bluuebunny/crossref_metadata_2025 huggingface dataset:
Caries risk analysis: considering caries as an individual time‐dependent process
Authors: Kalwitzki M. , Weiger R. , Axmann‐Krcmar D. , Rosendahl R.
Published: March 2003

Aim

.To estimate the probability that a tooth does not develop a cavitated lesion (= end‐stage caries) within time periods of interest. Additionally it was of interest to assess the heterogeneity between patients, in relation to the time periods required for their teeth to develop a cavitated lesion.

Design .A prospective study using patient data of a clinical pedodontic course.

Sample and methods .Forty‐one patients who had been followed for at least 3 years were selected. Before initiation of therapy, affiliation to a specific risk group was checked. Nine individuals who had belonged to a high‐risk group on test were excluded. Of 1968 teeth, 1378 were eligible for data evaluation. The statistical techniques applied originate from time‐to‐event analysis methods, including a parametric frailty approach providing estimates of the relative caries risk for each individual to develop a cavitated lesion.

Results In the selected group of patients the probability that a tooth remained free of a cavitated lesion within five years ranged from 0·89 to 0·95 applying a 95% confidence interval. In the present sample the true caries risk of the patients to develop a cavitated lesion varied considerably although such variation was not expected from the individual examinations at baseline.

Conclusion

The frailty model accounts sufficiently for the heterogeneity of each patient. The applied time‐to‐event methods facilitated reliable estimation of both the probability that a tooth remains free of a cavitated lesion within a certain time and the relative caries risk of an individual to develop a cavitated lesion.
Nurses’ attitudes towards primary health care: development of an instrument
Authors: Dykeman Margaret , Ervin Naomi E
Published: March 2003

In many countries nurses are the largest group of professionals providing health care If health care is to be provided following a primary health care philosophy, nurses must be among the leaders in making the change in the way health care is delivered To be effective nurses must develop positive attitudes towards primary health care and incorporate its principles into practice The purpose of this paper is to present the development and testing of an instrument to measure nurses’ attitudes towards primary health care The instrument has 35 items divided into five domains based on the principles of primary health care Two scales, one for attitude and one for importance of concept of professional role, are scored on six‐point Likert scales Initial psychometric evaluation resulted in alpha coefficients of 0 07 to 0 58 for the domains, 0 70 for the attitude scale and 0 93 for the importance scale Details are provided on the measures taken to establish validity of the instrument Plans for future testing are included
A complementary therapy approach to the management of individual stress among student nurses
Authors: Lindop Edward
Published: March 2003

This paper examines the difference between qualitative and quantitative research approaches and applies the debate to assessing student nurses’ stress coping styles In particular, it looks at the value of the qualitative approach as a means of appreciating the individual nature of the stress experience A pilot study was conducted among a small group of Project 2000 students The results illustrate that a flexible model which appreciates the differences in individual perception is a successful way of enabling students to handle negative stress The paper also reports on a new concept called Determination and the Hypnotic Interaction model which enables student nurses to utilize determined experiences from previous times and apply them to present and future negative stress The model utilizes a wide range of complementary therapy approaches including relaxation, imagery and hypnosis, to enable students to appreciate positive stress and to discover and use their natural resources of determination to deal with negative stress
Defining and assessing risky behaviours
Authors: McKie Linda , Al‐Bashir Mazen , Anagnostopoulou Tanya , Csepe Peter , Fonseca Helena , El‐Asfahani Aida , Funiak Stanislav , Javetz Rachel , Samsuridjal Samsu
Published: March 2003

This paper presents the deliberations and conclusions of an international group of health practitioners, researchers and planners who met in 1991 to explore risky behaviours and risk assessment in the context of the World Health Organization's strategy Health for All By 2000 A definition of risky behaviours is discussed and a method of exploring risk contexts,‘a risk equation', is presented Lay risk assessment is explored and contrasted with professional perceptions of risk as evidenced in health education campaigns It is concluded that the application of epidemiological techniques — the study of the incidence and prevalence of risk‐related and health‐related behaviours — employing qualitative methods provides a useful means of exploring the social and cultural context of risk behaviour
Nurses' attitudes towards aggressive behaviour, following attendance at ‘The Prevention and Management of Aggressive Behaviour Programme’
Authors: Collins John
Published: March 2003

