bluuebunny/crossref_metadata_2025 huggingface dataset:
Education and support for the newly diagnosed cardiac family: a vital link in rehabilitation
Authors: Wiggins Nancy C.
Published: December 2006

In eastern Canadian small cities, community programming for cardiac rehabilitation is in its infancy. As professional awareness of the special needs of cardiac clients has grown, some components of cardiac rehabilitation programmes have developed, albeit autonomously from one another, e.g. in‐hospital education, home visiting, exercise programmes, and support groups. Attempts are being made to establish communication channels among the health personnel involved in the different agencies in order to achieve a better availability and coordination of services for the benefit of cardiac clients and their families. To address needs arising after the first hospitalization or first diagnosis of cardiac disease, an education and support programme has been established by a university nursing faculty through the efforts of its junior students. This programme takes the form of 8‐week series of informal classes. Objectives, methods and outcomes are outlined. Some recommendations for future community cardiac rehabilitation efforts emerge from clinical practice and programme evaluation. Implications for health professionals in such future activities are discussed.
Episiotomy and perineal trauma during childbirth
Authors: Röckner Gunny , Wahlberg Vivian , Ölund Anders
Published: December 2006

A study was conducted to assess the frequency of episiotomy and spontaneous tears in 807 primiparas during singleton births. The incidence of episiotomy was 50%, spontaneous tears 22% and intact perineum 28%. A significantly lower frequency of episiotomy (P < 0.001) as well as epidural anaesthesia (P < 0.001) was found among immigrant women. There were no indications registered for 58% of the episiotomies. The non‐episiotomy group experienced more clitoris/labia tears (P < 0.01). On the other hand there was a tendency towards an increased risk for second and third degree tears, 4.2% in the episiotomy group compared to 1.7% in the non‐episiotomy group (P= 0.06). Haemorrhage (> 600 ml) was more frequent in the episiotomy group than in the non‐episiotomy group (P < 0.001). We conclude that there is little support for the claim that episiotomy prevents tears in normal deliveries, and that the rationale for the practice of episiotomy is in need of reappraisal.
Comprehensive health seeking and coping paradigm
Authors: Nyamathi Adeline
Published: December 2006

While scholars in nursing are charged with the responsibility of advancing and structuring a body of knowledge for application in nursing practice, many of the currently utilized theories have been borrowed from other disciplines. Until such knowledge is redefined and synthesized according to the perspective of nursing, borrowed knowledge cannot be adequately understood. The purpose of this paper is to present a comprehensive client‐orientated health seeking and coping paradigm. This paradigm is theorized to be a function of 12 factors which include: clients’ situational and personal factors, resources, sociodemographic characteristics, cognitive appraisal, health goals, health seeking and coping behaviours, nursing goals and strategies, clients’ perceived compliance, clients’ perceived coping effectiveness, and immediate and long‐term health outcome. The Lazarus Schema of Coping and Adaptation and the Schlotfeldt Health Seeking and Coping Paradigm were the parent conceptualizations from which the Comprehensive Health Seeking and Coping Paradigm (CHSCP)was derived. As a nursing‐orientated multidimensional framework, the CHSCP will provide a useful framework for nurses interested in altering, enhancing or promoting the health seeking and coping of clients. By providing an intellectual focus for the initial and ongoing assessment of a multitude of variables which influence health seeking and coping, the specification of appropriate strategies can be developed and enhanced.
A randomized controlled trial of in‐hospital nursing support for first time myocardial infarction patients and their partners: effects on anxiety and depression*
Authors: Thompson David R.
Published: December 2006

This study monitored and compared levels of anxiety and depression reported by first myocardial infarction (MI) male patients and their partners, throughout the patients’ hospital stay. An independent variable of a programme of supportive‐educative counselling provided by a coronary care nurse was introduced to determine whether it significantly affected reactions. Sixty couples were randomly assigned to one of two groups: (a) the treatment group (in which they received the systematic programme of nursing support in addition to routine care), or (b) the control group (in which they received routine care but no other intervention), Anxiety and depression were measured by the Hospital Anxiety and Depression (HAD) scale at 24 hours and 5 days after the patient's admission to hospital. At 5 days there were statistically significant differences between both groups with respect to the HAD scale mean scores. These findings strongly suggest that a simple programme of in‐hospital couple counselling, provided by a coronary care nurse, statistically significantly reduces anxiety and depression in first MI male patients and anxiety in their partners.
Students’ and trained nurses’ perceptions of their own interpersonal skills: a report and comparison
Authors: Morrison Paul , Burnard Philip
Published: December 2006

