Alice Kiger | University of Aberdeen (original) (raw)
Papers by Alice Kiger
International nursing review en español: revista oficial del Consejo Internacional de Enfermeras, 2006
Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% o... more Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% of eligible patients attending. Much of the poor attendance stems from invited patients failing to attend. Aim: To design a theoretically based intervention to improve attendance at cardiac rehabilitation. Methods: Our methods followed recommendations that have been developed from the Medical Research Council (MRC) framework for the design of complex interventions. We conducted three processes that progressed simultaneously: 1) literature review for evidence on epidemiology, behavioural theory, and efficacy of interventions; 2) expert meetings on behavioural theory and to select target points for intervention; and 3) development and theoretical modelling of the intervention. Result: Our final interventions were a theoretically worded invitation letter and leaflet based on the Theory of Planned Behaviour and the Common Sense Model of Illness, designed to: a) motivate patients through professional recommendation; b) provide simple information on the contents of cardiac rehabilitation emphasising ease for participants; c) reassure participants that the programme is tailored to their personal needs in a safe supervised environment; and d) reinforce the benefits of attending cardiac rehabilitation. Conclusion: A theoretically worded letter and leaflet could be an inexpensive intervention to improve attendance at cardiac rehabilitation. The letters and leaflets will now be evaluated in a randomised trial.
This study explored student nurses' images of nursing from their point of entry to training throu... more This study explored student nurses' images of nursing from their point of entry to training through their early experiences of clinical nursing. The research approach was based on Glaser and Strauss's principles for the generation of grounded theory, and the techniques of comparative analysis and theoretical sampling were employed. Student nurses from three intake groups at a single Scottish nursing college provided the population from which subjects were chosen. Following a short exploratory questionnaire administered to each student cohort, the primary means of data collection was through informal in-depth interviews, and twenty-four students were selected for this purpose. Among the twenty-four, all four branches of nurse training were represented (general nursing, mental handicap nursing, mental nursing, and sick children's nursing). Ages of interviewees ranged from seventeen to thirty-six years, and three of the students were male. Three rounds of individual interviews were conducted, the first being undertaken prior to the students' clinical experience, the second during their second clinical placements, and the third during their fourth or fifth clinical placements. Analysis of the first interviews revealed five major themes in the students' initial images of nursing: "pictures of nursing", "the good nurse", "what nursing entails", "occupational labels for nursing" and "being a studentbecoming a nurse". These themes were pursued in the later interviews and the characteristics of the students' experience-mediated images were identified. In addition, the processes through which students' images developed were analysed. These included the process of affirmation, when initial images were congruent with experience, and processes of accommodation and non-accommodation to disparity when image and experience lacked congruence. Associated processes which either facilitated or inhibited perceived affirmation or accommodation of the image included identification, disillusionment, and extenuation. A number of findings were highlighted. The picture of adult general nursing as typical or real nursing was evident in initial interviews, and this persisted in later interviews as well. This was true even for students who were undertaking training in one of the three other fields of nursing. "Working with people" and "helping" appeared consistently in the students' images as central characteristics of nursing. Notions of "the good and the bad" of nursing were found to underlie many features of the image. The paradoxical nature of "involvement" within the image was particularly noticeable. The presence of staff (good and bad) was prominent in students' images as being instrumental in determining the quality of their experience and the development of their images. There was clear evidence of the importance of support to enable students to adapt to disparities between their images and perceived reality. The concepts of commitment and belonging were integral to students' images of nursing and made it more than just a job. In this, it was seen to have features in common with other health care fields, but also particularly with police work.