The issue of aggression and violence is current in society Recent reports indicate that this is not just an issue for society at large, but also for its organizations and institutions The health care industry is no exception in this regard Nursing, among other disciplines, has focused an increasing amount of attention on this problem for its members This is evidenced by the increasing amount of literature on the topic One feature of this writing is the study of programmes designed to train professionals in techniques to prevent and manage aggression and violence To date, little attention has been paid to the evaluation of such programmes In these times of economic difficulty, this position cannot be supported This paper describes the study of one such educational programme In this case the evaluation focused on the study of attitude change in participants following attendance at‘The Prevention and Management of Aggressive Behaviour Programme’Although the indications are that the programme had a positive effect on attitudes, the author concludes that further study is required to illuminate the statistical significance of this positivity
The changing role of the nurse in neonatal care: a study of current practice in England
Authors: Harris Anne , Redshaw Margaret
Published: March 2003

The boundaries of nursing in neonatal care, and the interface between the work of nursing and medical staff in delivering care, are changing The enhanced or expanding role of the neonatal nurse is not a universally accepted one If this professional development is to be widely accepted and implemented, some key issues will need to be addressed so that the changing role of the nurse and associated skill base are well founded As part of a large‐scale national study of neonatal nursing in England, data were collected from nurses working in 24 different units Regional centres, subregional centres and district units from six widely separated health regions participated, and individual data were collected from 718 nurses (599 D‐I grades and 119 A‐C grades) While indicating that there is inter‐unit variation in nursing practice, the results also show that many nurses are already in the process of changing their role in this acute specialty Nurses doing so are more likely to have a qualification in this specialty, though not all of them have A small number of nursery nurses and nursing auxiliaries were undertaking tasks that could be considered part of an expanded role The implications of the findings are discussed
An exploratory study of students' perceptions of the benefits of regular small group tutorials in a 2‐year day release course
Authors: Ashton Helen , Shuldham Caroline
Published: March 2003

This study was undertaken with the intention of improving the effectiveness of small group tutorials in a diploma in nursing course There was concern to avoid some of the less valuable aspects of tutorials highlighted in the literature An investigation was conducted to elicit students’ perceptions of the benefits of group tutorials at a comparatively early stage in their 2‐year course, at the end of the second term A qualitative approach was taken to explore the views of four students through individual semi‐structured interviews Additional data were gathered through personal field notes to add the tutor's perspective of the group process Data were analysed inductively using a phenomenological approach in an attempt to elucidate the essence of each participant's experience of the tutorials While the findings suggested that students valued their involvement in small group tutorials, some questions were raised which point to the need for further investigation Themes were revealed which drew attention to the value students place on the experience of small group tutorials, thus endorsing the strategies employed Benefits to students include the opportunity to get to know a small group of people when part of a larger learning group, support when coping with the pressures of course work and being able to share ideas about issues relevant to nursing The report concludes that there is scope for further investigation and reflection in order to develop educational practice
Hildegard Peplau meets family systems nursing: innovation in theory‐based practice
Authors: Forchuk Cheryl , Dorsay Jan Park
Published: March 2003

Nursing theories which have evolved from mental health‐psychiatric nursing have focused on the individual nurse‐client relationship Other nursing theories generally focus on the individual as client Therefore, nurses working with families may have difficulty in applying these frameworks to their practice Nursing theories need to be expanded to include families, groups and communities more explicitly The well established theory of Hildegard Peplau, which previous studies have found to be the theory most frequently used by psychiatric nurses, and the family systems nursing theory of Wright and Leahey share a complementary focus Both theories form part of the interpersonal paradigm of nursing, both view nursing from an interactional perspective, rather than focusing on individuals Use of a combined theoretical approach offers several advantages The approach explicitly considers both the individual and the family The combination provides grounding for family work in an articulated nursing theory
Feminist teaching and the older nurse: the journey from resistance through anger to hope
Authors: Keddy Barbara Carter
Published: March 2003

Some of the material presented in the journals of mature student registered nurses in two nursing research methodology courses are analysed The classes were taught from a critical feminist perspective, that is, gender, race, sexual orientation and class issues were addressed as the science of ideas was explored The students kept journals of their experiences throughout the process While this was not a ‘research’ project in the usual sense of the word, material evolved which was primarily an evaluation of my teaching approach and their responses to it Excerpts of this material were kept as they provide rich data providing insights into teaching strategies Students cannot be identified in this analysis It was found that, initially, most resisted the ideas of feminist theory, research and praxis As the classes progressed, many feelings were of anger about the oppression they had experienced in the past at work and personally but had not understood Finally, towards the end of term, many students expressed hope that they would be able to bring about some social change within the profession as a result of the ideas discussed in classes However, several students remained unconvinced that feminism was the way to evoke change
Collegiality, adaptation and nursing faculty
Authors: Congdon Graham , French Peter
Published: March 2003