The theoretical framework known as Six Category Intervention Analysis is described. This framework has been used in the teaching of interpersonal skills in various settings but there appears to be little or no empirical work to test out the theory. In the present study, an instrument was devised for assessing student nurses’ perceptions of their interpersonal skills based on the category analysis. The findings of the study are presented and a quantitative comparison is made with the results of an earlier study of trained nurses’ perceptions. Marked similarities were noted between the two sets of findings. The key trend to emerge was that both groups of nurses tended to perceive themselves as being more authoritative and less facilitative in their interpersonal relationships, in terms of the category analysis. This trend and others are discussed and suggestions made for future directions in research and training in the field of interpersonal skills in nursing. Implications for the theory of six category intervention analysis are also discussed.
Mothers of very low birthweight babies: how do they adjust?
Authors: McHaffie Hazel E
Published: December 2006

A prospective study was conducted to investigate the perceptions of 21 mothers of singleton babies weighing 1500 g or less Six in‐depth interviews were held with each respondent from 1 week after delivery to 3 months after the baby's discharge from hospital Diaries and Neonatal Perception Inventories supplied additional data Six phases were identified each characterized by certain critical factors related to the mother's emotional state, her perceptions of the baby, and family responses Significant statistical differences were found between those mothers who did not feel ready to take the infant home and the rest of the sample Those who were not ready demonstrated a marked difficulty in establishing and maintaining relationships and held very inappropnate perceptions of the baby These findings have important implications for the discharge of very low birthweight babies after a prolonged stay in hospital
The development of theory in British nursing: current position and future prospects
Authors: Draper Peter
Published: December 2006

This paper is concerned with the development or theory in the discipline of nursing as it is practised in Great Britain It stems from dissatisfaction with the generally uncritical adoption by British nurses of models of nursing which have been developed to explain and enhance North American practice After the introductory paragraph, four roles for nursing theory are proposed These are to define nursing by describing nursing phenomena, to form a realistic basis for curriculum design, to provide tools for the professional prachce of nursing, and to provide a nursing language It is then argued that although British nurses have recognized the need for an adequate theoretical basis for practice, their response has been rather uncritical adoption of American models of nursing As a basis for practice, it is argued that American models generally fail to meet the needs described above, and therefore fail to have impact on clinical work Structural and philosophical reasons for this failure are identified Following a brief discussion of the inductive and deductive approaches to the development of theory, the paper closes with the argument that British nurses should be concerned with the development of new theory which, if grounded in the reality of practice, would be likely to be both useful and realistic
Computer training in nurse education: a bird's eye view across the UK
Authors: Chambers Mary , Coates Vivien E
Published: December 2006

This paper is borne of the increasing interest and relevance of computers in nursing It describes the method, and results obtained from a postal questionnaire survey distributed across the United Kingdom to gain information about the developments in computing in nursing education The results indicate that considerable developments have been made, but that they are more piecemeal than co‐ordinated A selection of the results are presented and discussed, and one or two points concerning future proceedings are raised
The Health‐Promoting Self‐Care System Model: directions for nursing research and practice
Authors: Simmons Susan J
Published: December 2006

In an effort to theoretically integrate perspectives of self‐care and health promotion, the Health‐Promoting Self‐Care System Model is proposed as a framework for identifying and explaining sequential patterns among factors which influence the decision‐making, performance and outcomes of health‐promoting lifestyles The model is based upon a synthesis of elements comprising constructs of the Self‐Care Deficit Nursing Theory as well as certain factors in the Interaction Model of Client Health Behaviour and the Health Promotion Model Directions for research and practice provided by the model should encourage the development of a cumulative nursing knowledge base and contribute to the goal of enhancing the health and well‐being of persons across developmental and sociocultural contexts
Combining cognitive therapy and pharmacotherapy in treating depression on an in‐patient basis
Authors: Segal Zindel V , Myran David D , Persad Emannuel , Josefowitz Nina
Published: December 2006

The authors present a case of a 40‐year‐old female with a history of recurrent unipolar depression in which combined treatment with cognitive therapy and medication was associated with significant clinical improvement Rather than providing a straightforward example of combined interventions for depressed inpatients, it is hoped that some of the complexities involved in such an endeavour will be highlighted Specifically, issues concerning planned communication between relevant staff, orientation of ward staff to nonorganic treatments, choice of treatment targets, and potential strains in the collaborative relationship between the cognitive therapist and treating physician are explored
The learner‐centredness of two registered general nursing and two registered mental nursing courses as perceived by third‐year nursing students
Authors: Sweeney John F
Published: December 2006

