bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial Predictors of Optimal Rehabilitation Post-Coronary Artery Bypass Surgery
Authors: Kos-Munson Barbara A. , Alexander Lucy D. , Culbert Hinthorn Pamela A. , Gallagher Ellen L. , Goetze Carolynn M.
Published: November 2024

The purpose of this prospective study was to determine the relationship between several patient preoperative perceptual/cognitive/demographic variables and a measure of self-perceived level of rehabilitation [Sickness Impact Profile (SIP)] six months and one year after coronary artery bypass surgery. A sequential sample of consenting surgical candidates for bypass surgery (N= 92) was given a series of paper and pencil tests on three occasions following coronary angiography and prior to bypass surgery. Perioperative and postoperative records were also reviewed. At the postoperative periods specified, individuals responded to the SIP and repeated tests to determine affective (SDS) and cognitive changes (CLAT). Results of multiple regression showed that pre-angiography level of depression and income level were significantly predictive of satisfactory rehabilitation, while valuing of work (VWI) approached significance in the hypothesized direction.
Caring and Practice: Construction of the Nurse’s World
Authors: Kahn David L. , Steeves Richard H.
Published: November 2024

Results of a study exploring the meaning for nurses of the caring relationship between nurses and patients are presented. Twenty-five nurses in their first quarter of a master’s degree program participated in semistructured, dialectical interviews. These nurses were asked to relate the language they used in talking about the nurse-patient relationship and stories from their practice illustrating the presence and absence of caring. Data analysis revealed the structure of the concept of caring. The nature of this structure is described and illustrated. The ethical contradictions inherent in the structure of the concept are discussed, and implications for the development of nursing theory are pointed out.
Empathy, Diversity, and Telepathy in Mother-Daughter Dyads: An Empirical Investigation Utilizing Rogers’ Conceptual Framework
Authors: Sanchez Regina
Published: November 2024

The purpose of this study was to examine empathy, diversity, and telepathy in natural mother-daughter dyads. The investigation was conceptualized and conducted according to the concepts and principles of the Rogerian Science of Unitary Human Beings. The sample for this descriptive study consisted of 180 volunteer mother-daughter dyads; the mother served as the receiver and the child as sender of telepathic messages. Empathy and diversity were expected to be related to telepathy levels. Results indicated that one form of empathy (personal distress) and diversity were significantly (p<.05) related to telepathy. When the components of the diversity score were further examined, only those subjects who were moderately differentiated and mobile demonstrated significant telepathy scores. Multiple regression analysis showed that 6% of the variance in telepathy was accounted for by diversity and empathy. Findings added to what is known about living systems that manifest negentrophy and evolve toward increasing diversity.
Life-Span Development: A Review of Theory and Practice for Families with Chronically Ill Members
Authors: Rankin Sally H. , Weekes DeLois P.
Published: November 2024

While the family’s primacy in the patient’s adaptation to chronic illness increasingly is being recognized by health professionals and social scientists, the reverse side of the coin, that is, the impact of chronicity on the family, has received little attention. A life-span development perspective is used to enrich the more traditional frameworks employed to study family development and also as a unifying framework from which to view the impact of illness on individual family members and the family as a unit. A review of selected literature reveals a profile of families most at risk for serious disruption in situations involving chronic illness. Propositions suggesting interventions directed at patients and families experiencing chronicity are derived.
Rural Nursing: Developing the Theory Base
Authors: Long Kathleen A. , Weinert Clarann
Published: November 2024

Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems.
The Relationship Among Background Characteristics, Purpose in Life, and Caregiving Demands on Perceived Health of Spouse Caregivers
Authors: Stetz Kathleen M.
Published: November 2024

Little is known about the impact on the family at home of managing the final course of cancer. Research to date has focused on the negative impact of physical caregiving on the caregiver’s physical and emotional well-being. Limited information exists about other dimensions of the experience which may serve to buffer or prevent negative health outcomes. The purposes of this study were to examine the effect of personal meaning and the experience of caregiving on spouse caregiver health. Cross-sectional data were obtained from interviews with 65 spouse caregivers of persons with advanced cancer. Findings from the multiple regression analysis revealed that sense of purpose in life (Beta=.32,p≤.05) and the caregiver’s level of uncertainty (Beta= −.46,p≤.01) were statistically significant predictors of health. The results of this study suggest that a stronger sense of purpose in life is positively associated with perceived health. Further, the finding that a higher level of caregiver uncertainty is negatively associated with health suggests the need for nursing interventions to assist caregivers to cope with their role.
Learned Self-Help Response to Chronic Illness Experience: A Test of Three Alternative Learning Theories
Authors: Jo Braden Carrie
Published: November 2024

