Care concept in medical and nursing students' descriptions--philosophical approach and implications for medical education.

INTRODUCTION: Care is seen as something that is peculiar to the medical sciences but its meaning and status for physicians and nurses differs. OBJECTIVES: The aim of this research was to learn how nursing and medical students understand and define care, and how their definition and views on their practice of caring change as they advance through their studies. MATERIAL AND METHODS: The study was conducted among two groups of students: before and after their first practicum (n=102). Analysis of the students' answers was carried out using Colaizzi's phenomenological descriptive methodology, which means that a qualitative approach was used. RESULTS: The qualitative analysis shows that the medical and nursing students define care in the same way, using 9 main categories: compassion, commitment, competence, confidence, conscience, communication, patience, courage and support. The nursing students viewed their caring to be within both practical and emotional dimensions and this was a core feature of their identity as nurses. Medical students, on the other hand, viewed the practical dimension of care as an additional activity. All the students in the study underlined the importance of having time to care and showed that, for them, 'time' in this context has a moral meaning. What was interesting to the research team centered on the initial attitudes to 'caring' from both medical and nursing students. CONCLUSIONS: We found that students of both nursing and medicine do not begin their studies with different attitudes and concepts of care. However, after their initial exposure to practical placements a process begins which forges different identities around the concept of care. This implies trends in the division of professional roles during their initial education.

Health-promoting activities performed by nurses for patients with COPD.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is the fourth most common cause of death in the world. The significance of health promotion is usually emphasised among the activities which nurses should undertake in relation to patients suffering from COPD. The aim of the study was to analyse the frequency and types of health promotion activities undertaken by nurses in relation to patients suffering from COPD. MATERIAL AND METHODS: The diagnostic survey with the use of a questionnaire constructed by the authors was applied in the study. Data collected in 2008 among 132 nurses (100%) working in outpatient and hospital healthcare sectors in Poland were quantitatively analysed. RESULTS: Nurses working in hospitals more frequently took part in diagnosing COPD (62.30%) than those working in outpatient establishments did (33.40%). Anti-smoking counselling was performed by 69% of respondents. Nurses very rarely used professional tools for the measurement of the level of nicotine addiction (6%) or the level of motivation to fight the addiction (4%). Activities in terms of health education carried out on a patient with COPD were declared by 66.67% of primary care nurses, and by 76.81% from hospitals. The nurses surveyed did not perform any monitoring of their recommendations and did not assess their effectiveness. Participation in interdisciplinary pulmonary rehabilitation programmes was declared by 9.53% of outpatient sector nurses and by 40.58% of nurses from hospitals. CONCLUSIONS: Nurses' activities in relation to patients suffering from COPD have a mainly educational nature, but unfortunately they are casual, occasional and unplanned. Planned and formal inclusion of nurses in the process of realisation of health promotion programs for patients with COPD is recommended, i.e. by planning funds for the tasks which can be performed by them. More attention should be payed to professional training of nurses for realisation of the process of health education, especially anti-smoking intervention.

Theoretical foundations of nursing practice in Poland.

This authors of this column explore the use of nursing theory in Poland. A quasi-experimental pretest-posttest study was conducted to explore what, if any nursing theories were used by nurses in Poland, and if an education program on nursing theory increased the use of nursing theory. The study found that while there were discrepancies between the nurses' theoretical knowledge base and their use of these theories in practice, there is evidence of the use of the ideas and theory of Nightingale, Orem, and Henderson in nursing practice in Poland.

Paediatric nurses' identification of violence against children.

AIM: This paper is a report of an evaluation of paediatric nurses' assessment and diagnostic skills and interventions used for child maltreatment. BACKGROUND: The use of violence against children occurs in all environments worldwide. Therefore, broader theoretical and practical knowledge related to this issue is needed in health care to facilitate more accurate identification of child maltreatment in order to instigate implementation of appropriate care for these children. METHODS: The study was based on cross-sectional data obtained with a convenience sample of 160 Registered Nurses employed at paediatric wards at two large cities in Poland (response rate 80%). Data collection took place between December 2005 and March 2006. The research tool was a questionnaire form designed on the basis of international literature concerning battered child syndrome. RESULTS: Battered child syndrome seems to be a relatively common phenomenon, as a great majority of participants (86·25%) had encountered it in their practice. The form of child maltreatment which was most often mentioned (by 30·00% of participants) was neglect. Almost three-quarters of the nurses (61·25%; n = 98) said that they had been involved in providing care for a maltreated child. CONCLUSION: Nurses should work with maltreated children on an individualized basis, combined with interdisciplinary cooperation with specialists from related disciplines concerned with the issue. There appears to be a need for specialized training for nurses to increase their competence in working with maltreated children and their families.

Perceiving and practicing the nature of nursing in Poland.

INTRODUCTION: The social and political transition taking place in Poland during the last decade has resulted in changes in the system of education. The results of empirical studies indicate that both the system of education and the period of its transition exerted an influence on the qualifications of nurses. AIM: The focus of the study was the relationship between the selected education factors and the occupational experience of nurses. METHODS: The study was conducted by the method of a diagnostic survey with the use of the authors' version of a questionnaire form. The variables were tested by means of chi-square test and Spearman's correlation test. The investigations covered a group of 324 occupationally active nurses in area of the city of Lublin. CONCLUSIONS: The analysis indicates that among many variables concerning education and occupational improvement, only the type of education (1st and 2nd level of occupational differentiation) has a statistically significant effect on auto-defining of nursing in the the nature of occupational activities performed.