bluuebunny/crossref_metadata_2025 huggingface dataset:
Soluble galectin-4 in colorectal cancer is associated with tumor progression, but is not a predictor of the disease outcome
Authors: Yakunina Elena Y. , Kovaleva Olga V. , Zukov Ruslan A. , Gratchev Alexey N. , Salamatin Sergey S. , Kochkina Sofya O. , Mammadli Zaman Z. , Kushlinskii Nikolay E.
Published: November 2024

Background: Galectin-4 is a member of β-galactoside-binding protein family, which is mainly expressed in gastrointestinal epithelial cells and also secreted into the extracellular environment. Studies have shown that galectin-4 is involved in the regulation of proliferation and metastasis of gastric and pancreatic cancer tumor cells. The results of studies on the clinical significance of galectin-4 in colorectal cancer (CRC) are ambiguous: some studies showed its increased expression, associated with aggressive course and unfavorable prognosis, while others showed its decrease.
Aim: To analyze the clinical significance of the soluble form of galectin-4 in CRC.
Methods: We retrospectively analyzed the medical records of 130 patients (mean age, 61 year) with a verified diagnosis of CRC, who had been examined and treated from 2016 to 2022. Galectin-4 levels were measured in serum obtained by a standard method before the start of specific treatment, by the enzyme-linked immunosorbent assay (ELISA). The control group consisted of 30 healthy donors (mean age, 53 years).
Results: The median concentration of galectin-4 in the CRC patients was higher than in the control group (531.9 [350.6–1380] pg/mL vs. 330.1 [173.0–566.4] pg/mL, p = 0.0004). The ROC analysis demonstrated maximum sensitivity and specificity of the test (66% and 67%, respectively) at a threshold value of 426.3 pg/mL (area under the curve 0.706 with 95% confidence interval 0.594–0.817; p = 0.0005). The galectin-4 levels were higher at advanced stages of the disease (p = 0.002) and in the presence of distant metastases (p 0.0001). Cox regression analysis showed that tumor size and distant metastases were independent prognostic factors (hazard ratio (HR) = 3.87; p = 0.0439; HR = 720.4; p = 0.0062, respectively) associated with decreased survival. Galectin-4 is not a prognostic marker of CRC (HR = 2.434; p = 0.079).
Conclusion: The amounts of the soluble galectin-4 are associated with tumor progression, indicating a possible tumor-promoting function of this protein. However, its diagnostic value remains limited, as the method of serum galectin-4 determination has shown insufficient sensitivity and specificity for its routine use for the diagnosis of CRC. According to the results of univariate and multivariate analyses, serum galectin-4 is not a significant prognostic marker of CRC.
La incorporación de los presupuestos de los procesos estructurales por el Supremo Tribunal Federal en el juicio de litigios estructurales
Authors: Hennig Leal Mônia Clarissa , Fardin de Vargas Eliziane
Published: November 2024

El estudio analiza la incorporación de los presupuestos de la teoría de los procesos estructurales por parte del Supremo Tribunal Federal (STF) en las decisiones en etapa de seguimiento por el Núcleo de Procesos Estructurales y Complejos - Nupec (ADPF 347, 635 y 709). Para tanto, adoptando el método de enfoque deductivo y el método de procedimiento analítico, se abordan los aportes teóricos sobre los litigios, los procesos y las decisiones estructurales, enumerando los presupuestos de la teoría de los procesos estructurales. Se exploran cuáles fueron las reestructuraciones internas que el Tribunal Supremo Federal implementó con el fin de ajustar los procedimientos judiciales de tratamiento de los litigios estructurales ante la falta de regulación legislativa de los procesos estructurales en Brasil. Por último, tomando como base los presupuestos de los procesos estructurales identificados al inicio del estudio, se analiza el contenido de las decisiones del Supremo Tribunal Federal con la intención de verificar si estas respetan e incorporan los elementos básicos de los procesos estructurales. De este análisis se concluye que las tres decisiones incorporan una perspectiva dialógica (tanto institucional como de las partes con el Poder Público), priorizan la participación de los grupos afectados en la construcción de decisiones justas y efectivas, aplican una actuación experimentalista, agregan mecanismos de seguimiento de la implementación y efectividad de la decisión y, en algunas ocasiones, realizan una traducción jurídico-cultural de experiencias y remedios estructurales extranjeros, aprendiendo de casos similares ya juzgados por Cortes de otros países, adaptando estos estándares a la realidad brasileña.
Redução de temperatura em tubos de PPR embutidos em alvenaria
Authors: Ferreira Armando Traini , Uehara Takashi
Published: November 2024

