The classification of schizophrenia is currently under review in a coordinated worldwide consulta... more The classification of schizophrenia is currently under review in a coordinated worldwide consultation for the Diagnostic and Statistical Manual of Mental Disorders (DSM V) and the International Classification of Diseases (ICD 11) - the standard manuals for psychiatric classification. To understand the issues under consideration, the underpinning foundations of the concept need to be understood. This article, the first of two parts, analyses the theoretical input of Kraepelin, Bleuler, Jaspers, Schneider and Crow in order to delineate the boundaries of current discussions. The second part will analyze the importance of nursing engagement with classification by contrasting it with the harm of not doing so.
The classification of schizophrenia is currently under review in a coordinated worldwide consulta... more The classification of schizophrenia is currently under review in a coordinated worldwide consultation for the Diagnostic and Statistical Manual of Mental Disorders (DSM V) and the International Classification of Diseases (ICD 11)--the standard manuals for psychiatric classification. Classification can seem remote from nurses by appearing to be the antithesis of person-centred approaches to recovery. This should not be the case. Nurses need to critically engage with methods of classification in order to better understand the biological, psychological, social and political assumptions underpinning them. It will be shown that these assumptions often compete, and some common objections to the construct of schizophrenia can be viewed as a function of this. However, it is argued here that a truly holistic approach to care needs to engage with all these factors. The alternative is to simply reject the process as irrelevant to mental health nursing. It will be shown that a corollary of this latter approach is the invention of nonsense terms such as 'mental health illness' as a function of trying to simultaneously deny yet acknowledge the existence of mental illness.
Mental Health and Learning Disabilities Research and Practice, 2009
Background and Aims New Ways of Working(NWW) encourages extensiono ft raditionalc aringr oles.T h... more Background and Aims New Ways of Working(NWW) encourages extensiono ft raditionalc aringr oles.T hisp aper discussest he impacto fo ne of thosee xtended roles: mental health nurse prescribing, in order to assess to what extent it meetsthe principles of NWW. Method Primaryd ata wasp resented to twoc onferences on mental health nurse prescribingi n2 008. Thep rimaryd ata constituted ag rounded theoryo ft he impacto fm ental health nurse prescribingi nN HS Greater Glasgow and Clyde. This paper reports on verification of this theoryfrompractising mental healthnurse prescribersinEngland and Scotland. Results Thirty twop ractising nurse prescribersc ompleted aq uestionnaireo nt he credibilityo ft he theory. This feedbacks howed that the theoryi sacoherent representation of how nurses develop competenceinprescribing. Analysis Thep rocess nursesg ot hrough to become competent closelym irrort he principleso fN WW. This offersp racticalsupportfor the principlesinherent in NWWa nd raisesspecific issues for the wider workforce. Discussion Ac onsequenceo fa nalysingh ow high leveln urseso perate is to consider what happens to thosen ursesw ho do not operate at thisl evel.I nt hisi nstanced eficitsi nm edicine management canbeseen as afunction of old ways of working. Recommendations aremade regarding structured educationi nm edicines management from pret op ostr egistration mental health nursing to addressthesedeficits.
Journal of Reproductive and Infant Psychology, 2012
Background and aim: Measuring women's satisfaction with their birth experience has been problemat... more Background and aim: Measuring women's satisfaction with their birth experience has been problematic. Recently an attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidenced-based tool. Standard procedures for validation have limitations. Qualitative techniques such as domain analysis offer an alternative and assist in better understanding the importance of each item. This paper examines the parsimony of the Birth Satisfaction Scale (BSS), which is a 30 item questionnaire designed to measure satisfaction with childbirth, with women's actual experience of childbirth. Methods. Primary free text data collected from 207 women who original tested the BSS was concurrently analysed with firsthand accounts of birth satisfaction collected from 19 qualitative papers. Results: The domain analysis confirmed three explanatory items within the BSS: 'being in control', 'things going as planned', and 'being supported'. Conclusions: The BSS accounts for all the analysed data, suggesting it is a robust measure of satisfaction in childbirth. Strengths and limitations of the method are discussed, as are implications for practice. With further development, the instrument could be used to establish correlates with other psychometric measures, i.e., selfefficacy, anxiety, depression, locus of control and bonding; and evaluate models or care systems as a stand-alone instrument, or as a screening test prior to detailed qualitative work.
