bluuebunny/crossref_metadata_2025 huggingface dataset:
Seeking Balance to Dialectic Tensions in Teaching Through Philosophic Inquiry
Authors: Hodges Helen F.
Published: October 2007

Purpose: To propose a plausible means of cultural criticism of nursing's educational environment for preparing new nurses by exploring epistemological tensions and their consequences from the perspective of educators.

Design: Naturalistic, qualitative, philosophic.

Method: Six nurse educators teaching in a university‐based traditional BSN program were interviewed in one southeastern state of the United States about their experience as creative, innovative teachers during 1991.

Findings: Three major themes were reflections of the positivist work culture of teaching, reconciliation of tensions, and repercussions from personal choices. Educators reconcile dialectic tension by suppression, subordination, or equilibrium and are influenced by their sense of tension and willingness to be risk takers.

Conclusions: Philosophical conflicts are inherent in nursing when commitments to empirical knowledge and personal meaning are both valued. A plausible means for moving beyond this tension is to increase awareness of the dynamics and consequences that occur when perspectives seem contradictory. Schools of nursing socialize future nurses. Calling into question the context in which the professional nursing culture is transmitted and reproduced is necessary if nurses of the future are to be in the forefront of changing health care.
Historical Methodology for Nursing Research
Authors: Lusk Brigid
Published: October 2007

Purpose: To describe the basic tenets of historical research methodology, with emphasis on researching nursing history.

Aims: To introduce students and researchers to historical research, through substantive guidelines for library and archival research, and definitions of primary and secondary sources. To discuss ethical considerations—particularly those provoked by recent scholarly interest in the history of ordinary people. To explore issues of external and internal criticism. To discuss analysis, synthesis, and presentation of historical findings.

Conclusions: Historical research, as a type of scholarly inquiry, requires attention to methodology to uncover and interpret findings for nursing.,/p>
Collaborating for International Research Development in Malawi, Africa
Authors: Brooten Dorothy , Thompson Joyce , Makoza Joan , Kaponda Chrissie , Mede Esther , Kachapila Lucy , Phoya Ann
Published: October 2007

Purpose: To describe a collaborative research effort by a U.S. school of nursing, an African school of nursing, and the Malawian Ministry of Health. Providing assistance to women leaders in Malawi to develop and conduct research to improve the health of women and infants in villages is necessary.

Scope: This 5‐year project, 1990‐1995, included organizing a workshop on the research process, developing and testing pilot projects, developing and conducting two full‐scale studies, and disseminating findings.

Results: Two full‐scale studies, one examining maternal mortality and one examining the effects of teen pregnancy, were completed with important health policy implications for Malawi.

Conclusions: Successful international collaborative research yields increased knowledge for all participants and important health information. lnternational research requires continuous communication, people skilled in group work, sensitivity to cultural differences, patience, persistence, and commitment.
Literature Review of Social Support and Caregiver Burden, 1980 to 1995
Authors: Vrabec Nancy J.
Published: October 2007

Purpose:To critique social support and caregiver burden studies for (a) explication of constructs, (b) associations between constructs, (c) statistical conclusion validity, and (d) generalizability. Social support moderates caregiver burden, yet studies using different conceptualizations raise questions about validity.

Framework and Scope:Cooper's (1984) methodology for an integrated literature review was used to examine 50 studies (1980‐1995) involving adult caregivers of older family members.

Findings:Inadequate explication of social support, potential spuriousness and reverse causation, threats to statistical conclusion validity, and lack of generalizability were found.

Conclusions and Implications:Progress has been made in caregiving and social support research, yet many problems remain. Future research should include multiple measures of support, controls for spuriousness and reverse causation, valid and reliable instruments, and samples of diverse populations.
Advice from Affected Persons about living with Human Papillomavirus Infection
Authors: Taylor Cynthia A. , Keller Mary L. , Egan Judith J.
Published: October 2007

Purpose: To describe the “advice or information” people who have had HPV for one year would give to the newly diagnosed.

Design: Descriptive

Population, Sample: The population was persons with HPV. A convenience sample of 61 women and 27 men, mean age 23.8 years, was recruited from 4 clinics in one midwestern U.S.A. city between 1990 and 1993.

Methods: Participants answered an open‐ended question about the advice and information they would give to newly diagnosed persons. Content analysis was done.

Findings: Six major areas of advice were provided including keeping a balanced perspective, getting treatment, sexual behavior, knowledge, self‐care, and other. A high percent of advice from women was to keep a balanced perspective on life. A high percent of the advice from men focused on sexual behavior.

Conclusions: Advice covered a variety of topics touching on many aspects of daily life, not simply disease control and sexual behavior.

Clinical Implications: Practitioners should carefully explore their clients’reactions to the diagnosis of HPV and address the sensitive emotional elements entailed.
Outcomes of Corporate Greed
Authors: Mohr Wanda Krystyna
Published: October 2007

Objective: This study is the context portion of a larger study that described the experience of 30 nurses in Texas, USA who worked in for‐profit psychiatric hospitals during a documented period of corporate deviance. The objective of the contextual portion was to describe the major findings in 1997‐1992 of investigating agencies that probed the scandal. Design: Exploratory descriptive.