No transporte de água quente através de tubulações, ocorre transferência de calor para o ambiente, ocasionando a redução da temperatura da água. Cabe aos projetistas de sistemas prediais de água quente estimar as perdas térmicas, contudo, os dados disponíveis para diferentes configurações e condições de operação são insuficientes. Este artigo visa determinar a redução de temperatura no escoamento de água quente em tubulações de polipropileno copolímero random (PPR) embutidas em alvenaria, considerando diferentes diâmetros de tubo e velocidades de escoamento. Para isso, foi elaborado um modelo com formulações fundamentadas na literatura de transferência de calor, e foram realizadas simulações de Dinâmica dos Fluidos Computacional. O teste-t indicou que os resultados de redução obtidos pelos dois métodos foram significativamente diferentes para os tubos de 20 mm (t = 2,7516 e p-valor = 0,02961) e 25 mm (t = 3,0391 e p-valor = 0,02080), porém, as diferenças se mantiveram aproximadamente constantes ao variar a velocidade. Considerando as características de cada abordagem, conclui-se que o modelo é promissor e pode representar uma opção para a estimativa da perda térmica nos tubos, sendo necessário um aprofundamento da compreensão do fenômeno com a realização de ensaios.
CORRELATION BETWEEN STUDENTS' EDUCATIONAL BACKGROUND AND MOTIVATION WITH LEARNING OUTCOMES IN ARABIC LANGUAGE CLASS X AT ISLAMIC INTERNATIONAL BOARDING SCHOOL (IIBS) AL-MAAHIRA
Authors: Anisah Suria , Abidin Munirul
Published: November 2024

Arabic language learning is only applied in a few schools and its application experiences several obstacles due to lack of interest. However, if Arabic language learning is applied from the beginning, student interest in learning will increase and will affect student learning outcomes. The purpose of this study is (1) to examine the correlation or relationship between educational background and Arabic learning outcomes (2) to examine the correlation between students' learning interest and Arabic learning outcomes (3) to examine the correlation between students' educational background and students' learning motivation on students' learning outcomes. The subjects in this study were 12 students of class X IIBS Al-Maahira. the data collection technique was to distribute questionnaires related to students' educational background and learning motivation. Data related to student learning outcomes using Arabic midterm exam scores. The data analysis technique is simple correlation analysis. The results of this study are (1) there is a relationship between educational background and learning outcomes as much as 0.710 (2) a simple correlation between learning motivation and correlation results with results as much as 0.710 (3) there is a high and significant relationship between students' educational background and student learning motivation with Arabic learning outcomes by showing a correlation coefficient of 0.736 and a coefficient of determination of 0.541
Growing Up with a Narcissistic Mother: Mediating Role of Self-Criticism in the Relationship of Maternal Narcissistic Traits with Depression and Anxiety
Authors: Alpay Emre Han , Aydın Arzu
Published: November 2024

Objective: This study aims to examine the mediating role of self-criticism in the relationship between narcissistic traits perceived from the mother in childhood and symptoms of depression and anxiety disorders in adulthood.
Method: A total of 512 adults aged between 18 and 45 years (mean age= 31.47, SD= 10.37) were included in the study. Participants completed the Socio-demographic Information Form, Scale of Narcissitic Traits Perceived from Mother, Forms of Self-Criticism and Self-Relief Scale, and Brief Symptom Inventory.
Results: In the model tested using Structural Equation Modeling, perceived maternal narcissism during childhood predicted self-criticism, depression and anxiety disorder symptoms. In addition, self-criticism predicted both depression and anxiety disorder symptoms. Indirect effects were examined with the bootsrap method and self-criticism was found to have a mediating role.
Conclusion: The results suggest that self-criticism mediates the relationship between narcissistic traits perceived from the mother in childhood and symptoms of depression and anxiety disorders. These findings suggest that a mother's narcissistic traits may have a negative impact on mother-child interaction and influence the child's development of a self-critical style. Moreover, high maternal narcissistic traits may increase the risk of depression and anxiety disorder symptoms by contributing to a self-critical thinking style.
Psychometric Properties of Turkish Adaptation of the Environmental Risk Coping Scale
Authors: Sarı Erkin , Girgin Şule , Budak Leyla , Öner Özkan Bengi
Published: November 2024

Objective: This study aims to adapt Environmental Risk Coping Scale into Turkish and examine its psychometric properties.
Method: For this aim, the psychometric properties of the scale adapted into Turkish were tested in a sample of 230 participants living in 6 cities with high earthquake risk in Türkiye. Participants responded to the Environmental Risk Coping Scale, Environmental Risk Perception Scale, questions on Present Fatalistic and Future Time Orientation, and a demographic information form (i.e., age, gender, education level, city of residence, and homeowner/renter status, past earthquake experience, extent of earthquake damage).
Results: The findings of the analyses (i.e., confirmatory factor analysis, reliability analysis) showed that this 12-item scale is reliable and valid in the Turkish sample. Specifically, desirable fit indices (χ2 / sd = 2.06, p < .001, CFI = .96, TLI = .95, RMSEA = .07, 90 % CI [.05, .09], SRMR = .04) demonstrated that the confirmatory factor analysis confirmed the two-factor structure (problem focused and emotion focused coping strategies) and Cronbach α values (.89 for 9-item problem focused coping strategies factor and .72 for 3-item emotion focused coping strategies factor) indicate that the internal consistency of the scale is high. In addition, the sub-dimensions of the Turkish version of the scale were correlated with variables such as risk perception, present-fatalistic time orientation, future time orientation, and demographic factors such as age, earthquake experience, and the extent of damage in earthquake(s) in line with the literature.
Conclusion: The Turkish adaptation of the Coping with Environmental Risk Scale was found to be a reliable and valid scale in the Turkish sample.
Need to Belong and Cognitive Flexibility in Young Adults: Mediating Role of Negative Affect and Moderating Role of Agreeableness
Authors: Yılmaz Selin , Alan Rana
Published: November 2024