Self-poisoning by ingestion of antidepressants is a common method of suicide. Although tricyclic ... more Self-poisoning by ingestion of antidepressants is a common method of suicide. Although tricyclic antidepressants (TCAs) are no longer the first choice treatment for depression they are still commonly taken in overdose causing poisoning and admission to acute care. This article describes ...
Background This paper reports original research on choice and control in childbirth. Eight women ... more Background This paper reports original research on choice and control in childbirth. Eight women were interviewed as part of a wider investigation into locus of control in women with pre-labour rupture of membranes at term (PROM) [1]. Methods The following study uses concurrent analysis to sample and analyse narrative aspects of relevant literature along with these interviews in order to synthesise a generalisable analysis of the pertinent issues. The original PROM study had found that women experienced a higher degree of control in hospital, a finding that appeared at odds with contemporary notions of choice. However, this paper contextualises this finding by presenting narratives that lucidly subscribe to the dominant discourse of hospital as the safest place to give birth, under the premise of assuring a live healthy baby irrespective of their management type. Results This complex narrative is composed of the following themes: 'perceiving risk', 'being prepared', ...
The aim of this review was to identify the factors associated with positive experiences in non-pr... more The aim of this review was to identify the factors associated with positive experiences in non-professional carers of someone with a cancer diagnosis. A systematic search of the following electronic databases was undertaken: Cochrane Library, CINAHL, PsycINFO, SocINDEX and Medline. Literature was searched using terms relating to cancer, caring and positive experiences. Additional records were identified through a manual search of relevant reference lists. The search included studies published in English from 1990-June 2015. Two raters were involved in data extraction, quality appraisal, coding, synthesis, and analysis. Evolutionary concept analysis was used as a guiding framework in order to focus on attributes associated with positive experiences. Fifty two articles were included in this review. Analysis identified four overarching attributes: 'gender', 'personal resources', 'finding meaning' and 'social context'. Despite the challenges associated with caring this combination of internal and external factors enabled some carers to report positive experiences related to caring. This knowledge may be clinically helpful when designing supportive interventions. Strengths and limitations of these claims are discussed.
People living with and beyond cancer are vulnerable to a number of physical, functional and psych... more People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impacts on the dynamics of the clinical consultation. This study aims to establish (1) how HNA affects the type of conversation that goes on during a clinical consultation and (2) how these putative changes impact on shared decision-making and self-efficacy. The study is hosted by 10 outpatient oncology clinics in the West of Scotland and South West England. Participants are patients with a diagnosis of head and neck, breast, urological, gynaecological and colorectal cancer who have received treatment for their cancer. Patients are randomised to an intervention or control group. The control group entails standard care-routine consultation between the patient and clinician. In the in...
The Distress Thermometer (DT) is a well validated screening tool, demonstrably sensitive and reas... more The Distress Thermometer (DT) is a well validated screening tool, demonstrably sensitive and reasonably specific to the construct of distress in cancer. Its brevity makes it ideal to incorporate into a system of distress management. To ascertain how far this idea has been developed in practice, and to support future research, a literature review was undertaken. Medline, CINAHL, PsycINFO, Embase, ASSIA, British Nursing Index, AMED, CCTR, and HMIC were systematically searched. Forty studies were reviewed that examined the function of the DT alone, together with the problem list (PL), and/or other validated measures. The majority of studies validated the DT against other robust measures of distress in order to establish 'caseness' in these populations, and establish factors associated with distress. Many of the studies recommended that further research should test their findings in clinical practice. A small section of the literature focused on the clinical utility of the DT as a facilitator of consultations, and found it to have potential in this regard. It is concluded that there is enough validation research, and in line with the majority of these studies' recommendations, future research should focus on the utility of DT as part of a structured distress management programme.
