Obesity in People with Learning Disabilities: the impact of nurse led health screenings and health promotion activities

Background. Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. Aim. Firstly, to follow up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. Methods. A clinic led by two learning disbaility nurses was held for all people aged 10 years and over (n=464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organised health promotion classes for 20 people over a 6 - 8 week period. Findings. The health screen identified 64% of adults and 26% of 10 - 19 year olds as being overweight or obese. Moreover, those aged 40 - 49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow up questionnaire sent after 3 months suggested that of the 122 people identified for wiehgt reduciton, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. Conclusion. Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabiltieis to create more active lifestyles.

Psychological processes underlying nurses' handwashing behaviour

Aim/Background Psychological models of behaviour change have been found to be useful in predicting health-related behaviour in patients but have rarely been used in relation to the health behaviour of staff. This study explored the association between a range of psychological variables and self-reported handwashing in a sample of nurses who work in a large general hospital. Method A questionnaire-based cross-sectional, correlational study was used. Questionnaires examining demographics, self-efficacy, perceived importance of handwashing, perception of risk, occupational stress and training related to handwashing were administered to an opportunity sample (n = 76) of nurses drawn from an acute hospital. ANOVAs, correlation and regression analyses were performed to determine significant covariates of handwashing behaviour. Findings There was a weak relationship between demographic variables and self-reported handwashing. The degree to which employees perceived their workplace to assist handwashing and perceived importance of handwashing were related to self-reported handwashing. Accordingly further covariates of these variables were sought. Training received and occupational stress both covaried with nurses’ perceptions of the degree to which their workplace assisted handwashing. Nurses’ beliefs regarding the transmission of infections covaried with perceived importance of handwashing. Conclusion Occupational stress was observed to reduce the perception of having a supportive employer: organisations need to facilitate handwashing and protect staff from factors that have a detrimental impact, such as work-related stress. Nurses’ perceived importance of the potential for poor handwashing practice to contribute to the transmission of infections should be highlighted in interventions.

Index of sources of stress in nursing students: a confirmatory factor analysis.

Aim. This paper is a report of a study to test the proposed factor structure of the Index of Sources of Stress in Nursing Students. Background. Research across many countries has identified a number of sources of distress in nursing students but little attempt has been made to understand and measure sources of eustress or those stressors likely to enhance performance and well-being. The Index of Sources of Stress in Nursing Students was developed to do this. Exploratory factor analysis suggested a three-factor structure, the factors being labelled: learning and teaching; placement-related and course organization. It is important, however, to subject the instrument to confirmatory factor analysis as a further test of construct validity. Method. A convenience sample of final year nursing students (n = 176) was surveyed in one university in Northern Ireland in 2007. The Index of Sources of Stress in Nursing Students, which measures sources of stress likely to contribute to distress and eustress, was completed electronically. The LISREL programme was used to carry out the confirmatory factor analysis and test the factor structure suggested in the exploratory analysis. Findings. The proposed factor structure for the items measuring ‘Uplifts’ proved to be a good fit to the data and the proposed factor structure for the items measuring ‘Hassles’ showed adequate fit. Conclusion. In nursing programmes adopting the academic model and combining university-based learning with placement experience, this instrument can be used to help identify the sources of stress or course demands that students rate as distressing and those that help them to achieve. The validity of the ISSN could be further evaluated in other education settings.

Using Focus Groups to Research Sensitive Issues: Insights from Group Interviews on Nursing in the Northern Ireland “Troubles”

In this article the authors discuss the usefulness of focus groups for researching sensitive issues using evidence from a study examining the experiences of nurses providing care in the context of the Northern Ireland Troubles. They conducted three group interviews with nurses during which they asked about the issues the nurses face(d) in providing nursing care amid enduring social division. Through a discursive analysis of within-group interaction, they demonstrate how participants employ a range of interpretive resources, the effect of which is to prioritize particular knowledge concerning the nature of nursing care. The identification of such patterned activity highlights the ethnographic value of focus groups to reveal social conventions guiding the production of accounts but also suggests that accounts cannot be divorced from the circumstances of their production. Consequently, the authors argue that focus groups should be considered most useful for illuminating locally sanctioned ways of talking about sensitive issues.