Using the conceptual framework of the Nottingham Andragogy Group, two first‐level British courses in general nursing and two in psychiatric nursing were studied to investigate their degree of perceived learner‐centredness Boydell's Scale for Measuring the Learner‐Centredness of a Course was administered to a non‐random sample of all 172 third‐year students at three schools of nursing Preference for learner‐centred nursing education was investigated using Boydell's Preferred Teaching Style Rating Scale with the student sample and by 31 nurse teachers Results indicated that first‐level nursing courses were perceived to be highly teacher‐centred in terms of planning, direction, sequence, pace and evaluation of learning The climate of learning proved to be moderately learner‐centred though teacher‐student relationships were perceived as formal Variety of learning approach was seen as limited with a tendency towards positivism rather than relativism of knowledge Both students and teachers of nursing expressed a slight preference for teacher‐centred courses despite the former's dissatisfaction with lack of participation in determining learning objectives Significantly greater perceived learner‐centredness of a psychiatric course was attributed to variations in the philosophy of learning within a particular school rather than to the course per se
Restructuring: an emerging theory on the process of losing weight
Authors: Johnson Rosemary
Published: December 2006

A qualitative research design (grounded theory) was used to analyse the experiences of dieters attending a weight loss programme Two hundred hours of observations at a nationally known weight reduction centre, a review of selected documents from the organization and multiple in‐depth interviews with 13 informants were the data sources for this study Data generation took place over a 21‐month penod A substantive theory of restructuring identified three stages in the process of losing weight These stages and key elements of the weight loss process are presented
The costing of nursing care: a study of 65 colorectal cancer patients
Authors: Walker AR , Whynes D K
Published: December 2006

Nursing care is a major factor in the cost of most medical treatments This paper reports on two alternative techniques for estimating the costs of nursing care, in the context of colorectal cancer treatment on a surgical ward in the University Hospital, Nottingham The simpler, but cruder, technique is based on average patient costs, whilst the other is patient‐specific and incorporates the use of nursing dependency data Results from the two estimation methods are compared and the implications for the proper costing of nursing care are discussed
Power for nursing education
Authors: Glen Sally
Published: December 2006

The topic of power and politics is a recurrent theme in the nursing literature, but not, I wish to suggest, in the nursing educational literature This paper introduces the topic of power as a nursing educational issue It is divided into three sections (a) what a concept of power might mean for nursing education, (b) the nature and form of power relationships within nursing education, and (c) the nature, form and efficacy of the current professional strategies to gain power First, two definitions of power for nursing education are explored (a) the power inherent in organizational structures, and (b) the notion of practising nursing education as an empowering profession Next, a theoretical framework is applied to specific examples of power relationships within nursing education Two views of power and their inter‐relationship with decision‐making in curriculum matters are described ‘overt conflict’ and ‘control of the institution's agenda’ It is argued that these still fail to pick up important instances of the strategies to gain power Finally, examples of strategies used to gain power in colleges of nursing are made explicit Concurrently, questions are raised in relation to their efficacy and alternative strategies more congruent with the role of professional educator are advocated It is argued that nursing education's most lasting form of power will rest in the development of pedagogical knowledge expertise and a research basis in essence, the development of an academic identity in nursing education
Assessing assertive behaviour in student nurses: a comparison of assertion measures
Authors: McCartan Patrick J , Hargie Owen D W
Published: December 2006

This study compared four different assertive measurements used to assess student‐nurse behaviour The measurements employed included a semantic differential ‘subjective self‐report’, the Rathus Assertiveness Schedule, a behavioural test, and observer ratings The study was divided into three different phases In phase one, subjects (n= 19) were requested to complete the two self‐report measures Several days later, they were asked to partake in a behavioural test which took the form of a response to an unreasonable request The final phase entailed observers (n= 9) viewing a video‐recording of the behavioural test (without sound) and rating subjects on levels of assertiveness Analyses of the results revealed only one significant finding, namely that there was a positive relationship between the scores on the Semantic Differential Measurement and the Rathus Assertiveness Schedule (P < 0.05) No other significant results emerged The findings of this investigation are discussed in the context of the role of assertive behaviour in nursing
Using self‐help support groups: a framework for nursing practice and research
Authors: Alley Nancy M , Foster Marilyn Chance
Published: December 2006

