Patient satisfaction with care has frequently been used as a measurement of quality, especially in attempts to demonstrate the benefits of changes in nursing practice. Unfortunately such attempts have frequently failed as patient satisfaction ratings have lacked sensitivity, consistently achieving very high scores. They have also failed to isolate the nursing component from the whole health care experience. The Newcastle Satisfaction with Nursing Scale (NSNS) has been developed after extensive research work as an attempt to establish reliable and valid measures of patients' experiences of and satisfaction with nursing care. This study evaluated the use of the NSNS in practice and found that it was readily understood by patients and easily administered by clinical staff. However, several lessons were learnt which could help its administration. The results demonstrated a very high degree of satisfaction with nursing care which left the discriminatory ability of the scale open to question, although its potential benefits in standard setting were demonstrated. Further evaluative studies are needed if the potential benefits of the NSNS are to be fully realised.

This article follows up a previous article on community nurses' perceived barriers to implementing research (Walsh 1997). Here the author examines the perceived barriers to research use among a sample of 63 hospital and 78 community nurses. The major barriers identified relate to the clinical setting and understanding research reports. The results have significant implications for managers of the service and educators who seek to promote research-based practice.

This article reports the findings of a study of community nurses to determine their perceptions of barriers to the implementation of research findings in practice. A questionnaire survey using a scale developed in the US (Funk and Champagne 1991) asked community nurse students to rank a series of perceived barriers in order of greatest to least obstruction. The results were also compared with those from Funk and Champagne's study (1991). The authors found that UK nurses considered lack of authority and the inaccessibility of research reports were major barriers to implementing research findings. The authors emphasise the need for collaboration between managers, academics and practitioners to overcome such barriers.

There has been much debate about the use made by the general public of accident and emergency services. A strong element of professional disapproval has been present, as shown by phrases such as 'inappropriate attender'. This paper examines the reasons why people attend accident and emergency and the factors that delay or accelerate attendance, utilizing a framework espoused in the medical sociology literature, i.e. the Health Belief Model. This predicts that individuals carry out a treatment cost-benefit analysis when making decisions about seeking medical assistance. A sample of 200 adult, ambulatory accident and emergency patients was interviewed whilst waiting to see the casualty officer for this study. The data demonstrated that much of the medical, sociological literature concerning patient consultation with doctors is applicable to the accident and emergency situation, in particular the Health Belief Model. A range of factors was shown to make statistically significant differences to the delay times involved in deciding to attend accident and emergency and the time it took to then subsequently attend and register as a patient. These factors also fit the cost-benefit analysis which the Health Benefit Model predicts takes place. Accident and emergency attendance therefore needs to be seen as a logical decision-making process that requires hospitals to provide appropriate services, rather than merely labelling the patients as inappropriate.

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