Sample: Over 1,240 pages and 40 hours of corporate records obtained under subpoena, and written and oral testimony before the USA House Select Committee on Children, Youth, and Families.

Methods: Content analysis, triangulating sources, and comparing as well as cross‐checking themes.

Findings: Four themes: insurance games, dumping patients, patient abuse, and playing with language.

Conclusions: Organizational deviance may become more widespread in profit ‐driven systems of care. Lobbying for whistleblower protection, collective advocacy, and creative educational reforms are used.
National Delphi Study to Determine Competencies for Nursing Leadership in Public Health
Authors: Misener Terry R. , Alexander Judith W. , Blaha Arlene J. , Clarke Pamela N. , Cover Catherine M. , Felton Gwen M. , Fuller Sara G. , Herman Joanne , Rodes Margaret M. , Sharp Harry F.
Published: October 2007

Purpose: To identify competencies needed by nurse leaders in public health programs.

Design: Five‐round national Delphi.

Sample: Convenience sample of members of major public health nursing associations and nurse and non‐nurse public health leaders in the USA.

Methods: Mailed survey in 1994‐7995 using a modified snowball technique based on a modification of the Pew Foundation health professions’competencies for Round I. Four additional rounds produced consensus.

Findings: Initially, 62 competencies were identified. Factor analysis resulted in four factors: political competencies, business acumen, program leadership, and management capabilities; 57 competencies were clustered in the four groupings and accounted for 91.4% of the variance.

Conclusions: Graduate schools in nursing and public health must prepare students with broad‐based competencies from a variety of disciplines. Findings of this national survey provide a database for curriculum development and evaluation ofprograms to prepare nurse leaders for roles in public health‐based delivery systems.
Readability of Advance Directive Documents
Authors: Ott Barbara B. , Hardie Thomas L.
Published: October 2007

Purpose: To assess the readability of advance directive documents.

Design: Descriptive.

Sample: Convenience, 10 advance directive documents from various sources.

Methods: Advance directive documents were electronically scanned in 1994 then evaluated using three readability formulas: Flesch‐Kincaid Grade Level, Flesch Reading Score, and Gunning's Fog Index.

Findings: The average readability (in schoolgrade levels) of the 10 documents was 11.3 using the Flesch‐Kincaid Grade Level and 18.2 using the Gunning's Fog Index.

Conclusions: All documents were above reading levels usually recommended for patients.

Clinical Implications: Patients must be able to read and understand advance directive documents before signing them. Refinement of the documents is recommended to support patient understanding and autonomy in end‐of‐life care.
Mothers’Help Seeking as Care Initiated in a Social Context
Authors: Pridham Karen F.
Published: October 2007

Purpose:To develop from the literature a rationale for a theoretical model of help seeking by mothers of young infants and to explore this model for two mothers.

Significance:Components of the help that mothers of young infants often seek concerning caregiving are specified and linked in the theoretical model. This type of model is needed to support research and development of theory concerning help seeking.

Organizing framework:Working model includes: (a) the meaning to the mother of a caregiving situation; (b) her goals in seeking help; (c) formal and informal sources of help; and (d) a mother's expectations about accessibility of help and her willingness to seek help.

Scope and sources:Forty‐six mothers of healthy, full‐term infants completed a self‐report form 3 months after the infant's birth. Responses of two mothers are used to illustrate the model.

Data extraction:Mothers used categorical options to describe the four working model components for four hypothetical infant‐care situations derived from mothers’reports in an earlier study. Mothers used ordinal rating scales to describe their help seeking in general.

Findings:The two mothers expected help sources to be accessible and were willing to seek help for caregiving from all types of help sources. Although both viewed themselves as having little need of help, both reported they would seek help for all the hypothetical problems. However, the women differed in what they wanted from help and from whom they would seek it and in variability in several working model components across caregiving situations.

Conclusions:Examination of the two mothers’responses suggests that the theoretical model provides a base for study of mothers’help seeking. Maternal experience and environmental and personal conditions may shape working model components. Further model development may require a narrative approach to learn about conditions associated with help seeking as well as to obtain a full sense of the meaning and evpectation components of the working model.

Implications:Knowledge of a mother's working model of help seeking can aid clinicians in responding sensitively to requests for help and in supporting a mother in seeking help.
Johns Hopkins Address: Does Nursing Have a Future?
Authors: Kitson Alison L.
Published: October 2007

Purpose: To outline the importance of identifying where nursing is heading as a profession and explore the metaphors it uses to explain its role to society. Current images of nursing are confused. Nurses should articulateb clearly why nursing should be retained as a social force for improving health and meeting the needs of vulnerable people.

Scope: The historical development of nursing considering the metaphors used.