European Journal of Cardiovascular Nursing, Aug 1, 2009
Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% o... more Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% of eligible patients attending. Much of the poor attendance stems from invited patients failing to attend. Aim: To design a theoretically based intervention to improve attendance at cardiac rehabilitation. Methods: Our methods followed recommendations that have been developed from the Medical Research Council (MRC) framework for the design of complex interventions. We conducted three processes that progressed simultaneously: 1) literature review for evidence on epidemiology, behavioural theory, and efficacy of interventions; 2) expert meetings on behavioural theory and to select target points for intervention; and 3) development and theoretical modelling of the intervention. Result: Our final interventions were a theoretically worded invitation letter and leaflet based on the Theory of Planned Behaviour and the Common Sense Model of Illness, designed to: a) motivate patients through professional recommendation; b) provide simple information on the contents of cardiac rehabilitation emphasising ease for participants; c) reassure participants that the programme is tailored to their personal needs in a safe supervised environment; and d) reinforce the benefits of attending cardiac rehabilitation. Conclusion: A theoretically worded letter and leaflet could be an inexpensive intervention to improve attendance at cardiac rehabilitation. The letters and leaflets will now be evaluated in a randomised trial.
You can copy or reproduce the information in this document for use within NHSScotland and for edu... more You can copy or reproduce the information in this document for use within NHSScotland and for educational purposes. You must not make a profit using information in this document. Commercial organisations must get our written permission before reproducing this document. www.nhshealthquaility.org An impact assessment of the health technology assessments produced by NHS Quality Improvement Scotland
SECTION 1 : THEORETICAL UNDERPINNINGS 1. Health and is promotion The Meaning of Health - Planning... more SECTION 1 : THEORETICAL UNDERPINNINGS 1. Health and is promotion The Meaning of Health - Planning for Health - Measuring Health - Current Ill Health in Britain(to include other countries) - Health Education and Health Promotion - Ethical Issues in Health Promotion - References - Further Reading 2. Health education concepts and practice Health Education Approaches and Models - Health Education Services in the UK(to include other countries) - Nurses as Health Educators - Teaching for Health - References - Further reading 3. Learning about Health Ideas about Learning and Teaching - Theoretical Considerations Relevant to Learning - References - Further Reading 4. Therapeutic and persuasive communication Therapeutic Communication - The Communication Process - Techniques of Therapeutic Communication - Persuasive Communication - Factors Affecting Communication and Persuasion - References - Further Reading SECTION 2 : THE PROCESS OF HEALTH TEACHING 5. Beginning the teaching - learning process: assessment of learning needs Assessment and the Concept of Need - Collecting Information - Analysing Information - Defining Learning Needs - Learning Needs of Healthy Individuals and Groups - References - Further Reading 6. Planning: preparation for teaching The Meaning of Planning - Who Plans? - The Mechanics of Planning - Preparing to Teach - The Teaching Plan - References - Further Reading 7. Implementing teaching plans Example 1 Stoma Appliance Management - Example 2 Female Secondary school Students and Menstruation - Example 3 Preoperative Preparation - References - Further Reading 8. Evaluation of health teaching The Benefits of Planned Evaluation - defining Evaluation - Setting Evaluation Criteria - Evaluation Designs for Outcome Assessment - Who needs feedback? - References - further Reading SECTION 3 : ISSUES IN HEALTH TEACHING 9. Research in health teaching Arguments about Value and Efficacy - Researching Health Teaching - Evaluating Research Approaches - Research-mindedness and the Health Teacher - References - Further Reading 10. Reflections on teaching for health Success in Health Teaching - Health Teaching in a Changing Scene - Professional Interfaces - Final Reflections - References - further Reading 11. Questions for review and reflection INDEX
European Journal of Cardiovascular Nursing, Jan 8, 2014
Background:With typically fewer than 35% of eligible patients attending outpatient cardiac rehabi... more Background:With typically fewer than 35% of eligible patients attending outpatient cardiac rehabilitation (CR), more accessible provision is required. Community-based cardiac rehabilitation is one option but its effects need to be compared with those of hospital-based CR.Aims:The purpose of this study was to compare changes in health-related quality of life (HRQOL), anxiety and depression, and exercise and smoking rates, between attendees at community-based and hospital-based CR programmes.Method:A prospective comparative cohort design was used. Consecutive patients admitted to Aberdeen Royal Infirmary and eligible for CR were recruited and followed up by self-report questionnaire. Outcomes were health status (RAND-36), Hospital Anxiety and Depression Scale (HADS), Godin Leisure-Time Exercise and smoking status.Results:There were 136 of 179 (75%) attenders at community-based CR, compared to 169 of 209 (80%) at hospital-based CR (p=0.242). In univariate analysis, there were no significant differences between the two groups in health status, HADS, and frequency or intensity of exercise immediately after the CR programme or six months later. Adjusting for other significant factors, patients who attended community CR reported higher RAND-36 energy scores at six months compared with attenders at hospital CR (p=0.020), but were less likely to undertake frequent exercise (p=0.041).Conclusions:Community-based CR appears to achieve similar attendance rates and effects on health status and health behaviour as hospital-based CR. This option might help overcome the poor attendance of patients with long travelling times to hospital-based CR.
