bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic Networking for Nurses
Authors: Sparks Susan M.
Published: October 2007

Electronic networks can provide access to other nurses locally and around the world via electronic mail and on‐line interactions. Networks can give nurses access to information and to the data that are processed and stored in computers in their own facility and in computers at remote sites. The major international networks, Internet, FidoNet, and BITNET each offer these opportunities. In addition, Internet, the network most useful to nurses, allows access to Sigma Theta Tau's International Nursing Library, E.T. Net, and the MEDLARS family of bibliographic data bases. Taking advantage of the services and resources networks offer can facilitate nursing practice, education, and research.
The Incidence of Reporting Consent Rates in Nursing Research Articles
Authors: Douglas Sara , Briones Jeanine , Chronister Connie
Published: October 2007

The study described the incidence of reporting consent rates (CRs) in nursing research articles, ascertained the mean CR for nursing research articles, ascertained differences between those studies that reported a CR and those that did not report a CR, and compared studies that used clinical populations to studies that used nonclinical populations. Research articles (371) from three nursing research journals were examined. Results showed that: (a) 40.7 percent of articles reported a CR, (b) the mean CR was 71.8 percent, (c) 41.1 percent reported inadequate CRs, (d) studies reporting a CR differed from those that did not on five of nine variables, and (e) studies employing clinical populations reported higher consent rates than did studies that employed nonclinical populations.
The Ethic of Care: A Comparison of Nursing and Medical Students
Authors: Peter Elizabeth , Gallop Ruth
Published: October 2007

The purpose of this research was to examine whether “caring” uniquely reflects the moral orientation of nursing students. Gilligan's theory of moral development and Kolhberg's theory of moral development structured this study of 119 nursing and medical students who described a real‐life moral dilemma and responded to a hypothetical clinical moral dilemma. The findings suggest that nursing students use care more than justice considerations, but their moral orientation could best be described as mixed. Differences were found between nursing and medical students, but these differences appeared to be related to gender, not professional role. Therefore, it was concluded that a caring moral orientation is not unique to nursing.
Identifying Types of Attending: Patterns of Nurses' Work
Authors: Bottorff Joan L. , Morse Janice M.
Published: October 2007

Verbal and nonverbal behaviors of nurses during interactions with cancer patients were examined by analyzing videotapes of caregiving. Using techniques of qualitative ethology, four types of attending were identified: doing more, doing with, doing for, and doing tasks. The findings provide support for an alternative method of classifying nurse‐patient interactions that captures patterns of caring.
Multicultural Students' Perceptions of Nursing as a Career
Authors: Reiskin Helen , Haussler Susan C.
Published: October 2007

Junior year students (=276) at a culturally diverse, urban high school were surveyed to examine how their perceptions of nursing compared with their perceptions of an ideal career. Findings indicate that significant differences exist among cultural and racial groups and between genders. Recommendations are made to increase recruitment of multicultural students into nursing.
Nurse Characteristics and Professional Autonomy
Authors: Schutzenhofer Karen Kelly , Musser Donna Bridgman
Published: October 2007

Relationships between selected demographic characteristics and professional nursing autonomy were examined. Identification of such relationships can strengthen development of the professional nursing role. Usable responses were returned by 542 RNs in a random sample of 2,000 nurses from four states. The Personal Attributes Questionnaire (Spence, Helmreich, & Stapp, 1974) and Nursing Activity Scale (Schutzenhofer, 1987) were used. Significant relationships were noted among autonomy and the following: nursing education, practice setting, clinical specialty, functional role, membership in professional organizations, and gender stereotyped personality traits.
Infant Relinquishment Through Adoption
Authors: Lauderdale Jana L. , Boyle Joyceen S.
Published: October 2007

The confidential nature of adoption and the stigma associated with out‐of‐wedlock pregnancies have limited the number of studies of infant relinquishment. Birthmothers' feelings of loss and grief have not been widely acknowledged. The purpose of this study was to describe the experiences of 12 women who had relinquished their infants for adoption. Data were collected using open‐ended questions to describe the experiences. Type of adoption influenced the experience of infant relinquishment. Four themes represented the process of relinquishment.
Clinical Decision‐Making Styles of Home Healthcare Nurses
Authors: dela Cruz Felicitas A.
Published: October 2007

Using grounded theory method, this study of 21 home health nurses describes three clinical decision‐making styles: skimming, surveying, and sleuthing. Experienced home health care nurses switch from one style to another when managing varying patient care situations. This study provides a broad view of clinical decision‐making by integrating the context of nursing practice with the patients' clinical status, nurse‐patient interaction, and nurses' knowledge and experience.
A Vulnerability‐Stress Framework for Evaluating Clinical Interventions in Schizophrenia
Authors: O'Connor Frederica W.
Published: October 2007