Many nurse educators in the United Kingdom are currently faced with the challenge of change, of leaving the culture of the British National Health Service and integrating into the culture of tertiary education This paper reports on a study of the process of developing collegial relationships in the context of a new collaboration to develop a combined curriculum for nurses within a tertiary institution The aims of the study were to analyse this process of integration and to identify the conditions that enhanced the development of collegiality between members of the nursing group The case study centred on the analysis of data collected on video during unstructured interviews with the five members of the group Data were analysed using Burnard's method of thematic content analysis The paper argues that during the transition from the National Health Service to tertiary education, individual nurse educators and their managers must address problems related to issues such as ‘ingroupism’, nursing the students, perceived difference between nurse academics and other academics, and expectations of power‐relationships
Correlates of nursing diagnosis quality in public health nursing
Authors: Mackenzie Sandra J , Laschinger Heather K Spence
Published: March 2003

The purpose of this study was to identify the relationship between the number and quality of nursing diagnoses generated by public health nurses (PHNs), and the use of different assessment databases (nursing or medical) In addition, the effect of experience with theory‐based nursing practice on the number and quality of the diagnoses was examined A convenience sample of 37 PHNs employed in two county health units provided the subjects for this study One agency had implemented theory‐based nursing practice, the other had not Analysis of the results revealed that use of a nursing database significantly affected the number of diagnoses generated by PHNs However, the database type did not significantly affect the quality of the diagnoses PHNs' experience with theory‐based practice had no significant effect on the number or quality of nursing diagnoses generated by PHNs, irrespective of database
Assessing the level of student reflection from reflective journals
Authors: Wong Frances KY , Kember David , Chung Loretta Y F , CertEd Louisa Yan
Published: March 2003

The concept of reflective learning has been widely adopted in many of the nursing curricula today Reflective learning is of particular relevance to the education of professionals, as it encourages students to integrate theory with practice, appreciate the world on their own behalf, and turn every experience into a new potential learning experience While nurse educators have widely accepted the educational benefits of reflection, research into reflective learning is hampered by the lack of reliable and widely accepted methods for assessing whether reflection takes place and the level of any reflection This study attempted to develop and test coding systems for written reflective journals based on two well‐known models of reflective thinking The reflective journals submitted by the students were subjected to content analysis at two levels The findings of this study suggest that student writing can be used as evidence for the presence or absence of reflective thinking The process of allocating students to three categories of non‐reflector, reflector and critical reflector was straightforward and reliable Identifying textual elements within journals and allocating them to the finer levels of reflection within a more complex model of reflective thinking was, however, more problematic and considerably less reliable
The life situation of a long‐term psychiatric patient: some restrictions in, and possibilities of, open care
Authors: Nikkonen Merja
Published: March 2003

This paper describes and analyses, from a sociocultural viewpoint, the ways of life of discharged long‐term psychiatric patients in northern Finland The paper focuses on subjectivity control of life and fundamental experiences in life The data consist of interviews with 25 outpatients who have moved to live in residential homes, rehabilitation centres or their own homes after receiving preparatory training in the psychiatric hospital The findings suggest that the way of life of the outpatients did not significantly differ from that of other people belonging to the same generation of Finns With respect to control of life, a conspicuous feature was the strong tendency to let themselves be led by others, and to self‐sacrifice for the good of others For the patients, independence was the best aspect of open care Fear for being branded as a psychiatric case or as a former mental patient threatened the patients’external control of life The central element of control of life of the Finns is work The outpatients thought work a matter of honour and they did not find their present, inactive way of life satisfactory
Post‐natal depression: the relevance of sociological approaches
Authors: Thurtle Valerie
Published: March 2003