Journal of Nursing Education, Sep 1, 1993
This article discusses findings from a qualitative study of student nurses' images of nur... more This article discusses findings from a qualitative study of student nurses' images of nursing from entry to training through early clinical experiences. Three rounds of interviews were conducted with 24 Scottish students. Analysis revealed five major themes in students' initial images: pictures of nursing, the good nurse, what nursing entails, occupational labels for nursing, and being a student/becoming a nurse. These were pursued in later interviews and characteristics of students' experience-mediated images were identified. The picture of adult medical-surgical nursing as typical of real nursing persisted throughout. "Working with people" and "helping" appeared as central characteristics of nursing. Notions of good and bad underlay many features of the image. The paradoxical nature of "involvement" was noticeable. Staff attitudes figured prominently in determining the quality of students' experience and in development of image. Commitment and belonging were integral to students' images and made nursing more than just a job. Processes through which students' images developed included affirmation, accommodation, and nonaccommodation. Associated processes included identification, disillusionment, and extenuation. There was clear evidence of the importance of support to enable students to adapt to image disparities.
University of Aberdeen, 2003
International nursing review en español: revista oficial del Consejo Internacional de Enfermeras, 2006
Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% o... more Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% of eligible patients attending. Much of the poor attendance stems from invited patients failing to attend. Aim: To design a theoretically based intervention to improve attendance at cardiac rehabilitation. Methods: Our methods followed recommendations that have been developed from the Medical Research Council (MRC) framework for the design of complex interventions. We conducted three processes that progressed simultaneously: 1) literature review for evidence on epidemiology, behavioural theory, and efficacy of interventions; 2) expert meetings on behavioural theory and to select target points for intervention; and 3) development and theoretical modelling of the intervention. Result: Our final interventions were a theoretically worded invitation letter and leaflet based on the Theory of Planned Behaviour and the Common Sense Model of Illness, designed to: a) motivate patients through professional recommendation; b) provide simple information on the contents of cardiac rehabilitation emphasising ease for participants; c) reassure participants that the programme is tailored to their personal needs in a safe supervised environment; and d) reinforce the benefits of attending cardiac rehabilitation. Conclusion: A theoretically worded letter and leaflet could be an inexpensive intervention to improve attendance at cardiac rehabilitation. The letters and leaflets will now be evaluated in a randomised trial.