The purpose of this study was to generate a self-help model depicting the essential dynamics of learned response to chronic illness experience. The method used to generate a self-help model was based on theoretical triangulation, as discussed by Houts, Cook, and Shadish (1986), Mitchell (1986), and Reichardt and Cook (1979). Theoretical triangulation, incorporating multiple perspectives and hypotheses in the same study, is a form of critical multiplism leading to testing of multiple rival hypotheses rather than single ones (Popper, 1972; Stinchcombe, 1968) and to construction of complex multivariate causal models instead of simple univariate ones (Blalock, 1961). Strong relationships were found between enabling skill, self-help, and life quality.
Alcoholism Recovery in Lesbian Women: A Theory in Development
Authors: Hall Joanne M.
Published: November 2024

Utilizing the modified practice-theory strategy for theory building, a provisional theoretical model was developed to describe alcoholism recovery in lesbian women. Assumptions are acknowledged, key concepts are identified, and propositions are formulated for the purpose of generating nursing knowledge about a significant health problem in this aggregate of women. The theory’s implications for nursing research, practice, and further theory development are discussed.
Effects of Antepartal Stress on Health Status During Early Motherhood
Authors: Ferketich Sandra L. , Mercer Ramona T.
Published: November 2024

A group of high-risk women who were hospitalized for a pregnancy-risk complication, and a group of low-risk women experiencing normal pregnancy were compared for differences in health status and the effects of antepartal stress on their health status from pregnancy through early motherhood. High-risk women reported a statistically significant poorer health status during pregnancy, early postpartal hospitalization, and at eight months following birth.

High-risk women reported greater stress from negative life events in addition to their greater pregnancy risk. Among both groups of women, negative life events’ stress had indirect effects on health status over time through either self-esteem, family functioning, mate relationships or perceived support. The effects of a high-risk pregnancy on health status were evident at eight months following birth; high-risk women’s feelings about their pregnancy and the extent of stress from hospitalization had direct effects on their health status, while negative life events had indirect effects.
Personal Knowing: Evolving Research and Practice
Authors: Moch Susan D.
Published: November 2024

Personal knowing is essential to the development of knowledge central to the practice of nursing. Personal knowing as a process of research within practice is conceptually developed through definition, components, attributes, and examples. Although personal knowing, i.e., discovery of self-and-other arrived at through reflection, synthesis of perceptions, and connecting with what is known, has been identified as a fundamental way of knowing for nursing (Carper, 1978), the process has not previously been systematically developed or tied in with the theoretical, syntactical, and practice structures of nursing. In this article, an increased emphasis on personal knowing within the research and practice domains of nursing is proposed, and implications and questions are raised regarding implementation.
Hardiness, Self-Perceived Health, and Activity Among Independently Functioning Older Adults
Authors: Magnani Lorraine E.
Published: November 2024

As the older population continues its rapid rise, it becomes increasingly important to identify variables that contribute to the quality of life—that which the gerontological literature refers to as “successful aging.” Since most studies have supported activity as the most satisfying pattern of aging, the notion that hardiness of personality and self-perception of health are related to activity levels was tested in a group of independently functioning older adults (n= 115). The obtained significant correlations between hardiness and self-perceived health were -.293 (p<.001, hardiness is negatively scored), and .210 (p<.01), respectively. Together these variables explained 10% of the variance in activity. The sub-variable challenge, within the hardiness construct, did not correlate with activity, thereby diminishing the composite score of hardiness and activity. These data support existing studies of perceptual and activity theories, the theoretical links between the constructs, and have identified hardiness as an antecedent variable of successful aging.
Predictors of Burden Among Wife Caregivers
Authors: Robinson Karen M.
Published: November 2024

The relationship of caregiver health, past marital adjustment, as well as received social support to caregiving burden was studied in 78 wives who served as primary caregivers to husbands with irreversible memory impairment for an average of 4 years and 10 months. In addition, socioeconomic status and attitudes toward asking for help were investigated. This paper is based on the same data set as a previous article that focused on depression. Past marital adjustment was a significant (p< .001) predictor of subjective burden and accounted for 20% of the total explained variance (22%). Socio-economic status and attitude toward asking for help were the significant (p< .001)predictors of objective burden and accounted for 12% of the total variance (17%). Received social support did not predict caregiver adjustment. The finding that past marital adjustment was significantly related to subjective burden suggests that caregivers with unhappy past marriages may need intervention in order to reframe past grievances in their marriages. Findings regarding social status indicate that caregivers with a higher income could purchase services, thus decreasing the amount of disruption in their lives and households.
Reconceptualizing Nursing Ethics
Authors: Cooper Mary C.
Published: November 2024