Conclusions: Because of contemporary pressures on nursing, the metaphors used are inconsistent and require interpretation. Nurses should find new metaphors and resolve comlex internal tensions. Unless nursing can articulate its primary function more cogently, it risks extinction.
Comparison of Nursing Interventions Classification and Current Procedural Terminology Codes for Categorizing Nursing Activities
Authors: Henry Suzanne Bakken , Holzemer William L. , Randel Carol , Hsieh Sheng‐Fang , Miler Thomas J.
Published: October 2007

Purpose: To compare the frequecy with which nursing activity terms could be be categorized using Nursing Interventions Classification (NIC) and Current Procedural Terminology (CPT) codes.

Design: Descriptive. The sample was 201 patients with AIDS hospitalized 1989–1992 for pneumocystis carinii penumonia in three US medical centers.

Methods: Nursing activity terms (n = 21, 366) wer collected from patient records, then were categorized using NIC and CPT codes.

Results: Nursing activity terms were categorized into 80 NIC interventions across 22 classes and into 15 CPT codes. All terms in the data set were classifiable using the NIC system of the majority (60%) of the terms were classified by CPT codes. The most frequently used CPT code was “pulse oximetry.” Significantly (p >.0001) greater numbers of nursing activity terms could be categorized in the NIC system compared to the CPT system.

Conclusions: Findings provide evidence that NIC is superior to CPT for categorized nursing activities in this study's population. The findings support the importance of discipline‐specific classifications for categorized of health care interventions. Nursing‐specific intervention classification systems such as NIC, the Omaha System, and the Home Health Care Classification are essential to defining the contribution of nursing to both quality and cost outcomes.
Review of the Literature on Falls Among the Elderly
Authors: Rawsky Elaine
Published: October 2007

Purpose: To review and summarize the literature from nursing, medical, and ancillary fields on falls among the elderly. Major injuries from falls are associated with mortality, especially among the elderly. Researchers indicate that, in many cases, falls can be prevented. A summary of the available literature provides information which can be used to plan interventions.

Organizing Framework: Over 100 publications, 1979–1996 related to falls by elderly were reviewed. Descriptive terms used for searching MEDLINE were falls, elderly, and accidents. Literature from several disciplines was reviewed.

Findings: Fall risk can be predetermined and nursing actions can be taken to reduce the occurrence and severity of falls.

Conclusions: To reduce the deleterious effects of falls in the elderly, knowledge‐based practice is essential.
Adapting to and Managing Diabetes
Authors: Paterson Barbara L. , Thorne Sally , Dewis Marilyn
Published: October 2007

Purpose: To advance understanding of the lived experience of diabetes as described in published research and theses. Meta‐analysis extends the analysis of individual research studies beyond individual experience to incorporate dominant system beliefs and health system ideologies.

Organizing Framework: Curtin and Lubkin's (1990) conceptualization of the experience of chronic illness.

Sources: Forty‐three qualitative interpretive research reports in six computerized data bases 1980–1996 pertaining to the lived experience of diabetes and published in nursing, in the social sciences, and in allied health journals were used.

Methods: Meta‐ethnography in which trustworthiness was achieved by using multiple researchers, identifying negative or disconfirming cases, and testing rival hypotheses Findings: Balance is the determinant metaphor of the experience of diabetes. People learn to balance diabetes through their experience and experimentation with strategies for managing their illness.

Conclusions: Learning to balance is a developmental process in which one learns to assume control of diabetes management. Support for such development requires that nurses know their clients as individuals and value the expertise they have gained in living with diabetes. Control of blood sugar levels within a prescribed range may be a goal established by professionals, but the goal of healthy balance determines a person's willingness to assume an active role in self‐care.
Conceptualization and Measurement of Doing Family Caregiving Well
Authors: Schumacher Karen L. , Stewart Barbara J. , Archbold Patricia G.
Published: October 2007

Purpose: To review progress in the conceptualization and measurement of five concepts related to doing family caregiving well: caregiving mastery, self‐efficacy, competence, preparedness, and quality. Families are increasingly involved in providing complex care to ill or aged family members at home. Their ability to do caregiving well is vitally important and a focus of nursing practice in many clinical settings.

Organizing framework: Concepts were organized into two groups: those that refer to caregivers' perceptions of how well they are providing care and those that refer to professional assessment of the quality of care provided.

Sources: Family caregiving literature from nursing, gerontology, psychology, and social work, 1987–1996.

Findings: There is growing interest in doing family caregiving well. However, research in this area is limited by the current state of development of ideas and measures.

Conclusions: Two issues that should be addressed to advance research are the perspective taken on doing caregiving well and change over time in doing caregiving well.
Nursing Model of Hospitalization Events
Authors: Smith Amy Rex
Published: October 2007

Purpose: To provide a model of hospitalization events from a nursing perspective. Hospitalization has become an event of highly technical care coupled with intense nursing care requirements. This proposed model is needed to support clinical nursing research among hospitalized patients.