Objective: Previous studies propose that the need to belong can explain some emotional and cognitive mechanisms. Yet, it is unclear which cognitive and emotional mechanisms may be predicted by the need to belong and whether this relationship varies within different personality traits. The general purpose of this study was to scrutinize the role of emotion and personal traits in the relationship between the need to belong and cognitive flexibility with the help of a model.
Method: A total of 719 university students, 446 female and 273 male, employed the participant group of the study (M ± SDage = 21.38 ± 1.97). Data measurement tools were Standard Information Form, Cognitive Flexibility Scale, Need to Belong Scale, Big Five Personality Traits Scale, Positive and Negative Affect Scale.
Results: The mediation analysis demonstrated a significant indirect effect of the need to belong on cognitive flexibility through negative affect (b =-.0606, t = -3.189). This finding showed that the need to belong reduced cognitive flexibility by increasing negative affect. With regard to the moderation analysis results, the interaction effect of the need to belong and agreeableness personality trait (need to belong X agreeableness) significantly predicted cognitive flexibility (b =-.1169; CI 95% =-.2033 to -.0304, t =-2.6542, p = 0.0081). Accordingly, the negative direct effect of the need to belong on cognitive flexibility was stronger in the lower agreeableness condition.
Conclusion: The current study indicated that agreeableness moderates the negative effect of the need to belong on cognitive flexibility. The highest cognitive flexibility was observed in the lower need to belong and higher agreeableness conditions. In conclusion, it is suggested that the effect of the need to belong on cognitive abilities may be accompanied by personality traits and emotional processes.
Needs of Spouses of Surgical Patients: A Conceptualization Within the Roy Adaptation Model
Authors: Silva Mary C.
Published: November 2024

Within the framework of the Roy Adaptation Model, three research questions were raised: What individual needs are most important to spouses of patients undergoing major general surgery? What category of needs (factor label) best accounts for spouses’ responses to the study questionnaire? Do factors identified from the individual needs reflect the four modes of Roy’s model? The study sample was composed of 75 spouses 21 years of age or older whose husbands or wives had undergone cholecystectomy, herniorrhaphy, hysterectomy, or prostatectomy for a benign condition. Spouses were asked to respond to a 46-item Needs of Spouses of General Surgical Patients questionnaire. Individual need items considered most important to spouses were related to reassurance about quality of patient care, availability of hospital staff, and understandability of information provided about the patients’ hospitalization and surgery. When the individual need items were submitted to factor analysis, all four modes of the Roy Adaptation Model were reflected, but in a somewhat different patterning than that suggested by the model. Factors were labeled Psychosocial Needs, Physiological Needs, Staff Support/Confidence in Care Needs, and Information Needs. The category of needs that best accounted for spouses’ responses was Psychosocial Needs.
Mothers’ Perceptions of Children’s Temperament and Mother-Child Attachment
Authors: Kemp Virginia H.
Published: November 2024

This study focuses on the relationship between mothers’ perceptions of their children’s temperament and mother-child attachment. Twenty-eight mother-child pairs were assessed on these two variables. Mothers completed the Cary Infant Temperament Questionnaire when their children were eight months of age to evaluate their perceptions of their children’s temperament. When the children were 12 months of age, the mother-child pairs were videotaped according to Ainsworth’s Strange-Situation Procedure in order to classify children’s attachment. Using discriminant function analysis, temperament scores were able to significantly (p=.07) predict membership into one of three attachment groups including A (avoidant attachment), B (secure attachment), or C (anxious attachment).
The Effect on Bonding Behavior of Giving a Mother Her Premature Baby’s Picture
Authors: Huckabay Loucine M. D.
Published: November 2024

To investigate the effect on bonding behavior of giving mothers their premature baby’s picture, 40 mother-infant dyads were randomly assigned to experimental (E) and control (C) groups. The E mothers were given a picture of their baby. The C mothers did not receive pictures. Both groups had visitation rights 24 hours a day. Two bonding observation measures were obtained—pretest and posttest. Results showed that E mothers exhibited significantly more bonding behaviors on posttest measured by (a) a bonding observation checklist, and (b) a physical examination observation checklist, than the C mothers.
The Concept of Adaptation: Examining Alternatives for the Study of Nursing Phenomena
Authors: Duffy Mary E.
Published: November 2024