This paper offers a comparative analysis of four central concepts of moral theory—autonomy, moral posture, universal vs. particular, and the role of rules and principles. These concepts are compared as they function in traditional rule-and-principle ethics and the more recently explicated ethic of care. Implications of the distinctiveness of these two extant frameworks for the development of nursing ethics are set out. In conclusion, the claim is made that an inclusive approach to these different moral visions which places them in a mutually informative relationship holds the potential to enrich and enliven the developing nursing ethic.
Gender, Time, and Money in Caregiving
Authors: Ward Debbie
Published: November 2024

Nurses and scholars in other disciplines have examined the consequences of caregiving on the caregiver in behavioral and attitudinal terms, under the general rubric of “burden.” This paper considers caregiver burden in less commonly used labor and economic terms. In addition to expanding nursing’s conception of caregiver burden, this approach highlights issues gender-specific to the majority of caregivers, women. Housework is used as a model for women’s unpaid work. Based on this model, studies are reviewed in which hours and dollars are measures of caregiving burden. Some specific calculations of the value of elder kin care are given. It is urged that the economic consequences of caregiving be routinely considered and evaluated when nurses in practice and/or research address the needs of caregivers.
Serenity: Caring with Perspective
Authors: Roberts Kay T. , Fitzgerald Linda
Published: November 2024

It is possible to care too much. Thus, there is a need to assist clients to achieve a state of caring with perspective (i.e., caring that lies in the gray area between excessive caring and not caring). Serenity is a concept that offers direction for attainment of this perspective; the concept of serenity is valued by many clients. Yet, the term is missing in nursing literature and the meaning of serenity in the literature that exists on the topic is vague. This article presents results of a concept analysis of serenity and discusses the relationship of serenity to the concept of caring.
A Nursing Model for Chronic Illness Management Based Upon the Trajectory Framework
Authors: Corbin Juliet M. , Strauss Anselm
Published: November 2024

The trajectory framework developed by Strauss and associates provides a conceptual basis for developing a nursing model that gives direction for practice, teaching, and research in the area of chronic illness. This paper presents an overview of the trajectory framework and shows how it can be used to generate such a nursing model.
Using The Trajectory Framework: Reconceptualizing Cardiac Illness
Authors: Hawthorne Mary H.
Published: November 2024

Cardiac disease is known to be the leading cause of premature morbidity and mortality in the United States. Nursing management of cardiac illnesses, as such, is a primary concern for most practicing nurses. Dramatic changes in cardiac patient populations and associated technology available for treatment indicate a need to reconceptualize the nature of cardiac illness and to consider alternative approaches to guide the care of these patients. Traditional care, to a large degree, has focused upon acute illness, consequently limiting needed attention to the increasing group of patients suffering chronic illness and disability.

In the present paper, the major changes in the cardiac patient population and in utilization of available technology are presented. The application of the Corbin and Strauss trajectory framework as an appropriate and useful framework for conceptualizing cardiac illness and care is then discussed. Five characteristics of the framework which render the model particularly well suited to address cardiac care are identified and discussed. These characteristics are: 1) comprehensiveness of care, 2) patient-centered care, 3) gender issues in care, 4) family-focused care, 5) technology and cardiac care.
Use of the Trajectory Model of Nursing in Multiple Sclerosis
Authors: Smeltzer Suzanne C.
Published: November 2024

Multiple sclerosis (MS) is a chronic, demyelinating disorder that is unpredictable in its overall course, in the type of symptoms that will predominate, and in its eventual outcome. It has been used as a model in research, education, and practice to examine the course of chronic illness, patient and family responses, coping and adjustment to chronic illness, and specific concepts and variables of interest to researchers. MS is used in this paper to evaluate for nursing practice the utility of the Corbin and Strauss trajectory model of nursing. The assumptions and major concepts of the trajectory framework are discussed, use of the model in multiple sclerosis is demonstrated, and the strengths and limitations of the framework as a nursing model are identified.
Shaping the Course of a Marathon: Using the Trajectory Framework for Diabetes Mellitus
Authors: Walker Elizabeth A.
Published: November 2024

Persons with either insulin-dependent or non-insulin-dependent diabetes mellitus live with a chronic illness that can have both acute and long-term complications. The therapeutic regimen for glycemic control in diabetes is often complex and is lifelong; it requires special knowledge and skills for both patients and health care providers. In this article, the Corbin and Strauss trajectory framework for chronic illness management is clinically applied to the planning of patient care in two case studies of persons with diabetes. The benefits of using the trajectory framework as a model for care in diabetes include: introduction of the concepts of “locating” the patient on the trajectory and assessing the trajectory projection for both patient and provider, and a more realistic evaluation of incremental change in chronic illness. Two possible barriers to clinical application of the framework for diabetes management are: difficulty in translating the framework for clinical use, and some terminology in the framework that does not seem to describe reimbursable care. The trajectory framework provides a necessary shift in focus to quality of life issues in diabetes management over the lifespan.
Chronic Sorrow: A Lifespan Concept
Authors: Lindgren Carolyn L. , Burke Mary L. , Hainsworth Margaret A. , Eakes Georgene G.
Published: November 2024