Scope: Hospitalization occupying space and time as a discrete event on the health‐illness continuum. First developed to provide a framework for a descriptive study, the model shows the factors involved in hospitalization and provides a framework for understanding the nursing care that occurs. Selected results from descriptive research that used patients hospitalized with AIDS as subjects are reported as an example of use of the model.

Conclusions: Research about hospitalization events continues to be critical for the advancement of clinical nursing. This model is presented to provide a conceptual framework for future research.
Racial and Gender Differences in Quality of life Following Kidney Transplantation
Authors: Johnson Cheryl D. , Wicks Mona N. , Milstead Jean , Hartwig Mary , Hathaway Donna K.
Published: October 2007

Purpose: To determine if race or gender affected changes in quality of life (QoL) reported by nondiabetic kidney transplant recipients from pre‐ to 6 and 72 months post‐transplant and offer possible explanations. Information gained may offer direction for interventions de signed to enhance post‐transplant QoL for patients who may be less likely to attain im proved outcomes.

Design: Descriptive, prospective clinical study. A convenience sample of 90 male and female Caucasian‐American and African‐American patients was used. Patients were 79 to 67 years of age, nondiabetic, and undergoing kidney transplantation at one university hospital located in the southern United States. Data were collected 7990 to 7995.

Methods: Three questionnaires measuring QoL were used: the Sickness Impact Profile, Ferrans and Powers' Quality of Life Index, and the Adult Self‐Image Scales. Patients completed questionnaires at the time of transplant and at their routine 6– and 12‐month post‐transplant evaluation visits. Repeated measures analysis of variance with multiple pre‐planned comparisons of least‐squares (LS) means were performed to determine if differences existed between and within study groups over time.

Findings: African‐Americans achieved less improvement than Caucasian‐Americans in affective as well as functional measures of QoL. Women scored consistently lower than men on most QoL measures at baseline and reported greater improvement in functional ability while perceptions of self‐image remained low.

Conclusions: Although transplantation dramatically improves QoL, some segments of the patient population, namely African‐Americans and women, do not benefit to the same extent as others. Nurses need to recognize sociocultural differences in patients and how these differences affect care requirements.
Postpartum Onset of Panic Disorder
Authors: Beck Cheryl Tatano
Published: October 2007

Purpose: To describe the experience of panic disorder in mothers during the postpartum period. The onset of panic disorder during the postpartum period has recently been reported. Clinicians are urged to differentiate between the more widely known presentation of postpartum depression and the newly reported postpartum panic disorder.

Design: Phenomenology. The purposive sample consisted of six women with panic disorder during the postpartum period.

Methods: In 1995, mothers were interviewed regarding their experiences with panic. The verbatim transcripts of these interviews were analyzed using Colaizzi's phenomenological method. In all, 214 statements regarding mothers' experiences of panic were extracted and clustered into six themes.

Findings: Panic‐ during the postpartum period seriously comlicated mothers' lives as they struggled to maintain their composure during panic attacks. As a result of recurring panic attacks, negative changes in women's lifestyles ensued stripping them of their self‐esteem and leaving them to bear the burden of disappointing not only themselves, but also their families.

Clinical Implications: Implications for nursing practice with mothers suffering from postpartum onset of panic disorder can be derived from each one of the six themes. Nurses can help women identify panic triggers to help prevent further panic attacks. Also, nursing interventions can target the guilt mothers experience over repeatedly dissapointing themselves and their families.
Expert Nursing Knowledge in the Care of Patients at Risk of Impaired Swallowing
Authors: McHale Jeanne M. , Phipps Marion A. , Horvath Kathy , Schmelz Joseph
Published: October 2007

Purpose: To describe the practical knowledge of expert nurses when they assess and feed patients at risk of impaired swallowing. Observation uncovered a lack of well‐developed nursing practices in assessing patients' swallowing and eating, and a wide range of inter ventions in the care of difficult‐to‐feed‐patients. Finding little previous nursing research to guide practice for patients with impaired swallowing, the authors undertook a study to identify and describe the knowledge embedded in the everyday practice of nurses.

Design: Descriptive, exploratory using purposive sampling. Twelve nurses were identified in 1994 as expert in the care of patients at risk of impaired swallowing in one Boston, Massachusetts teaching hospital.

Methods: Data were collected using written narratives by each participant; group interviews in which nurses discussed the written narratives; nonparticipant observations and individual interviews of the expert nurses; and patients' chart review. Data were analyzed using interpretive phenomenology.

Findings: Most nurses in the study did not perform a complete assessment of swallowing before feeding their patients. Yet, through feeding patients, they were able to describe several components of the swaliowing assessment used in their practice.

Conclusions: The areas of assessment described by the nurses can serve as a template for the development of educational content and assessment tools for swallowing.
Staying Healthy in Immigrant Pakistani Families Living in the United States
Authors: Jan Rafat , Smith Carol A.
Published: October 2007

Purpose: To determine the meaning of “staying healthy” as experienced by immigrant Pakistani families living in the United States.

