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Aim: This paper is a report of an evaluation of cognitive continuum theory and identification of revisions required for application to clinical judgement and decision-making in nursing., Background: The importance of nurses' developing and applying sound clinical judgement is reflected in an international classification of nursing practice. Cognitive continuum theory synthesizes rival and complementary approaches to decision theory in an accessible format, which has been applied in medicine, and various nursing scholars have advocated its use to enhance the effectiveness of nurses' clinical judgement and decision-making., Method: Parse's structure and process criteria are applied in critiquing the relevance of cognitive continuum theory to nursing., Findings: Cognitive continuum theory illustrates how different judgement tasks are suited to different thought processes and how matching the two can optimize decision-making. However, existing modes of inquiry applied to medicine emphasize experimental research, ignoring many alternative approaches used in nursing. A revised version of the cognitive continuum is developed, incorporating examples of nursing judgements and decisions, a broader evidence base, an ethical dimension, and evaluative competence criteria., Conclusion: The revised cognitive continuum promotes awareness of the nature and the variety of patient-centred judgement tasks and decisions in nursing, how to select the most suitable intervention tactic from available options, and the fallibility of all forms of human judgement from intuitive/experiential to analytic/rational. Hence, it is recommended for use as an educational tool and practice guide to facilitate theory development and the practice of judgement and decision-making in nursing.

Aim: To test the validity of The Newcastle Satisfaction with Nursing Scales as measures of patient satisfaction with nursing care in an inpatient postpartum unit., Background: The Newcastle Satisfaction with Nursing Scales (Experience of Nursing Care Scale and Satisfaction with Nursing Care Scale) were developed to measure the satisfaction of medical-surgical inpatients with nursing care., Methods: The Newcastle Satisfaction with Nursing Scales were administered by interviewers to 189 postpartum women prior to hospital discharge. We tested the construct validity of the scales by making five a priori predictions: mothers who were more satisfied would be more likely to have one nurse caring for them and to recommend the postpartum unit to a friend. We also predicted that the Experience of Nursing Care and Satisfaction with Nursing Care Scales would be positively correlated with each other, with a global question about satisfaction with nursing care, and with a global question about satisfaction with overall postpartum stay., Results: Four of the five a priori predictions were supported by the data. The mean Newcastle Satisfaction with Nursing Scale scores of mothers who would recommend the unit to a friend were higher (more satisfied) than those who would not (P < 0.001). The Experience of Nursing Care Scale and Satisfaction with Nursing Care Scale were positively and significantly correlated with each other (r = 0.9, P < 0.001). There was a positive and significant correlation between the scales and global ratings of nursing care (Experience Scale r = 0.79, P < 0.001; Satisfaction Scale r = 0.82, P < 0.001) and overall postpartum stay (Experience Scale r = 0.64, P < 0.001; Satisfaction Scale r = 0.68, P < 0.001)., Conclusion: The Newcastle Satisfaction with Nursing Scales are valid measures of maternal satisfaction with inpatient postpartum nursing care.

Unlabelled: AIM(S) OF THE PAPER: This paper gives a description of illuminative evaluation and argues for its use in process-focused research investigating the reciprocal interpersonal interactions between clinical supervisors and their supervisees. Experiences from conducting an initial pilot study, which is a part of larger qualitative project concerned with individual clinical supervision in mental health nursing, are highlighted., Background: Research investigating fundamental process issues in clinical supervision and their influence on outcomes for nursing is uncommon. Previous work in this area has stopped short of exploring the supervisory relationship and illuminating the importance of this interpersonal process in the delivery of gains. At the heart of the present project are questions about which supervisor interventions facilitate and constrain the supervisee's use of individual clinical supervision., Method: Data were collected using individual in-depth interviews, critical incident journals, session documents and audio recordings of supervision using illuminative evaluation and a case study approach., Findings: Supervisor interventions included taking the lead, suggesting an option, exploring the supervisee's work, reflecting back, conveying an understanding of client issues, being supportive and giving information. Using Heron's framework, catalytic, prescriptive, informative and supportive interventions were identified. Interestingly, informative interventions related mainly to the sharing of team policy issues and were derived from the clinical supervisor's agenda. Although undoubtedly relevant to the supervisee's practice, such organizationally focused information giving may be at odds with progressing the therapeutic integrity and professional development of the supervisee. Degenerative interventions were also illuminated., Conclusions: Following the pilot study, it was concluded that the research approach known as illuminative evaluation using multiple case studies is an appropriate design to explore the supervisory process and the particular clinical supervisor and supervisee interactions which influence this. Potential outcomes from the supervisory experience will be contextualized with how mental health nurses engage in the supervisory process and the particular supervisor interventions delivered during supervision sessions.