Losses are an integral part of chronic illness and disability. The term chronic sorrow, has been used to describe the long-term periodic sadness the chronically ill and their caregivers experience in reaction to continual losses. In this conceptual analysis of chronic sorrow, identified critical attributes are: cyclic sadness over time in a situation with no predictable end; external and internal stimuli triggering the feelings of loss, disappointment, and fear; and, progression and intensification of the sadness or sorrow years after the initial disappointment or loss. Model, borderline, related, contrary, and illegitimate cases illustrate what the concept is and what it is not. The meaning of chronic sorrow is compared to the meaning of unresolvable grief and depression. Chronic sorrow in various stages of life is illustrated in descriptions of: the situation and feelings of parents of handicapped children; multiple sclerosis patients in the middle, productive years; and elderly caregivers of spouses with dementia. Implications for research include the need to study the concept in various populations to determine its prevalence and operation. Through research, the meaning of the concept can be further clarified. This is a beginning step toward developing nursing theory that will give direction for providing care to persons encountering sadness over long periods of time.
A Description of the Nature and Dynamics of Coping Following Coronary Artery Bypass Surgery
Authors: Redeker Nancy S.
Published: November 2024

The purpose of this study was to explore the nature and dynamics of coping following coronary artery bypass surgery (CABS). The coping strategies of 129 subjects recovering from (CABS) were assessed at 1 and 6 weeks following surgery using the Revised Ways of Coping Checklist. The most frequently used coping strategy was seeks social support, followed, in descending order of frequency, by problem focused coping and the emotion-focused coping strategies of blamed self, wishful thinking, and avoidance. There was an overall decrease in coping between 1 and 6 weeks following CABS. Seeks social support, blamed self, and wishful thinking coping were used significantly less frequently at 6 weeks than at 1 week following CABS. The decreases in problem focused and avoidance coping, however, were not statistically significant. This study provides insight into the process of coping following CABS and supports the need for development of nursing strategies to promote coping in this population.
Maternal Role Satisfaction: A New Approach to Assessing Parenting
Authors: Ohashi Julianne P.
Published: November 2024

There is a need to study the maternal role beyond the child’s first year of life. This investigation, using a framework of Locke’s expectancy theory, describes the expectations, surprises, values, and satisfactions experienced by 102 mothers of teens. Content analysis of written narratives describing surprises encountered by these mothers is also presented. Data were collected by questionnaire. Findings offer support for Locke’s theory in two ways: (1) expectation for role was less important than value attainment in predicting the level of maternal role satisfaction, and (2) encountering at least one positive surprise was associated with a higher level of maternal role satisfaction. These variables are offered as a useful nursing approach to the assessment of the parenting experience. Knowledge of the satisfactions reported may be encouraging to mothers anticipating this stage of life.
Patient Advocacy — An Important Part of the Daily Work of the Expert Nurse
Authors: Segesten Kerstin
Published: November 2024

Over the past two decades, patient advocacy has been recognized as a part of nursing. For the most part, the issue has been treated by means of theoretical reasoning and case studies. Narratives describing lived experiences of nursing by expert nurses from Sweden were analyzed in this study. The nurses were identified by their superiors as expert nurses, as having a special gift, a “green thumb” for nursing. One third of the narratives concerned patient advocacy situations. The analysis of the narratives showed that the patient advocacy situation is composed of the following elements: a powerless patient, a problem concerning the patient’s own will or what is good for him or her, and an adversary. Further, it includes a trigger situation, and a prompt decision and action by the nurse. The nurse acts out of conviction, accepts an additional work load, and takes the risk of being punished.
Development and Validation of the Perinatal Nursing Self-Efficacy Scale
Authors: Murphy Christine A. , Kraft Linda A.
Published: November 2024