This article shows that the terms compliance, adherence and concordance are used interchangeably ... more This article shows that the terms compliance, adherence and concordance are used interchangeably in the medication management literature. As such, it is argued that nurses should focus on those interventions that are demonstrably effective in enhancing medication management for the older adult rather than attempt to make sense of a meaningless ideal. In this article the concepts of concordance, compliance and adherence are first critiqued and it is then argued that all the terms remain valid for practical purposes. That is, a literature search of all the terms is required to comprehensively discuss medication management. Focus then switches to factors that have been shown to be beneficial as well as detrimental to medication management in older adults. While many factors appear to correlate with good and bad management of medication the conclusion is that individual, tailored approaches are most effective. For the purpose of this article, the term 'older adult' refers to those over 65 years where not otherwise specified.
Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schiz... more Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schizophrenia has a biological origin still predominates despite consistently inconclusive evidence. Current research consequently favours finding a cure as opposed to focusing ...
British journal of nursing (Mark Allen Publishing)
Despite global support for the ideal of shared decision making, its enactment remains difficult i... more Despite global support for the ideal of shared decision making, its enactment remains difficult in practice. The UK charity, Macmillan Cancer Support, attempted to incorporate the principles of shared decision making within a programme of distress management in Scotland. Distress management begins by completing the Distress Thermometer (DT). Although the DT is a screening tool, its function in this programme was extended to facilitate collaborative communication within a consultation. The aim of this grounded theory was to analyse the patient experience of the process. Nineteen people underwent semi-structured interviews focused on their experience of distress management. Participants were a mixed-cancer cohort aged 40-79 years. Findings were discussed in a structured manner with a further 14 service users and carers, and 19 clinical specialists in cancer. Constant comparison of all data revealed that the process of positive distress management could best be explained by reference t...
Journal of Psychiatric and Mental Health Nursing, 2008
Quantitative analysis of mental health nurse prescribers in Scotland The UK parliament approved l... more Quantitative analysis of mental health nurse prescribers in Scotland The UK parliament approved legislation expanding prescribing rights for all registered nurses in 2006. Mental health nurses do not appear to be embracing prescribing to the same degree as their colleagues. For example, mental health nurses represent 14% of the UK nursing population, but only 3% nurse prescribing population. In order to explore this disparity, the paper discusses quantitative analysis of the following objectives: (1) describe the impact of nurse prescribing on nurse prescribers in NHS Greater Glasgow and Clyde; and (2) identify differences between mental health nurse prescribers and other nurse prescribers in NHS Greater Glasgow and Clyde. Following online pilot study, a 26-item questionnaire was posted to 668 nurse prescribers in NHS Greater Glasgow and Clyde. A total of 365 questionnaires were returned (55.4%). Significant differences were found between mental health nurse prescribers and others in terms of age, gender, prescribing practice, academic achievement, method of prescribing, workplace, experience and attitude to prescribing. Possible reasons for these differences are suggested and form the basis of further planned research.
Journal of Psychiatric and Mental Health Nursing, 2010
• Competent mental health nurse prescribers improve medicine management for their clients. • Comp... more • Competent mental health nurse prescribers improve medicine management for their clients. • Competent prescribers apply the principles of concordance in action. • Mental health nurse prescribers continue to struggle with the anxiety that prescribing somehow conflicts with the purpose of nursing. Successful prescribers negotiate this. • Becoming a prescriber generates greater understanding of medicines. This is to be expected, but on reflection this increased understanding revealed previously unknown levels of incompetence.