Clients’ adaptation frequently is studied in nursing and used to guide nursing practice. Many nurse authors have suggested that adaptation may be a unique conceptual framework for nursing. Other nurse authors have suggested, however, that in focusing on adaptation, nursing limits its focus to changing clients to fit the environment and neglects to change the social system or environment to meet clients’ needs. The purpose of this article is to argue that adaptation theory limits the range of clients’ acceptable responses to change. Adaptation theory assumes clients are responsible for adjusting to the norms or standards established by a relatively immutable environment. An alternate set of assumptions broadens the range of acceptable responses by clients and targets the environment for change. On the basis of these assumptions, directives are given for nursing research aimed at studying clients’ responses to change.
Sleep Apnea in Alzheimer’s Patients and the Healthy Elderly
Authors: Hoch Carolyn C. , Reynolds Charles F. , Houck Patricia R.
Published: November 2024

The incidence of sleep apnea was explored in 80 elderly subjects. Through the use of several criteria, sleep apnea was found more frequently in Alzheimer’s patients (n= 24) than in healthy controls (n= 56). Alzheimer’s patients were also found to have a significantly higher proportion of apnea related to non-rapid eye movement than to rapid eye movement sleep. Apnea-positive Alzheimer’s patients also had significantly more awake time during the course of die night. A significant positive correlation between apnea index and severity of dementia, as measured by the Blessed Dementia Rating Scale, was found for apnea-positive Alzheimer’s patients (r= 0.57, p <.0l) as well as for the entire sample of Alzheimer’s patients (r= 0.41, p <.05). Neuropathological implications are discussed, as are implications for nursing practice.
Women’s Talk and Nurse-Client Encounters: Developing Criteria for Assessing Interpersonal Skill
Authors: Kasch Chris R. , Kasch John B. , Lisnek Paul
Published: November 2024

This discussion furnishes a starting point for conducting outcome-process research in nursing with respect to nurse-client interactions. The argument put forth suggests the following: (a) the health care context often presents nurses with problems, the resolution of which requires interpersonal intervention; (b) the conceptualization of nursing action as a process of social interaction with discernible phases can provide a framework for understanding how interpersonal skill may influence the level of competence achieved within a particular encounter; and (c) criteria for assessing a nurse’s level of interpersonal skill can be derived from a review of the communication behaviors traditionally associated with women.
Parents’ Perceptions of Their Children’s Recovery 5 to 10 Years Following Day-Care Abuse
Authors: Burgess Ann W. , Baker Timothy , Hartman Carol R.
Published: November 2024

A follow-up study of 19 parents whose children had been physically, sexually and psychologically abused in day care 5 to 10 years previously, suggests that as perceived by the parent, over one third of the children remain clinically symptomatic, one third are in the normal symptomatic range, and one third are asymptomatic. Also, parents themselves were still distressed by the event and expressed concern as to their child’s future interpersonal relationships. It is recommended that nurses provide brief counseling sessions to parents for management of their children’s posttrauma symptoms.
Clinical Trials: Testing of Adult Chemical Heating Pad
Authors: Herman JoAnne , Davis Carol , Mackey Marlene , Fuller Sara , Tavakoli Abbas
Published: November 2024

Chemical packs are recent innovations in the delivery of dry heat. Because these delivery systems do not have any mechanism for verifying temperature during application, research to determine their safety seems warranted. The purpose of this study was to measure the skin temperature of adults during a 30-minute application of the MediHeat adult heating pad (MH-AHP). Seventy-seven subjects received a 30-minute application of the MH-AHP to their backs while lying in both supine and prone positions. The mean skin temperature in both positions was 101°F. There were significant differences, however, in minimum and maximum skin temperature between positions. Subjects in the prone position had significantly higher maximum skin temperature and significantly lower minimum skin temperature than subjects in the supine position. It is possible that the prone position allows for more air flow over the MH-AHP and that more heat was generated causing the higher maximum temperature. This explanation does not account for the lower minimum temperature. There were no significant differences in perception of heat between the positions at either 5 minutes or 30 minutes. Findings suggest that caution is necessary when applying heating devices that depend on air circulation for heat generation.
Social Support and Patterns of Adjustment to Breast Cancer
Authors: Hoskins Carol N. , Baker Sonia , Sherman Deborah , Bohlander Jean , Bookbinder Marilyn , Budin Wendy , Ekstrom David , Knauer Cynthia , Maislin Greg
Published: November 2024

The effect of marital support and support from other adults on the emotional and physical adjustment of 128 women with breast cancer was examined. Role function and satisfaction with health care also were evaluated as predictors of adjustment. Intact data series were obtained at 7-10 days, at 1, 2, 3, and 6 months, and 1 year postsurgery. Emotional adjustment could be predicted by satisfaction with a spouse’s response to interactional and emotional needs and by support from other adults. The relationships were significant at concurrent times, across contiguous times, and predicting from the 7-10 day postsurgical period to both the 6-month and 1-year end points. Physical adjustment was not predicted by support but satisfaction with health care was predictive of perceived overall health status. Functional status in vocational, domestic, and social roles was significantly related to emotional and physical adjustment at all phases with few exceptions.
Wilsonian Methods of Concept Analysis: A Critique
Authors: Hupcey Judith E. , Morse Janice M. , Lenz Elizabeth R. , Tasón Maritza C.
Published: November 2024