Design: Phenomenological, interpretive using a convenience, purposive sample, in 1994, of members of four Pakistani immigrant families in one Midwestern U.S. city.

Method: Heideggerian interpretive analysis applied to verbatim Urdu translated to English text by four researchers.

Findings: The relational themes found were: feeling understood, maintaining spiritual peace, keeping family and neighbor support, longing for the former way of being, and knowing how. Achieving wholeness was found to be the constitutive pattern. Participants viewed health as a dynamic experience of “being on the right path”.

Conclusions: Acceptance of care interventions depends on congruence with one's sense o what is “right”—spiritually as well as physically. Viewing health and illness as unitary and planning care once the meaning people assign to health and illness is clearly understood is important for clinical practice.
Research Instrumentation and Elderly Subjects
Authors: Burnside Irene , Preski Sally , Hertz Judith E.
Published: October 2007

Purpose: To address instrumentation problems in conducting research with elderly subjects.

Scope: The needs of older adults are considered with regard to instrument selection. Techniques for pretesting instruments are provided through illustrations from research reports and instrument development. Types of instruments are evaluated for use with older adults and methods for strengthening their applicability are provided.

Significance: Instrument development is sorely needed in gerontological research. Many of the instruments currently used to study elderly subjects lack adequate testing for applicability with old and very old populations. Knowledge about instrumentation can help researchers choose appropriate instruments for elderly subjects and strive to balance subject capacity and the demands of research.

Conclusions: Four factors for consideration in selecting research instruments for use with older adults include subject (a) fatigue, (b) anxiety, (c) ethnic background, and (d) education. These factors are not adequately addressed in the current literature. Certain types of instruments may be more useful than others in studying the elderly.
Vulnerability as a Key to Authenticity
Authors: Daniel Linda E.
Published: October 2007

Purpose: Vulnerability is explored as a human trait that gives nurses an opportunity to engage in authentic nursing. Vulnerability in both nurse and patient is necessary for the practice of nursing with caring as its basic premise.

Organizing Framework: Philosophic discourse.

Scope: Vulnerability is explored in terms of its traditional connotation and existential meaning.

Conclusions: To be authentic, nurses must be aware of their own vulnerability, recognize themselves in others, and be willing to enter into mutual vulnerability. If nurses deny the opportunity to be vulnerable, they deny the opportunity to participate in humanness and are more likely to dehumanize others.
Clinical Validation of Ineffective Breathing Pattern, Ineffective Airway Clearance, and Impaired Gas Exchange
Authors: Carlson‐Catalano Judy , Lunney Margaret , Paradiso Catherine , Bruno Joan , Luke Barbara Kraynyak , Martin Teri , Massoni Margaret , Pachter Susan
Published: October 2007

Purpose: To describe the clinical validation of symptoms or defining characteristics of three respiratory diagnoses. The contributing factors or etiologies of the diagnoses were identified and the degree of importance of 30 nursing interventions, 15 direct care and 15 teaching, was rated for each diagnosis and each patient. Three nursing diagnoses—ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (ICE)—were among the most frequently used, yet no reported clinical studies validated the defining characteristics of these diagnoses. This study answers the research questions: What are the defining characteristics of IBP, IAC, and ICE? What are the etiologies of IBF IAC, and IGE? What are the most important interventions for IBF, IAC, and IGE?

Design: Standardized clinical validation using a convenience sample of 76 people hospitalized with medical and surgical diagnoses, in one U.S. city and identified as having one of the three diagnoses. Data were collected in 1992–1993.

Methods: A literature‐based concept analysis generated 37 possible defining characteristics for the three diagnoses which were included in the instrument. The nurse experts conducted a health history and physical examination of each patient and decided (a) whether the 37 defining characteristics were present or absent, (b) the degree of importance of each possible defining characteristic for making one or more of the diagnoses, (c) the etiologies, and (d) which of the 30 nursing interventions were important for each diagnosis and patient.

Findings: For each diagnosis, many of the 37 possible defining characteristics were judged as present but few reached the criterion of.50 as important for making one of the diagnoses. Two of the possible defining characteristics reached this criterion for IBP, seven for IAC, and two for IGE. In contrast to the defining characteristics approved by NANDA, the subjective cues of “expresses fatigue” and “expresses anxiety” were judged as important for making one or more of the diagnoses.

Conclusions: Clinical validation methods allow discriminating among defining characteristics. Data that are present are not necessarily characteristic of a diagnosis, and the subjective cues of expresses fatigue or anxiety may be important for making these diagnoses.
Insights of Nurses about Assault in Hospital‐based Emergency Departments
Authors: Levin Pamela F. , Hewitt Jeanne Beauchamp , Misner Susan Terry
Published: October 2007

Purpose: To explore contributing factors, consequences, and solutions to the assault of nurses working in U.S. hospital emergency departments. This preliminary study targeted emergency nurses whose risk for assault was significantly greater than many other workers. Exploring nurses' opinions about factors they believe contribute to assault provides important information for designing acceptable preventive measures.