Symptom management and prevention of psychotic relapse are major treatment concerns in schizophrenia. Research shows a relationship between psychotic symptom levels and several intrapersonal, interpersonal, and environmental factors. These determinants are incorporated into an etiologic causal model of psychotic symptoms based on a vulnerability‐stress framework. Then a multifaceted intervention model to influence symptom determinants is advanced, and examples of intervention elements are specified. Finally, a research agenda to evaluate the effectiveness of the intervention model is described, and related methodologic issues are considered.
Reproductive Decision‐Making in the Age of AIDS
Authors: Bradley‐Springer Lucy A.
Published: October 2007

The forecast for the HIV epidemic in the United States includes increasing numbers of infected women and children, the latter of whom will be born to infected mothers. As the epidemic progresses, nurses will be more frequently called on to assist women in making difficult reproductive decisions. Using four levels of analysis, this discussion explores current knowledge about reproduction in HIV‐infected women and suggests interventions and nursing actions.

Beth is a 32‐year‐old mother with a history of drug use. She was tested for the HIV when she was 8 months pregnant at the urging of her sister. She was surprised when the test was positive and unprepared for the events that followed: abandonment by her obstetrician, delivery at a strange hospital, and isolation on the post‐partum unit. Her 5‐year‐old son is not infected.

Carmen, now 17 years old, was infected with HIV through sexual activity at age 14. When she became pregnant at 16, her doctor told her not to have the baby. Despite religious convictions and personal desires, she had an abortion. She says, “That may have been my only chance to have a baby and now it's gone.”
Decision Points in Choosing Family Self‐Report Scales in Research
Authors: Dashiff Carol J.
Published: October 2007

Literature that systematically highlights critical decision‐making points in conducting family research is sparse. The wide‐spread use of self‐report instruments in family research suggests that explication of decision‐making points involved in the use of self‐report instruments is needed. A specific instrument, the Family Environment Scale (Moos & Moos, 1986), is used to illustrate relevant decision‐making. Conceptualization of a study, instrumentation, and data analysis are addressed.
Promoting Situational Support for Nurses in Practice
Authors: Brooks Evelyn , Wilkinson Judith M. , Popkess‐Vawter Sue
Published: October 2007

Situational support entails promoting autonomy, control over practice, group cohesion, manager consideration, and substantive exchange. Support can reinforce nurses' coping mechanisms, preserve their integrity, and thereby promote quality patient care. Using concept clarification and case examples the authors identify support mechanisms and coping styles for nurses at work and discuss how situational support can be used to cope with stress.
Successful Aging of Oldest Old Women in the Northeast Kingdom of Vermont
Authors: Laferriere Rita H. , Hamel‐Bissell Brenda P.
Published: October 2007

Health life ways of six oldest old women, who have lived in northeastern Vermont for an average of 70 years are described. Life histories were obtained using participant observation and intensive interviewing to identify dominant themes associated with successful aging: being a woman with family and friends, living off the land, dealing with difficult times, and working hard and staying active. Health values and practices as well as personal characteristics combined with a strong network of social support emerge as dimensions of successful aging and considerations for nursing practice.
Dimensions of Nurse Caring
Authors: Wolf Zane Robinson , Giardino Eileen Riviello , Osborne Patricia A. , Ambrose Marguerite Stahley
Published: October 2007

Dimensions of nurse caring were elicited through nurse and patient responses on the revised Caring Behaviors Inventory (CBI), a 43‐item instrument. Subjects included 278 nurses and 263 patients and former patients. An exploratory factor analysis using the principal components method with varimax rotation was used to identify CBI dimensions; a five factor solution resulted. The five dimensions of nurse caring were respectful deference to others, assurance of human presence, positive connectedness, professional knowledge and skill, and attentiveness to the other's experience
A Literature Review of the Critical Elements in Translation Theory
Authors: McDermott Mary Anne Nelson , Palchanes Kathleen
Published: October 2007

A review of some of the classic literature on translation is provided. The work of Brislin is detailed as a foundation for testing the translation equivalence of quantitative measures. Selected recent studies are presented that describe variations in the translation process
Factors Encouraging and Discouraging the Use of Nursing Research Findings
Authors: Pettengill Marian Martin , Gillies Dee Ann , Clark Carolyn Chambers
Published: October 2007

A sample of 543 members of Midwest Alliance in Nursing and Midwest Nursing Research Society were surveyed to identify factors encouraging and discouraging research utilization. Lack of time was the factor that most discouraged research utilization. A library containing research journals was available to most service (82 percent) and educator nurses (86 percent). Computer services were more available to educators (85 percent) than service nurses (68 percent). A research newsletter was ranked as more helpful than continuing education or computer networks for keeping abreast of research findings
Schizophrenic Clients' Experiences of Power: Using Hermeneutic Analysis
Authors: Dzurec Laura Cox
Published: October 2007

