Fostering nursing research among nurse clinicians in an Australian area health service.

BACKGROUND: The Nursing Research Centre for Adaptation in Health and Illness (NRCAHI) is a collaborative effort of the University of Sydney and Central Sydney Area Health Service (CSAHS) in Sydney, Australia. This article reports findings of a research needs-analysis of clinical nursing staff in CSAHS that was conducted to provide research training. METHOD: A questionnaire was administered to a random sample of nurses working in CSAHS. The questionnaire gathered information about employment and demographic information, interest in research participation, current and future levels of research skills, and areas where skill and knowledge enhancement is desired. RESULTS: Overall, nurses expressed low levels of perceived confidence, knowledge, and research skills. Results were used as the basis for developing a range of strategies designed to enhance research confidence and participation. These strategies were sufficiently flexible to cater for the needs of nurses with varying levels of research experience. CONCLUSION: Strategies implemented by the NRCAHI in its first 4 years of operation have produced positive outcomes in terms of increased research participation.

Ageing with long-standing hearing impairment and deafness.

Until recently, ageing with a long-standing disability had not been a major consideration for governments around the world. Policy and planning for this substantial subgroup had not kept abreast with developments in regard to the growing numbers of older people in general. Consultations held in Australia provided information and recommendations for use by governments and service agencies. The focus was on the viewpoints of consumers. This article reports results for people with long-standing deafness and hearing impairment. It is believed that disadvantages throughout life act to restrict freedom of choice and well-being in old age. Important factors perceived to underlie disadvantage include lifelong restricted access to the opportunities afforded by education and employment and their concomitant effects on the ability to develop the skills, attitudes and knowledge necessary for independence in old age; attitudes of others (including service providers); and the complexity and inflexibility of service systems. However, there are positive aspects. Comparison with published reports about people who acquired hearing loss as a result of the ageing process suggests that people with long-standing disability have learned to live with their situation. In contrast, people whose loss was associated with ageing often report emotional issues and isolation.

Strategies for promoting research participation among nurses employed as academics in the university sector.

This article documents the process of developing a research culture and enhancing research participation among nurses employed within the Faculty of Nursing at the University of Sydney. It outlines strategies and lessons learned by the researchers in order to provide information useful for others wishing to enhance research productivity. When the Institute of Nursing Studies at the Sydney College of Advanced Education amalgamated with the University of Sydney, the university sector added new dimensions to the job responsibilities of nurse academics. In particular, active research participation became an integral part of academic duties. Previously, relatively few members of academic staff were actively involved in research. This article reports the strategies implemented to promote research. The first step was conduct of an academic staff research needs analysis. Results from this project were used to design a research promotion strategy. A follow-up survey was conducted 2 years later in order to determine level of research skills and participation within faculty staff. Results indicate a substantial change in perceived research skills and confidence.

The Senior Psychiatrist Survey III: attitudes towards personal ageing, life experiences and psychiatric practice.

OBJECTIVE: The aim of this study is: to explore whether there is a relationship between the effects of gender, age and perceptions of personal health on psychiatrist's reactions to personal ageing; and to determine the effects of psychiatrist's reactions to personal ageing upon their approach to clinical practice, retirement planning and post-retirement activities. METHOD: A postal survey was conducted. Respondents were Fellows of the Royal Australian and New Zealand College of Psychiatrists resident in Australia or New Zealand. Of 1086 eligible subjects, 529 participated. The main outcome measures were: Reactions to Ageing Questionnaire (RAQ); self-rated health; location and type of psychiatric practice; the perceived benefits and drawbacks of age on psychiatric practice and case selection; and retirement plans. RESULTS: Positive attitudes towards personal ageing were significantly associated with old age, males and good or excellent self-rated health. Negative attitudes were associated with working in universities and anticipated retirement due to poor health. Field of practice, anticipated post-retirement activities and approach to clinical practice were not found to have a significant effect on attitudes towards personal ageing. CONCLUSIONS: The effects of life experiences on psychiatrists' attitudes towards personal ageing are complex. Attitudes towards personal ageing have little impact on psychiatric practice.

An international validation of the interaction with disabled persons scale.

The Interaction with Disabled Persons Scale (IDP) was devised to measure attitudes in terms of discomfort reported about social interaction with people with disabilities. The Scale has been used in Australia for ten years. This article reports results of an international validation project that was designed to determine whether psychometric characteristics and norms emerging for Australian groups apply elsewhere. A methodological proforma was developed to maximize uniformity of data collection across nine countries: Australia, Canada, Croatia, England, Germany, Hong Kong, Poland, Scotland and the United States. In most countries the Scale was administered in English; however it also was translated into Germany, Polish, French and Croat. Results indicate that across countries mean scores fell within ten points, similar moderate to high levels of item homogeneity occurred and level of prior contact with people with disabilities emerged as the strongest predictor of IDP scores. It was concluded that the IDP Scale is a valid measure that is able to discriminate between respondents within the countries included in the study.

The need for disability awareness training among rurally based Australian general medical practitioners.

This project followed a needs analysis of people with disabilities living in rural and remote areas of New South Wales, Australia, in which consumers (people with disabilities and their carers or closest person) argued that there was an urgent need for disability awareness training for rurally based general medical practitioners (GPs). The project reported here explored the perceptions of rurally based GPs to determine whether they also perceived a need for disability awareness training. It also explored GPs' awareness and use of referral services available within their communities. Information gathered through questionnaires was used by a discussion group to develop recommendations. These support the need for disability awareness training for GPs at both undergraduate and in-service levels, and include strategies for providing information to rurally based professionals on an ongoing and regular basis in order to address the difficulties they experience in keeping up to date on issues associated with disability.

Attitudes toward people with disabilities of physiotherapists and members of the general population.