This study explored student nurses' images of nursing from their point of entry to training throu... more This study explored student nurses' images of nursing from their point of entry to training through their early experiences of clinical nursing. The research approach was based on Glaser and Strauss's principles for the generation of grounded theory, and the techniques of comparative analysis and theoretical sampling were employed. Student nurses from three intake groups at a single Scottish nursing college provided the population from which subjects were chosen. Following a short exploratory questionnaire administered to each student cohort, the primary means of data collection was through informal in-depth interviews, and twenty-four students were selected for this purpose. Among the twenty-four, all four branches of nurse training were represented (general nursing, mental handicap nursing, mental nursing, and sick children's nursing). Ages of interviewees ranged from seventeen to thirty-six years, and three of the students were male. Three rounds of individual interviews were conducted, the first being undertaken prior to the students' clinical experience, the second during their second clinical placements, and the third during their fourth or fifth clinical placements. Analysis of the first interviews revealed five major themes in the students' initial images of nursing: "pictures of nursing", "the good nurse", "what nursing entails", "occupational labels for nursing" and "being a studentbecoming a nurse". These themes were pursued in the later interviews and the characteristics of the students' experience-mediated images were identified. In addition, the processes through which students' images developed were analysed. These included the process of affirmation, when initial images were congruent with experience, and processes of accommodation and non-accommodation to disparity when image and experience lacked congruence. Associated processes which either facilitated or inhibited perceived affirmation or accommodation of the image included identification, disillusionment, and extenuation. A number of findings were highlighted. The picture of adult general nursing as typical or real nursing was evident in initial interviews, and this persisted in later interviews as well. This was true even for students who were undertaking training in one of the three other fields of nursing. "Working with people" and "helping" appeared consistently in the students' images as central characteristics of nursing. Notions of "the good and the bad" of nursing were found to underlie many features of the image. The paradoxical nature of "involvement" within the image was particularly noticeable. The presence of staff (good and bad) was prominent in students' images as being instrumental in determining the quality of their experience and the development of their images. There was clear evidence of the importance of support to enable students to adapt to disparities between their images and perceived reality. The concepts of commitment and belonging were integral to students' images of nursing and made it more than just a job. In this, it was seen to have features in common with other health care fields, but also particularly with police work.
European Journal of Cardiovascular Nursing, Aug 1, 2009
Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% o... more Background: Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% of eligible patients attending. Much of the poor attendance stems from invited patients failing to attend. Aim: To design a theoretically based intervention to improve attendance at cardiac rehabilitation. Methods: Our methods followed recommendations that have been developed from the Medical Research Council (MRC) framework for the design of complex interventions. We conducted three processes that progressed simultaneously: 1) literature review for evidence on epidemiology, behavioural theory, and efficacy of interventions; 2) expert meetings on behavioural theory and to select target points for intervention; and 3) development and theoretical modelling of the intervention. Result: Our final interventions were a theoretically worded invitation letter and leaflet based on the Theory of Planned Behaviour and the Common Sense Model of Illness, designed to: a) motivate patients through professional recommendation; b) provide simple information on the contents of cardiac rehabilitation emphasising ease for participants; c) reassure participants that the programme is tailored to their personal needs in a safe supervised environment; and d) reinforce the benefits of attending cardiac rehabilitation. Conclusion: A theoretically worded letter and leaflet could be an inexpensive intervention to improve attendance at cardiac rehabilitation. The letters and leaflets will now be evaluated in a randomised trial.
You can copy or reproduce the information in this document for use within NHSScotland and for edu... more You can copy or reproduce the information in this document for use within NHSScotland and for educational purposes. You must not make a profit using information in this document. Commercial organisations must get our written permission before reproducing this document. www.nhshealthquaility.org An impact assessment of the health technology assessments produced by NHS Quality Improvement Scotland