Wilsonian methods of concept analysis—that is, the method proposed by Wilson and Wilson-derived methods in nursing (as described by Walker and Avant; Chinn and Kramer [Jacobs]; Schwartz-Barcott and Kim; and Rodgers)—are discussed and compared in this article. The evolution and modifications of Wilson’s method in nursing are described and research that has used these methods, assessed. The transformation of Wilson’s method is traced as each author has adopted his techniques and attempted to modify the method to correct for limitations. We suggest that these adaptations and modifications ultimately erode Wilson’s method. Further, the Wilson-derived methods have been overly simplified and used by nurse researchers in a prescriptive manner, and the results often do not serve the purpose of expanding nursing knowledge. We conclude that, considering the significance of concept development for the nursing profession, the development of new methods and a means for evaluating conceptual inquiry must be given priority.
The Pediatric Physiologic Stress Response: A Concept Analysis
Authors: Rosenthal-Dichter Cathy H.
Published: November 2024

Pediatric nurses have had a long-standing interest in stress and its effect on infants and children. Recently, there has been increasing interest in the physiological stress response on the part of nurses. While in the pediatric critical care setting, nurses continually assess the physiologic stability of the critically ill child, as well as the child’s responses to a variety of interpersonal interactions, clinical interventions, and treatments. This status is continually challenged by a multitude of stressors which induce subsequent responses by the child. Only through a better understanding of the age-appropriate physiologic stress response can nurses accurately confirm its presence and evaluate its potential consequences. A concept analysis of the pediatric physiological stress response was conducted, primarily using the strategy recommended by Walker and Avant (1988). Accordingly, this analysis included: (1) a literature review; (2) determination of possible uses of the concept; (3) selection of defining attributes; (4) identification of empirical referents; (5) identification of antecedents and consequences; (6) construction of model and alternative cases; and (7) review of implications for nursing research.
Bandura’s Theory of Self-Efficacy: Applications to Oncology
Authors: Lev Elise L.
Published: November 2024

Self-efficacy (Bandura, 1986) has been shown to impact on health practices as well as adaptation to illness and treatment. The purposes of this paper are to describe self-efficacy theory and review literature using self-efficacy theory to investigate prevention of cancer and adaptation to cancer. Measurement of self-efficacy is also discussed. Evidence from research examining applications of Bandura’s theory of self-efficacy in oncology suggests relationships between self-efficacy and cancer prevention and self-efficacy and adaptation to cancer. Strong percepts of self-efficacy predict intention to quit smoking, increased participation in screening programs, and adjustment to cancer diagnosis. Increased self-efficacy is associated with increased adherence to treatment, increased self-care behaviors, and decreased physical and psychological symptoms. The advanced practice nurse is in an excellent position to give feedback that may help support patients’ self-efficacy.
Nursing Presence: An Existential Exploration of the Concept
Authors: Doona Mary E. , Haggerty Lois A. , Chase Susan K.
Published: November 2024

Nursing presence emerged in the nursing literature in the 1960s as a coherent and consistent philosophical term based in the existentialism of Gabriel Marcel and Martin Heidegger, and the religious philosophy of Martin Buber. Since the mid-1980s, however, the precision in definition has deteriorated and presence has accrued multiple meanings, resulting in a weakened sense of the concept. After delineating the etymological and philosophical foundations of nursing presence, the concept is defined. The existential nature of nursing presence is explored and arguments for the indispensability of nursing presence are offered to counter the claims of bottom-line thinking. A definition is offered of nursing presence as an intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to “spend” herself* on his behalf.
Response to “Bandura’s Theory of Self-Efficacy: Applications to Oncology”
Authors: Froman Robin D.
Published: November 2024

Lev has written a three-part article about the theory of self-efficacy. To best understand the implications of the article, it might be useful to consider its three parts separately: the history and origin of self-efficacy as a construct, self-efficacy applications in oncology research, and the measurement properties of self-efficacy.
Ethics and the Geography of the Nurse-Patient Relationship: Spatial Vulnerabilities and Gendered Space
Authors: Liaschenko Joan
Published: November 2024

In a study that sought to understand the ethical concerns of home care and psychiatric nurses, relationship proved to be of central import. Yet the sense of relationship was not limited to, not even primarily, the interpersonal bond that is most commonly understood by relationship. For the nurses in this study, serious ethical concerns originated in those structural aspects of relationship reflecting the social space that patients and nurses occupy. These concerns can be broadly grouped into two categories, spatial vulnerabilities and gendered space. The ethical concerns of spatial vulnerability include poverty, exploitation of patients for institutional gain, homogenization of identity, and the fragmentation of care. Gendered space includes invisibility, instrumentality, and relations to other nurses. Geography may be a useful way to think about the nurse-patient relationship because relationship is itself a spatial term and because geography allows for the dimensionality of scale from the local or intimate to the global or structural. How we organize and structure our social relations is ethically significant.
Caregiving: Concept Analysis and Outcomes
Authors: Swanson Elizabeth A. , Jensen Deborah P. , Specht Janet , Johnson Marion L. , Maas Meridean , Saylor Dixie
Published: November 2024