1. Nurs Times. 2006 Sep 19-25;102(38):38-40. The requirements for original doctoral research in n... more 1. Nurs Times. 2006 Sep 19-25;102(38):38-40. The requirements for original doctoral research in nursing. Snowden A. Ravenscraig Hospital, Greenock, Scotland. Clinical and academic doctorates (PhDs) demand an original piece of research. ...
There is increasing concern that mental health nurses in UK are inadequately trained in medicines... more There is increasing concern that mental health nurses in UK are inadequately trained in medicines management. Recommended solutions entail proposals for further training to improve safety for service users. Although fundamentally important, these organizational approaches lack a conceptual framework to explain how individual practitioners develop competence in medicines management. This is important because applying knowledge of how individuals learn makes strategic interventions more effective. This article presents empirical evidence of how individual mental health nurse prescribers develop competence in prescribing within the context of the therapeutic relationship. It is proposed that these findings can then be extended to inform medicines management training relevant to all mental health nurses, whether prescribers or not.
British journal of nursing (Mark Allen Publishing)
Despite global support for the ideal of shared decision making, its enactment remains difficult i... more Despite global support for the ideal of shared decision making, its enactment remains difficult in practice. The UK charity, Macmillan Cancer Support, attempted to incorporate the principles of shared decision making within a programme of distress management in Scotland. Distress management begins by completing the Distress Thermometer (DT). Although the DT is a screening tool, its function in this programme was extended to facilitate collaborative communication within a consultation. The aim of this grounded theory was to analyse the patient experience of the process. Nineteen people underwent semi-structured interviews focused on their experience of distress management. Participants were a mixed-cancer cohort aged 40-79 years. Findings were discussed in a structured manner with a further 14 service users and carers, and 19 clinical specialists in cancer. Constant comparison of all data revealed that the process of positive distress management could best be explained by reference t...
Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schiz... more Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schizophrenia has a biological origin still predominates despite consistently inconclusive evidence. Current research consequently favours finding a cure as opposed to focusing ...
The classification of schizophrenia is currently under review in a coordinated worldwide consulta... more The classification of schizophrenia is currently under review in a coordinated worldwide consultation for the Diagnostic and Statistical Manual of Mental Disorders (DSM V) and the International Classification of Diseases (ICD 11) - the standard manuals for psychiatric classification. To understand the issues under consideration, the underpinning foundations of the concept need to be understood. This article, the first of two parts, analyses the theoretical input of Kraepelin, Bleuler, Jaspers, Schneider and Crow in order to delineate the boundaries of current discussions. The second part will analyze the importance of nursing engagement with classification by contrasting it with the harm of not doing so.
The classification of schizophrenia is currently under review in a coordinated worldwide consulta... more The classification of schizophrenia is currently under review in a coordinated worldwide consultation for the Diagnostic and Statistical Manual of Mental Disorders (DSM V) and the International Classification of Diseases (ICD 11)--the standard manuals for psychiatric classification. Classification can seem remote from nurses by appearing to be the antithesis of person-centred approaches to recovery. This should not be the case. Nurses need to critically engage with methods of classification in order to better understand the biological, psychological, social and political assumptions underpinning them. It will be shown that these assumptions often compete, and some common objections to the construct of schizophrenia can be viewed as a function of this. However, it is argued here that a truly holistic approach to care needs to engage with all these factors. The alternative is to simply reject the process as irrelevant to mental health nursing. It will be shown that a corollary of this latter approach is the invention of nonsense terms such as 'mental health illness' as a function of trying to simultaneously deny yet acknowledge the existence of mental illness.
