Primeros pasos en la investigación cualitativa: desarrollo de una propuesta de investigación / Getting started with qualitative research: developing a research proposal

El objetivo de este artículo es ilustrar en detalle las cuestiones importantes que tienen que tratar los investigadores noveles durante el diseño de una propuesta de investigación cualitativa en Enfermería y en ciencias de la salud. Los autores han desarrollado un proceso de 17 pasos para describir el desarrollo de un proyecto de investigación cualitativa. Este proceso puede ayudar de un modo sencillo para comenzar a investigar y asegurar una propuesta integral y rigurosa (AU)

The aim of this article is to illustrate in detail important issues that research beginners may have to deal with during the design of a qualitative research proposal in nursing and health care. The authors have developed a 17-step process to describe the development of a qualitative research project. This process can serve as an easy way to start research and to ensure a comprehensive and thorough proposal (AU)

Ectopic pregnancy: risk factors, diagnostic procedures and treatment.

This article provides an overview of ectopic pregnancy and describes the risk factors, diagnostic procedures and treatment options. In addition, the nurse's role in caring for and supporting women experiencing an ectopic pregnancy is discussed.

'Again': the impact of recurrence on survivors of cancer and family members.

AIM: To examine the psychosocial impact of recurrence on survivors of cancer and their family members. BACKGROUND: Cancer recurrence is described as one of the most stressful phases of cancer. Recurrence brings back many negative emotions, which are different and may be more intense than those after first diagnosis of cancer. Survivors and their family members have to deal with new psychological distress. DESIGN: A qualitative descriptive study was conducted in four cancer units of two hospitals in North of Spain. METHODS: Fifteen survivors of cancer with a recent diagnosis of recurrence, 13 family members and 14 nurses were interviewed. Data collection and analysis were based on the constant comparative method of grounded theory. RESULTS: Four major categories were found: (1) 'Again': when cancer comes back, (2) the shock of recurrence, (3) the impact of the diagnosis on family life, and (4) factors that influence the impact of recurrence. Learning that cancer had come back was, for most of the families, more devastating than hearing that they had cancer for the first time. Signs of shock and suffering were experienced by families as an initial response to recurrence. The new diagnosis often entailed a change in the family life. Survivorship period and age seemed also significant in the psychosocial experience of recurrence. CONCLUSIONS: The term 'again', used by all the participants to describe a recurrence of the disease, symbolised a beginning and a continuation with cancer; it implied a re-encounter with health services, and it represented new suffering for the families. RELEVANCE TO CLINICAL PRACTICE: Therapeutic nursing interventions should be planned and provided to both patients with recurrent cancer and their family members. Family nursing can play an important role in helping families master the impact of the recurrent illness.

Getting started with qualitative research: developing a research proposal.

The aim of this article is to illustrate in detail important issues that research beginners may have to deal with during the design of a qualitative research proposal in nursing and health care. Cristina Vivar has developed a 17-step process to describe the development of a qualitative research project. This process can serve as an easy way to start research and to ensure a comprehensive and thorough proposal.

Informational and emotional needs of long-term survivors of breast cancer.

AIMS: This paper presents a review of the informational and emotional needs of long-term breast cancer survivors, with particular attention to the different needs of women according to their age and to critiquing healthcare provision to these women. BACKGROUND: Women with a history of breast cancer are the largest group of cancer survivors. While they may be disease-free, their cancer diagnosis has ongoing physical and psychosocial implications for their lives and well-being. METHODS: A literature search for the period 1985 to March 2004 was undertaken using the CINAHL, MEDLINE, CANCERLIT, PubMed and CUIDEN databases and the keywords long-term, breast cancer survivors, needs and social support. Hand-searching was also done, and reference lists of papers were examined for relevant studies. RESULTS: Survivors of breast cancer continue to experience informational and emotional needs during their long-term survivorship, and variation in the amount and type of support required is age-related. However, women's needs are often unmet by oncology teams and they have to find other sources of support, such as self-help groups. Thus, ongoing care is required after completion of medical treatment, and nurses have a significant contribution to make here. CONCLUSIONS: Nursing research on long-term breast cancer survivorship is limited. Future studies need to investigate the unmet needs of long-term survivors of breast cancer and, specifically, explore the kind of support women would like to receive from oncology teams, and particularly from breast cancer nurses.

Emotional intelligence in nursing work.

BACKGROUND: Emotional labour has been widely accepted in the literature as part of nursing work, however the contribution of emotional intelligence in the nursing context requires further study. AIM: This paper aims to present an analysis of the literature on emotional intelligence and emotional labour, and consider the value of emotional intelligence to nursing. METHOD: A literature search was undertaken using the CINAHL and MEDLINE databases. Search terms used were 'emotions', 'intelligence', 'emotions and intelligence' and 'emotional labour'. A hand-search of relevant journals and significant references added to the data. RESULTS: Emotional intelligence plays an important part in forming successful human relationships. Emotional labour is important in establishing therapeutic nurse-patient relationships but carries the risk of 'burnout' if prolonged or intense. To prevent this, nurses need to adopt strategies to protect their health. The potential value of emotional intelligence in this emotional work is an issue that still needs to be explored. CONCLUSIONS: Analysis of the literature suggests that the modern demands of nursing draw on the skills of emotional intelligence to meet the needs of direct patient care and co-operative negotiations with the multidisciplinary team. The significance of this needs to be recognized in nurse education. The link between emotional intelligence and emotional labour is a fruitful area for further research. The potential benefits of gaining a better understanding of how these concepts interact is largely conjecture until we have more evidence. The prospect that there may be advantages to both nurses and patients is a motivating factor for future researchers.

Tiredness and fatigue in the postnatal period.

AIMS OF THE PAPER: This paper aims to analyse critically a selective review of the literature on tiredness and fatigue in health and illness. This analysis is then applied to the experience of the new mother in the postnatal period. BACKGROUND AND RATIONALE: Although the twin concepts of tiredness and fatigue are well known in both sickness and health, our understanding of them is less complete. This paradox of familiarity and lack of understanding applies particularly to the postnatal period. METHOD: A literature search was undertaken using MEDLINE, CINAHL and Web of Science. The search terms 'tiredness', 'fatigue' and 'post natal' were used. FINDINGS: This search of the literature produced a small number of articles. Few of these, however, addressed the problem of tiredness or fatigue in the postnatal period, suggesting that this problem needs more research attention. CONCLUSIONS: On the basis of this analysis, it is suggested that childbirth education could be extended to foster more realistic expectations and more effective coping skills to facilitate women's adjustment to motherhood. The possibility of midwives educating mothers about the need to access, recruit and delegate some household activities to willing helpers is addressed. We propose that midwives can help women to have more realistic expectations about life after the birth, by providing advice and legitimizing the need for support and the use of coping mechanisms to assist the transition to motherhood.

Flow effects on the viability and lysis of suspended mammalian cells.

A mouse myeloma cell line growing in suspension was subjected intermittently to flow through a sudden contraction and turbulent flow in a capillary tube. The probability of lysis per pass through the capillary tube increased with average wall shear stress level and with residence time per pass in the tube. Lysis was first observed at a threshold average wall shear stress level of 1800 dyn/cm2. Although the flow caused lysis, it had no effect on cell viability.