Social support groups are receiving increased attention in professional literature and the media and the number of groups is growing Nurses are often urged to utilize social support groups as part of client care These groups cannot be effectively used by nurses unless they are approached from the framework of the nursing process This approach helps assure individualization of referrals and evaluation of the support group in relation to the client's needs Based on the literature reviewed and the proposed nursing process framework, many research questions are identified
Preparation for Caesarean childbirth: derivation of a nursing intervention from the Roy Adaptation Model
Authors: Fawcett Jacqueline
Published: December 2006

The paper describes a programme of research directed toward developing and testing a nursing intervention derived from the Roy Adaptation Model of Nursing and designed to prepare expectant parents for unplanned Caesarean birth The first study was a retrospective survey of Caesarean‐birth parents that revealed the need for detailed information about the events surrounding Caesarean birth The second study was a clinical field test of the nursing intervention, which consisted of a pamphlet containing information about all aspects of Caesarean birth with follow‐up discussion of pamphlet content Data analysis indicated that Caesarean‐birth parents found the pamphlet content informative and reassuring and found the follow‐up beneficial The third study was a clinical field test of a modified version of the intervention consisting of the pamphlet and focused discussion about Caesarean birth Data analysis revealed that the nursing intervention provided the information expectant parents needed to prepare for the possibility of Caesarean childbirth The fourth study is an ongoing experiment designed to test the effects of the nursing intervention on responses to unplanned Caesarean birth Emphasis throughout the paper is placed on the links between the Roy Adaptation Model and the methodology and findings of each study
Triage in accident and emergency departments
Authors: Mallett Jane , Woolwich Cherine
Published: December 2006

This study was carried out to investigate the effect of triage on attenders’ waiting times in an accident and emergency(A & E) department The A & E department comprised three separate areas the A & E unit, dressing clinic and review clinic Data on all A & E attenders were collected by the nursing staff over a period of 1 week using a data collection form The waiting times for the attenders to be seen by a doctor in 1988 were longer than in 1986 This may partly reflect the lower number of people using A & E in 1986, while the current practice of an initial triage assessment may slow the patients’ access to a doctor This latter finding is a cause for concern, since the receptionist is the main triage assessor at night However, the time the attender spent waiting to be clinically assessed by a health care professional (nurse) was shorter in 1988 than when performed by a health care professional (doctor) in 1986 This indicated that nurse triage enabled a shorter waiting time between arrival and assessment of the A & E unit attender
The primary‐care nurse's dilemmas: a study of knowledge use and need during telephone consultations
Authors: Timpka Toomas , Arborelius Elisabeth
Published: December 2006

In Sweden (population 8 million) there are 20 million calls every year to receptionist nurses at health‐care centres The aim of this study was, first, to develop a general description of these telephone consultations in terms of the decision‐making process and interpersonal communication Second, the dilemmas that receptionist nurses encounter were to be recorded and analysed A two‐level video method was used At the first level, a video recording of the consultation was used to draw a ‘consultation map’ At the second level, the receptionist nurses reviewed and commented on the video‐recording using a ‘freeze frame’ technique for stimulated recall and the comments were categorized Analysis of the consultation maps showed that the receptionist nurses focused mainly on tasks related to medical diagnosis and management strategy, with less time spent on the patient's concerns, ideas and expectations Analysis of the dilemmas showed that medical dilemmas were the most frequent occurring in two consultations out of three Dilemmas in the area of interpersonal communication frequently concerned distrust, either in what the patient presented, or in what the patient was said to have understood The conclusions are that the receptionist nurses were oriented towards medical management, and that they employed an informing rather than counselling strategy Measures must be considered to support the receptionist nurses in the medical decision‐making process Action research is suggested to apply these results in the development of the work‐role of the receptionist nurse
A critical review of the use of Rogers’ model within a special hospital: a single case study
Authors: Mason T , Patterson R
Published: December 2006

This case study presents a problematic patient who has been resident m a special hospital for mentally handicapped people for years due to a gross sexual fantasy disorder, continuous self‐injurious behaviour and an array of disordered conducts which resulted in negative nursing reports The introduction of Rogers’ model, with its abstract finer conceptualizations produced an alternative framework by which to assess the patient This holistic interactive model generated a paradigmatic shift in the nursing perceptions, at a conceptual level, which was manifested in their reporting behaviours The results appeared to indicate a sudden and dramatic change in the patient's behaviour However, alternative interpretations proved the more convincing on closer analysis The use of Rogers’ framework proved difficult in its practical application due to its underpinning requirements for role adoption and negotiation, both being problematic in a secure environment
Implementing the Roy model: challenges for nurse educators
Authors: Morales‐Mann Erlinda T , Logan Manon
Published: December 2006