Mental Health and Learning Disabilities Research and Practice, 2009
Background and Aims New Ways of Working(NWW) encourages extensiono ft raditionalc aringr oles.T h... more Background and Aims New Ways of Working(NWW) encourages extensiono ft raditionalc aringr oles.T hisp aper discussest he impacto fo ne of thosee xtended roles: mental health nurse prescribing, in order to assess to what extent it meetsthe principles of NWW. Method Primaryd ata wasp resented to twoc onferences on mental health nurse prescribingi n2 008. Thep rimaryd ata constituted ag rounded theoryo ft he impacto fm ental health nurse prescribingi nN HS Greater Glasgow and Clyde. This paper reports on verification of this theoryfrompractising mental healthnurse prescribersinEngland and Scotland. Results Thirty twop ractising nurse prescribersc ompleted aq uestionnaireo nt he credibilityo ft he theory. This feedbacks howed that the theoryi sacoherent representation of how nurses develop competenceinprescribing. Analysis Thep rocess nursesg ot hrough to become competent closelym irrort he principleso fN WW. This offersp racticalsupportfor the principlesinherent in NWWa nd raisesspecific issues for the wider workforce. Discussion Ac onsequenceo fa nalysingh ow high leveln urseso perate is to consider what happens to thosen ursesw ho do not operate at thisl evel.I nt hisi nstanced eficitsi nm edicine management canbeseen as afunction of old ways of working. Recommendations aremade regarding structured educationi nm edicines management from pret op ostr egistration mental health nursing to addressthesedeficits.
Journal of Reproductive and Infant Psychology, 2012
Background and aim: Measuring women's satisfaction with their birth experience has been problemat... more Background and aim: Measuring women's satisfaction with their birth experience has been problematic. Recently an attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidenced-based tool. Standard procedures for validation have limitations. Qualitative techniques such as domain analysis offer an alternative and assist in better understanding the importance of each item. This paper examines the parsimony of the Birth Satisfaction Scale (BSS), which is a 30 item questionnaire designed to measure satisfaction with childbirth, with women's actual experience of childbirth. Methods. Primary free text data collected from 207 women who original tested the BSS was concurrently analysed with firsthand accounts of birth satisfaction collected from 19 qualitative papers. Results: The domain analysis confirmed three explanatory items within the BSS: 'being in control', 'things going as planned', and 'being supported'. Conclusions: The BSS accounts for all the analysed data, suggesting it is a robust measure of satisfaction in childbirth. Strengths and limitations of the method are discussed, as are implications for practice. With further development, the instrument could be used to establish correlates with other psychometric measures, i.e., selfefficacy, anxiety, depression, locus of control and bonding; and evaluate models or care systems as a stand-alone instrument, or as a screening test prior to detailed qualitative work.
Self-poisoning by ingestion of antidepressants is a common method of suicide. Although tricyclic ... more Self-poisoning by ingestion of antidepressants is a common method of suicide. Although tricyclic antidepressants (TCAs) are no longer the first choice treatment for depression they are still commonly taken in overdose causing poisoning and admission to acute care. This article describes ...
Background This paper reports original research on choice and control in childbirth. Eight women ... more Background This paper reports original research on choice and control in childbirth. Eight women were interviewed as part of a wider investigation into locus of control in women with pre-labour rupture of membranes at term (PROM) [1]. Methods The following study uses concurrent analysis to sample and analyse narrative aspects of relevant literature along with these interviews in order to synthesise a generalisable analysis of the pertinent issues. The original PROM study had found that women experienced a higher degree of control in hospital, a finding that appeared at odds with contemporary notions of choice. However, this paper contextualises this finding by presenting narratives that lucidly subscribe to the dominant discourse of hospital as the safest place to give birth, under the premise of assuring a live healthy baby irrespective of their management type. Results This complex narrative is composed of the following themes: 'perceiving risk', 'being prepared', ...