This hermeneutic study was conducted to describe the personal power experienced by 15 people with schizophrenia. Analysis revealed that the essence of power was integrality or connection with the environment. The extent of power was determined by personal awareness of integrality. Among all participants, the range of power was modest. Power for people with schizophrenia differs from power for people in general. The characteristic of power for people with schizophrenia may interfere with their ability to adapt to living in the community
Clinical features and psychosocial factors in young adults with genital herpes
Authors: Swanson Janice M. , Dibble Suzanne L. , Chenitz W. Carole
Published: October 2007

Clinical features of genital herpes, perceived causes, stress symptoms, treatments, and psychosocial factors in 70 young adults as compared to normative data for non‐patient controls are described. The clinical features of the disease were congruent with those of other groups studied. Stress was viewed as the major cause of recurrence, headaches the major stress symptom, and acyclovir (an antiviral drug), was the major treatment. Statistically significant differences were found between scores obtained from the sample of young adults with genital herpes on three of four standardized psychological instruments when compared with normative data for non patient controls. Young adults with genital herpes had a lower self concept, more psychopathology, a greater frequency of daily hassles, and less intensity of uplifts. No differences were found, however, between the two groups in scores on depression.
Smoking behaviors of women after diagnosis with lung cancer
Authors: Sarna Linda
Published: October 2007

The purpose of this study was to describe the smoking behavior of women with a recent diagnosis or recurrence of lung cancer. A convenience sample of women (N=65) participated in interviews about their smoking status, their perception of the effect of their diagnosis on the smoking behaviors of others, and self reports of symptom distress and functional status. Content analysis of the audiotapes was used to classify responses. Exemplars describe feelings related to smoking, smoking cessation, and responses of others. Current smokers were likely to be younger (F460=4.3, p<.05). In this small sample, symptom distress and functional status were not statistically differentiated by smoking status; current smokers had the greatest mean distress from cough. Diagnosis had a variable effect on the smoking behavior of family members with over 25% stopping smoking in response to the diagnosis; 31 % of smoking spouses continued to smoke.
Validation and coding of the nic taxonomy structure
Authors: McCloskey Joanne , Bulechek Gloria
Published: October 2007

Processes for validation and coding of the taxonomy for the Nursing Interventions Classification (NIC) are described. A sample of nurses expert in theory development rated the NIC taxonomy using five criteria. Following identification of a stable structure, the taxonomy was coded with each intervention receiving a unique number. A coded and valid taxonomic structure facilitates use of the classification in computerization and makes possible the collection of comparable data. A coded classification can also be used in reimbursement systems.
Duplicate publication in the nursing literature
Authors: Blancett Suzanne Smith , Flanagin Annette , Young Roxanne K.
Published: October 2007

The purpose of this study was to identify examples of duplicate publication in the nursing literature and determine what types of duplicate articles are published. From the sample of 642 articles published by 77 authors during a 5‐year period, 181 articles were classified as duplicate. Forty‐one authors published at least one form of duplicate article. Fifty‐nine duplicate articles did not reference the primary article. Duplicate publication itself is not unethical, but duplicate publication without referencing duplicate work is unethical and may violate copyright law.
A Heideggerian Hermeneutical Analysis of Older Women's Stories of Being Strong
Authors: Moloney Margaret F.
Published: October 2007

As people in our society live longer, affirming the quality of their lived experience becomes more important. The purpose of this study was to ascertain and analyze the meanings of “being strong” as revealed from within the stories of older women. A Heideggerian hermeneutical approach, from a critical feminist perspective, was the methodology used. The sample consisted of 12 women, 7 White and 5 Black, over the age of 65. A team of researchers analyzed the transcripts. Findings consisted of three constitutive patterns: “Surviving,”“Finding Strength,” and “Gathering the Memories. Seeing the Patterns.”
A Conceptual Model for Community Interagency Collaboration
Authors: Polivka Barbara J.
Published: October 2007

Although interagency community collaboration has been suggested to increase programming and decrease costs, theoretical understanding for this in nursing is limited. A conceptual framework for community interagency collaboration is described that depicts collaboration as a function of environmental conditions, organizational situations, and task characteristics. Transactional patterns including intensity, formalization, interrelational patterns, and structured relationships are discussed as are outcomes pertaining to organizations, interorganizational relations, clients, and communities.
Transcending Alcoholic Denial
Authors: Wing Donna Marie
Published: October 2007

