Older peoples' perceptions of oral health: 'it's just not that simple'.

OBJECTIVES: Little is known about older persons' perceptions of oral health and oral health care. The purpose of this study was to explore the viewpoint of older adults' regarding their oral health care practices. METHODS: A qualitative interpretive methodology was employed comprising three analytic levels: coding of data into concepts, analysis of concepts into themes, followed by an in-depth analysis of relationships within concepts and between themes. In-depth individual interviews were conducted with 19 participants aged 65 to 87 years. RESULTS: Older people's decision to access oral health care involves complex and personally meaningful strategies. A dental visit surfaces hopes and fears based on past and present experiences. Mouth and teeth are not merely objects of dental care; they represent a person's social and relational self. Age-related changes challenge the relational self as represented in societal ideal images of youth and perfection (the perfect smile). This study highlights older peoples' resilience and determination when faced with the dilemmas in accessing oral health care--it costs, personally as well as financially. Contrary to the assumption that older peoples' oral health status is related to neglect, rather for many, it is the result of the intersection of their history with technological advances. CONCLUSIONS: These findings challenge oral health care practitioners to be sensitive to the contexts affecting their older client's oral health care status. They do not 'just go' to the dentist; they bring with them their past dental experiences and their hopes for the future. It matters how one is treated at this vulnerable time.

Stories of lesbian in/visibility in nursing.

In this article, a study of the life histories of 5 self-identified lesbian women in nursing is reported. A metastory of "In/Visibility" captured the essence of lesbians being the focus of intense scrutiny while at the same time feeling the pressure to keep their lifestyle and identity hidden from others. Seven story themes were elaborated: closeting of lesbianism in nursing, isolating and hiding from self and others, living a double-life, self-loathing and shame, experiencing discrimination from others, keeping safe, and threatening others who are closeted.

Three approaches to use of questioning by clinical lecturers: a pilot study.

In the current health care climate nurses require very good problem solving and critical thinking skills. Questioning as a teaching strategy is viewed as one way to promote such student learning. Using a comparative descriptive quantitative and a qualitative approach, this pilot study investigated the types of questions asked of students by lecturers working within the preceptorship model in the clinical setting. A convenience sample of five volunteer nursing lecturers were tape recorded during their interactions with undergraduate students (n = 8). Initially two auditing approaches were used to analyse the interview data: relevant parts of Mogan and Warbinek's (1994) Observation of Nursing Teachers in Clinical Settings instrument (ONTICS Tool) and Craig and Page's (1981) conceptual framework as adapted by Sellappah, Hussey, Blackmore and McMurray (1998). The data were further analysed by qualitative content analysis. This study supported the findings of the ONTICS tool and Sellappah et al's framework that teachers asked predominantly directive style and low level questions. What the two approaches did not adequately capture was the complexity of the lecturers' questioning behaviours or the effects of contextual factors. The content analysis process however, identified three broad categories forming a model that effectively integrated aspects of the context of the lecturer/student interaction. It also represented lecturer questioning behaviours more comprehensively. The preliminary model offered has the potential to highlight the importance of lecturers asking questions that lead students to extend their thinking about practice. It could also contribute to student learning by assisting lecturers to understand the value and critical nature of their questioning and serve as a framework for staff development.

Revealing sexuality: have nurses' knowledge and attitudes changed?

All nurses should be adequately prepared for assisting clients with issues relating to sexuality. This article describes a descriptive study undertaken between 1988 and 1991 which used a questionnaire to survey the knowledge and attitudes of New Zealand pre- and post-registration nursing students regarding sexuality. The results of this study have previously been available only in an unpublished report. As interest in this area of research is increasing overseas, and as it is now time to consider resurveying New Zealand nurses, it is useful to have a summary of the findings available to a wider audience. Phase One analysed the responses of a convenience sample of 319 registered nurses undertaking a one-year post-registration programme in four New Zealand schools of nursing in either 1988 or 1989. Phase Two analysed 575 questionnaires completed by a convenience sample of nursing students in their first and/or third years of a three-year programme leading to nursing registration. Analysis of the 35 true/false items showed that students near the completion of their programme were as knowledgeable or more knowledgeable than registered nurses, although there were areas where both groups lacked information. Analysis of the 33 items measuring attitudes on a 5-point Likert scale suggested that the attitudes of both pre- and post-registration students were more liberal than conservative, but with some differences discernible when participants were grouped by demographic variables. Importantly, the study found that 55% of pre-registration students, and 88% of registered nurse participants, felt that nurses were inadequately prepared for helping clients with concerns about sexual matters. The findings are compared with those of studies undertaken overseas this decade.