Post‐natal depression is much discussed yet definitions and approaches are not homogenous, neither in terms of the cause of post‐partum mental ill health, its treatment or how further research in the area should proceed This paper seeks to examine post‐natal ‘upsets’ and to consider the different explanations that have been and could be made of post‐partum mental ill health The paper reviews the dominant biomedical and psychological approaches, evaluating their ability to explain post‐natal mental illness The writer believes biological and psychological approaches are in the ascendance but seeks to demonstrate that they do not present a full picture Sociological approaches drawing upon stress, labelling and feminist models are examined, exploring new ways of looking at post‐natal illness The paper concludes that biological and psychological approaches do not provide complete explanations and a multidisciplinary approach is needed Most significantly the woman's own perception of post‐natal ill health is largely absent from the literature The need for an approach using ethnographic methods is highlighted
Challenging old notions of professionalism: how can nurses work with paraprofessional ethnic health workers?
Authors: Fuller Jeff
Published: March 2003

Despite a recognition that health care systems in western countries need to become more responsive to their culturally diverse populations, health professionals have been slow to change their dominant monocultural work practices Paraprofessional ethnic health workers have been employed in Australia to increase the access of non‐English‐speaking background communities to health services, however, they have generally not been able to form effective teamwork relationships with health professionals Research into the use of ethnic health workers is explored to propose changes in the way that professional nurses practise alongside these workers Concepts within professionalism and within a primary health care approach are considered against a framework of cultural differences between nurses and non‐English‐speaking background clients It is unrealistic that nurses should expect to attain the cultural knowledge required to provide total care to all their clients in a diverse society, without a partnership with cultural intermediaries Such an expectation is likely to produce lists of cultural traits that stereotype ethnic clients, rather than lead to an understanding of each client's individual needs More effective teamwork between professional nurses and paraprofessional ethnic health workers is proposed so that together they can ensure health care is delivered in ways that are flexible and responsive to cultural differences
Definitions of quality of life: a taxonomy
Authors: Farquhar Morag
Published: March 2003

Quality of life is of central concern in evaluative research, improved quality of life is probably the most desirable outcome of all health care policies However, definitions of quality of life are as numerous and inconsistent as the methods of assessing it Stemming from a larger piece of work looking at the definition and measurement of quality of life, this paper highlights the lack of a consensus definition of quality of life by means of a taxonomy of definitions that emerge from the literature The paper describes and gives examples of four main types of definition which make up the taxonomy global (type I), component (type II), focused (type III), and combination definitions (type IV) In addition, an outline of factors influencing the definition of quality of life is given, and an alternative strategy for both defining and measuring the concept (the use of lay definitions) is suggested
Social support: a conceptual analysis
Authors: Langford Catherine Penny Hinson , Bowsher Juanita , Maloney Joseph P. , Lillis Patricia P.
Published: March 2003

Using the methodology of Walker and Avant, the purpose of this paper was to identify the most frequently used theoretical and operational definitions of social support. A positive relationship between social support and health is generally accepted in the literature. However, the set of dimensions used to define social support is inconsistent. In addition, few measurement tools have established reliability and validity. Findings from this conceptual analysis suggested four of the most frequently used defining attributes of social support: emotional, instrumental, informational, and appraisal. Social network, social embeddedness, and social climate were identified as antecedents of social support. Social support consequences were subsumed under the general rubric of positive health states. Examples were personal competence, health maintenance behaviours, perceived control, sense of stability, recognition of self‐worth, positive affect, psychological well‐being, and decreased anxiety and depression. Recommendations for future research were made.
Therapeutic touch, nursing practice and contemporary cutaneous wound healing research
Authors: Daley Barbara
Published: March 2003

The nursing profession is and always has been at the cutting edge of research and development into innovative and effective methods to treat, manage and enhance wound regeneration. One such method which was developed specifically for nursing science is a non‐invasive, easily administered technique known as therapeutic touch (TT). Although there have been numerous anecdotal reports over the last two decades attesting to the efficacy of TT for cutaneous wounds, there have been only five experimental studies to date which have examined the phenomena in a scientifically rigorous manner. These five studies utilized randomized, double‐blind, placebo controlled protocols to analyse the effect of an experimental derivative of TT‐non‐contact therapeutic touch (NCIT)‐on the healing rate of surgically administered full thickness human dermal wounds. The experiments introduced many original concepts and approaches to healing research and nursing practice. The data from the five studies indicated a statistically significant accelerated rate of wound healing for the treatment group in the initial two experiments, and nonsignificant and reverse significant effects for the remaining three studies. Although, experimentally, these results are far from impressive, clinically, the significant results of the first two experiments should be enough to encourage the nurse clinican to explore and utilize a similar non‐invasive TT treatment method for patients with dermal lacerations. While the results of the studies were inconsistent overall, the series of experiments nonetheless significantly expanded the theorectical boundaries and understanding of the TT process and, due to the rigorous, double‐blind methodological protocols used, have established the critical groundwork and guidelines for future nursing science research in the area.
Patients' perceptions of their education needs in the first six weeks following discharge after cardiac surgery
Authors: Goodman Helen
Published: March 2003