Denial is a characteristic of alcoholism and other drug addictions that must be appreciated in order to understand the recovery process. The purpose of this field study was to describe the internal processes that alcoholics experience as they transcend denial. Grounded theory methods guided data collection and analysis. The author observed and interviewed 42 patients in an inpatient alcoholism treatment facility, then followed 30 participants over a 3‐year period. Using the constant comparison method of data analysis, a basic social process theory of transcending alcoholic denial emerged. The theory has five progressive stages: reacting to the critical event; role disaffiliation; ambiguous anticipation; peer affiliation; and acceptance. The theory also elucidates consequences of unresolved stages.
Health Diaries in Nursing Research and Practice
Authors: Burman Mary E.
Published: October 2007

Health diaries have been used in research and clinical practice to examine the daily symptoms of healthy and ill people, responses to symptoms, and efficacy of symptom response. This article describes current uses of health diaries in nursing research and practice, the types of typical health diaries, factors affecting the quality of diary data, and the costs and analytic issues related to health diaries. The implications of health diaries for nursing education, practice, and research are considered.
Gender Differences in Pain
Authors: Vallerand April Hazard
Published: October 2007

Apparent gender differences have been identified in epidemiologic surveys of patients with pain and in clinical studies of responses to pain. Women are reported to have lower pain thresholds and lower pain tolerance than men have. Whether women are more willing to report pain than men are or experience pain differently than men do is unclear. However, beliefs about gender differences and pain affect nurses' decisions made regarding the treatment of pain. This article reviews the literature addressing pain in women and suggests how clinical practice is affected. Literature from Medline (1966 to 1994), CINAHL (1983 to 1994), and Psych‐Lit (1967 to 1994) data bases was searched using the key words pain, gender, and sex. Comments in the manuscript reflect only those studies addressing epidemiology, experimentally‐induced pain, or pain in the clinical setting. Studies describing gender differences in an animal model were not included. Limitations of space required that representative examples of studies in the major areas be included; others describing similar design and outcome were not included.
Use of Physiologic Variables in Nursing Research
Authors: Pugh Linda C. , DeKeyser Freda G.
Published: October 2007

In this study, the use of physiologic variables is described in research reports published 1989‐1993 in four broad‐based research journals. The National Institute for Nursing Research (NINR) emphasizes the need for more physiologically based nursing research. This analysis documents the current number and proportion of such research reported in four journals during a 5‐year period. Each report was evaluated for the population sampled, type of physiologic variable, type of study, definitions, and reporting of reliability and validity measures. Among the 763 reports, 114 (15%) examined physiologic variables. The most frequently studied physiologic variables were blood pressure, heart rate, and body temperature. The majority of studies posed and answered a clinical nursing question, and the study populations sampled were adults. Theoretical and operational definitions were included in most reports. Evidence of reliability and validity analysis were in 36% and 60% of the reports respectively. Although most nursing research focuses primarily on psychosocial aspects of care, several conceptual and psychometric issues were also addressed in studies that examined physiologic variables
Delineating the Concept of Hope
Authors: Morse Janice M. , Doberneck Barbara
Published: October 2007

This description of the concept of hope was developed using interview data from four participant groups: patients undergoing heart transplant, spinal cord‐injured patients, breast cancer survivors, and breastfeeding mothers intending to continue nursing while employed. Advanced techniques of concept analysis (using qualitative methods) enabled the delineation of the seven abstract and universal components of hope: a realistic initial assessment of the predicament or threat, the envisioning of alternatives and the setting of goals, a bracing for negative outcomes, a realistic assessment of personal resources and of external conditions and resources, the solicitation of mutually supportive relationships, the continuous evaluation for signs that reinforce the selected goals, and a determination to endure. Comparison of the various manifestations of these components in the four participant groups revealed unique and distinct patterns of hope. These were labeled: hoping for a chance, incremental hope, hoping against hope, and provisional hope. The implications for nursing practice are discussed
The Art of Comfort Care
Authors: Kolcaba Katharine Y.
Published: October 2007

Nursing art is defined and a template is presented for practicing one type of nursing art called comfort care. Propositions for comfort care are derived from a theory of comfort. Benefits are listed for integrating comfort care into practice. Testimony from a student who learned and applied comfort care provides support for its effectiveness as a learning tool. Comfort care is a holistic, individualistic, creative, and efficient model
Music, Noise, and the Human Voice in the Nurse‐Patient Environment
Authors: Pope Diana Spies
Published: October 2007

Sound is an essential and constant component of the human environment. Nurses have a responsibility to therapeutically manipulate the environment, but some have not fully recognized the significance of noise, voice, or music in the nurse‐patient milieu. This literature review provides a starting point for new studies that acknowledge the perception of sound as well as the physiological and psychological effects of sound on patients' well‐being
Life Event Timing Synchrony
Authors: Sorenson Dianna Lee Spies
Published: October 2007

This paper traces the evolution of “life event timing” with particular emphasis on the derived concept, “life event timing synchrony.” Life event timing synchrony refers to the degree to which an experience is perceived as harmonious and congruent with an individual's temporal expectations. Pregnancy serves as an illustration for application. Suggestions for further theoretical and empirical development are provided
Medical Futility and Nursing
Authors: Taylor Carol
Published: October 2007

