Perceptions of the Nurse Practitioner Role in Facilitating the Implementation of an Onsite Pain Management Team in Long Term Care

Background: One strategy to improve pain management in long term care (LTC) is to optimize the emerging role of the nurse practitioner (NP) in LTC. The purpose of this sub study was to learn about the NP role in implementing an onsite, interdisciplinary Pain Team in the LTC home setting.

Methods: We used a case study design that included two NPs who worked at separate LTC homes. Each of the NPs completed a weekly questionnaire of pain-related activities that they engaged in over a one-year implementation period; and a diary, using critical reflection, about their experiences and strategies used to implement the Pain Team. Descriptive statistics and thematic content analysis were used to analyze the case study data.

Findings: NPs tended to be most engaged in pain assessment and collaborated more with licensed nurses and personal support workers; less with pharmacists. NPs were more involved in organizational level activities, such as participating in committee work or assisting with the development of policies and procedures about pain. NPs created palliative care and pain service protocols; engaged in policy development, in-servicing, quality assurance and advocacy; and encouraged best practices. NPs were challenged with time constraints for pain management and balancing other role priorities and felt that increased scope of practice for them was needed.

Conclusions: The results of this study highlight how NPs implemented a Pain Team in LTC which may be helpful to others interested in implementing a similar strategy to reduce residents’ pain.

Perceptions of high involvement work practices and burnout: investigating the mediating role of procedural justice and role overload and the moderating role of colleague support

Purpose
The purpose of this paper is to investigate the impact of employees’ perceptions of high involvement work practices (HIWPs) on burnout (emotional exhaustion and depersonalisation) via the mediating role of role overload and procedural justice. Further, perceived colleague support was hypothesised to moderate the effects of role overload and procedural justice on these outcomes.

Design/Methodology
The study was conducted on a random sample of unionised registered nurses (RNs) working in the Canadian public health care sector, stratified by mission and size of the institution to ensure representativeness. Of the 6546 nurses solicited, 2174 returned a completed questionnaire, resulting in a response rate of 33.2%. To test our hypotheses we conducted structural equation modelling (SEM) in Mplus version 6.0 (Muthen and Muthen, 1998 – 2010) with Maximum Likelihood (ML) estimation.

Results
The results showed that procedural justice and role overload fully mediated the influence of HIWPs on burnout. Moreover, colleague support moderated the effects of procedural justice and role overload on emotional exhaustion but not depersonalisation.

Limitations
The study used a cross-sectional research design and is conducted among one occupational group (i.e. nurses).

Research/Practical Implications
The findings question the dark side of HRM in the health care context. They also contribute to the lack of theoretical and empirical work dedicated to understanding the ‘black box’ problem (Castanheira and Chambel, 2010).

Originality/Value
The study employs a well-known theoretical perspective from the occupational health psychology literature to the HR field in order to contribute to the lack of theorising in the HR-well-being link.

Undergraduate Student perceptions of a Restorative Dentistry OSCE

Objectives: The Objective Structured Clinical Exam (OSCE) is a widely accepted assessment method in undergraduate dental education. It aims to test higher order skills, attitudes and aspects of professionalism which other summative assessments such as MCQs and other written examinations are less able to do. The aim of this study was to evaluate the perceptions of 4th year undergraduate dental students of an OSCE undertaken in the Conservation Department.
Methods: On completion of the OSCE examination 51 fourth year undergraduate students were asked to complete an anonymised questionnaire. The questionnaire was made 22 questions, and requiring the students to provide both open and closed responses.
Results: A lot of positive aspects to the OSCE were observed in responses, students felt that the OSCE was a meaningful way for assessing their clinical skills (85%), it reflected real life conditions (79%) and that it was a fair method of assessment (75%).
A number of negative aspects were also noted. Most students felt the OSCE was stressful (72%) and they felt nervous during the examination (77%). Of the undergraduates asked 42% did not feel confident doing the OSCE.
A number of students felt it would be helpful to have additional information given to them on the OSCE prior to the assessment process.
Conclusion: In general the students found the OSCE a fair, meaningful form of assessment which reflected real life clinical situations, providing them with an opportunity to show their clinical knowledge and practical skills. A number study cohort did not feel confident during the OSCE and felt nervous and stressed by the experience. The information gained from the reflective nature of the feedback questionnaire has proved invaluable in the design of subsequent diets of the OSCE examination. 