The Interaction with Disabled Persons (IDP) Scale is a new instrument developed to measure community attitudes towards people with disabilities. This article reports a section of the validation study for the IDP which took place between 1988 and 1990. It reports a comparison of performance on the IDP of a sample of 109 practising physiotherapists who responded to a questionnaire distributed by the Australian Physiotherapy Association and a sample of 4180 cases which covered a broad cross section of the Australian population. Results support hypotheses that members of the physiotherapist sample would be more positive in their attitudes and that positiveness of attitude is related to level of prior close contact with people with disabilities.

RNs as teachers of junior doctors.

Interviews with registered nurses and with interns were part of a preliminary study that explored the question of whether, because of the close working relationships between junior doctors and registered nurses on the wards, the latter might in fact play an important role in educating and supervising the former. Results of the study provide support for the hypothesis that nurses do play a role in teaching interns clinical procedures and in inducing them into ward routines and aspects of patient care. However, this teaching function is officially unacknowledged. It appears to proceed within the confines of the 'doctor-nurse game' in that the teaching-learning relationship involves an inversion of power and authority that cannot be acknowledged by participants. One recommendation from the study is that if registered nurses play this teaching role they should receive training and recognition for it.

Judgements by health professionals of personal characteristics of people with a visible physical disability.

Discussion within rehabilitation literature suggests that visible disability is a cue which influences impressions that others form of a person. These impressions extend to include personality and social characteristics that have no necessary relationship with the disability. Evidence of such "spread" of judgement has emerged in studies with health professionals and raises concern for the quality and appropriateness of their interactions with clients with disabilities. This article incorporates the feature of disability within the wider context of implicit personality theory by exploring its effects on impression formation in conjunction with the effects of gender and manner of behaviour. A sample of 636 trainee and practising health professionals made Semantic Differential ratings of a job applicant observed in a videotaped interview. Twelve parallel videos were produced in which disability (use of a wheelchair), gender, and manner of behaviour (shy-neutral-brash) of the applicant were varied. Analyses of variance revealed significant main effects for each independent variable. Interaction effects were limited. Further study of Semantic Differential ratings indicated that respondents devalued the disabled applicants, with presence of wheelchair influencing judgments about social and psychological adjustment and about general competence and capability. Reasons posited for these findings include the nature of health professional-client relationship and occupation-related experiences. A disability awareness package is described which is aimed at health professionals and service providers and which is designed to address negative attitudes by providing accurate information and personal contact with people with disabilities.

Nurse practitioners' and students' attitudes towards people with disabilities.

This article reports the results of assessments of nurse practitioners' and nursing students' attitudes toward people with disabilities. Findings of three projects that used the Interaction with Disabled Persons Scale suggest that Australian nurses' and nursing students' attitudes are more positive than those of the general population and that nurse education strategies are effective in promoting positive attitudes. These findings contrast with the results of overseas studies which indicate that health professionals' attitudes toward people with disabilities are negative and unaccepting.

Generality vs. specificity of attitudes towards people with disabilities.

This study explored the generality vs. specificity of attitudes as measured by the Interaction with Disabled Persons Scale. This scale is a new measure devised to measure discomfort in social interaction posited to be experienced by people with low levels of prior contact with people with disabilities. Twelve parallel versions of the IDP Scale were administered to a sample of 481 respondents. Eleven versions specified a different disabling condition in the preamble to the scale, whilst one version was based on the general concept of disability. Analyses of variance indicated that type of disability did not significantly influence responding, whereas a significant main effect emerged for level of prior contact. These findings are interpreted as providing support for the rationale of the IDP Scale and for the operation of generalized attitudes towards people with disabilities. Further analysis using t tests revealed six significant differences between parallel forms for diabetes, AIDS, drug dependence and other disabilities. These results were interpreted as reflecting high public awareness of these conditions and the likelihood that they fall outside the public definition of disability.

Perceptions of disability of persons with cerebral palsy, their close relatives and able bodied persons.

The insider-outsider view of disability is applied to the perception of problems associated with cerebral palsy. Twenty-five persons with cerebral palsy, 22 close relatives and 70 able bodied members of the public were asked to rate the severity of 48 problems likely to confront a cerebral palsied adult between the ages of 18 and 35 years. Results, analysed using the Kruskall-Wallis analysis of variance, provided support for predictions that persons with cerebral palsy would perceive problems as being less severe than would their relatives or able bodied persons. Two explanations are preferred for emerging differences: the greater optimism of the disabled sample can be interpreted as support for the 'insider' concept but could also reflect expectations and standards at variance with those of other groups sampled in the study. Qualified support was received for the third prediction that relatives would perceive problems as less severe than would able bodied persons. Relatives tended to emphasize problems associated with everyday management of the disability, restrictions in functioning and concern about the future, whilst 'outsiders' emphasized psychological problems and areas of personal interaction. The latter also seemed aware of their attitudes as a source of handicap for the disabled. It was concluded that greater interaction between disabled and able bodied people could bring into closer harmony their views of life with a disability. However evidence suggests that levels of contact between the two are still relatively low.

Enhancing Physiotherapy Students' Attitudes toward Disabled People.

Negative or narrow attitudes toward the physically disabled can be detrimental to success in rehabilitation, yet programmes aimed at improving attitudes frequently fail. An 18 hour programme aimed at increasing first-year physiotherapy students' knowledge of the disabled and reasons for negative attitudes was evaluated. At course commencement when compared with an Australia-wide sample, students revealed more positive attitudes regarding the needs but not the characteristics of the disabled. At course completion students perceived the disabled as more similar to other people in their characteristics and needs. Students felt less ignorant about disability and exhibited more of a coping perspective: pitying and admiring the disabled less and fearing disability less. They still experienced guilt and discomfort regarding interaction.