Defining medical futility is central to the efforts of clinicians and ethicists who seek to identify the limits of patient autonomy. This article is a critique of current efforts to define and then use policies of medical futility to justify refusing requests for treatment and care that have no perceived medical benefit. After exploring the current definitions of medical futility in the bioethics and clinical literature, comparisons of the advantages and disadvantages of the following three options are provided: allowing patients to decide all but physiologic futility, allowing clinicians to decide futility, and pursuing negotiated compromise. The third option–negotiated compromise–is recommended. A role is developed for nurses in preventing and resolving conflict about futile treatment
Relationships Between Nurse‐Expressed Empathy, Patient‐Perceived Empathy and Patient Distress
Authors: Olson Joanne K.
Published: October 2007

It is increasingly important that nursing care be associated with measurable patient outcomes. A correlational study examined relationships between nurse‐expressed empathy and two patient outcomes: patient perceived empathy and patient distress. Subjects (N = 140) were randomly selected from RNs and patients on medical and surgical units in two urban, acute care hospitals. Nurse‐subjects (N = 70) completed two measures of nurse‐expressed empathy: the Behavioral Test of Interpersonal Skills and the Staff‐Patient Interaction Response Scale. Patient‐subjects (N = 70) completed the Profile of Mood States, the Multiple Affect Adjective Checklist, and the Barrett‐Lennard Relationship Inventory. Findings indicated a negative relationship (r =−.71, p<.001) between a set of empathy variables and a set of patient distress variables and a positive relationship between nurse‐expressed and patient perceived empathy (r=37 −.47,p<.05). This study is one of the first to link behavioral measures of nurse empathy to patient outcomes
Reconciling Technologic and Family Care in Critical‐Care Nursing
Authors: Chesla Catherine A.
Published: October 2007

An interpretive phenomenologic study examined the practice of 130 nurses caring for families in critical care units (CCUs) using group interviews and multiple observations of practice. More than 100 examples of care of the family in CCU served as text for interpretation. A range of practice with families was observed, including practice focused on biomedical management of the patient and care that expertly incorporated the family while at the same time addressing the complex, technologic care of the critically ill. Reciprocal clinical knowledge transfer is needed among nurses at the bedside who are working in family practice and nurses who are skilled and knowledgeable about family interventions.
Preliminary Testing of a Proposition from the Roy Adaption Model
Authors: Hamner Jenny B.
Published: October 2007

Objective: To test a framework based on a proposition of the Roy Adaptation Model predicting the relationships of severity of illness, perceived control over visitation (PCV), hardiness, state anxiety, and length of stay in an intensive care unit (ICU).

Design: Descriptive‐correlational.

Population, Sample, Setting: Convenience sample was 60 general medical‐surgical ICU patients admitted to one regional medical center in the Southeastern U.S.A. Patients completed data collection instruments after a minimum of 20 hours in the ICU during January‐March 1994.

Methods: Instruments included the PCV Scale, the State Anxiety Inventory, the Health Related Hardiness Scale, and the Acute Physiologic and Chronic Health Evaluation II, Model testing and path analysis were done.

Findings: The study variables explained 18% of the variance in length of stay in the ICU, with anxiety and hardiness being the major contributing variables. The path between hardiness and PCV was the only path in the model supported by the data.

Conclusions: The proposed model had inadequate support in this preliminary testing. However, interventions that increase a patient's feelings of control and hardiness could decrease length of stay in ICU's.
Women's Experience of Bed Rest in High‐Risk Pregnancy
Authors: Schroeder Carole A.
Published: October 2007

Objective:To explore women's experience of bed rest in high risk pregnancy.

Design:Naturalistic, qualitative.

Sample, Setting:Twelve adult, pregnant women on prescribed bed rest of a minimum of 20 hours per day and for at least 3‐weeks duration were interviewed in one Western state of the U.S.A. regarding their experiences.

Findings:Three major themes were perceptions of high risk pregnancy, perceptions of bed rest, and the experience of time and restricted movement. The women described a high level of physical, emotional, familial, and economic hardship resulting from the bed‐rest experience. Having adequate income, health insurance, and a supportive relative to take over household responsibilities were dimensions of successful maintenance of bed rest in the women.

Conclusions:The routine obstetric procedure of bed‐rest should be reevaluated in light of its lack of demonstrated effectiveness and potential to seriously harm women and their families.

Clinical Implications:Women should be fully informed about controversies surrounding the efficacy of bed rest in pregnancy and encouraged to participate in decisions when complications occur regarding the prescription of prolonged bed rest.
Nursing Intervention Classification Systems
Authors: Bowles Kathy H. , Naylor Mary D.
Published: October 2007

Purpose: To analyze the features, development, and research of the Omaha System, the Iowa Nursing Intervention Classification, and the Home Health Care Classification and provide a critical review of the unique components of each.