More than ever before, caregiving has become a salient public policy issue. A number of recent and anticipated demographic, economic and social changes have occurred that make it imperative for researchers to critically examine the impact of caregiving on family caregivers’ health, behavior, emotions, and social status. Researchers at the University of Iowa College of Nursing are working to classify standardized nursing-sensitive patient outcomes for use in language development, practice, research, and education to evaluate the effectiveness of nursing interventions and clinical nursing services. This article focuses on family caregiving and the analysis of caregiver role performance in both direct and indirect care, linking outcomes and indicators, to enable nurses to promote the health of caregivers.
Patterns of Resistance: African American Mothers and Adult Children With HIV Illness
Authors: Boyle Joyceen S. , Hodnicki Donna R. , Ferrell Jim A.
Published: November 2024

Although the research on caregiving and caregivers has been extensive, there have been few studies on the cultural context and meaning of African American caregiving in relation to HIV illness. Many Black feminists have argued that African American women experience a world different from those who are not Black and that failure to take account of race, class, and gender is paramount in an attempt to authentically portray the lives of African American women. This study argues that rural African American culture and experiences of racism and discrimination in the rural South shaped the responses of mothers when their adult children developed HIV illness. The study employed the ethnographic techniques of participant observation and in-depth interviews with 14 rural, poor, African American mothers who cared for adult children with HIV illness. Analysis of the data identified patterns of resistance that mothers employed throughout the caregiving experience. Mothers resisted labels and other controlling images that they believed marginalized them and negated what was happening to their children. Mothers used culturally patterned behaviors to protect their families and resist the stigma of HIV/AIDS.
An Interpretive Study Describing the Clinical Judgment of Nurse Practitioners
Authors: Brykczynski Karen A.
Published: November 2024

Devaluation of nursing practice by both practicing nurses and nurse educators is giving way to keen interest in clinical scholarship. A naturalistic study was conducted to provide a contextual account of the actual practice of experienced nurse practitioners. Data collection procedures consisted of clinical situation interviews with nurse practitioner pairs, participant observation of patient visits to nurse practitioners in four hospital-based ambulatory settings, individual interviews with nurse practitioners, and administration of a brief demographic questionnaire.

The 199 clinical situations that constituted the resulting text were analyzed using phenomenological and existential perspectives. The clinical judgment of experienced nurse practitioners is described through interpretive analysis of the text according to the dictates of hermeneutical phenomenology. This methodology provides a way of describing and communicating the knowledge that develops among experienced practitioners and their patients. Text interpretation also produced an adaptation of Benner’s (1984a) domains and competencies specifically for nurse practitioner practice, which may be useful as a conceptual framework for nurse practitioner practice, education, and research.
Rural Nursing: Developing the Theory Base
Authors: Long Kathleen Ann , Weinert Clarann
Published: November 2024

Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs, isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems.
Elder-Caregiver Care Negotiations As Dances of Dependency
Authors: Russell Cynthia K. , Phillips Linda R. , Cromwell Sandra L. , Gregory David M.
Published: November 2024

Well-developed metaphors function as heuristic devices for the communication of scientific ideas. When applied to common, typical situations, metaphorical conceptualization enables a richer and deeper understanding. In this article, the routinized and taken-for-granted situation of eldercaregiver care negotiations is examined through the use of a dance metaphor, thedance of dependency.Metaphorical models of theory are intended to be elaborated and developed in ways that good poetic metaphors are not. Therefore, we systematically describe the general aspects of the dance (rules, facilitators, performances, aesthetics) and relate the specific elements of a dance to the dance of dependency. The picture that emerges is one of elder-caregiver care negotiations as performances, with elders as agents who actively and creatively engage caregivers in their dances of dependency. Participants in these dances sustain a complex organization of behavior to meet the situational demands and maintain themselves as fully integrated participants, based on standards set forth by the jointly negotiated working consensus of the dyad. The resulting description extends what is currently understood about everyday care negotiations, allowing an appreciation of the processes and dynamics by which care negotiations and elder-caregiver relational cultures in multiple contexts unfold, change, and are challenged.
The DSM and Child Psychiatric Nursing: A Cautionary Reflection
Authors: Mohr Wanda K. , Regan-Kubinski Mary Jo
Published: November 2024