The aim of this study was to discover what information and support patients fell they need in the 6‐week rehabilitation period following discharge after cardiac surgery. It was undertaken at the request of the hospital multidisciplinary cardiac rehabilitation team to enable them to plan a package of information to meet those needs. It was a local study aiming to gain insight into the patient's own views by asking them to keep a diary over the 6‐week period and then take part in an unstructured interview when they returned for their 6‐week out‐patient appointment. The analysis of the respondents' comments gave an insight into their whole experience of the first 6 weeks following discharge. The analysis of the respondents' comments gave an insight into their whole experience of the first 6 weeks following discharge. The themes which emerged were wide‐ranging and were grouped under the headings of the early discharge needs of pain relief and sleep promotion, psychological needs, practical needs and community support. To take the study forward, several recommendations were made to improve the rehabilitation experience. These included additions to the literature and patient education sessions, and changes to ensure a smoother transition into the community. The findings also suggest the need for improvements in and further research into the whole area of the psychological preparation for discharge after cardiac surgery.
Clinical decision‐making by midwives: managing case Complexity
Authors: Cioffi Jane , Markham Roslyn
Published: March 2003

In making clinical judgements, it is argued that midwives use ‘shortcuts’ or heuristics based on estimated probabilities to simplify the decision‐making task. Midwives (n= 30) were given simulated patient assessment situations of high and low complexity and were given simulated patient assessment situations of high and low complexity and were required to think aloud. Analysis of verbal protocols showed that subjective probability judgements (heuristics) were used more frequently in the high than low complexity case and predominated in the last quarter of the assessment period for the high complexity case. ‘Representativeness’ was identified more frequently in the high then in the low case, but was the dominant heuristic in both. Reports completed after each simulation suggest that heuristics based on memory for particular conditions affect decisions. It is concluded that midwives use heuristics, derived mainly from their clinical experiences, in an attempt to save cognitive effort and to facilitate reasonably accurate decisions‐making process.
The emergence of the ‘waiting game’: a critical examination of the psychosocial issues in diagnosing breast cancer
Authors: Poole Karen
Published: March 2003

Undergoing diagnostic investigations for symptoms of breast disease constitutes an intensely stressful experience for any woman. The widespread use of contemporary fine‐needle techniques throughout specialist breast clinics, whilst removing the necessity of hospitalization and general anaesthesia for many women, has introduced the notion of the ‘waiting game’. The ability to ascertain definitive results within a matter of hours has led to diversification in the structure of diagnostic breast services; however, the significance of the ‘waiting game’ in terms of distress experienced by women has not been investigated. This paper systematically reviews the research that has explored psychosocial morbidity in this phase of the disease trajectory, and provides summative recommendations for further research.
The use of ‘dementia care mapping’ as a method of evaluating care received by patients with dementia – an initiative to initiative to improve quality of life
Authors: Williams Jane , Rees John
Published: March 2003

‘Dementia care mapping’(DCM) is a method of assessing care standards as received by dementia victims. Through the application for this tool, shortcomings in care practice can be highlighted in the hope of achieving improvements. The method was employed by the Elderly Mentally Ill (EMI) unit of a National Health Service trust in South Wales. Baseline evaluations were undertaken on each of the EMI wards containing dementia patients, and reports delivered to the appropriate members, of staff. Mean care scores for the unit as a whole were found to lie in the ‘good’ category, as defined by the method. Staff training in the underlying principles of DCM will be followed by re‐evaluations of care standards to evaluate the outcome of the attempts made to engender improvements.
Facilitation: a concept analysis
Authors: Burrows Dee E.
Published: March 2003