SECTION 1 : THEORETICAL UNDERPINNINGS 1. Health and is promotion The Meaning of Health - Planning... more SECTION 1 : THEORETICAL UNDERPINNINGS 1. Health and is promotion The Meaning of Health - Planning for Health - Measuring Health - Current Ill Health in Britain(to include other countries) - Health Education and Health Promotion - Ethical Issues in Health Promotion - References - Further Reading 2. Health education concepts and practice Health Education Approaches and Models - Health Education Services in the UK(to include other countries) - Nurses as Health Educators - Teaching for Health - References - Further reading 3. Learning about Health Ideas about Learning and Teaching - Theoretical Considerations Relevant to Learning - References - Further Reading 4. Therapeutic and persuasive communication Therapeutic Communication - The Communication Process - Techniques of Therapeutic Communication - Persuasive Communication - Factors Affecting Communication and Persuasion - References - Further Reading SECTION 2 : THE PROCESS OF HEALTH TEACHING 5. Beginning the teaching - learning process: assessment of learning needs Assessment and the Concept of Need - Collecting Information - Analysing Information - Defining Learning Needs - Learning Needs of Healthy Individuals and Groups - References - Further Reading 6. Planning: preparation for teaching The Meaning of Planning - Who Plans? - The Mechanics of Planning - Preparing to Teach - The Teaching Plan - References - Further Reading 7. Implementing teaching plans Example 1 Stoma Appliance Management - Example 2 Female Secondary school Students and Menstruation - Example 3 Preoperative Preparation - References - Further Reading 8. Evaluation of health teaching The Benefits of Planned Evaluation - defining Evaluation - Setting Evaluation Criteria - Evaluation Designs for Outcome Assessment - Who needs feedback? - References - further Reading SECTION 3 : ISSUES IN HEALTH TEACHING 9. Research in health teaching Arguments about Value and Efficacy - Researching Health Teaching - Evaluating Research Approaches - Research-mindedness and the Health Teacher - References - Further Reading 10. Reflections on teaching for health Success in Health Teaching - Health Teaching in a Changing Scene - Professional Interfaces - Final Reflections - References - further Reading 11. Questions for review and reflection INDEX
European Journal of Cardiovascular Nursing, Jan 8, 2014
Background:With typically fewer than 35% of eligible patients attending outpatient cardiac rehabi... more Background:With typically fewer than 35% of eligible patients attending outpatient cardiac rehabilitation (CR), more accessible provision is required. Community-based cardiac rehabilitation is one option but its effects need to be compared with those of hospital-based CR.Aims:The purpose of this study was to compare changes in health-related quality of life (HRQOL), anxiety and depression, and exercise and smoking rates, between attendees at community-based and hospital-based CR programmes.Method:A prospective comparative cohort design was used. Consecutive patients admitted to Aberdeen Royal Infirmary and eligible for CR were recruited and followed up by self-report questionnaire. Outcomes were health status (RAND-36), Hospital Anxiety and Depression Scale (HADS), Godin Leisure-Time Exercise and smoking status.Results:There were 136 of 179 (75%) attenders at community-based CR, compared to 169 of 209 (80%) at hospital-based CR (p=0.242). In univariate analysis, there were no significant differences between the two groups in health status, HADS, and frequency or intensity of exercise immediately after the CR programme or six months later. Adjusting for other significant factors, patients who attended community CR reported higher RAND-36 energy scores at six months compared with attenders at hospital CR (p=0.020), but were less likely to undertake frequent exercise (p=0.041).Conclusions:Community-based CR appears to achieve similar attendance rates and effects on health status and health behaviour as hospital-based CR. This option might help overcome the poor attendance of patients with long travelling times to hospital-based CR.
Journal of Nursing Education, Sep 1, 1993
This article discusses findings from a qualitative study of student nurses' images of nur... more This article discusses findings from a qualitative study of student nurses' images of nursing from entry to training through early clinical experiences. Three rounds of interviews were conducted with 24 Scottish students. Analysis revealed five major themes in students' initial images: pictures of nursing, the good nurse, what nursing entails, occupational labels for nursing, and being a student/becoming a nurse. These were pursued in later interviews and characteristics of students' experience-mediated images were identified. The picture of adult medical-surgical nursing as typical of real nursing persisted throughout. "Working with people" and "helping" appeared as central characteristics of nursing. Notions of good and bad underlay many features of the image. The paradoxical nature of "involvement" was noticeable. Staff attitudes figured prominently in determining the quality of students' experience and in development of image. Commitment and belonging were integral to students' images and made nursing more than just a job. Processes through which students' images developed included affirmation, accommodation, and nonaccommodation. Associated processes included identification, disillusionment, and extenuation. There was clear evidence of the importance of support to enable students to adapt to image disparities.
University of Aberdeen, 2003