The DSM is the key reference guide for clinicians and it continues to be the way in which practitioners apply discrete categories to behaviors that are sufficiently disruptive to social institutions to have come to the attention of tertiary care systems. As a way to classify and diagnose mental disorders, the DSM has been a source of controversy in the psychiatric community since its development. This article reviews some of the limitations of the DSM approach to psychiatric nosology with respect to practice with children. Alternative conceptualizations and approaches to childhood psychopathology are proposed and implications for child psychiatric nurses are discussed.
Impact of a Research Study a Decade Later: The Use of Pictures in a Neonatal Intensive Care Unit As a Mode of Nursing Intervention to Enhance Maternal-Infant Bonding
Authors: Huckabay Loucine M. D.
Published: November 2024

Approximately 12 years ago a preliminary study (Huckabay, 1987) was published on the use of giving mothers the picture of their premature babies as a mode of nursing intervention to enhance maternal-infant bonding. There is a mandate (Polit & Hungler, 1999) which stipulates that nurses need to be informed consumers of nursing research, be aware of the range of effective interventions that have been published, and use them in improving their nursing care. As reports of successful nursing interventions are published, a question is raised as to the impact of such studies on the actual care of patients or on furthering the knowledge base. To answer this question, an extensive computer search of the literature was done and neonatal intensive care unit (NICU) specialists of six major hospitals in southern California were interviewed to determine if they provide mothers the pictures of their premature babies as part of their nursing intervention to facilitate maternal-infant bonding. Findings based upon the NICU specialist interviews and the computer search of the literature are presented in the following order: (1) Current practices regarding use of pictures in six major hospitals, (2) Update of the incidence of premature births and the challenges they present, (3) Update of the importance of bonding theory and controversial issues surrounding its implementation, (4) A cross-cultural bonding study resulting from the use of the tool developed by Huckabay (1987) study, (5) Studies that have extended the use of pictures as a mode of nursing intervention in other situations, (6) Conclusion.
Clinical Sensitivity: The Inseparability of Ethical Perceptiveness and Clinical Knowledge
Authors: Nortvedt Per
Published: November 2024

This article argues that there is an important connection between ethical sensitivity and clinical competency in nursing. This is more than a defense for ethical attitudes and virtues in clinical practice, however. I will show in what way ethical sensitivity is important not only to moral judgment, but to professional clinical knowledge and judgment as well. Drawing on central insights from continental philosophy, Husserl, Heidegger, Levinas and Foucault, as well as classical virtue theory, the article elucidates the inseparability of ethical sensitivity and clinical knowledge in nursing. Ethical sensitivity has bearing upon clinical knowledge and awareness in two important ways. First, what we consider relevant clinical knowledge and therapeutic measures frequently encounter the realities of clinical conditions, realities which embody certain moral qualities and appeal to moral values. In clinical nursing, it is important to understand how this encounter between professional knowledge and moral values informs clinical action, making it morally as well as professionally proper. Second, sensitivity to vulnerability qualifies clinical knowledge in the way that it alerts clinical sensitivity altogether. Perception of morally salient features informs the nurse about significant changes in the patient’s pathological condition. The ability to be touched morally by the patient’s condition, his or her vulnerability or vitality and positive experience is epistemologically and prognostically significant.
Recovery: A Phenomenon Extending Beyond Discharge
Authors: Baker Carol A.
Published: November 2024

The purpose of this study was to conceptualize and order theoretically the process of recovery. Intensive telephone interviews were carried out at 2, 4, and 6 weeks postoperatively to elicit descriptions of post discharge experiences from 25 subjects who had experienced uncomplicated hospitalizations for cholecystectomy surgery. Post discharge recovery was a process of returning to normal as defined by pre-illness comparative standards of physical, social, and psychological well-being that progressed sequentially in three phases: passivity, activity resumption, and stabilization. Decisions concerning phase progression were made by integrating physiological and health professional cues with self-imposed and situational pressures. Subjects who perceived negative physical symptoms, especially fatigue, and who were unable to respond to pressures expressed frustration with the recovery process. Implications for nursing practice include providing patients with individualized anticipatory guidance and interventions that build endurance.
Health and Service Utilization Patterns Among Homeless Men in Transition: Exploring the Need for On-Site, Shelter-Based Nursing Care
Authors: Brush Barbara L. , Powers Emily M.
Published: November 2024

Between September 1999 and May 2000, as part of a larger faculty/student teaching project, data describing the demographic, health problem and service utilization patterns of 183 newly sheltered homeless men (mean age = 42) seeking on-site nursing clinic services were collected and analyzed. Upon arrival to the transitional shelter, 46% of the study participants were medically uninsured or received state subsidized health benefits (49%). Almost all (99%) were in recovery from substance addiction. Despite numerous self-reported health problems, 44% had no primary care provider and 35% were seen only sporadically in local hospital clinics or in emergency departments. During the study period, nurse practitioner students and faculty managed most of the residents’ episodic illnesses on-site, while assisting them to secure insurance coverage and medical appointments as a prelude to independent living. This was an attempt to curtail residents’ previous pattern of waiting until medical problems became serious before seeking treatment. These findings mirrored those in studies of similar populations equating onsite delivery of health care to cost reduction. Unfortunately, many nurse-managed clinics, like our study site, fail to generate data supporting nurses’ clinical efficiency and cost effectiveness in caring for homeless individuals. As such, nurses’ work remains invisible and underappreciated. This article argues that future studies examining nurses’ work and worth in caring for homeless individuals are necessary in determining future health care service planning with this vulnerable population.
The Theory and Measurement of the Self-Efficacy Construct
Authors: van der Bijl Jaap J. , Shortridge-Baggett Lillie M.
Published: November 2024