The term ‘facilitation’ appears to be open to a wide variety of definitions and interpretations. If teachers are to act as facilitators of learning they need a clearer understanding of facilitations as a strategy for nursing education. This concept analysis uses Walker and Avant's framework. Following a review of the literature related to facilitation, the paper postulates that there are four critical attributes for effective facilitation: genuine mutual respect; a partnership in learning; a dynamic, goal‐orientated process; and critical reflection. The necessary antecedents and likely consequences are identified. Model and alternative cases are offered. A distinction is made between educational facilitation and facilitation in counselling. Recommendations are given regarding the future development of empirical referents. To enhance the reader's understanding of concept analysis, the paper incorporates a reflection on the process, together with a discussion of the way in which decisions regarding the attributes were reached.
Protective care‐receiving: the active role of care‐recipients
Authors: Russell Cynthia K. , Bunting Sheila M. , Gregory David M.
Published: March 2003

Historical and contemporary conceptualizations of caregiving have not addressed the active role of care recipients within caregiver‐care‐recipient relationships. Using an interpretive synthesis method, the authors developed the concept of protective care‐receiving from three qualitative studies of different groups of care receivers (older adults with chronic illnesses, persons with AIDS, and persons in treatment for active cancer). This paper describes the focus of care recipients’protective care‐receiving efforts, the goals they hoped to achieve, and the strategies they used to assist themselves in attaining their goals. Examples of their efforts and strategies are illustrated with quotations from the data. These findings extend what is known about care recipients’selfcare activities. Moreover, the findings reveal a new dimension in the role of care recipients — protective care given by care recipients to their professional care providers, family and friend caregivers, and other care recipients. The concept of protective care‐receiving advances our understanding of caregiving relationships and presents researchers with the opportunity to investigate the complex encounter between caregiver and care recipient. Recognizing and facilitating care recipients’protective care‐receiving is an ethical imperative for a ‘caring’ profession such as nursing.
To meet with a stroke: patients’ experiences and aspects seen through a screen of crises
Authors: Nilsson Imogene , Jansson Lilian , Norberg Astrid
Published: March 2003

The aim of this study was to elucidate the experiences of stroke victims during the course of disease and the first few months after discharge. Ten individuals, recently having suffered their first manifest stroke with lasting neurological symptoms, narrated their experiences and gave their views at two different appointments during the first few months after discharge. A deductive approach was applied, on the basis of the theory of developmental crises. The analyses of the interviews were performed using a phenomenological hermeneutic method inspired by the philosophy of Ricoeur. The analyses disclosed phenomena signifying developmental crises in all the cases, though the cirses profiles were marked by the sequelæ the individuals suffered after stroke and by the age‐specific stages of which they were in the middle. The solution of the crises was far from being reached within the period of data collection, as the interviews were performed relatively early after home‐coming and the individuals were in the middle of grasping their new situation. The phenomenon‘to meet with a stroke’ seems to challenge the whole of the individual's being. The study calls attention to the need for awareness of this matter, which should be indicated to a much greater extent in nursing care and education than has been done until to date.
Grey glasses: sadness in young women
Authors: Gramling Lou F. , McCain Nancy L.
Published: March 2003

Sadness as a developmental phenomenon in young women was discovered in a study designed to identify developmental transitions and the relationship of these transitions to mental health. Sadness is conceptualized as a pervasive feeling of disillusionment and unhappiness that influences the meaning of life events and decision‐making. Field research and interpretive analysis techniques were used to observe, describe and analyse the life experiences of 25 volunteer participants. For most women in the study, sadness was found to be time‐limited and perhaps had beneficial effects. Some women, however, were unable to resolve sadness and became depressed. Sadness can be an antecedent to depression. Sadness that is recognized and validated may facilitate reshaping of a woman's expectations, a form of cognitive restructuring. The transitional nature of sadness has important implications for women's mental health.
The experience of people awaiting coronary artery bypass graft surgery: the Icelandic experience
Authors: Jónsdóttir Helga , Baldursdóttir Lovísa
Published: March 2003