Design: In this descriptive study, an ecological, occupational‐health framework was used which integrates personal, organizational, and societal influences. The six components of the framework were personal factors, workplace factors, environmental factors, assault injuries, solutions, and effects of workplace violence.

Method: Four focus groups were used comprised of 22 RNs employed in emergency departments in one large metropolitan area in the United States. Half the nurses had been physically assaulted at work.

Findings: Fourteen themes emerged: nurse attitude, vulnerability, security, administrative issues, assault reporting, safety training, beyond control, societal changes, types of patients, geographic location, pervasiveness of anger, previous assault experiences, effects, and possible solutions. Personal, workplace, and environmental factors all contribute to assault. Verbal and physical assaults are common and affect nurses' personal and professional lives.

Conclusions: Assault‐related injuries are preventable. Only physical injuries are treated; all employees who have been verbally or physically assaulted should be referred for post‐incident debriefing. Hospital managers should implement violence‐prevention programs. The ecological, occupational health framework is useful for identifying factors that contribute to assault.
Comparison of Continuing Care Communication
Authors: Anderson Mary Ann , Helms Lelia B.
Published: October 2007

Purpose: To describe and compare the patient‐care communication exchanged between personnel in hospitals and nursing homes (NHs) and hospitals and home health agencies (HHAs) in referrals of elderly patients using an adaptation of classic communication theory. Little research on patient‐care communication across organizational settings has been reported. This study offers baseline information about inter‐organizational communication and insight into barriers to patient care communication.

Design: A retrospective, descriptive study using a convenience sample of 455 medical records of referrals to NHs and 300 to HHAs.

Methods: Medical records were audited and a Referraf Data inventory (with established reliability and validity) was completed for each of the records reviewed. Data were collected between January and June 1995.

Findings: Greater amounts of referral data were transferred to NHs, than to HHAs. Patient information was composed largely of background and medical data, followed by some nursing care data and limited psychosocial data. Hospitals employed more formal channels of communication in referring patients to NHs than to HHAs, and communicated information more promptly. Some organizational factors related to both the referring hospitals and receiving organizations resulted in discrepancies in patient‐care communication.

Conclusions: Continuity of patient care involves a series of coordinating linkages across time, settings, providers, and consumers of health care. Communication is a core task in coordinating patient care. increased and improved inter‐organizational communication is needed when patients are discharged to nursing homes or home health agencies.
Change in the Word Symbol for Nurse in Korea
Authors: Cho Ho Soon Michelle , Kashka Maisie Schmidt
Published: October 2007

Purpose: To analyze the 7987 change in the written symbol for the word “nurse” in Korea, engendered by Mo Im Kim.

Design: Descriptive historical and narrative analysis.

Methods: Data were collected from documents in four libraries 7992–7996 in Seoul, Korea and Dallas, Texas. Kim and 20 of her friends, colleagues, and associates were interviewed. Findings from the interviews were compared with historical nursing documents and letters.

Findings: Kim's work with her colleagues and their joint endeavors resulted in a change in nursing's status and responsibilities through an alteration of the Korean symbol for nursing. The symbol change resulted in the definition of nursing moving from that of manual laborer to that of teacher or professional.

Conclusions: Changing the symbol for nurse reflected the shift in nursing's responsibilities and caused a legal change in the official civil service classification of nurse. This, in turn, has changed the status of nursing and led to more professional practice.
Plato, Nightingale, and Contemporary Nursing
Authors: LeVasseur Jeanne
Published: October 2007

Purpose: To explore the influence of Plato's ideal of leadership on Nightingale's vision for nursing. Nightingale left her imprint on nursing; greater understanding of Nightingale's legacy clarifies several contemporary problems in the field.

Organizing Framework: Qualitative, historical research in which the great person framework is used to focus on Nightingale and Plato. Nightingale's familiarity with Plato, whose work she read in the original Greek, is established.

Sources: Evidence for Platonic influence is uncovered in primary sources, then inductive reasoning and reflective analysis are used.

Findings: Nightingale's conception of nursing is akin to Plato's conception of public service. Platonic education aims to turn talented people into leading citizens who care for the good of the community. Modern nursing did not evolve from a craft guild tradition, as did medicine. This profound difference in the constitution of nursing is part of what distinguishes it.

Conclusions: Reminiscent of Plato's “Republic,” Nightingale's legacy leaves a guardian‐like stamp on nursing. Although this legacy also leaves nursing with some ambiguities about technical training and hierarchical systems, it is an orientation to the general good that provides the basis for nursing's holism.
Use of Immigration Policy to Manage Nursing Shortages
Authors: Glaessel‐Brown Eleanor E.
Published: October 2007

Purpose: To examine long‐term implications of using temporary, nonimmigrant nurse programs to manage fluctuations in the demand for registered nurses.