The expenence of selecting and implementing a nursing model appropriate to the nursing course in the first year of the generic baccalaureate programme of the University of Ottawa School of Nursing is described Many challenges surfaced for the professors in year one as this curriculum change was implemented Four challenges (1) adapting the course to be congruent with the Roy model, (2) developing teaching tools suitable for student learning, (3) sequencing of content for student learning, and (4) obtaining competent role models, and how they were met, are discussed
Ethical dilemmas associated with small samples
Authors: Ford Joan S , Reutter Linda I
Published: December 2006

This paper describes the ethical dilemmas which the authors encountered when conducting qualitative research with samples consisting of a small number of participants Ethical conflicts are explored in terms of the principles of autonomy, non‐maleficience, and beneficience with examples from the authors’ research experiences Although there are no definitive resolutions to these conflicts, the paper may increase awareness of the special concerns which require further study and debate
HIV infection and AIDS in England: the experience, knowledge and intentions of community nursing staff
Authors: Bond Senga , Rhodes Tim , Philips Peter , Setters Jo , Foy Christopher , Bond John
Published: December 2006

A postal survey of 5243 community nursing staff throughout England sought information about their experience, education, knowledge, confidence and beliefs in relation to the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS) A response rate of 74% was obtained While experience of patients positive for HIV antibody or with AIDS was limited, one‐third of community nursing staff had encountered patients worried about HIV infection However, most lacked confidence to provide health education, counselling and terminal care A quarter felt that they should have the right to refuse to care for patients with AIDS, while 85% were concerned about their lack of experience In order to play an effective role in the prevention and management of HIV infection, community nursing staff need to be assisted in making links between knowledge they already possess and its application to HIV infection, and in developing and practising skills
Efficacy of self‐care measures for perimenstrual syndrome (PMS)
Authors: Kirkpatrick Mary K , Brewer Jo Ann , Stocks Barbara
Published: December 2006

More than 90% of women are affected by one or more of the signs and symptoms of perimenstrual syndrome (PMS), which causes disruptions at work and in family relations and can be economically costly Self‐care measures relating to lifestyle modifications, most particularly nutrition and exercise, can be helpful in preventing and/or alleviating the number and seventy of symptoms This quasi‐experimental study of a pre‐test and post‐test design showed a statistically significant increase in self‐care measures for PMS with a significant decrease in symptoms, thus impacting on the control of PMS
The Neuman System Model applied to mental health nursing of older adults
Authors: Moore Sharon L , Munro Margaret F
Published: December 2006

As we move into the 21st century, nurses are facing the challenge of contributing to the health care of a society with an increasing proportion of ageing persons This group of people become more heterogeneous as they age, bringing with them an extended life history of experiences of wellness and illness They have been faced with numerous stressors and losses and have made successful or unsuccessful adaptation to those life experiences One of the disconcerting stressors of the elderly is the promotion and maintenance of mental health In this paper we will examine the application of the Neuman System Model to the mental health nursing of older adults
A systematic comparison of feedback and staff discussion in changing the ward atmosphere
Authors: James Ian , Milne Derek L , Firth Hugh
Published: December 2006

The efficacy of therapeutic programmes depends on several characteristics of the treatment environment For this reason therapists are increasingly directing their efforts towards changing the social characteristics of treatment units This study aimed to promote change in social climate by providing nursing staff with structured information about their unit The ‘real’ and ‘ideal’ social climate of the unit was defined and assessed using the Ward Atmosphere Scale All staff were asked to complete it during an assessment penod Feedback about their perception of the unit was provided to staff in two ways One group of staff received written feedback only, a second group received in addition the opportunity to discuss the feedback and strategies for reducing the real—ideal discrepancies in four once‐monthly meetings The effect of the feedback on the social climate of the unit was ascertained by further assessment using the WAS and from interviews with all staff The evaluation suggested that the feedback had contributed to changes in several procedures in the unit and to a reduction in the real—ideal discrepancies for the systems maintenance elements The effect was greater for the group of staff who had the opportunity to discuss the feedback in a formal setting
Male and female nurses in intensive‐care wards in The Netherlands
Authors: Dassen Theo WN , Nijhuis Frans JN , Philipsen Hans
Published: December 2006

This article presents the results of a national survey among intensive‐care nurses, establishing whether male nurses and female nurses can be distinguished with respect to issues such as professionalizahon, career orientation and their preference for technical departments The study showed that there is an over‐representation of men in technical wards At IC/CC‐units the percentage of male nurses is twice as large as in the hospital as a whole (IC/CCU included) The distribution of labour among male and female nurses is taking place according to traditional sex‐specific role patterns Male nurses are more oriented towards professionalizahon than female nurses Male IC‐nurses see their jobs more in a medical perspective and they also show a higher frequency in the performance of medically reserved activities Male IC‐nurses seem to be particularly directed at upgrading their own profession The differences between male and female nurses can also be explained by culturally determined differences between men and women regarding their own career perspective and career development, as well as by internal staff policy
Time‐use in later life
Authors: Ross Margaret M
Published: December 2006