Prolonged waiting for major elective surgery has been a problem in several Western countries for many years. In Iceland coronary artery bypass graft (CABG) surgery was installed in 1986 and this descriptive study was conducted to describe systematically the experience of Icelandic people waiting for CABG surgery with the purpose of gaining information about what nursing services these people need during the waiting period. The survey used a mailed questionnaire developed by the authors. The target population consisted of people awaiting coronary artery bypass graft surgery at the National University Hospital in Iceland, at two predetermined days with a 10‐month interval. The return rate was 81·8% (n=72). Mean time on the waiting list was 5 to 6 months. The waiting for surgery had negative effects on the work and daily life of the majority of the subjects and they were dissatisfied with their health status. Prominent symptoms were fatigue, shortness of breath, chest pain, anxiety and depression. Most patients (86·6%) experienced stress with 28·4% of them reporting a serious level of stress. The majority reported considerable negative influences of their illness on their spouse and family, particularly on their emotional condition. The conclusion drawn is that shortening the waiting period for CABG surgery should be a primary objective; however, that may be unlikely with the present Icelandic health care system. Therefore, helping the individuals and their families live with the lengthy wait is a necessity.
Coping strategies and quality of life among patients on continuous ambulatory peritoneal dialysis (CAPD)
Authors: Lindqvist Ragny , Sjödén Per‐Olow
Published: March 2003

The present study describes CAPD patients’ coping strategies and quality of life. A descriptive‐comparative design was chosen and a consecutive series of patients (n=26) was included. Data collection was performed through questionnaire and interview. Coping was measured by the Jalowiec Coping Scale and quality of life by the Swedish Health‐Related Quality of Life Survey (SWED‐QUAL). The main results show that an optimistic coping style was the most widely used by both men and women and this style was also considered to be the most effective in terms of dealing with stressful treatment aspects. Significantly more men than women found emotive coping to be less effective. Compared to a sample from the general population, CAPD patients had lower values on all SWED‐QUAL sub‐scales except those that tapped family functioning and emotional health. In general, women evidenced a more negative perception of their health than did men. With respect to emotional well‐being/negative aspect, the CAPD patients achieved higher scores than the general population. The findings suggest targets for nurse practitioners’ provision of support and information and in assisting patients to better utilize adequate coping methods to enhance their quality of life.
The role of cognitive‐behavioural therapy in the management of pain in patients with sickle cell disease
Authors: Thomas Veronica Nicky , Wilson‐Barnett Jenifer , Goodhart Frances
Published: March 2003

Painful crisis is the most common manifestation of sickle cell disease and accounts for the second greatest number of admissions with an average length of stay of 7 days in central London. Despite this frequency of admissions, the management of pain is fraught with problems. This is not surprising since the psychological challenges presented by sickle cell disease are manifold, resulting in significant psychological distress for some individuals. This paper considers the literature on the psychosocial impact of sickle cell disease, and the American research evidence which suggests that pain management strategies that incorporate a psychological intervention can significantly reduce psychological distress as well as hospital admissions. Britain has been slow to incorporate psychology in the pain management strategies, and we have embarked on research to fill this gap. Although this research constitutes work in progress, an argument is put forward for utilizing the cognitive‐behavioural perspective in the management of pain in sickle cell disease and we conclude by giving a brief summary of pilot work which is both the foundation and justification for the current ongoing research.
Is befriending by trained volunteers of value to people suffering from long‐term mental illness?
Authors: Bradshaw Tim , Haddock Gillian
Published: March 2003

People who suffer from long term mental illness may be vulnerable to loneliness and isolation when living in community settings. Befriending by volunteers may be an effective way of combating such problems and helping clients to develop social networks. The findings of a small scale project to evaluate the views of people suffering from long term mental illness of an organized befriending scheme are reported. Nine subjects who suffer from severe mental illness were interviewed, all subjects felt befriending was helpful to them, and 67% of subjects thought it had improved their confidence when in social situations. Subjects who lived alone indicated a preference to see volunteers at home, whilst those who lived with carers preferred support in going out socially. The value of befriending schemes as part of community care services for this needy client group are discussed.
Homophobia: an evolutionary analysis of the concept as applied to nursing
Authors: Richmond Janice P , McKenna Hugh
Published: March 2003

Homophobia is a socially accepted, culturally based belief, which is heavily influenced by an individual’s or a community’s inherent attitudes, beliefs and values. This conceptual analysis of homophobia has endeavoured to review existing literature on homophobia and subsequently identify and examine the phobic constituents of the concept. References to homophobia are mostly from the 1970–1980 period and there is much unacknowledged conceptual baggage that accompanies the term, which results in restrictive and inappropriate ideas about this concept. This is mainly the consequence of comparisons of homophobia to other phobias, which directly infers fear of homosexuals, while in reality homophobia is more of a biased disgust at homosexuals’ lifestyles. This paper attempts to re‐conceptualize homophobia so that empirical research can begin to test the critical attributes of the concept. This forms the basis for the development of a comprehensive social psychological theory of attitudes towards homosexuals. Such a theory would transcend the unilateral and unidimensional concept of homophobia as a fear and help the understanding of attitudes and feelings towards homosexuals.
Participation of expectant mothers in decision making in maternity care: results of a population‐based survey
Authors: Pelkonen Marjaana , Perälä Marja‐Leena , Vehviläinen‐Julkunen Katri
Published: March 2003