Organizing Framework: This discussion is located in the full context of migration—reviewing theories and concepts of labor migration—referring to experience with guest‐worker programs worldwide, outlining recent nursing shortages in the United States, describing the Immigration Nursing Relief Act (INRA), and raising questions for nurses in the United States and in the global marketplace.

Sources: Review of scholarly literature on international migration, existing studies on nurse migration to the United States, and original research, conducted between 1992 and 1994, for the Immigration Nursing Relief Advisory Committee (INRAC) Report.

Methods: Policy analysis of theories, concepts, and perspectives related to nurse migration.

Findings: In the United States, highly skilled foreign nurses tend to complement rather than displace local labor. Yet recruiting foreign‐educated nurses for entry‐level jobs perpetuates patterns of dependency in the sending country and delays creative solutions to staff development in the host country. Nonimmigrant status creates a vulnerable workforce. There may be a disparity between the ideal of nurse migration as collaborative exchange and the reality of institutionalized occupational migration networks.

Conclusions: While foreign nurse recruitment might solve short‐term needs, repetitive temporary nurse migration programs create long‐term consequences that are not in the best interests of the profession. The absence of consistent policy creates an opportunity for nursing to take an active role in developing the rules and direction of future nurse migration.
Nursing Manpower Development and Strategic Planning in Greece
Authors: Plati Chryssanthi , Lemonidou Chryssoula , Katostaras Theofanis , Mantas John , Lanara Vassiliki
Published: October 2007

Purpose: A national study to register all working nursing personnel and nursing students; to estimate the nursing needs of the Greek population beyond the year 2000; to design a nursing resource master plan for the nursing needs of Greece.

Design: first, a questionnaire was distributed to register all nursing personnel. Second, required personnel were estimated according to the population of each of the country's regions. Third, a master plan for developing nursing personnel to the year 2010 was developed.

Results: The number of nursing personnel was found to be 35,715 which included 11,497 RNs and health visitors, 22,318 assistant nurses, 1,900 midwives. The number of students was 9,252. The majority of nursing personnel work in areas with the highest population. The need for nursing personnel was estimated to be 62,000:36,300 RNs, 21,700 assistant nurses and 4,000 midwives.

Conclusions: There is a serious shortage of RNs in the Greek health services resulting in a downgrading of nursing care quality.
Wellness Self‐care by Healthy Older Adults
Authors: Clark Carolyn Chambers
Published: October 2007

Purpose: To examine self‐care behaviors in healthy older adults. The number of older adults continues to increase. Nurses need a framework for understanding and supporting healthy behaviors in this population.

Design: Descriptive.

Method: Data about self‐care behaviors were elicited in 1997 about how healthy older adults stay well. Using a key‐informant criterion and critical case approach, a small convenience sample of 28 older adults (ages 57–83) responded to a questionnaire based on a self‐care wellness model.

Findings: Age was not related to differences in healthy behaviors. Many informants reported no digestive or sleep difficulties. All were active, regularly kept in touch with family and friends, were confident their environment was safe, obtained sufficient sleep and rest, and managed stress well. All but one attributed their quality of life and zest for living to remaining active, eating healthy food, exercising, pacing themselves, doing preferred activities, and reading the Bible, or “feeding the life of the mind.”

Conclusions: Participant statements of actions can provide inspiration for less‐active seniors and a beginning framework for nurses for understanding and supporting wellness self‐care behaviors in older adults.
Historic and Future Health Promotion Contexts for Nursing
Authors: Morgan Irene S. , Marsh Gene W.
Published: October 2007

Purpose: Health promotion in the United States has been narrowly defined focusing primarily on individual behaviors, risk factors, and lifestyle. This article traces the historic and conceptual roots of health promotion care in the United States and critically examines the direction nurses have taken in health promotion.

Scope: Health promotion care in Western ideology emphasizes the value of individuals and the importance of personal responsibility for success or failure.

Conclusions: Health promotion nursing interventions, based on the tenets of individual choice and knowledge, restrict the range of interventions. The complex nature of health promotion requires that nurses consider the economic, sociopolitical, and cultural context in which health care takes place. Recommendations are made for an expanded nursing role in health promotion, one that is consistent with nursing's underlying contextual focus and concern with environments.
Ocular and systemic distribution, and excretion of radioactivity following topical ocular administration of 14C‐TG100801 to pigmented rabbits
Authors: STRUBLE C , CHOINSKI R , MARTIN M
Published: October 2007

Purpose: To determine the ocular distribution, systemic exposure, and routes of excretion of single 0.44 mg/eye topical ocular doses of 14C‐TG100801 to pigmented rabbits.

Methods: Dutch Belted rabbits received single topical ocular doses of 14C‐TG100801. One group received bilateral doses; urine and feces were analyzed by LSC. Two groups received unilateral doses and were analyzed by quantitative autoradiography. Transverse and sagittal sections, respectively, were used to determine ocular and whole‐body distribution.