(Re)examining the relationship between children's subjective wellbeing and their perceptions of participation rights

In recent years wellbeing has been linked increasingly with children’s rights, often characterised as central to their realisation. Indeed it has been suggested that the two concepts are so intertwined that their pairing has become something of a mantra in the literature on childhood. This paper seeks to explore the nature of the relationship between wellbeing and participation rights, using a recently developed ‘rights-based’ measure of children’s participation in school and community, the Children’s Participation Rights Questionnaire (CPRQ), and an established measure of subjective wellbeing – KIDSCREEN-10. The data for the study came from the Kids’ Life and Times (KLT) which is an annual online survey of Primary 7 children carried out in Northern Ireland. In 2013 approximately 3,800 children (51% girls; 49% boys) from 212 schools participated in KLT. The findings showed a statistically significant positive correlation between children’s overall scores on the KIDSCREEN-10 subjective wellbeing measure and their perceptions that their participation rights are respected in school and community settings. Further, the results indicated that it is the social relations/autonomy questions on KIDSCREEN-10 which are most strongly related to children’s perceptions that their participation rights are respected. Exploration of the findings by gender showed that there were no significant differences in overall wellbeing; however girls had higher scores than boys on the social relations/autonomy domain of KIDSCREEN-10. Girls were also more positive than boys about their participation in school and community. In light of the findings from this study, it is suggested that what lies at the heart of the relationship between child wellbeing and children’s participation rights is the social/relational aspects of both participation and wellbeing.

Radiographers perceptions of magnetic resonance imaging: a study of the causes that lead to the exams repetition

Purpose: To know how often occur the repetitions of MRI exams and sequences in radiology departments. Methods and Materials: A self applied-questionnaire was used as instrument and assigned to 57 radiographers who performed MRI exams to determine which were the causes that lead to the repetition. The questionnaires were interpreted and statistically analyzed through descriptive statistics and Spearman’s rho correlations. Results: At a 95% confidence interval, the major results suggest that the patient’s movement during de MRI exams is the main cause to repeat this exams (mean of 3.88 on a 5 points likert scale). However, there are causes related to the radiographer’s and the results showed that the introduction of wrong imaging parameters by the performer are a major cause too (N=26). Spearman rho correlations between radiographer’s time of experience and frequency of MRI exams repetitions were poor and not significant (r=0.141; p=0.297). The correlations between radiographer’s tiredness and frequency of MRI exams repetitions were negative, weak and not significant (r= -0.151; p=0.263). Conclusion: The patients’ movement may disrupt the examination or degrade the images with artifacts. The level of experience doesn’t influence the repetitions of MRI exams, it seems that seniors radiographers don’t have improvements in performance as it should be expected. It’s recommendable to do training courses regularly to improve the performance and systematically evaluate. Several features will need to be identified which would decrease the MRI exams repetitions.

Elite Rugby Union Players Perceptions of Performance Analysis

This study provides an in depth insight into the current views and opinions of elite level rugby union players regarding the use of performance analysis as a tool for improving their own playing performance and in highlighting the strengths and weaknesses of upcoming opponents. A total of seventy-three elite level rugby union players from two clubs in Great Britain completed a semi-structured questionnaire. Additionally, four players completed a semi-structured interview and following inductive content analysis, four key themes emerged: (1) the use of video for player development, (2) preparing for a match, (3) using video for player reflection in addition to other psychological tools and (4) players suggestions for improvements to the clubs current performance analysis programme. The main finding of the study concludes that players viewed performance analysis as a beneficial and useful tool to support their development and preparation. As a result the study provides an insight into the use of performance analysis within professional rugby union, enabling rugby coaches and practitioners to gain an understanding and appreciation of the players views towards the clubs current provision. Additionally, the findings help build and strengthen the on-going knowledge coaches, analysts and researchers currently have regarding how players perceive performance analysis.