Self-efficacy, a central construct of Bandura’s social cognitive theory, provided the framework for developing a measure of perinatal nursing knowledge and skills. The 24-item Perinatal Nursing Self-efficacy Scale (PNSE) encompasses knowledge and skills required of nurses practicing in family-centered single room maternity care (SRMC) settings. Response data from 188 registered nurses were evaluated to assess the reliability and construct validity of the instrument. The instrument demonstrated strong factorial validity and sub-scales derived from the factor analysis generated high alpha reliabilities. A MANO VA produced results consistent with the propositions of self-efficacy theory and supported construct validity. Since self-efficacy expectations are situation specific and have significant predictive value, they provide both an important adjunct to needs assessment data for educational planning and helpful baseline data for outcome evaluation of perinatal nursing educational programs and transitions to SRMC settings.
Predictors of Children’s Self-Care Performance: Testing the Theory of Self-Care Deficit
Authors: Moore Jean B.
Published: November 2024

Orem’s theory of self-care deficit proposes relationships between self-care performance and (a) basic conditioning factors, (b) self-care agency, and (c) dependent-care agent performance. The purpose of this study was to examine these proposed relationships in children. The study sample was composed of 414 students in grades 4 through 12, ages 9 through 18 years. Using regression analyses, study findings were that the variables chosen to represent the basic conditioning factors together accounted for 19% of the variance in children’s self-care performance. Separately, both age and health state were significant predictors. Additionally, when self-care agency was added to the regression model, the combination accounted for 36% of the variance. A correlational analysis showed a moderate relationship between a child’s self-care performance and her or his mothers’ dependent-care agent performance. Future research should continue to investigate Orem’s theories and the operationalization of the concepts.
Operationalizing the Corbin & Strauss Trajectory Model for Elderly Clients with Chronic Illness
Authors: Robinson Linda A. , Bevil Catherine , Arcangelo Virginia , Reifsnyder JoAnne , Rothman Nancy , Smeltzer Suzanne
Published: November 2024

A research team of six nursing faculty at Thomas Jefferson University College of Allied Health Sciences collaborated to develop a research proposal to provide nursing care to a selected population of chronically ill elderly persons. The Corbin and Strauss Nursing Model for Chronic Illness Management (1991) was selected as the organizing framework to guide research and care delivery. While conceptual models offer direction for nursing practice, specific guidelines for providing care can only be identified when major concepts of the model are operationalized (Fawcett, 1989). This article describes the first step in operationalizing the Corbin and Strauss Trajectory Model undertaken by the research team which resulted in the development of eight “Phase-specific protocols.” Two of the eight phase-specific protocols are presented.
The Nurse-Patient Relationship Reconsidered: An Expanded Research Agenda
Authors: Lowenberg June S.
Published: November 2024

This article examines gaps in the available research on the nurse-patient relationship and proposes an expanded research agenda. The author’s previous research comparing the physician-patient relationship in holistic health to traditional medical practice is reviewed and then contrasted with the literature describing the nurse-patient relationship. Five dimensions of the relationship are examined: affectivity, specificity, status differential, placebo salience, and trust. Most of the existing research in nursing focuses on the dimension of affectivity. Further empirical data on how each of these components is enacted in concrete clinical encounters is needed. Beyond expanding our understanding of each dimension, comparing them to equivalent attributes in other prominent models of provider -client relationships can provide further insight into those complex processes.
Sensing Patient Needs: Exploring Concepts of Nursing Insight and Receptivity Used in Nursing Assessment
Authors: Morse Janice M. , Miles Marianne W. , Clark Darlene A. , Doberneck Barbara M.
Published: November 2024

Nursing assessment utilizes skills that enable the nurse to “sense” the patient’s needs and the patient’s condition, and that provide a humanistic dimension to the provision of nursing care. The explanatory concepts describing these processes include intuition, emotional empathy, inference, knowing, counter transference, compathy and embodiment. In this paper these concepts are defined, and the more commonly used concepts (i.e., intuition, empathy, and inference) are compared. The underlying assumptions and characteristics are identified and the antecedents or prerequisites, mechanisms, and outcomes of each concept are explored. While some overlap and blurring of boundaries are evident, these concepts are diverse and were developed to apply to different contexts and non-nursing situations. When used alone, none is comprehensive enough to account for nurses’ ability to sense patient needs. We conclude that, given the unique aspects of nursing, we must consider using innovative methods to examine this phenomenon (e.g., the use of ethology to examine intuitively perceived changes in the patient’s condition), to increase efforts to explore the newer concepts (i.e., embodiment, compathy and “knowing”), and to develop new concepts or models that better represent this complex phenomenon that better fits nursing contexts and situations.
Perspectives on Activity
Authors: Redeker Nancy S. , Mason Diana J.
Published: November 2024

Activity is integral to human health, well-being, development, and functioning. Despite its importance to health, there have been few efforts to develop conceptual definitions of activity as a basis for nursing research in this area. The purposes of this paper are to review the major attributes of physical activity found in the nursing and health care literature, to formulate a comprehensive definition of activity based on the literature, and to suggest directions for future research.
End-of-Life Family Decision-Making From Disclosure of HIV Through Bereavement
Authors: Stewart Barbara M.
Published: November 2024