Organizing Framework: Five elements: achievement of original purpose, language used, ease of computerizing format, clinical utility, and linkage of the Nursing Minimum Data Set (NMDS) nursing care elements.

Conclusions: Further testing and development of nursing classification systems should be done to determine the general value of nursing classification, the extent to which the original goals and purposes of classification are met, and to identify the unique features and contributions of each system. Further testing is important to determine the strengths, weaknesses, and applicability of the various systems for capturing the elements of the NMDS for different care settings, care givers, and patient populations.

Implications: Nursing classification may eventually lead to naming and describing the work of nurses. Research findings will continue to provide information leading to a unified nursing language system that describes the practice of nursing in local, regional, national, and international health‐care data sets used for research, clinical, education, policy, and administrative purposes.
Healing of Adult Male Survivors of Childhood Sexual Abuse
Authors: Draucker Claire Burke , Petrovic Kathleen
Published: October 2007

Objective: To generate a framework of healing by male survivors of childhood sexual abuse.

Design: Qualitative using grounded theory methodology.

Population, Sample, Setting, Years: Population was American men living in the community who have experienced some healing from childhood sexual abuse. Sample was 19 men who were recommended by area therapists or who had publicly identified themselves as survivors. Participants were interviewed in 1993 and 1994.

Method: Formal, unstructured interviews using open‐ended questions.

Findings: The core variable that emerged was “Escaping the dungeon: The journey to freedom.” The metaphor of “dungeon” reflects the men's experiences of powerlessness, isolation, silence and darkness, shame, and pain from their abuse. Healing was described as breaking free, living free, and freeing those left behind.

Conclusions: Healing involves a struggle against an internal force, emotional pain, and against an external force, the sociocultural prescription that men should not be victims.

Clinical implications: Clinicians working with adult male survivors should consider the pervasive effects of some childhood sexual abuse experiences. Therapists can address the intrapsychic wounds of male survivors while acknowledging the context of their healing, a society where the victimization of men is often invalidated.
Shared Experiences and Meanings of Military Nurse Veterans
Authors: Stanton Marietta P. , Dittmar Sharon S. , Jezewski Mary Ann , Dickerson Suzanne S.
Published: October 2007

Objective: To determine the shared perceptions, feelings, and expriences of U.S. military nurse veterans.

Design: Phenomenological based on Heideggerian philosophy.

Population, Sample, Setting: The population was of military nurse veterans in the U.S.A. from World War II, Korea, Vietnam, and Operation Desert Storm. The convenience sample was 22 nurses recruited from local and national veterans' groups who volunteered to be interviewed.

Methods: Transcribed interviews with team members producing written interpretations; the team produced consensus about themes. Each interview was summarized and validation from the research team and respondents was sought.

Conclusions: Five common themes or shared meanings emerged: reacting personally to the war experience, living in the military, the meaning of nursing in the military, the social context of war, and images and sensations of war.

Clinical Implications: A coherent review of wartime nursing.
Serenity as a Goal for Nursing Practice
Authors: Roberts Kay T. , Whall Ann
Published: October 2007

Purpose:To extend a conceptual analysis of serenity by explaining how serenity develops and to present an analysis of serenity interventions.

Significance:Serenity is highly desired by many. There is evidence that the experience of serenity improves health. The information presented proposes how nurses can use knowledge about serenity in practice.

Organizing Framework:Serenity is viewed as a learned, positive emotion of inner peace that can be sustained. It is a spiritual concept that decreases perceived stress and improves physical and emotional health.

Sources and Approach:Results of a conceptual analysis of serenity, research findings related to development of a Serenity Scale, practice experience, and the literature provided a foundation for the analysis. Inductive reasoning and substruction were the primary methods of constructing the proposed relationships. A nursing practice example is included.

Conclusions:The experience of serenity is related to development of the higher self. Four levels of serenity are a safe, wise, beneficent, and universal self. Knowledge about serenity can help nurses to select interventions that promote clients' health.
Accuracy of Chemical Dot Thermometers in Critically Adults and Young Children
Authors: Erickson Roberta S. , Meyer Linda T. , Woo Teri Moser
Published: October 2007

Chemical dot thermometers are used widely, but their clinical accuracy is not well documented. Temperature measurements with chemical dot and electronic thermometers were compared at the oral site in 27 adults and the axillary site in 44 adults and 34 young children in critical care units. In adults, mean readings with chemical dot thermometers were lower by ‐0.4°C orally, but higher by 0.4°C in the axilla. Axillary readings in children did not differ significantly with the two methods, although individual differences of ±0.4°C or more were common. Chemical dot thermometers provided rough temperature estimates, performing differently at the oral and axillary sites and in the two age groups.
Transforming Practice Knowledge into Nursing Knowledge—A Revisionist Analysis of Peplau
Authors: Reed Pamela G.
Published: October 2007

Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice‐based theory, as well as nursing theory‐based practice.
Motivation in Geriatric Rehabilitation
Authors: Resnick Barbara
Published: October 2007

In this study, critical ethnography was used to explore the factors that help motivate people in a geriatric rehabilitation unit and factors that decreased motivation. Five key informants were chosen using purposeful selection. The participants were white women with an average age of 87. The women were interviewed within the first week of admission and follow up interviews were done at 3‐ to 5‐day intervals. Each informant was interviewed at least three times and one informant was interviewed eight times. Additionally, participants were observed in therapy and on the nursing unit. The following themes emerged regarding factors that improved motivation — goals, humor, caring, beliefs, encouragement, a motive disposition, and “power with” relationships. Several factors decreased motivation including feelings of domination and negative beliefs. The study helped identify ways in which clinicians can motivate older adults in a geriatric rehabilitation program.
Peer Review by Nursing Research Committees in Hospitals
Authors: Rempusheski Veronica F. , Wolfe Barbara E. , Dow Karen Hassey , Fish Loretta C.
Published: October 2007

With the increasing amount of nursing research conducted in clinical settings, the value of peer review by nursing research committees (NRCs) in hospitals has come under greater scrutiny. Research facilitation has been the prevailing paradigm of NRCs for several decades. Reports of activities by NRCs in the literature appear to indicate a shift in that paradigm. The presence of clinical nurses with expert knowledge and advanced academic degrees who are serving as intra‐ and interdisciplinary scientific reviewers are leading a shift in the paradigm of NRCs toward activities that strengthen nursing science and nurse scientists. Eight strategies to support NRCs as review bodies for scientific merit are recommended.
Decisions About Substance Abuse Among Adolescents in Juvenile Detention
Authors: Ruth Anderson Nancy Lois
Published: October 2007

Ethnographic research was done to discover how adolescents make decisions about substance abuse while in juvenile detention. Segments of transcribed data from small focus group discussions portray the perspectives of 20 teenage girls in one juvenile detention facility located in a large metropolitan area. Observations and individual interviews corroborated the dynamic interactive dialogue occurring among the teens during group discussions. The young women described the situations and problems that led to substance abuse and their subsequent detention. The sharing of life experiences provided an opportunity to reinforce resolutions to change and plans to abstain from troublesome behaviors in the future.
“The Measure of My Days” Critiqued by the Oldest Old
Authors: Running Alice F.
Published: October 2007

The practice of nursing begins by listening to individual stories—to personal interpretations. This project elicited personal interpretations of aging. The biographical book by Florida Scott‐Maxwell, A Measure of My Days, was critiqued by eight men and women over the age of 85. Each person was visited two to three times. Discussions during the visits were audiotaped and transcribed. Transcriptions were reviewed by the participant and researcher together to create critiques. Excerpts of the critiques presented are a result of each participant's interpretation of the text and are written in the participant's words. These individual interpretations of The Measure of My Days are just that, individual interpretations. Left in story form, they serve a different purpose than themes or categories developed to illuminate or define. Thematizing or categorizing critiques serves to describe an aggregate reaction. While useful, aggregate reactions may be of limited use for nurses working with any single individual.
Discharge Planning: Comparison of Patients'and Nurses'Perceptions of Patients Following Hospital Discharge
Authors: Reiley Peggy , Iezzoni Lisa I. , Phillips Russell , Davis Roger B. , Tuchin Lauren , Calkins David
Published: October 2007

Planning for hospital discharge is an important component of nursing. Results are presented of a study to determine how well primary nurses predict the functional ability of their patients following discharge and to assess whether patients and nurses agree about their patients' understanding of the post‐discharge treatment plan. Comparing nurses' predictions with patients' reports of functional status 2 months following discharge, we found that nurses consistently underestimate the functional ability of their patients. Comparing nurses' perceptions of their patients' understanding of their post‐discharge treatment plan with patients' reports about their understanding, significant differences were found between nurses' perceptions and patients' reports. Nurses' perceptions were that patients were much more knowledgeable than their patients reported. These preliminary data suggest that hospital discharge planning is an area for further investigation and intervention. Nurses should explore new paradigms for patient education as lengths of hospital stay decrease and care shifts from acute care to community care.
Advance Directives and Opportunities for Nurses
Authors: Johns Jeanine L.
Published: October 2007