The purpose of the study was to acquire knowledge of the opportunities that expectant mothers had to participate in decision making regarding their care in maternity clinics during their last pregnancy. The study is a part of a larger national survey ‘Family planning services in Finland’ carried out by the National Research and Development Centre for Welfare and Health. The rationale for the study were the known benefits of participation in one's care and its emphasis in health policy documents. The subjects were a random sample of women aged between 18 and 44. The response rate was 73% (n=1289). The data were gathered by a mailed questionnaire and analysed statistically. According to the results mothers had fairly good opportunities to participate in decision making. However, there were statistically significant differences in opportunities between the women. The mothers who were most satisfied were aged 25–29 years, lived in a permanent relationship, had 12 years of basic education and had three children. Opportunities to participate in care have improved from the 1970s to the 1990s. The results have many implications for the development of nursing practice in maternity clinics and the deepening of the knowledge base in nursing education. The study, being the first national survey on this topic, also gives suggestions for further studies.
The use of clinical logs to improve nursing students’ metacognition: a pilot study
Authors: Fonteyn Marsha E. , Cahill Mary
Published: March 2003

The purpose of this study was to examine the effectiveness of the use of a reflective clinical log to improve students’ thinking strategies and metacognition (cognitive awareness). Rather than prepare a written nursing care plan prior to entering the clinical setting, students instead were asked to write in a clinical log at the completion of their clinical day, reflecting upon client problems that they had identified, the data that were used to identify these problems, the nursing interventions that were used, and the results of these interventions. The students reported that they preferred the use of a reflective log over writing nursing care plans and they felt that the logs improved their ability to think about their thinking (i.e. their metacognition). The results of this pilot study indicate that reflection in clinical logs assists students to become more active learners, to manage their own thinking, and to improve their metacognition. Additional research in this area is needed to confirm study findings and to provide further understanding regarding the effectiveness of clinical logs as a teaching strategy to improve students’ metacognition.
Caring and cancer nursing: framing the reality using selected social science theory
Authors: Kelly Daniel
Published: March 2003

Caring and cancer nursing: framing the reality using selected social science theory Despite the recent interest in caring for both academic and clinical nursing, the theoretical basis of this concept may appear somewhat elusive as the research and debate vary widely in their focus. As a result, the available literature may fail to consider the specific contextual issues which characterize caring as it is understood across different health care settings. Consideration of theory from disciplines close to nursing, it is suggested, may be useful in understanding the nature of such ‘real world’ caring. In this discussion the concept of caring within cancer nursing is explored by drawing on a number of social science and nursing sources. It is known that cancer provokes unique caring demands for nurses practising in this area. By examining the context of cancer, it is argued that effective caring deserves to be recognized as an important clinical variable which can influence a diverse range of issues such as patient satisfaction or therapeutic outcome. It is suggested that other nursing specialisms should also explore the psychosocial dimensions of caring in relation to their own role.
Significant elements of community involvement in participatory action research: evidence from a community project
Authors: Lindsey Elizabeth , McGuinness Liza
Published: March 2003

Significant elements of community involvement in participatory action research: evidence from a community project¶Participatory action research (PAR) has been heralded as an important research methodology to address issues of research relevance, community involvement, democracy, emancipation and liberation. Increasingly, nurse researchers are turning to PAR as a method of choice. Although nursing interest in PAR is expanding little is known about how to successfully involve the community in research. This article attends to this dearth of information by presenting the results of a study investigating the significant elements of community involvement in PAR. Through the use of qualitative research methods, five themes emerged that describe the community participation process: (a) planning for participation, (b) the structural components of community participation, (c) living the philosophy, (d) enhancing the credibility, and (e) the type of leadership required to facilitate community participation. It is hoped that by sharing these results others may consider the knowledge gleaned from this project as they plan and proceed with the challenges and rewards inherent in PAR.
Struggling for control: the care experiences of ‘difficult’ patients in mental health services
Authors: Breeze Jayne Ann , Repper Julie
Published: March 2003

Struggling for control: the care experiences of ