This initial report of a longitudinal study of 192 English hospital nurses measured Nursing Values (the 6Cs of nursing); Personality, Self-Esteem and Depression; Burnout Potential; Work-Life Balance Stress; “Hardy Personality”; and Intention to Leave Nursing. Correlational, component, and cluster analysis identified four groups: “The Soldiers” (N = 79), with medium scores on most measures, who bravely “soldier on” in their nursing roles, in the face of numerous financial cuts to the National Health Service, and worsening nurse–patient ratios; “Cheerful Professionals” (N = 54), coping successfully with nursing roles, and a variety of challenges, in upwardly mobile careers; “High Achievers” (N = 39), senior nurses with strong profiles of a “hardy personality”, and commitment to fundamental nursing values; and “Highly Stressed, Potential Leavers” (N = 20), with indicators of significant psychological distress, and difficulty in coping with nursing role challenges. We have initiated a program of co-counselling and social support for this distressed group, by nurses who are coping more successfully with multiple challenges. We discuss the role of nurse educators in fostering nursing values, developing and supporting a “hardy personality” and emotional resilience in recruits to nursing. This study is framed within the disciplinary approach of Critical Realism, which identifies the value basis for research and dialogue in developing strategies for social change. The importance of this research is that: (a) it is part of the new thrust in nursing research, applying Critical Realist theory and methodology to research on nursing stress; (b) it has established, through network sampling, a group of nurses who can be supportive of each other in their stressful careers; (c) it establishes the reliability and potential validity of a measure of core nursing values; (d) it is among the first studies in research on nursing stress, to use the humanizing methodology of moving from data analysis (description of “things”), to describing a typology of nursing stress and career progress (description of individuals).
We offer a narrative review of the findings of available British research on the sexual abuse of children, and its behavioural and mental health sequels in adolescent and adult adjustment, and link this to the growing world literature on child abuse, which frequently occurs within family settings. The evidence shows that around 9% of women, and about 3% of men have experienced prolonged, bodily intrusive abuse by the age of 16 or 18. This has many adverse sequels including impaired self-esteem, clinical levels of depression and anxiety, self-harm and substance abuse, somatic disorders, and many forms of maladaptation. Poly-victimisation combining physical, sexual and emotional abuse has particularly negative impacts. The long-term burden in human suffering and public health costs is high. In school, abuse victims are often bullied and isolated in school, which exacerbates (or even triggers) the negative effects of abuse. Teachers and school counsellors and social workers have an important role to play in identifying abuse victims, and offering help in ways which prevents the development of serious mental health problems.
Critical realism emerged from the philosophical writings of Roy Bhaskar, and has evolved into a philosophy of social science research using the model of "dialectical critical realism" (DCR) which begins with the researcher's assumptions that the structures being researched have a real, ontological grounding which is independent of the researcher. This approach has proved fruitful in British and European social science research, but has had less influence in North America. We outline DCR's four-level model for understanding society and its changing social structures through "the pulse of freedom". DCR has been used by Marxists, Muslims, Catholics and secular scholars who engage fruitfully in morphogenic dialogues leading to a critical realist understanding of society and social research, which transcends positivist and social constructionist models. Examples of DCR's application in the fields of childhood research, child abuse, education, and research on organisations are outlined to illustrate the working of this new research paradigm. We are enthusiastic in our advocacy of DCR as a model of qualitative research, and for constructing models of positive social change, and are particularly impressed by the substantive and theoretical expositions of DCR by Priscilla Anderson, Matthew Wilkinson and Margaret Archer, whose work we document and review.
Specialist child care centres focusing on urban areas in which significant numbers lived in poverty were part of policies to reduce chronic poverty and disadvantage, and associated negative behaviours and achievements in children and young people. They were initiated by the New Labour government in the late 1990s, and evolved in various ways as Sure Start centres, and Early Childhood Care Centres. Methodologically sophisticated evaluation has shown that these interventions have been partially successful in various ways, particularly with regard to preschool children's behaviour and adjustment, and parent-child interactions. When early interventions were linked to health programmes, and to teacher-led initiatives, the programmes were most successful. Nevertheless, the programmes failed to reach some 5 percent of those identified as most in need, for whom profound and chronic poverty was the cause of parental problems, and dysfunctional parent-child interactions. When programmes for such families were reduced because of changes in the manner and amount of funding, outcomes for the very poor families and their children were significantly worse. The Sure Start programmes were, in the final analysis, underfunded and subject to political change and interference, and hardly dented the chronic disadvantages imposed by England's system of class division.
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