Karen Luker

The University of Manchester · School of Nursing, Midwifery and Social Work

Aim To explore the introduction of an evidence-based information intervention – the ‘Caring for Someone with Cancer’ booklet – within home care and end-of-life care, to inform future implementation and practice development within this setting. Background Family carers’ contribution is crucial to enable care and death of people at home. The ‘Caring...

Aim To appraise and synthesize empirical literature on implementation of evidence within community nursing. To explore the use of implementation theory and identify the strategies required for, and the barriers and facilitators to, successful implementation within this context. Background There is an international consensus that evidence-based pra...

The majority of people die in acute care, although most prefer to be cared for and die at home. Family carers are crucial to enabling this preference. Interventions offering practical information to prepare carers for this role are required. Luker and colleagues developed and evaluated such an intervention: Caring for Someone with Cancer booklet. T...

The study reported here sought to describe the differences between nurses’ attitudes towards work with older people in the collective sense and their attitudes towards the individuals with whom they work A convenience sample of 136 community nurses was obtained Data were collected by means of a questionnaire incorporating the report of two critical...

Objectives: To investigate if pain, physical function and the quality of life changed among adults with osteoarthritis while on the waiting list for hip or knee joint replacement. Methods: A longitudinal study of patients listed for primary hip or knee joint replacement. Participants were interviewed at baseline (n = 105) and followed up at 3 (n...

This paper reports a small exploratory study which identifies what community nurses consider to be the scope of their practice and the sources of influence on their clinical decisions The study was stimulated by the emergence of the nurse prescribing initiative, which is likely to bring clinical decision making to the centre of professional debate...

The aim of this paper is to critically examine and challenge some of the assumptions which underpin the research and non-research based literature on patient education. Doubts are expressed concerning the transferability of theories of adult learning to patient education; and concern is expressed over the imbalance in the literature where emphasis...

This paper reports a study which examined the specific information needs and sources of information for 105 women with breast cancer at two time points, the time of diagnosis and a mean of 21 months from diagnosis At diagnosis the priority information needs concerned survival issues Further from diagnosis survival issues were still a concern, but i...

The role of the district nurse (DN) is difficult to define. Knowledge about the perspectives of patients with cancer, and their informal carers, on the roles of DNs and community services is lacking. The aim of this study is to identify the roles of DNs and community services as perceived by patients with cancer and their carers before and after ho...

Background: Fifty-four per cent of people who die in England and Wales do so in hospital. Evidence suggests that care delivered to dying people in hospital does not match up to the ideal of a good death. These studies have provided organizational and structural explanations of nurses' behaviour that support argument for change at the macro level, i...

Objectives To explore preferred treatment decision-making roles, and rationales for role preference, and to identify perceived facilitators to and barriers from attaining preferred role. Design Qualitative design. Setting and Participants One secondary care and four primary care sites in North-west England. Purposive sample of 32 adult asthma patie...

Patient and carer needs following a cancer-related hospital admission: the importance of referral to the district nursing service Background. Despite 30 years of research attention, discharge planning and district nurse (DN) referral remain problematic and few cancer-related publications exist. With shorter hospitalizations, discharged cancer patie...

An evaluation of information cards as a means of improving communication between hospital and primary care for women with breast cancer This paper describes an intervention study aimed at improving communication between hospital services and the primary health care team. A series of information cards were developed by breast specialist secondary ca...

Information and support needs of women with primary relatives with breast cancer: development of the Information and Support Needs Questionnaire Aims of the study. The aim was to develop and pilot test a newly developed measure, The Information and Support Needs Questionnaire (ISNQ), for use with women with primary relatives with breast cancer. Bac...

Protecting children: intuition and awareness in the work of health visitors This paper is based upon an ethnographic study of a group of health visitors engaged in child protection work. The purpose of this paper is to explore the meanings individual health visitors attach to events concerned with identifying children who may be at risk of harm fro...

In the UK, Project 2000 nurse education, introduced over the last eight years, aimed to increase the professional status of nurses and enhance skills, focusing on wider community care. This paper reports some of the results from a research project conducted between 1994 and 1996, funded by the Department of Health (Project 2000 Fitness for Purpose...

The importance of ‘knowing the patient’: community nurses’ constructions of quality in providing palliative care This paper reports findings from a study conducted in one community health care trust where 62 members of the district nursing team (grades B–H) were interviewed. An adaptation of the critical incident technique was used to determine fac...

Objective An exploratory study has been carried out to examine decision‐making role preferences and information needs for a sample of people with colorectal cancer ( n =48). The work replicated a larger study carried out for women with breast cancer ( n =150), and this paper compares and contrasts findings for both disease groups. Design A cross‐se...