Contributo para a validação da versão portuguesa do instrumento de avaliação VOICE (service users perceptions of impatient care, Views on Inpatient Care)

RESUMO: Nos últimos anos assistiu-se a um reposicionamento das pessoas portadoras de doença mental na sociedade, no sentido de viverem em pleno os seus direitos, sem restrições. Esta tendência acompanhou as transformações que se têm vivido na forma como os utentes dos serviços de saúde interagem com os mesmos e com os profissionais de saúde, de forma a permitir uma maior autonomização e responsabilização no que concerne ao tratamento da sua doença, a relação que estabelecem com o seu médico, e a participação na avaliação e monitorização da qualidade dos serviços. Mais recentemente, também no mundo científico, esta afirmação se fez sentir, com o surgimento de investigação liderada por utentes, no sentido de estudar de forma adequada questões que partem do seu ponto de vista, e que possibilitem a produção de conhecimento significativa no contexto das suas experiências. Com o presente trabalho pretende-se contribuir para a validação da versão portuguesa do VOICE (Service Users’ Perceptions of Inpatient Care, Views on Inpatient Care) (Evans et al., 2012), instrumento para a avaliação dos serviços de internamento de agudos em psiquiatria, construído a partir de um investigação liderado por utentes e partindo das suas perspectiva. O VOICE é constituído por 19 questões, agrupadas em sete domínios: admissão; cuidados e tratamento; medicação; equipa de técnicos do internamento; terapia e atividades; ambiente e diferenças. O presente estudo envolveu uma amostra de 85 utentes de um serviço de internamento de agudos de uma instituição psiquiátrica do Norte de Portugal. A versão portuguesa do VOICE apresentou boa aceitação por parte dos utentes e boas características psicométricas - a consistência interna foi alta (α = 0,87) e todos, exceto um item (item 6), apresentam elevadas correlações item-total (variando de 0,18 - item 6 a 0,71 - item 11; M = 0,54, DP = 0,15), sugerindo ser um instrumento útil na avaliação dos serviços de internamento de agudos. No futuro torna-se necessário alargar o estudo a outros contextos de internamento e envolvendo amostras mais alargadas.-------------- ABSTRACT: In recent years there has been a gradual process to help people with the experience of mental illness regaining their full rights. Following the advances in the understanding of mental health problems, and the use of medication to help patients overcome symptoms, service-users have become more autonomous and responsible in the way they deal with health professionals, and are now called to participate in assessing and monitoring mental health services and policies. In the context of these transformations we have assisted to the emergence of research led by service-users (in this case of psychiatric and mental health services) in order to emphasize their point of view, and to enable the production of significant knowledge resulting from their experiences, and perceptions. The present study aims to contribute to the dissemination of service-user led research, based on the adaptation and validation of the Portuguese version of the VOICE - Service Users' Perceptions Questionnaire, Views on Inpatient Care. (Evans et al., 2012). The VOICE is composed of 19 questions, grouped in seven domains: admissions, care and treatment, medication, team of technicians during hospitalization, therapy and activities, environment and diversity. The present study involved a sample of 85 inpatient of a psychiatric institution in Northern Portugal. The Portuguese version of the VOICE showed good psychometric properties and was well accepted by patients [high internal consistency (α = 0,87); and high correlation of each item, except item 6, with the total score (ranging from 0.18 on item 6 to 0.71 on item 11; average=0,54; SD=0,15), suggesting it to be a useful tool for assessing inpatient services. In the future there is a need to extend the study to other contexts and include larger samples.

Families of the traumatically brian-injured : a case study approach to perceptions of quality of service, degree of satisfaction, and family needs /

The purpose of this qualitative research study was to foster an understanding of the rehabilitation counselling practice offamilies of the brain-injured. Specifically, the study explores the perceptions of stakeholders in regards to the degree of satisfaction with the quality of service received. Questionnaires were administered, and semi-structured, openended interviews were conducted, with six participating families (n=8). Preliminary data were collected via two instruments: (i) the Family Participant Questionnaire, consisting of participants' sample characteristics, information pertaining to the history of the family, details of the injury, and information relating to the type, use, and need offamily services utilized; and (ii) the Community Integration Questionnaire, a measurement of the degree of social displacementllevel of community integration of the injured family member. Utilizing the procedural steps outlined by Colaizzi's (1978) method of protocol analysis, recommendations for a future program based on related and current family needs are discussed in detail. Substantiating and supporting information are offered to rehabilitation practitioners, educational planners, and policymakers alike, concerning the degree of satisfaction with rehabilitative service, and the means of improving upon the overall quality of health care to families of the brain-injured. Implications for clinical practice and research are also raised for discussion.