Aims of the Study: Core competencies are important in enabling an individual to adapt to new environments and perform superior professional practice. This study was to identify the underlying competencies which contributed to effective nursing performance., Background: Most of the previous competencies are either derived from researchers' conceptual analysis or based on practitioners' direct report. Competencies derived from these methods either are subject to bias or are unable to identify the essential elements for effective nursing care., Method: Following the McBer method, 50 experienced nurses in China were asked to report 82 valid critical incidents in their jobs. Two individuals coded the scripts and decided the presence of each competency according to a pre-established coding system., Results: Ten competencies including interpersonal understanding, commitment, information gathering, etc. were identified. Each competency was illustrated by behavioural indicators., Conclusions: Skills, traits, motives and attitudes all contribute to effective nursing performance. The findings assist in the delineation and development of nursing competencies and thus provide realistic working behaviours for nursing education and management.

One of the roles of qualitative enquiry is the utilization of qualitative methods for the development, refinement or modification of concepts. Yet, to date, there are no criteria for evaluating the adequacy of a concept. In this paper, the anatomy of a concept is presented, methods of concept analysis critiqued, and criteria for evaluation of the level of maturity of a concept suggested. Evaluation of criteria include assessment of: the definition of the concept, the characteristics of the concept, the conceptual preconditions and outcomes, and the conceptual boundaries. The authors argue that evaluation of a concept must necessarily precede concept development research (using a Wilsonian-derived method, a critical analysis of the literature, or qualitative enquiry) and precede more formal research procedures (such as operationalization or identification of the variables).

This study focuses on descriptive accounts of one Macmillan nurse's work, as provided by key individuals coming into contact with this specialist professional service. Twenty respondents (eight patients, five carers, five district nurses and two general practitioners) were interviewed using a variation of the critical incident technique. Data were analysed in terms of meaningful observed events (critical happenings) that were perceived as effective or ineffective with respect to the delivery of high-quality nursing care. Some variations were found between groups of respondents in their perception of the nurse's role. However, there was a general emphasis on the possession of specialist knowledge of terminal cancer care and the positive impact of interventions to both the patient and to lay and professional carers. The critical incident technique was found to be a valuable method for eliciting detailed accounts of the work of the nurse in this specialized field of practice.

In a resource conscious environment, it is imperative that nurses use their skills and knowledge to provide an optimum service. It is suggested that nurses working in the community must measure the impact of their nursing interventions to guide their own role development and to inform the purchasing process. This literature review has revealed, however, that little progress has been made in this area by nurses within the community setting. Indeed, it is suggested that research is needed to test reliable and valid methods of outcome measurement.

Arguably, nursing, like all health care disciplines, is an applied science. Essentially, this refers to the application of theory in order to understand and respond to the health problems of clients. These theories may be drawn (borrowed) from any applied science, or generated inductively from clinical nursing practice. Alternatively, nurses may attempt to apply deductive theory (global theoretical frameworks) known as nursing models. In this paper, all theoretical approaches, irrespective of origin, are referred to as models used by nurses. Thirteen criteria by which clinicians, and others, can evaluate the clinical and practical utility of models used by nurses which are expressed in the form of questions are identified and discussed. The criteria are an extension, both in detail and in number, of those developed by Reynolds and Cormack and subsequently applied by those writers to the Johnson Behavioural System Model of Nursing. The value, or otherwise, of individual models, or of models in general, will not be discussed in this paper. However, the authors propose that if the evaluation criteria described here are applied to existing models, serious deficits will be identified in relation to their clinical and practical utility.

Secondary data are increasingly incorporated into nursing research studies, as nurses seek to capture and address the complexity of patient care. There is, however, little discussion in methodological literature about this type of data; the meaning is taken for granted and the data are regarded as simple sources of information, which are convenient and cost-effective. This approach denies the social meaning of the data, and is likely to lead to misinterpretation of the content. This paper discusses these analytical issues with reference to a research study which used secondary data (nursing care plans) in an examination of the ways in which nurses assess their patients. Using this data led to an increased understanding of the social world in which assessment took place.

Assessing patients' satisfaction with the care they receive is assuming greater importance and satisfaction with nursing is no exception. The kinds of study in which patient satisfaction has been used as an outcome are considered and show the range of conceptualizations and the general lack of rigour in its measurement. It is argued that research methods are often flawed by using inappropriate measures and greater care is warranted in their selection. Where appropriate measures do not exist, only then is the costly process of developing new assessments warranted. Some of the necessary steps in arriving at reliable and valid measures of patient satisfaction are discussed in the context of asking particular research questions.