Skills competency in nurse education: nurse managers' perceptions of diploma level preparation This paper reports on part of a national study conducted between 1994 and 1996, the overall aim of which was to examine the `fitness for purpose' of the Project 2000 nursing education reforms. The study used multiple methods of data collection, including...

A study was carried out to examine the economic and qualitative aspects of nurse prescribing for patients, carers, nurses and other health care professionals. The design was a case study, without controls or randomisation, and involved patients, nurses, general practitioners and other health care professionals in GP fundholding practices, one in ea...

Primary health care is proposed as a key strategy for improving the health of the world community and nurses are acknowledged as the prime health care professionals in providing primary health care. The aim of this study was to describe students' self reports of their experiences with primary heath care (PHC) during classroom learning, clinical pla...

Atopic eczema is a relatively common disease which frequently occurs during childhood. This paper reports the findings of a research study which explored the effects upon family life of caring for a child with severe atopic eczema. Seventy‐seven accounts written by mothers of preschool children with this disease were analysed using qualitative late...

Breast cancer is a major threat to the health of women, two-thirds of women diagnosed with breast cancer are likely to die from the disease hi North America one woman in nine will experience breast cancer at some point in her lifetime In the United Kingdom, the figure is somewhat lower, one in 12, and increasing Increasing age and a family history...

The meaning that women with breast cancer ascribe to their disease may well have an impact on the effectiveness of coping strategies used to come to terms with breast cancer Health rare professionals need to know what meanings women with breast cancer are ascribing to their disease if they are to identify maladaptive coping strategies and ensure th...

User satisfaction with the care of hospitalized children is examined in this paper. It is argued that parents are proxy consumers but that their status is conditional on the way in which they exercise choices. Parents' involvement in the care of their children means that the term 'user' is more appropriate than 'consumer'. Methodological problems i...

The study reported here sought to describe the differences between nurses' attitudes towards work with older people in the collective sense and their attitudes towards the individuals with whom they work. A convenience sample of 136 community nurses was obtained. Data were collected by means of a questionnaire incorporating the report of two critic...

At a time of unprecedented change in community nursing, it is appropriate to revisit the role of specialist and generalist nurses in community nursing teams. The data presented here are from a study of 130 home visits of 16 district nurses; the methods of data collection were participant observation and in-depth interview. Findings reflect a climat...

Elderly people object to the early morning routines forced upon them in hospital, report Karen Luker and Karen Waters, who describe research carried out in a rehabilitation unit.

The contract for general practitioners (GPs) introduced in April 1990 and the Community Care Act which becomes operational in April 1993 have put the issue of assessment of the needs of older people, people with mental health problems and people with learning disabilities clearly on to the policy agenda. In addition, the last five years have seen a...

This study addressed the effect of social isolation on vocally disruptive demented patients (V); the results center on the amount of time patients spent in interactions, and the differences in type and time of staff-patient interaction (IA), compared to controls (C). Semi-structured observations were collected (1100 hours) for 37 vocally disruptive...

There is no doubt that there is much contention about the use of nursing models and I propose to set out some of the principal reasons why they are valuable and why nurses should adopt a model-based approach to practice.

The widespread attachment of district nurses and health visitors to general practitioners has created the opportunity for a team approach to primary health care, but how these teams are organised and the way individual members operate vary to a considerable degree. This lack of uniformity reflects a combination of factors, including different prior...

The aim of this paper is to shed some light on the way trained nurses responded to the challenge of teaching patients to manage life on Continuous Ambulatory Peritoneal Dialysis (CAPD). This topic is of interest since nursing skills and knowledge are central to the successful management of patients on CAPD. More importantly, the treatment has the p...

The data on which this paper is based were collected by means of informal interviews with final year nursing undergraduates at one university. From students' accounts it is apparent that the lives of undergraduate nurses are dominated by an all embracing feeling of 'difference'. This paper centres on the theme of 'difference' and draws upon the lit...

This paper attempts to explain some general issues in evaluation and evaluative research in the health care field with specific reference to nursing. The evaluation process and nursing process are contrasted and methods used in evaluative research discussed. The case is made for more emphasis to be placed on the evaluation phase of the nursing proc...

The study described in this paper was undertaken as part of the pilot work for a main study, which attempts to evaluate the effectiveness of health visitor intervention on an elderly female population in Scotland. The Life Satisfaction Index A (Neugarten et al. 1961) was modified by the researcher and tested on a female Scottish population and is s...