Results: There was considerable local absorption of 14C‐TG100801 into ocular tissues and no appreciable systemic or contralateral eye exposure. Highest levels were in tissues of the anterior globe and radioactivity was translocated to the posterior globe (posterior sclera, choroid, and retina) for up to 96 hours. Little or no radioactivity was detected in the iris, ciliary body, lens, vitreous humor, or optic nerve head. In the whole body, radioactivity was primarily confined to the contents of the gastrointestinal tract. The primary route of elimination of was via feces.

Conclusions: The results of this investigation demonstrate the efficiency of topical ocular instillation of TG100801 for treatment of local tissue while circumventing systemic exposure; there was considerable local ocular absorption of 14C TG100801 into the anterior globe, progressing to the tissues of the posterior globe (posterior sclera, choroid, and retina). Radioactivity in the posterior globe was likely absorbed and translocated to this location because it is beyond the conjunctival fornix. There was no appreciable systemic or contralateral eye exposure and radioactivity was primarily excreted via the feces.
Effectiveness of intraocular pressure phasing
Authors: ARIF FARIS , HARDING A , HENSON D , SPENCER F
Published: October 2007

Purpose: To investigate the value of intraocular pressure phasing during normal working hours in patients with and without anti‐glaucoma treatment.

Methods: This study is a retrospective case note review of 61 patients referred for intraocular pressure phasing (every 2 hours from 8.00am to 4.00pm).

Comparison between pre‐phasing intraocular pressure measurements (mean and range) taken during earlier routine visits (5 measurements) and phasing intraocular pressure (mean and range) for each eye was performed using paired t‐test. Scatter plots were used to display the relationship of pre‐phasing and phasing intraocular pressure.

Subgroup analysis of 119 eyes into untreated and medically treated groups was performed.

Results: Eyes in the untreated group (51 eyes) showed no difference between the mean intraocular pressure at pre‐phasing and phasing (p value=0.8) but a significant difference between the intraocular pressure range (p value=0.007).

For the medically treated group (68 eyes), there was no significant difference between the mean intraocular pressure at pre‐phasing and phasing (p value=0.9) and no significant difference between the intraocular pressure range (p value=0.66). In the total 119 eyes the peak intraocular pressure was found to occur at 10‐11am.

Conclusions: Intraocular pressure phasing is most useful on untreated patients. Intraocular pressure phasing is less likely to give much additional data, compared to pre‐phasing intraocular pressure measurements, in treated patients.

If a clinician wanted to identify the peak intraocular pressure the best time is between 10‐11 am.
Glucose‐6‐Phosphate Dehydrogenase (G6PD) deficiency in anterior ischemic optic neuropathy
Authors: PINNA A , MASIA C , SOLINAS G , ZINELLU A , CARTA A
Published: October 2007

Purpose: The reported incidence of G6PD deficiency in Sardina, Italy, ranges from 10% to 15%. Evidence indicates that patients with G6PD deficiency are protected against ischemic heart and cerebrovascular disease and retinal vein occlusion. The purpose of this study was to assess the incidence of G6PD deficiency in Sardinian patients with anterior ischemic optic neuropathy (AION) and ascertain whether G6PD deficiency may have a protective effect against these vascular disorder.

Methods: G6PD blood levels were measured in 153 patients (70 males, 83 females) with AION. 306 age‐ and sex‐matched subjects undergoing cataract surgery and having no history of AION served as controls. Logistic regression models were used to investigate the association between G6PD deficiency and AION.

Results: G6PD deficiency was found in 7 (4.6%) out of 153 patients with AION and in 37 (12.1%) out of 306 controls. Differences between AION patients and controls were statistically significant (odds ratio: 0.35, 95% confidence interval: 0.15‐0.81, P=0.01).

Conclusions: The incidence of G6PD deficiency in Sardinian patients with AION was lower than expected. Results suggest that patients with G6PD deficiency have a significantly lower risk of developing AION.
Experimental glaucoma development in albine rabbits
Authors: GUERRI N , EGEA ESTOPINAN MC , GARCIA MA , PEREZ‐OLIVAN S , LOU JM
Published: October 2007

Purpose: To compare four different glaucoma development models in albine rabbits, based on achieving a chronic elevation of intraocular pressure (IOP).

Methods: A total of 16 animals were used for the glaucoma development model. Rabbits were divided in four groups: Cautery of three vortex veins was performed in the first group (four animals) and cautery of four vortex veins in the second group (four animals). Three vortex veins were ligated in the third group (four animals) and ligation of four vortex veins was performed in the last group (four animals). IOP was measured by Tonovet rebound tonometer during six weeks follow up. The opposite unoperated eye served as control.

Results: Cauterization of four vortex veins (second group) and ligation of four vortex veins (fourth group) achieved IOP elevation (40mmHg) but only for the first twenty four hours. The others groups IOP did not reach statistical differences between treated and control eye. None of the methods developed chronic elevation of IOP.

Conclusions: Vortex vein surgery in albine rabbits was not able to achieve chronic elevation of IOP. Therefore, none of this methods showed capacity to develop a glaucoma experimental model.