on the 2,112 residents admitted during the year preceding census day. Measurements: age, sex, self-reported health, marital status, residence (not in care home, residential home, dual registered home, nursing home), elderly mentally infirm care provision. Results: the median survival among nursing home residents was 2.33 years (95% CI 2.25–2.59), for dual registered homes 2.75 (95% CI 2.42–3.17) and for residential homes 4.51 (95% CI 3.92–4.92) years. Age, sex and self-reported health showed weaker associations in the sicker populations in nursing homes compared to those in residential care or among the non-institutionalised. Conclusions: the high mortality in care homes indicates that places in care homes are reserved for the most severely ill and dependent. Death rates may not be an appropriate care quality measure for this population, but may serve as a useful adjunct for clinical staff and the planning of care home provision.

Causal conjunction fallacies: The roles of causal strength and mental resources

In two experiments we tested the prediction derived from Tversky and Kahneman's (1983) work on the causal conjunction fallacy that the strength of the causal connection between constituent events directly affects the magnitude of the causal conjunction fallacy. We also explored whether any effects of perceived causal strength were due to graded output from heuristic Type 1 reasoning processes or the result of analytic Type 2 reasoning processes. As predicted, Experiment 1 demonstrated that fallacy rates were higher for strongly than for weakly related conjunctions. Weakly related conjunctions in turn attracted higher rates of fallacious responding than did unrelated conjunctions. Experiment 2 showed that a concurrent memory load increased rates of fallacious responding for strongly related but not for weakly related conjunctions. We interpret these results as showing that manipulations of the strength of the perceived causal relationship between the conjuncts result in graded output from heuristic reasoning process and that additional mental resources are required to suppress strong heuristic output.

Roles for the subiculum in spatial information processing, memory, motivation and the temporal control of behaviour

The subiculum is in a pivotal position governing the output of the hippocampal formation. Despite this, it is a rather under-explored and sometimes ignored structure. Here, we discuss recent data indicating that the subiculum participates in a wide range of neurocognitive functions and processes. Some of the functions of subiculum are relatively well-known-these include providing a relatively coarse representation of space and participating in, and supporting certain aspects of, memory (particularly in the dynamic bridging of temporal intervals). The subiculum also participates in a wide variety of other neurocognitive functions too. however. Much less well-known are roles for the subiculum, and particularly the ventral subiculum, in the response to fear, stress and anxiety, and in the generation of motivated behaviour (particularly the behaviour that underlies drug addiction and the response to reward). There is an emerging suggestion that the subiculum participates in the temporal control of behaviour. It is notable that these latter findings have emerged from a consideration of instrumental behaviour using operant techniques; it may well be the case that the use of the watermaze or similar spatial tasks to assess subicular function (on the presumption that its functions are very similar to the hippocampus proper) has obscured rather than revealed neurocognitive functions of subiculum. The anatomy of subiculum suggests it participates in a rather subtle fashion in a very broad range of functions, rather than in a relatively more isolated fashion in a narrower range of functions, as might be the case for

The immediate Life support course: implementation into an undergraduate nursing programme

This paper outlines how the immediate life support (ILS) course was incorporated into an undergraduate-nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The aim was to develop the student’s ability to recognise the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this the ILS course was only available to qualified nurses and this paper reports on the first time students were provided with an ILS course in an undergraduate setting. The ILS course was delivered to 89 third year nursing students (Adult Branch) and comprised one full teaching day per week over two weeks. Recognised Advanced Life Support (ALS) instructors, in keeping with the United Kingdom Resuscitation Council guidelines, taught the students. Participants completed a 17 item questionnaire which comprised an open-ended section for student comment. Questionnaire data was analysed descriptively using SSPSS version 15.0. Open-ended responses from the questionnaire data was analysed by content and thematic analysis. Results Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge Conclusion. The inclusion of the ILS course provides students with necessary skills to assess and manage the deteriorating patient. In addition the data from this study suggest the ILS course should be delivered in an inter-professional setting – i.e taught jointly with medical students. References: Department of Health & Quality Assurance Agency (2006). Department of Health Phase 2 benchmarking project – final report. Gloucester: Department of Health, London and Quality Assurance Agency for Higher Education