Technical, social, and economic factors are an impetus for expressing end‐of‐life decisions as advance directives (ADs) including a living will and durable power of attorney. Despite opportunities, nurses do not appear to be widely involved in practice and research regarding ADs. To provide perspectives for nursing participation, the literature was reviewed, and a set of outcomes regarding ADs were identified. The historical background and the ethical issues associated with ADs are examined. Appropriate roles for nurses with respect to ADs are suggested. Research and practice opportunities are identified. The databases reviewed were the Cumulative Index to Nursing and Allied Health Literature from 1983 to January 1996, and MEDLINE, from 1985 to January 1996.
Dialectical Analysis Concerning the Rational Aspect of the Art of Nursing
Authors: Johnson Joy L.
Published: October 2007

It is often claimed that nursing is both a science and an art. Science, it is argued, involves a rational process in which empirical findings are used to determine what is the case. Art, on the other hand, is associated with creative and intuitive activities. The author steps back from this position and examines the question of whether the art of nursing is properly conceived as involving a rational aspect. The study upon which this paper is based involved the analysis of a discourse contained in the work of 43 nurse scholars, published between 1860 and 1992. A philosophical approach is used to examine two contrary positions regarding the place of the rational aspect in relation to the art of nursing. The analysis attempts to expand the discourse by delineating questions and concerns that, as yet, have not been fully considered.
Preferences for Cardiopulmonary Resuscitation
Authors: Puopolo Ann Louise , Kennard Mary J. , Mallatratt Lee , Follen Marilyn A. , Desbiens Norman A. , Conners Alfred F. , Califf Robert , Walzer Janet , Soukup Jane , Davis Roger B. , Phillips Russell S.
Published: October 2007

Purpose: To examine nurse‐patient communication about preferences for cardiopulmonary resuscitation (CPR).

Design: Prospective cohort. Sampled were patients and nurses caring for patients enrolled in SUPPORT (1989‐91), a multicenter study of seriously‐ill hospitalized adults at four U.S. hospitals.

Methods: Information about patient preferences was obtained by interviews with patients and their designated surrogates. For selected patients, nurses were interviewed prospectively about their understanding of patients' preferences and whether they discussed these preferences with their patients. Nurse demographic information was obtained by questionnair. Additional patient data were obtained by interview and chart review. Logistic regression was used to identify independent correlates of nurse‐patient communication and nurses' understanding of patients' preferences.

Findings: For 1,763 study patients, 1,427 nurse interviews (response rate 81%) were obtained. The median age of interviewed nurses was 29 years; 96% were women, 68% had a bachelor's or master's degree, and 62% had worked for 5 years or more as a nurse. Nurses reported discussions about CPR with 13% of their patients, and these discussions were more likely if the nurse thought the patient did not want CPR (adjusted odds ratio [AOR] 2.68; 95% CI 1.84 to 3.90), if the nurse had spent more time with the patient (AOR 1.05; 95% CI 1.02 to 1.08) per 5 additional days, if the patient had metastatic cancer (AOR 3.56; 95% CI 1.86 to 6.78), or if the patient was in an intensive care unit at the time of study entry (AOR 2.08; 95% CI 1.26 to 3.42). Diagnosis and study site were also associated with nurses' reports of discussions with patients. Of 551 patients with available data, 58% (n=317) wanted CPR and 30% (nequals;164) did not. Nurses understood patients' CPR preferences correctly for 74% of the patients. Nurses were more likely to understand patients' preferences to forgo CPR if the patient was 75 years of age or older (AOR 6.6; 95% CI 2.0 to 22.0) or if the nurse and patient had discussed the patient's preferences (AOR 25.3; 95% CI 6.5 to 98.6) or if the patient had cancer (AOR 10.9; 95% CI 2.3 to 50.1). Nurses' understanding of patients' preferences for CPR was no better than that of physicians or patients' surrogate decision‐makers.

Conclusions: In this sample of seriously ill hospitalized adults, discussions between patients and nurses about CPR were infrequent. Nurses' understanding of patients' preferences for care was similar to that of physicians and patients' surrogate decision‐makers. Educational interventions should focus on increasing the frequency of nurse‐patient discussions about end‐of‐life care and improving nurses' understanding of patients' preferences for care.
Policy Issues Associated With Analyzing Outcomes of Care
Authors: Jones Katherine R. , Jennings Bonnie Mowinski , Moritz Patricia , Moss Mae Taylor
Published: October 2007

Policy questions associated with the conduct of outcmes studies are addressed and outcomes management and outcomes research are differentiated. Multiple outcomes initiatives are being undertaken inthe United States, from the institutional to national and international levels. Nurses have had limited invlvement, thus far‐althoughthe array of outcomes being examined is cnsiderable. Members of an American Academy of Nursing expert panelon quality health care discuss the environmental context and multiple focuses of outcomes analysis. they provide an overview of current activities, present the challenges confronting nursing in its pursuit of a quality assessment agenda, and make recommendations for increasing nurses' participation in quality initiatives.