Working well

Abstract

The influence of Sheffield's occupational health nurses spreads into the most unlikely corners, from all the city's schools to the local crematorium. As Principal Occupational Health Nurse for the City and [Illegible Word] Metropolitan Area, Jean Raper works with a team of three nurses offering a service to all local authority employees.

Do programmes of medicine self‐administration enhance patient knowledge, compliance and satisfaction?

“…In contrast with Thomas' (1992) study, m which most patients were m favour of nurses administering their medications for them, the majonty of patients m the present study wanted and, mdeed, expected to administer their own medications Seven of the eight patients whose medications were given by their nurse had expressed a desire for their medications to be administered m this way Interestingly, these patients all said that they were responsible for administering their own medications at home Thomas (1992) discussed 'the sick role' in relation to the desires of patients m her study She descnbed such patients as those who preferred to relmquish responsibility for their health care to a health care professional Some of the patients m the current study may have adopted such a role Indeed, when the seven patients wbo said that they would like their nurse to admuuster their medications were asked to give a reason, four patients stated that they wanted their nurse to take control Participation m other self-care activities was not examined dunng the course of the present study Hence, non-self-administenng patients' desire to take responsibility for their health care was not determined Redelmeier et al (1993) reviewed the psychology literature m an attempt to understand how patients make decisions They found that an lnfiuencing factor was the patient's pomt of reference This usually corresponds with the status quo, the customary outcome, or some other norm The seven patients who said that they would hke their nurse to administer their medications may have based their decision on past expenence, rather than a desire to adopt the sick role Indeed, when asked to give a reason for their choice, three patients stated tbat they were happy with current practice Other authors (for example Bird 1990) have advocated the mtroduction of SAM programmes because they provide patients with more opportunities to gam knowledge about their medications than normal Gaining knowledge IS an important peirt of a SAM programme and 'to gam knowledge' was given by six patients in the present study as a reason for expectmg or wanting to self-medicate However, patients considered that other factors, such as convenience, ability and mvolvement in care, were of greater importance to them…”