Self-efficacy is the major concept of Bandura’s social cognitive theory. Self-efficacy is influenced by four important sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological information. Other determinants of self-efficacy are internal personal factors and external environmental factors. The degree of change in self-efficacy is partly a function of the variability and the controllability of its determinants. Level of self-efficacy predicts how people are functioning in terms of choice of behavior, effort expenditure and persistence, thought patterns and emotional reactions. Measurement of self-efficacy is related to three dimensions: magnitude, strength and generality. Self-efficacy should be measured in terms of particularized judgments of capability that may vary across realms of activity, different levels of task demands within a given activity domain, and different situational circumstances.
Self-Efficacy in Children With Diabetes Mellitus: Testing of a Measurement Instrument
Authors: Kappen Michel J. , van der Bijl Jaap J. , Vaccaro-Olko Mary Joan
Published: November 2024

The study reported here assessed the psychometric properties of an instrument to measure diabetes management self-efficacy in Dutch children, ages 8 to 12. Content validity of the item list was tested by consulting an expert panel of diabetes nurse specialists and a child-oriented rating scale was developed. A pretest was conducted to assess whether the instrument was clear and comprehensible for children. Then the instrument was tested in children with diabetes at the outpatient diabetes clinics for children at three Dutch hospitals. Reliability and criterion-related validity of the instrument were assessed. The instrument was judged content valid by the expert panel of diabetes nurse specialists, and the language of the instructions, the items and the rating scale was found to be clear and understandable for children of this age group. The study yielded only a moderate internal consistency estimate (Cronbach’s = 0.71) and limited support for criterion-related validity. Several useful theoretical and methodological issues were identified.
Strategies Enhancing Self-Efficacy in Diabetes Education: A Review
Authors: van de Laar Katja E. W. , van der Bijl Jaap J.
Published: November 2024

Enhancing self-efficacy in patients with chronic illnesses has been shown to have a positive effect on behavior change. In fact, according to Bandura (1986), self-efficacy is the most important predictor of change in behavior. Thus, in order to make positive changes, effective measures for enhancing self-efficacy are needed in educational programs. There are four important sources of information for increasing self-efficacy: performance accomplishments, vicarious learning, verbal persuasion, and self-appraisal of emotional and physiological responses. Strategies for enhancing self-efficacy are described here for each source of information and for combinations of sources.
The Use of Self-Efficacy Enhancing Methods in Diabetes Education in the Netherlands
Authors: Koopman-van den Berg Dorine J. E. M. , van der Bijl Jaap J.
Published: November 2024

According to the social cognitive theory of Bandura, self-efficacy predicts behavorial change. Bandura notes that self-efficacy is based on four major sources of information: performance accomplishments, vicarious experience, verbal persuasion and self-evaluation. This exploratory study examined the use of these four sources of information by Dutch nurse diabetes educators to enhance self-efficacy among people with diabetes mellitus. A survey questionnaire was sent to all Dutch nurse members of the European Association of Diabetes Educators (EADE) asking about the use of self-efficacy-enhancing methods, and four different educational programs were observed. Survey respondents said that performance accomplishments and verbal persuasion were often used, vicarious experience was hardly ever used, and the use of self-evaluation varied. The observations gave a different picture: only verbal persuasion was observed often; the other three sources were hardly ever used. Clearly, self-efficacy-enhancing educational methods are not systematically used in the Netherlands and there is little variety in the methods used. More varied methods of enhancing self-efficacy need to be developed and implemented in diabetes education programs.
Sensitivity of the Derdiarian Behavioral System Model Instrument to Age, Site, and Stage of Cancer: A Preliminary Validation Study
Authors: Derdiarian Anayis K.
Published: November 2024

This study explored the effects of the variables of age, site, and stage of cancer on the factors of the Derdiarian Behavioral System Model (DBSM) instrument in an attempt to examine the ability of these factors to discriminate among the groups stratified according to those variables. A nonrandom sample of 223 adult cancer patients was studied. Based on developmental, medical, and nursing theories, effects of the variables of age, site, and stage of cancer were proposed. One-way Analysis of Variance (ANOVA), followed by Two-way ANOVAs, were performed on the factor mean scores of the increase/decrease measures of the DBSM instrument. Results indicated significant differences in some of the factor mean scores in the Achievement, Aggressive/Protective, Dependence, Eliminative, Ingestive, Restorative, and Sexual subsystems among the groups stratified by age, site of cancer, and stage of cancer. The differences were consistent with the expectations based on developmental, medical, and nursing theories. The findings suggested the ability of the DBSM instrument to discriminate the groups as stratified by age, site, and stage of cancer.