Independent nursing practice: a national survey of attitudes of practice employed nurses in Scotland.

BACKGROUND: During the last decade, the number of practice nurses has increased dramatically and their role has evolved according to demand rather than through planning and design. Consequently, many nursing roles have become extended and nurses now perform many of the tasks previously performed by doctors. With increasing emphasis on primary care, their new role has become widely accepted and continues to develop. There is now a real question as to whether, with suitable training, it is timely to consider a formal extension to independent practice for at least some practice nurses. OBJECTIVE: The aim was to describe the characteristics of practice nurses and to explore their attitudes to independent practice. For the purpose of this study, independent practice was taken to mean specialised autonomous practice. DESIGN: This was a descriptive, cross-sectional study undertaken by postal questionnaire. A two stage sampling process was used. SETTING: Firstly a 1/2 sample of all general practices in Scotland (n = 625) was asked for the names of all practice employed nurses. Secondly, one practice nurse from each practice was sent a postal questionnaire. RESULTS: Five hundred and thirty eight general practices responded. Eighty six practices had no practice employed nurse. Four hundred and thirty three practices (96%; 433/452) were willing to allow their practice nurses to be approached to take part in the study. Four hundred practice nurses returned questionnaires (92%; 400/433). Fifteen were excluded because the nurses were not fully practice employed. Three hundred and eighty five were suitable for inclusion in the study (85%; 385/452). Most practice nurses were over 35 years of age and had been in post for more than three years. Almost half had at least one other nursing qualification in addition to registration. Eighty six percent thought that there should be independent practice for some nurses within the profession and 65% would, themselves, be happy to practise independently. CONCLUSION: Most practice nurses throughout Scotland think that there should be independent practice for some nurses.

Dyspepsia in England and Scotland.

A validated postal questionnaire has been used to establish the prevalence of dyspeptic symptoms in five geographical locations from the south coast of England to the north of Scotland. The six month period prevalence of dyspepsia in the 7428 respondents to the questionnaire is 41% and equal between the sexes, with similar prevalence rates in the centres studied. There is considerable overlap between upper abdominal symptoms and symptoms of heartburn; 56% of patients with dyspepsia experience both groups of symptoms. Symptom frequency falls progressively with age in men and women, but the proportion of people seeking medical advice for dyspepsia rises with age. One quarter of the dyspeptic patients studied have consulted a general practitioner about their symptoms. This study suggests that the prevalence of dyspepsia in the community has changed little over the last 30 years, despite evidence that the frequency of peptic ulcer disease is falling. Symptom prevalence is unrelated to social class, but this factor is associated with consultation behaviour, the consultation rate rising from 17% in social class 1 to 29% in social class 4. The use of investigations--barium meal and endoscopy--is similarly related to social class; the lowest rate for ulcer diagnosis (4.7%) is found in social class 1 and the highest (17.1%) in social class 5.