The aim of this review was to identify the factors associated with positive experiences in non-pr... more The aim of this review was to identify the factors associated with positive experiences in non-professional carers of someone with a cancer diagnosis. A systematic search of the following electronic databases was undertaken: Cochrane Library, CINAHL, PsycINFO, SocINDEX and Medline. Literature was searched using terms relating to cancer, caring and positive experiences. Additional records were identified through a manual search of relevant reference lists. The search included studies published in English from 1990-June 2015. Two raters were involved in data extraction, quality appraisal, coding, synthesis, and analysis. Evolutionary concept analysis was used as a guiding framework in order to focus on attributes associated with positive experiences. Fifty two articles were included in this review. Analysis identified four overarching attributes: 'gender', 'personal resources', 'finding meaning' and 'social context'. Despite the challenges associated with caring this combination of internal and external factors enabled some carers to report positive experiences related to caring. This knowledge may be clinically helpful when designing supportive interventions. Strengths and limitations of these claims are discussed.
People living with and beyond cancer are vulnerable to a number of physical, functional and psych... more People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impacts on the dynamics of the clinical consultation. This study aims to establish (1) how HNA affects the type of conversation that goes on during a clinical consultation and (2) how these putative changes impact on shared decision-making and self-efficacy. The study is hosted by 10 outpatient oncology clinics in the West of Scotland and South West England. Participants are patients with a diagnosis of head and neck, breast, urological, gynaecological and colorectal cancer who have received treatment for their cancer. Patients are randomised to an intervention or control group. The control group entails standard care-routine consultation between the patient and clinician. In the in...
The Distress Thermometer (DT) is a well validated screening tool, demonstrably sensitive and reas... more The Distress Thermometer (DT) is a well validated screening tool, demonstrably sensitive and reasonably specific to the construct of distress in cancer. Its brevity makes it ideal to incorporate into a system of distress management. To ascertain how far this idea has been developed in practice, and to support future research, a literature review was undertaken. Medline, CINAHL, PsycINFO, Embase, ASSIA, British Nursing Index, AMED, CCTR, and HMIC were systematically searched. Forty studies were reviewed that examined the function of the DT alone, together with the problem list (PL), and/or other validated measures. The majority of studies validated the DT against other robust measures of distress in order to establish 'caseness' in these populations, and establish factors associated with distress. Many of the studies recommended that further research should test their findings in clinical practice. A small section of the literature focused on the clinical utility of the DT as a facilitator of consultations, and found it to have potential in this regard. It is concluded that there is enough validation research, and in line with the majority of these studies' recommendations, future research should focus on the utility of DT as part of a structured distress management programme.
This article shows that the terms compliance, adherence and concordance are used interchangeably ... more This article shows that the terms compliance, adherence and concordance are used interchangeably in the medication management literature. As such, it is argued that nurses should focus on those interventions that are demonstrably effective in enhancing medication management for the older adult rather than attempt to make sense of a meaningless ideal. In this article the concepts of concordance, compliance and adherence are first critiqued and it is then argued that all the terms remain valid for practical purposes. That is, a literature search of all the terms is required to comprehensively discuss medication management. Focus then switches to factors that have been shown to be beneficial as well as detrimental to medication management in older adults. While many factors appear to correlate with good and bad management of medication the conclusion is that individual, tailored approaches are most effective. For the purpose of this article, the term 'older adult' refers to those over 65 years where not otherwise specified.
Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schiz... more Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schizophrenia has a biological origin still predominates despite consistently inconclusive evidence. Current research consequently favours finding a cure as opposed to focusing ...
British journal of nursing (Mark Allen Publishing)
Despite global support for the ideal of shared decision making, its enactment remains difficult i... more Despite global support for the ideal of shared decision making, its enactment remains difficult in practice. The UK charity, Macmillan Cancer Support, attempted to incorporate the principles of shared decision making within a programme of distress management in Scotland. Distress management begins by completing the Distress Thermometer (DT). Although the DT is a screening tool, its function in this programme was extended to facilitate collaborative communication within a consultation. The aim of this grounded theory was to analyse the patient experience of the process. Nineteen people underwent semi-structured interviews focused on their experience of distress management. Participants were a mixed-cancer cohort aged 40-79 years. Findings were discussed in a structured manner with a further 14 service users and carers, and 19 clinical specialists in cancer. Constant comparison of all data revealed that the process of positive distress management could best be explained by reference t...
