Validation of the needs assessment for advanced lung cancer patients (NA-ALCP)

Objective: The Needs Assessment for Advanced Cancer Patients (NA-ACP) is a 132-item self-report questionnaire designed to assess the seven needs domains of patients with advanced, incurable cancer. This study aimed to evaluate the short derivative form of that questionnaire with advanced lung cancer patients.

Methods: Item factor loadings, item test–retest data and response distributions were used to retain or reject items from the original NA-ACP scale. This resulted in 38 items being maintained, preserving the original subscales. The response scale was simplified following feedback from patients. 108 people with advanced lung cancer completed the shortened NA-ALCP along with measures of psychological distress (HADS, DT) and quality of life (EORTC QLQ-C30). A-priori predictions were made for divergent and convergent validity.

Results: Internal consistency coefficients were satisfactory for six of seven subscales, range 0.71–0.95. Correlations between NA-ALCP and HADS, DT and EORTC-QLQ-C30 provided support for 11 of the 22 divergent (r = 0.13–0.27) and convergent predictions (r = 0.45–0.71).

Conclusions: Subscales of the NA-ALCP demonstrated internal reliability consistent with the original scale. Results provided supporting evidence for divergent and convergent validity. This study indicates that the NA-ALCP is psychometrically robust, easily understood and one-quarter the length of the original version

Transition from paper to electronic nursing documentation in residential aged care: an actor network theory analysis

Objectives: To examine the role of technology when introduced into the specific setting of residential aged care and then analyse the associated changes to this complex socio-technical network of human and technology actors on the introduction of this technology using the rich lens of Actor Network Theory. Methods: An exploratory qualitative single case study was conducted. The specific focus being the implementation of a nursing information system in an aged care context, i.e. the transition from paper-based nursing documentation to electronic nursing documentation. A series of 19 semi structured interviews with facility managers, nursing coordinators, and the nursing and care staff were conducted. The collected data were analysed using standard qualitative techniques such as thematic analysis and a priori themes were developed from the application of Actor Network Theory. Results: A priori themes coupled with emergent themes served to highlight the impact of a disruptive technology solution into a complex context. Conclusion: An Actor Network Theory analysis enables a rich theoretical lens to be used to examine the introduction of a disruptive technology into a complex context. On such examination critical success factors were identified as well as key barriers. Moreover, people issues were found to be central to the success of such a solution.

The contours of employee voice in SMEs: the importance of context

This article develops a context-sensitive approach to analyse how and why voice operates in small- to medium-sized enterprises (SMEs), an area that remains under-theorised and under-researched. By building on a priori frameworks with proven ability to unpack complexity and take account of the wider context of SMEs, this article explores how resources (human and social capital) and constraints (product market, labour market and strategic orientation) interact to shape voice practices. The article finds significant differences between 'reported' compared with 'actual' practices in situ, and identifies different types of firms ('strategic market regulation', 'strategic market-led' and 'non-strategic market-led') along with the factors that influence the form and practice of voice. Overall, the article argues that researchers should further pursue research that appreciates the layered nature of ontology and the role played by firm context to explain complex organisational phenomena, if we are to advance our understanding of voice practices in SMEs and beyond.