Web based content and hybrid teaching: student perceptions of the effectiveness of using web based content and hyper-linked teaching units in teaching hybrid business and marketing post secondary classes /

This exploratory, descriptive action research study is based on a survey of a sample of convenience consisting of 172 college and university marketing students, and 5 professors who were experienced in teaching in an internet based environment. The students that were surveyed were studying e-commerce and international business in 3^^ and 4*'' year classes at a leading imiversity in Ontario and e-commerce in 5^ semester classes at a leading college. These classes were taught using a hybrid teaching style with the contribution of a large website that contained pertinent text and audio material. Hybrid teaching employs web based course materials (some in the form of Learning Objects) to deliver curriculimi material both during the attended lectures and also for students accessing the course web page outside of class hours. The survey was in the form on an online questionnaire. The research questions explored in this study were: 1. What factors influence the students' ability to access and learn from web based course content? 2. How likely are the students to use selected elements of internet based curriculum for learning academic content? 3. What is the preferred physical environment to facilitate learning in a hybrid environment? 4. How effective are selected teaching/learning strategies in a hybrid environment? The findings of this study suggest that students are very interested in being part of the learning process by contributing to a course web site. Specifically, students are interested in audio content being one of the formats of online course material, and have an interest in being part of the creation of small audio clips to be used in class.

A constructivist grounded theory of firefighter perceptions of stress, coping and the relationship to health

This qualitative research was a constructivist grounded theory designed to develop an understanding of how firefighters perceive and cope with stressful situations and the impact this has on their perceptions of health. This study was framed in a social ecological perspective with the community of firefighting providing the environment within which to explore stress and coping. Of particular concern here are the stressors associated with firefighting. Prior research with firefighters has often been epidemiological and statistical in nature, focusing on measures of cardiovascular disease, cancer, and depression (Baker & Williams, 2001 ; Brown et al., 2002; Murphy et al.,1999; Regehr et al., 2002; Regehr et al., 2003). Qualitative research examining the perception of stress among firefighters that includes personal stories allows firefighters the opportunity to describe what it is like to be met with physically and mentally challenging situations on a daily basis. Twelve in-depth, semi-structured, face-to-face interviews with a brief questionnaire were conducted with firefighters from a Southern Ontario Fire Department. Four main themes emerged describing the persona of the firefighter, the stressors of firefighters, coping strategies of firefighters, and firefighters' perceptions of health. Stressors include requirements of the job, traumatic calls, tensions with co-workers, the struggle between the family at home and the family at work, political stressors with the City, and the inner struggle. Avoidance coping, approach coping, and gaining perspective emerged as the three coping styles of firefighters. Health was defined as including physical, mental, social and spiritual aspects. A model of the findings is provided that depicts the cyclical nature of the stress-coping-health relationship among firefighters.

The perceptions of commune health workers about an education strategy received for counselling fathers about infant and breastfeeding involvement

Objective To evaluate the perceptions of healthcare workers in Vietnam about the efficacy of a continuing education strategy about father involvement and breastfeeding counselling. Design One group, post-test only, quasi-experimental design Method A questionnaire based on Social Cognitive Theory (SCT; Bandura, 2004) was disseminated to participants (N=28). This questionnaire measured self-efficacy, outcome expectations, socio-structural factors, goal setting and behaviour. Multiple regressions were analyzed predicting participants’ practice of client focused father involvement consulting. Results Bivariate correlations demonstrated the anticipated patterns of association between SCT-based constructs. Multiple regression analysis indicated that outcome expectations and barriers were significant predictors of client focused father involvement consulting. Conclusions Participants reported that the education increased their self-efficacy, outcome expectations and client focused father involvement consulting behaviour. Future education should be accessible, increase counselling confidence and address beliefs about the outcomes and challenges of father involvement consulting.