This paper seeks to demonstrate the significance of the time budget methodology for nursing as a means of exploring the use of time in later life and its relation to health and well‐being With increasing concern for quality of life issues, the use of time and the proportion of time that is allocated to specific domains of life become important life‐style decisions that merit both personal concern and professional inquiry The paper begins with a review of the time budget methodology and the research employing the time budget methodology dating back to the 1960s It continues with a description of how people allocate and use their time in later life as revealed by these studies, and concludes with the significance of this method of inquiry for nursing
Assessment of hearing loss in elderly people: the feasibility of a nurse administered screening test*
Authors: Newman Deborah
Published: December 2006

This paper examines the findings and implications of an exploratory study which was designed to determine the feasibility of a nurse administered hearing screen test for elderly patients Theoretical and practical considerations which influenced the design of the hearing assessment test (HAT) and the method of the study are discussed A sample of 27 elderly hospital inpaients, with a mean age of 81 years, participated in the study The results of the new HAT were validated by comparison with audiometric assessment results Analysis using the Generalized Linear Model showed a significant (P 0 01) relationship between the total HAT score and the audiometnc measures, with the exception of the audiometnc classification of hearing loss which was significant at P.0 05 The results demonstrate that the HAT is a potentially useful tool for nurses to use, but that refinement of the scale and further validity and reliability testing is required before it can be adopted as part of the nursing assessment of elderly people
A comparison between the care of vocally disruptive patients and that of other residents at psychogeriatric wards
Authors: Hallberg Ingalill R , Norberg Astrid , Eriksson Sture
Published: December 2006

This study aimed at examining the relationship between the occurrence of vocally disruptive behaviour and the care of demented patients The results presented here focus on the contents of the patient's daily life provided by the staff In all the psychogenatnc wards within one county council, having patients identified as vocally disruptive, 37 patients exhibiting this behaviour and 37 controls were studied Semistructured continuous observations for 15 hours per patient (7 00 a m ‐10 00 p m) were made Data from a previous report revealed that the vocally disruptive patients were more physically dependent on the staff as compared to controls However, the physical care provided did not differ significantly The patients spent 21% of the observed time in caring activities, mainly physical care, 18% of the time they were sleeping or dozing, and 71% of the observed time they were left to themselves and reduced to inactivity and solitude Regression analysis disclosed that only the amount of activating care in a group was significantly related to the vocally disruptive behaviour Hence the data support the idea that understimulation is present in the demented patient's life but it can hardly be the cause of the behaviour However, the environment might contribute to the occurrence and maintenance of vocally disruptive behaviour
The unexpected relocation of elderly in‐patients in response to a threatened strike
Authors: Powell C , Walker J , Christie M , Mitchell‐Pedersen L , Rauscher C
Published: December 2006

A threatened strike by non‐professional hospital employees caused a teaching hospital to halve its in‐patient numbers This paper describes this unexpected, involuntary intervention in patient care in the Department of Genatnc Medicine Fifty‐three patients were discharged, 46 patients were transferred for 12 days to another hospital and 29 remained in the department There was no evidence of important disruption in patient‐care nor exacerbation of patient‐distress as seen in ratings of patients’ social, emotional and physical functioning It is suggested that important factors in achieving successful unexpected relocation are selection of patients who are medically stable albeit with significant physical and mental disability, the preparation and participation of patients and staff, and the continuation of patient care by nursing staff familiar to the patients
Comprehensive assessment of AIDS patients using the behavioural systems model for nursing practice instrument
Authors: Derdianan Anayis K , Schobel Deborah
Published: December 2006

The major changes resulting from the AIDS diagnosis and illness were measured, described and classified in the Behavioural Systems Model's eight subsystems — achievement, affiliative, aggressiveness/protectiveness, dependence, ingestive, elimmative, restorative and sexual Thirty male AIDS patients with Kaposi's Sarcoma were drawn as a convenience sample from a major medical centre's outpatient clinic The subjects self‐rated their perceived changes in the above eight major areas, using a 140‐item instrument (DBSM) consisting of 24 categories of changes distributed in the above eight areas Patients reported changes in all categories and described them in terms of direction, quality and relative importance Ordinal ranks of changes existed among the eight major subsystems’ frequency and importance of change scores, as shown by ANOVA and Tukey's studentized t‐tests of rank
The Betty Neuman Systems Model applied to practice: a client with multiple sclerosis
Authors: Knight Janet B
Published: December 2006

