The effectiveness of restraint and seclusion interventions in the nursing management of disturbed and aggressive clients remains questionable. Considerable debate continues regarding the use of these treatment options in psychiatric hospitals. The existing literature suggests that the controversial nature of restraint and seclusion creates a complex dilemma for nurses, which initiates emotional distress. This study specifically explored the emotions and feelings experienced by a group of psychiatric nurses working in Ireland in relation to incidents of restraint and seclusion. A qualitative research approach was employed incorporating focus group discussions. A total of 23 nurses participated in three focus group interviews. The data were analysed using qualitative interpretive analysis. Three themes were created consisting of: (1) the last resort - restraint and seclusion; (2) emotional distress; and (3) suppressing unpleasant emotions. It is suggested that the nurses' experience of restraint and seclusion created a dynamic movement between the release and suppression of distressing emotions. The oscillatory characteristics embedded within the nurses' emotional responses were reminiscent of a model of suffering developed by Morse in 2001. Consequently, this model is incorporated throughout the discussion of the findings to provide a more in-depth description of the emotional distress experienced by the nurses in the study.

Nurses should engage in open and honest discussions with patients in relation to kidney transplantation so that they are able to recognize and address their concerns about kidney transplantation.

Empathy is an essential component of professional nursing practice. In order to empathise appropriately with patients, it is crucial that nurses appreciate, understand and respond to their patients' experience of illness. This study sought to explore the experiences of 16 people with end stage renal disease on haemodialysis therapy in Ireland. A hermeneutical phenomenological methodology was employed incorporating qualitative interviews. The data were analysed using qualitative interpretive analysis. The experience of waiting was significant for the participants in the study. The experience of waiting was constituted by two themes labelled killing time and wasting time. It is suggested that the participants' experience of waiting is reminiscent of Heidegger's existential account of boredom. Moreover, the existential perspective of boredom contained within the participants' accounts is also depicted by Beckett in his play Waiting for Godot. Consequently, the literature of both existential writers is incorporated to provide a more in-depth description of the participants' experience of waiting. It is hoped that the insights provided in this paper will enable practitioners to gain a new awareness and understanding of patients' experiences of end stage renal disease and haemodialysis therapy. This would subsequently enable these professionals to empathise more effectively with their patients' situation and respond more appropriately to their care needs.End stage renal disease (ESRD) is a chronic and lifethreatening illness. In order to survive, the person requires renal replacement therapy. Haemodialysis is one modality of renal replacement therapy. During the treatment, high volumes of the person's blood are continuously filtered through a dialyser (artificial kidney), where the blood is purified and returned to the patient. The person on haemodialysis has to adhere to a strict regime of dialysis, dietary and fluid restrictions, and medications. Moreover, there are numerous physical, psychological and social problems associated with the treatment, which make it particularly difficult to accept. Consequently, the existing literature emphasises the losses and lifestyle disruptions imposed on the person's life by ESRD and dialysis. [1][2][3] A recent study was carried out to explore the experiences of 16 patients on hospital-based haemodialysis. The findings indicated that the experience of waiting was significant for the participants in the study. The participants' accounts illustrated that they spent a lot of time waiting when they attended haemodialysis therapy. The experience of waiting culminated in boredom for the participants. We suggest that the boredom illustrated within the participants' accounts depicts the perspective of boredom portrayed by the existential writers Martin Heidegger and Samuel Beckett. Consequently, this paper describes how the existential conceptualisation of boredom advanced by both writers, provides new insights on the perceptions of haemodialysis therapy, illustrated by the part...

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Introduction: The diagnostic interview for social and communication disorders (DISCO – 11; Wing 2006), is a semi-structured, interview-based instrument used in the diagnosis of children with autism spectrum disorder (ASD). This paper explores the psychometric properties of the DISCO-11 used in a specialist Paediatric clinical setting. Two key research questions were examined; (1) Does the factor structure of the DISCO-11 reflect the diagnostic and statistical manual 5th edition (DSM-5, American Psychiatric Association [APA], 2013) dyad of impairment in ASD? (2) Is there evidence of diagnostic stability over time using the DISCO? Methods: Review assessments of 65 children with ASD were carried out using standardised measures including the DISCO-11 and the autism diagnostic observation schedule. Results: The results revealed two factors resembling the DSM-5 algorithms, as used in DISCO-11, which were named as social-communication, and restricted and repetitive behaviours. The reliability, for the overall DISCO score was good (Cronbach’s alpha = 0.78). The social communication and social interaction subscale showed good reliability (Cronbach’s Alpha = 0.77) as did the restricted and repetitive patterns of behaviour, interests or activities subscale (Cronbach’s Alpha = 0.74). Acceptable internal reliability was found for the overall DISCO score and the subscales of social communication and social interaction and the restricted and repetitive patterns of behaviour, interests or activities. Test–retest showed good stability of diagnosis over time. Discussion: This study supports that the DISCO-11 shows potential as a valid and reliable instrument that can be used both for clinical and research purposes.