Journal of Psychiatric and Mental Health Nursing, 2008
Quantitative analysis of mental health nurse prescribers in Scotland The UK parliament approved l... more Quantitative analysis of mental health nurse prescribers in Scotland The UK parliament approved legislation expanding prescribing rights for all registered nurses in 2006. Mental health nurses do not appear to be embracing prescribing to the same degree as their colleagues. For example, mental health nurses represent 14% of the UK nursing population, but only 3% nurse prescribing population. In order to explore this disparity, the paper discusses quantitative analysis of the following objectives: (1) describe the impact of nurse prescribing on nurse prescribers in NHS Greater Glasgow and Clyde; and (2) identify differences between mental health nurse prescribers and other nurse prescribers in NHS Greater Glasgow and Clyde. Following online pilot study, a 26-item questionnaire was posted to 668 nurse prescribers in NHS Greater Glasgow and Clyde. A total of 365 questionnaires were returned (55.4%). Significant differences were found between mental health nurse prescribers and others in terms of age, gender, prescribing practice, academic achievement, method of prescribing, workplace, experience and attitude to prescribing. Possible reasons for these differences are suggested and form the basis of further planned research.
Journal of Psychiatric and Mental Health Nursing, 2010
• Competent mental health nurse prescribers improve medicine management for their clients. • Comp... more • Competent mental health nurse prescribers improve medicine management for their clients. • Competent prescribers apply the principles of concordance in action. • Mental health nurse prescribers continue to struggle with the anxiety that prescribing somehow conflicts with the purpose of nursing. Successful prescribers negotiate this. • Becoming a prescriber generates greater understanding of medicines. This is to be expected, but on reflection this increased understanding revealed previously unknown levels of incompetence.
1. Nurs Times. 2006 Sep 19-25;102(38):38-40. The requirements for original doctoral research in n... more 1. Nurs Times. 2006 Sep 19-25;102(38):38-40. The requirements for original doctoral research in nursing. Snowden A. Ravenscraig Hospital, Greenock, Scotland. Clinical and academic doctorates (PhDs) demand an original piece of research. ...
There is increasing concern that mental health nurses in UK are inadequately trained in medicines... more There is increasing concern that mental health nurses in UK are inadequately trained in medicines management. Recommended solutions entail proposals for further training to improve safety for service users. Although fundamentally important, these organizational approaches lack a conceptual framework to explain how individual practitioners develop competence in medicines management. This is important because applying knowledge of how individuals learn makes strategic interventions more effective. This article presents empirical evidence of how individual mental health nurse prescribers develop competence in prescribing within the context of the therapeutic relationship. It is proposed that these findings can then be extended to inform medicines management training relevant to all mental health nurses, whether prescribers or not.
British journal of nursing (Mark Allen Publishing)
Despite global support for the ideal of shared decision making, its enactment remains difficult i... more Despite global support for the ideal of shared decision making, its enactment remains difficult in practice. The UK charity, Macmillan Cancer Support, attempted to incorporate the principles of shared decision making within a programme of distress management in Scotland. Distress management begins by completing the Distress Thermometer (DT). Although the DT is a screening tool, its function in this programme was extended to facilitate collaborative communication within a consultation. The aim of this grounded theory was to analyse the patient experience of the process. Nineteen people underwent semi-structured interviews focused on their experience of distress management. Participants were a mixed-cancer cohort aged 40-79 years. Findings were discussed in a structured manner with a further 14 service users and carers, and 19 clinical specialists in cancer. Constant comparison of all data revealed that the process of positive distress management could best be explained by reference t...
Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schiz... more Abstract Schizophrenia remains a contentious concept. Kraepelin's presumption that schizophrenia has a biological origin still predominates despite consistently inconclusive evidence. Current research consequently favours finding a cure as opposed to focusing ...
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