The importance of nursing theories and models for the growth and development of the profession of nursing is widely acknowledged The variety of nursing phenomena and situations demands some flexibility in the choice of specific conceptualizations to be used This paper demonstrates the goodness of fit of the Betty Neuman Systems Model to the care of clients with multiple sclerosis An adapted assessment tool, based on Neuman's tool, but more useful in the acute care medical setting, is used to gather data related to a woman with recently diagnosed multiple sclerosis A nursing care plan illustrating the use of Neuman's model is generated, implemented and evaluated The Neuman Model is demonstrated to be useful and effective in the implementation of the nursing process in this case
The Roy Adaptation Model: are nursing diagnoses amenable to independent nurse functions?
Authors: Logan Marion
Published: December 2006

In this article, current knowledge of nursing diagnosis is compared to the assumptions of the Roy Adaptation Model for Nursing More specifically the relationship between the aetiology component of diagnostic statements and stimuli is explored Examples of nursing diagnoses from the literature are also presented to analyse the relationship between aetiologies and independent nurse functions
The politics of American health care
Authors: Smith James P
Published: December 2006

The developments leading to the present American health care organization are traced It is clear that hospitals have dominated at the expense of primary health care programmes Health care costs have soared dramatically There are particular problems inherent in a system shared between federal and state governments and a private health care industry Attempts to provide a fully (or partially) tax‐funded health service in the USA have been bedevilled by a number of factors These include opposition from labour unions, politicians, vested‐interest groups and, in particular, the American Medical Association As part of its opposition, the AMA politicized itself in 1950 But, in the political literature, American nurses are not portrayed as being very politically active Reasons for this are explored The introduction of Medicare and Medicaid programmes is discussed and the legal, social and political implications Recent attempts in the USA to control costs are assessed and new trends and new problems identified
Social reform versus education reform: university nursing education in Canada, 1919–1960
Authors: Baumgart Alice J , Kirkwood Rondalyn
Published: December 2006

Nurses’ struggle to attain educational parity with other professional groups is closely aligned with the struggle of women for social equality within Canadian institutions The attempts of nursing educators to shift their perspective from social reform to educational reform and to develop nursing scholarship has been restricted by the cultural views of women Consequently, nurses’ gains in attaining higher education have been realized by reforms in social and health care policies thought suitable for women With advancement in university nursing education closely tied to social reform, nurses were not expected, nor did they expect, to pursue scholarly enquiry or develop research endeavours This paper suggests that the feminist movement offers nurses a social and psychological basis from which to complete the educational reform of nursing
An exploratory study of selected female registered nurses: meaning and expression of nurturance*
Authors: Geissler Elaine M
Published: December 2006

The words ‘nurse’ and ‘nursing’ originate in the word ‘nurture’ which dates back to the 14th century ‘Nurturance’ appeared for the first time in the 1976 Supplement to the Oxford English Dictionary and in a United States dictionary in 1983 Etymologically and semantically bound to nursing, little is known about the term nurturance An exploratory design using phenomenological analysis was applied to understand the female registered nurses’ experience of nurturing patients throughout the life‐span and to uncover behaviours commonly bebeved nurturant Interviews with 14 RNs practising in diverse settings revealed 39 nurturant behaviours that were intuited into four themes describing the subjects’ perceived structure of nurturance as (1) enabling maximum potential, (2) providing physical and emotional protection, (3) engaging in a supportive interaction, and (4) conveying shared humanity Data were formulated into an exhaustive description of the phenomenon nurturance Additionally, the resultssupport Greenberg‐Edelstem's theoretical model of the positive reciprocity of nurturance between nurse and patient
A model for body‐image care
Authors: Price Bob
Published: December 2006

It is by no means clear that the diagnosis ‘altered body image’ is sufficiently clear to enable the nurse to plan and deliver a package of body‐image care This paper proposes a model of body‐image care based upon five central concepts, and the accepted metaparadigms of nursing It is suggested that the nurse is uniquely positioned to deliver the best body‐image care, and that this model will assist her to assess body‐image needs and to then action the altered body‐image diagnosis more effectively
Putting nursing research findings into practice: research utilization as an aspect of the management of change*
Authors: MacGuire Jillan M
Published: December 2006