End-of-life decision-making is conceptualized as the foreground against the background of a family, transitional model of illness with the human immunodeficiency virus (HIV). Both foreground and background represent new knowledge and theory development emerging from six research studies over a 7-year period. The research was phenomenological, longitudinal, ethnographic, descriptive survey, narrative, and grounded using the constant comparative method. In all, 100 families were studied in their home settings in the District of Columbia and 29 states across the United States. Throughout the transitional process from disclosure of HIV through bereavement, families engaged in end-of-life decision-making. Their decision-making style was primarily cognitive or primarily emotional or somewhere in between. Families using a cognitive style of decision-making were less disrupted and more able to surmount hurdles and move toward goals. Exemplars from 23 families illustrated family decision-making and components of the transitional, family model.
Health-Promoting Behaviors and Quality of Life Among Individuals With Multiple Sclerosis
Authors: Stuifbergen Alexa K.
Published: November 2024

Chronic conditions have profound and pervasive effects on the quality of life of millions of Americans (USDHHS, 1991). The estimated one-quarter million Americans with MS face a unique set of stressors and challenges as they seek to adapt to a chronic illness with an unknown cause, few medical therapies, and an uncertain prognosis that almost always includes some degree of functional disability (Wasserman, 1988). The purpose of this study was to explore factors related to performance of health-promoting behaviors and to examine the relationship between the practice of health-promoting behaviors and perceived quality of life for individuals with MS. A general conceptual model was used as a framework for exploring the relationships among antecedent variables (demographic/disease factors, barriers, resources, perceptual factors), health-promoting behaviors, and perceived quality of life with a convenience sample of 61 individuals with MS. Analyses supported a hypothesized relationship between health-promoting behaviors and quality of life. Subsequent research with larger samples is needed to clearly address the relative strength and path of variables in the proposed model.
In-Home Communication Intervention Training for Parents of Multiply Handicapped Children
Authors: Elder Jennifer H.
Published: November 2024

Two major questions derived from social-interactional theory were addressed: What are the effects of an in-home communication training program for parents on (1) the acquisition of child-training skills (imitating/animating and expectant waiting) by parents of developmentally delayed children who have severe language impairments and autistic features and (2) the acquisition of communication behaviors in the children themselves? Questions regarding the social value of the intervention and effects on parent-child interactions were also addressed.

Four mothers were taught two parent-training skills (imitating/animating and expectant waiting) during two in-home training sessions. Following the parent training, the mothers conducted training sessions in their homes with their children for 10 minutes, three times per week for 8-12 weeks. All sessions were videotaped and frequency counts taken of the target parent skills and child target behaviors.

Asingle subject experimental research designwas used incorporating a multiple baseline across two parental child-training skills (i.e., imitating/animating, expectant waiting). Data were analyzed visually as is customary in single subject experimentation, and direct behavioral counts showed that all four mothers demonstrated increases in the frequency with which they used the child-training skills following treatment. Increases in four child behavior frequencies (i.e., vocal utterances, social responding, social initiating, and intelligible words spoken) were also noted. The ECO Scales Interaction Profile results supported direct behavioral count data, showing significantly improved parent-child interactions for the subject dyads over three conditions (p<.034). Additionally, Parental Consumer Satisfaction Questionnaire results indicated that the intervention was positively perceived by the parents. Furthermore, the utility of single subject experimentation procedures in clinical nursing practice was clearly demonstrated in this research, and the findings support nurse-conducted, in-home parent training as a practical and socially valid means of addressing the complex needs of chronically disabled children and their families.
The Work of Worrying: Battered Women and Their Children
Authors: Humphreys Janice
Published: November 2024

Battered women’s worries about their children have been reported as significantly influencing their own behaviors, including the decision to leave abusive relationships. The purpose of this study was to describe battered women’s worries about their children and their responses to those worries. An ethnography using the method described by Spradley (1979) was conducted. Qualitative analysis of the data revealed two themes about battered women’s worries about their children and their responses to those worries. While the abusive adult male was a source of worry, violence outside the home was pervasive and hazardous to children. Battered women’s experiences reflect the work of worrying; that is, the constant and energy-depleting nature of this difficult and vitally important process.
Stages in the Delivery of Home-Based Services to Parents at Risk of Child Abuse: A Healthy Start Experience
Authors: Wallach Vicki A. , Lister Larry
Published: November 2024

Hawaii’s Healthy Start program of home-based services to families identified at risk for child abuse and neglect is becoming a model for the nation. The present paper provides background information about Healthy Start and describes a three-phase process of engagement and service delivery that characterizes the Healthy Start home visitation model.
Family Caregiver Role Acquisition: Role-Making Through Situated Interaction
Authors: Schumacher Karen L.
Published: November 2024

