This month in JAN


  • Jane Robinson Editor

The September issue of the Journal of Advanced Nursing contains 30 papers covering a wide range of subjects, and using all nine category headings. The editorial on This month in JAN will highlight some of the areas of interest and the possible cross-connections between them.

The issue begins with four papers on Nursing and health care management issues. Different from many on the theme of clinical supervision, the first paper considers what is described as the ‘conceptual muddle’ in nursing models for supervision and offers instead the structured model of cognitive therapy supervision as a possible alternative. A second paper reporting on an evaluation of nurses’ rostering practices in 50 National Health Service hospitals found that initial hypotheses regarding three approaches to rostering were not supported, and that a quite different picture emerged from the study. Strong recommendations are made for how rostering might be managed in the future. A third paper reports on research that once again demonstrates the importance of interpersonal relationships to nurses’ job satisfaction. The final paper in this section relates to Australian nurses in perioperative nursing roles. As in many areas of nursing practice the reality falls short of the ideal, and recommendations for change are made in order to influence posit- ively the cost-effective delivery of perioperative nursing care. This paper will find echoes for perioperative nurses in many other countries, including the United Kingdom, where the role is currently being debated.

Remaining with the theme of efficiency, a comparative study of the financing, provision and quality of care in nursing homes in four European countries is described. The strategic options followed by policy makers in this study contrasts intriguingly with a paper from Northern Ireland (under Issues and innovations in nursing practice) on families’ and staff's perceptions of the role of relatives in nursing homes. The authors suggest that families in their study were more willing to help with their relatives’ care than staff allowed, and that this led to their under-valuing as a resource in the nursing home setting.

The needs of families are considered in a number of further papers. For example, in a paper from Taiwan, it was found that the characteristics of caregiver needs changed during the discharge transition; from an early need for information on preparation for caregiving to one, later, where there was a greater need for emotional support. The implications for discharge planning, and for the community nursing services everywhere, are apparent. The use of the Corbin & Strauss chronic illness trajectory, not as a methodological basis for qualitative research, but as a framework in stroke rehabilitation, is considered in a further paper with implications for the care of caregivers. Pattern recognition to facilitate caring partnerships for families with cancer is suggested in a third.

Cancer care is the subject of two papers written from different perspectives but similar underlying themes may be identified. In a literature review on social perceptions of cancer, the impact of stigmatization and avoidance behaviour on social relationships is explored. Nurses’ own experiences of being present with a patient receiving a diagnosis of cancer are reported in a small qualitative study from Northern Ireland. The continuing social impact of cancer comes through very clearly in these papers, and the importance of its discussion in nursing practice and education.

Psychiatric care features in three papers. One, from Sweden, describes the experience of care as seen by the attempted suicide patient, a rare but important perspective. A second paper from England describes the characteristics of absconding patients compared with a control group of nonabsconders. Unexplained but significant variations were found between different wards and between different psychiatrists. The authors point to the need for further investigation of this phenomenon. A third paper reports on the application of Woodlands Therapy with people with moderate to severe dementia. The crucial importance of staff facilitation strategies with this group of patients, and the helpfulness of verbal interventions in promoting positive responses are described. This paper gives an important perspective on the vital, informed contribution of staff which may, mistakenly, be understood simply as a ‘caretaking’ role.

Returning to the area of support for patients and families, emotion work is discussed in one paper within the context of the ‘gift relationship’. Drawing on the earlier work of several authors, Richard Titmus’ (1970) seminal work on the altruistic noncommerical nature of the gift relationship in blood donation in Britain is cited. It is perhaps useful to remind ourselves that this paper is an example of the sociological study of nursing, as is the role of intuition and awareness in the work of health visitors in a paper in this issue on child protection.

Cross-cultural experiences are described in three papers with very different basic subject matters. Two papers from the United States of America consider, respectively, the contexts of adherence for African American men with high blood pressure, and the process of adjustment to American hospitals for Korean nurses. A third paper describes the application of primary health care principles in the Kingdom of Saudi Arabia. Together, these papers remind us that cultural considerations are present in all aspects of nursing and health care work, whether in clinical practice, nurses’ own experiences, or in nursing policy and education.

As internationalism is a continuing objective of the Journal of Advanced Nursing, this is perhaps an appropriate point to commend the September issue to our readers, and to anticipate that within its apparent wide diversity many connecting themes of interest will be found.

Ancillary