This paper discusses a number of different levels at which the implementation of nursing research findings needs to be addressed and identifies 10 areas of potential difficulty the complexity of the change process, the genesis of research programmes, the formulation of research questions, differences in theoretical approaches, timescales and planning cycles, information overload, credibility, applicability, response to change and the management of change An attempt is made to shift the nature of the discourse from the personal to the organizational and from a diffusionist perspective to that of change management It is suggested that it is simplistic to regard the apparent lack of take‐up of research‐based practice findings as a failure on the part of individual nurses to respond rationally to the production of new information The integration of research and practice has to be addressed at all levels within an organization, from policy statements to procedure manuals and from managers, educators and clinicians to support workers within the framework of the management of change The potential of action research and quality circles in this context is touched on
Integrating nursing research and practice —the role of the researcher as teacher
Authors: Wilson‐Barnett Jenifer , Comer Jessica , De Carle Brenda
Published: December 2006

For the past two decades authors have discussed the lack of research‐based nursing practice Many explanations are afforded but few focus on the way in which the researcher plans to involve staff in each stage of the process The desire by practitioners to become researchers has been confounded in the main by increasing pressures on staff and a failure to realise that special training and opportunities are necessary for the generation and fruition of research ideas In this article two recent studies are briefly discussed to demonstrate how the researcher can work with nurses to identify relevant topics, provide support and specific education to improve care and subsequently to evaluate the effects Final discussion reflects the importance of introducing a number of individuals with a researcher—teacher role amid the practitioners
Coping with palliative chemotherapy
Authors: Payne Sheila A
Published: December 2006

Comparatively little is known about how patients with advanced cancer cope with palliative chemotherapy This study uses grounded theory to analyse the coping responses of 24 women with advanced breast or ovarian cancer Half the sample received chemotherapy at home, and the remainder were treated in hospital The results suggest that four predominant coping styles are used, think positive/fighter (n = 8), acceptance (n = 8), fearfulness (n = 5) and hopelessness (n = 3) In addition, a range of coping strategies that reduced the threat of chemotherapy are identified. The findings have implications for the provision of quality patient care in palliative therapy, especially in relation to individualizing patient education
Family dynamics during pregnancy
Authors: Tomlinson Barbara , White Marjone A , Wilson Margaret E
Published: December 2006

Pregnancy as a transition in family life is perceived as a crisis by many families Sociodemographic characteristics of families during pregnancy can serve as important sources of information to nurses in drawing out family strengths and providing assistance during this crisis Family dynamics were measured in 160 women in the third trimester of pregnancy Half were in their first pregnancy and half were in their second pregnancy The research question addressed the relationship between family dynamics and several sociodemographic characteristics Statistically significant relationships were found between the sociodemographic variables of marital and social status, and several dimensions of family dynamics Families in which couples were married and who enjoyed a higher social status had more positive family dynamics in the dimensions of individuation, stability, flexibility, mutuality and communication Race, maternal age and parity were not related to level of family dynamics Strengths in families who have more positive dynamics may be explained by availability of resources, their expertise in using the system, societal approval of marriage and internal family support from the husband It is essential for nursing care to include systematic family assessment, socialization in effectively using the health care system and individualized family guidance
Understanding postnatal depression: a mother‐centred approach
Authors: Nicolson Paula
Published: December 2006

Research findings on the causes and correlates of postnatal depression divide into two explanatory frameworks The clinical/medical model identifies the mothers as being ‘ill’, and the social science model suggests a particular vulnerability to additional social stress factors Despite attempts to predict those women at risk, and develop preventative programmes, most treatment initiatives are reactive, which is a direct result of the inconclusive nature of available evidence The study reported here suggests that the concept ‘postnatal depression’ needs to be re‐examined and that rather than it being an individual illness or vulnerability, it is more akin to a normal grief reaction and part of a normal postnatal profile It only becomes a problem when it is defined and treated inappropriately The implications from this research lead to a new approach to understanding the mother's experience of postnatal depression, and types of counselling and support which might effectively be employed by midwives and health visitors
Building a programme of research from the Roy Adaptation Model of Nursing
Authors: Fawcett Jacqueline , Tulman Lorraine
Published: December 2006

This paper describes a senes of methodological and substantive studies denved from the Roy Adaptation Model of Nursing The research encompassed development of an instrument to measure functional status after childbirth and retrospective and longitudinal studies of variables associated with functional status during the postpartum penod The conceptual model proved to be a useful guide for the design and conduct of these studies as well as ongoing investigations of functional status during pregnancy and following diagnosis of breast cancer Findings from completed studies support the credibility of Roy's conceptual model