Family caregiver role acquisition is an important, but little studied phenomenon. In this article, a conceptual approach for research on caregiver role acquisition is suggested. Caregiver role acquisition is defined as a family role transition. During this transition, the caregiving role is created through interaction between the caregiver and care receiver and between the dyad and others. Thus, caregiver role acquisition is a role-making process. An approach to social roles that integrates symbolic interactionism and structural role theory suggests that the role-making processes inherent in caregiver role acquisition occur through situated interaction. Concepts are identified from interactionist and structural perspectives that account for variation in individual experience with role acquisition. Indicators of health during caregiver role acquisition are also identified. Included are subjective indicators (role strain and role satisfaction), behavioral indicators (role insufficiency and role mastery), and interpersonal indicators (family conflict and mutuality).
The Contrary Ideals of Individualism and Nursing Value of Care
Authors: Katims Ide
Published: November 2024

Despite the relational worldview that underpins nursing caring, the cultural value of individualism remains firmly embedded in nursing’s conceptual systems. Individualism forms the basis of notions such as autonomy, self-reliance, personal rights and entitlement. When nurses concomitantly espouse the value of care, an orientation that stands in contrast to the predominant societal motif of the autonomous individual, they find themselves having to reconcile contrary ideals. The significance of the coexistence of the values of individualism and care rests upon the capability of each to contrast and sharpen our understanding of the other. The convergent outcome is the empowerment of nurses to refine their understanding of the human condition in illness and health, and to articulate a public practice of care that would temper the fundamental mark of noninterference in the traditional notion of individualism in American culture.
An Exploration of an Innovative Methodological Approach for Examining Nurses’ Heuristic Use in Clinical Practice
Authors: Fisher Anastasia , Fonteyn Marsha
Published: November 2024

What heuristics (reasoning strategies) do experienced critical care nurses use to assist in reasoning and making decisions about patient care? In this study, think aloud data were collected and protocol analysis was utilized to identify and describe the heuristics that permitted nurses to evaluate patient data, assess patient status, and make decisions necessary to maintain patient stability. Five heuristics were identified:pattern recognition, attending, anchoring, focused questioning, andlisting. Clearer understanding of nurses’ heuristic use could improve reasoning in practice, and could also provide educators with strategies to enhance the reasoning of their students.
The Power of Human Caring: Early Recognition of Patient Problems
Authors: Minick Ptlene
Published: November 2024

The purpose of this qualitative study was to gain an understanding of the processes used by critical care nurses in the early recognition of patient problems. Patient-care narratives related by the 30 nurses who participated in the study revealed that caring, as manifested by an involved stance from the nurse, can actually heighten nurses’ perceptions, thus improving assessment skills so as to allow early recognition of patient problems. This power of caring was sharply contrasted with situations where the recognition of patient problems was delayed or never occurred and that were characterized by a detached relationship between the nurse and patient. In this study, nurses confirmed that caring heightened their perceptions, improved assessment skills, and enabled the early recognition of patient problems. Clearly, practices that evolve from an involved stance from the nurse can make a difference in patient outcomes.
Improving Clinical Judgment of Newly Licensed Nurses With In Situ and Structured Debriefing: An Evidence-Based Practice Project
Authors: Stuffle Megan E.
Published: November 2024

Background:Sound clinical judgment (CJ) is essential for providing quality patient care. Newly licensed nurses lack the previous experiences needed to inform CJ, which could result in harm.Objective:This project aimed to evaluate the effectiveness of in situ and structured debriefing on the development of CJ among newly licensed nurses during their orientation.Methods:A quasi-experimental nonequivalent control group posttest design was used to compare CJ among newly licensed nurses who used in situ and structured debriefing during their initial orientation to those who did not use debriefing methodology.Results:CJ was improved through in situ and structured debriefing. Newly licensed nurses also perceived debriefing as valuable for analyzing their performance and developing a personal improvement plan.Conclusions:Debriefing during orientation has the potential to improve CJ among newly licensed nurses and promote patient safety.Implications for Nursing:Nurse leaders must implement methods to improve CJ among newly licensed nurses to address the existing decline in competency. Given their benefits, efficiency, and cost-effectiveness, debriefing methodologies should also be considered to promote CJ development among nurses transitioning to new care environments and advanced practice roles.
LA NARRATIVA MUTANTE PARA EL SIGLO XXI EN ESPAÑA
Authors: Veljović Jelica
Published: November 2024