A study of information-seeking behavior and user perceptions of academic researchers

The purpose of this paper is to examine the information-seeking behavior of science and social science research scholars, including service effectiveness, satisfaction level on different type of sources and various methods adopted by the scholars for keeping up to dateData were gathered using a questionnaire survey of 200, randomly selected, PhD students of science and social science departments of four universities in Kerala, IndiaAlthough similarities exist between social science and science PhD students with regard to information-seeking behavior, there are significant differences as well. There is a significant difference between science and social science scholars on the perception of the adequacy of print journals and database collection which are very relevant to the research purposes. There is no significant difference between science and social science scholars on the perception of the adequacy of e-journals, the most used source for keeping up to date. The study proved that scholars of both the fields are dissatisfied with the effectiveness of the library in keeping them up to date with latest developments

Farmers’ knowledge and perceptions of potato pests and their management in Uganda

As we initiate entomological research on potato (Solanum tuberosum L.) in Uganda, there is need to understand farmers’ knowledge of existing insect pest problems and their management practices. Such information is important for designing a suitable intervention and successful integrated pest management (IPM) strategy. A farm household survey using a structured questionnaire was conducted among 204 potato farmers in six districts of Uganda (i.e., Kabale, Kisoro, Mbale, Kapchorwa, Mubende, and Kyegegwa) during August and September 2013. Diseases, insect pests, price fluctuations, and low market prices were the four highest ranked constraints in potato production, in order of decreasing importance. Cutworms (Agrotis spp.), aphids (Myzus persicae (Sulzer)), and potato tuber moth (Phthorimaea operculella (Zeller)) were the three most severe insect pests. Ants (Dorylis orantalis Westwood), whiteflies (Bemisia tabaci (Gennadius)), and leafminer flies (Liriomyza huidobrensis (Blanchard)) were pests of moderate importance. Major yield losses are predominantly due to late blight (Phytophthora infestans (Mont.) de Bary) and reached 100% without chemical control in the districts of Kabale, Kisoro, Mbale, and Kapchorwa. On average, farmers had little to moderate knowledge about pest characteristics. The predominant control methods were use of fungicides (72% of respondents) and insecticides (62% of respondents). On average, only 5% of the 204 farmers knew about insect pests and their natural enemies. This lack of knowledge calls for training of both farmers and extension workers in insect pest identification, their biology, and control. Empowering farmers with knowledge about insect pests is essential for the reduction of pesticide misuse and uptake of more environmentally friendly approaches like IPM. Field surveys would need follow-up in order to assess the actual field infestation rates and intensities of each insect pest and compare the results with the responses received from farmers.

Too much information? : Drama teachers’ perceptions of the value of subject knowledge

This paper reports on research into what drama teachers consider they really need to know as drama specialists. In the first instance the very concept of knowledge is discussed as it pertains to education in the arts as is the current situation in England regarding the extent to which new drama teachers’ subject specialist knowledge has been formally accredited and what the implications of this may be to an evolving curriculum. The research itself initially involved using a questionnaire to investigate the way in which drama teachers prioritised different aspects of professional knowledge. Results of this survey were deemed surprising enough to warrant further investigation through the use of interviews and a multiple-sorting exercise which revealed why the participants prioritised in the way they did. Informed by the work of Bourdieu, Foucault and Kelly, a model is proposed which may help explain the tensions experienced by drama teachers as they try to balance and prioritise different aspects of professional knowledge.

Interdisciplinarity: perceptions of the value of computer-supported collaborative work in design for the built environment

This paper presents the findings from a study into the current exploitation of computer-supported collaborative working (CSCW) in design for the built environment in the UK. The research is based on responses to a web-based questionnaire. Members of various professions, including civil engineers, architects, building services engineers, and quantity surveyors, were invited to complete the questionnaire. The responses reveal important trends in the breadth and size of project teams at the same time as new pressures are emerging regarding team integration and efficiency. The findings suggest that while CSCW systems may improve project management (e.g., via project documentation) and the exchange of information between team members, it has yet to significantly support those activities that characterize integrated collaborative working between disparate specialists. The authors conclude by combining the findings with a wider discussion of the application of CSCW to design activity-appealing for CSCW to go beyond multidisciplinary working to achieve interdisciplinary working.