El objetivo del presente trabajo es presentar las últimas tendencias de la narrativa española, con especial atención a la Generación Nocilla, también denominada generación Afterpop o Mutante. La poética de los escritores que se asimilan bajo estos nombres exige experimentación con las nuevas modalidades y formas de narración, apoyadas en los rasgos de la cibercultura, la realidad virtual y el mundo digital. Conectando la narrativa con la fenomenología de la pantalla, se subraya el carácter mutante de sus textos, que por lo tanto representan no solo una ola de frescura en la literatura española de la época contemporánea, sino también una oposición al método realista tradicional y una renovación poética en el ámbito hispano. Para indagar en la poética de los «mutantes españoles», este artículo se centrará en los trabajos de los críticos literarios más relevantes en el tema, pero también en los ensayos, artículos o entradas virtuales de escritores del grupo mutante como Vicente Luis Mora, Agustín Fernández Mallo, Germán Sierra, Juan Francisco Ferré o Eloy Fernández Porta. Intentaremos mantener un enfoque transmedial, dado el hecho de que su poética literaria supone una totalidad narrativa y mediática, abarcadora de diferentes dimensiones de la existencia humana en la Cuarta revolución industrial.
Safety Evaluation of Snake Plant (Sansevieria trifasciata) Leaves Extract as Potential Herbal Medicine
Authors: Fitria Laksmindra , Gunawan Isma Cahya Putri , Sanjaya Wilda Bunga Tina
Published: November 2024

Snake Plant (Sansevieria trifasciata) has been commonly used as traditional herbal medicine in addition to being ornamental plant and phytoremediation agent. Toxicity studies on pharmaceutical substances are required to assess the level of hazard and safety before processing as drugs. Conventional toxicity test focused on determining LD50, despite the fact that not all substances induce death in experimental animals. They might survive but suffering or get sick. This study aimed to evaluate safety level of oral administration of chloroform extract of S. trifasciata leaves (CESTL) for 28 days (subacute) in Wistar rats (Rattus norvegicus) as model animal through the observation of clinical signs that lead to lethal and sublethal effects. The procedure referred to OECD Guideline No. 407 with the dose of CESTL was 1000 mg/kg bw (Limit Test). Adult female nulliparous Wistar rats were assigned into three groups which received CESTL, Tween 4 % (solvent for CESTL), or distilled water as control (placebo) 1 mL/individual/day. Parameters observed consisted of mortality, general physical examination, individual and social activity and behavior, body weight, body temperature, food intake, water consumption, fecal condition, and fasting blood glucose (FBG) level. Results showed that no animals died or suffered as a result of CESTL poisoning. There were no significant differences in all parameters value among three groups, indicating that CESTL did not generate adverse effects on animal normal physiological condition. Thus, it can be concluded that CESTL at the dose of 1000 mg/kg bw is relatively safe for consumption during­ subacute period.
Manevi Bakım ve Danışmanlığın Teolojik Temeli Olarak Çoban Metaforu Üzerine Dinlerarası Karşılaştırmalı Bir İnceleme
Authors: Çatma Latife , Söylev Ömer Faruk
Published: November 2024

Manevi bakım ve danışmanlık alanında giderek artan öneme sahip olan 'çobanlık' kavramı, Batı'da manevi danışmanlığın temelini oluşturmaktadır. Bu kavramın, etimolojiden teolojiye kadar dinler arası bir perspektifle incelenmesi, manevi bakım ve rehberlik pratiklerinin derinlemesine anlaşılmasına katkı sağlamaktadır. Bu çalışmada, Hristiyanlık’ta ve İslam’da çobanlık metaforunun manevi danışmanlık bağlamındaki işlevi ve önemi ele alınmıştır. Doküman analizi yöntemiyle gerçekleştirilen araştırma, manevi danışmanlık pratiğinin temel unsurlarını belirlemektedir. Bu makale, mevcut literatürdeki bilgilerin yanı sıra, bazen manevi danışmanlık ve rehberlik olarak adlandırılan alanın teolojik ve kültürel bağlamdaki gelişimine yeni bir bakış açısı getirmektedir. Çünkü çobanlık kavramının, manevi bakım ve danışmanlığın temel prensipleriyle olan ilişkisi, günümüz toplumsal ve kültürel değişimlerin ışığında incelenmesi gereken önemli bir konudur. Bu makale, akademik literatüre çobanlık kavramının manevi danışmanlık ve rehberlik alanındaki rolünü derinlemesine inceleyerek kavramın Hristiyanlık’ta ve İslam’daki benzerlik ve farlılıklarına işaret etmektedir. Dolayısıyla, bu çalışma, manevi danışmanlık ve rehberlik alanındaki araştırmalara katkı sağlayacak bir kaynak niteliği taşımaktadır.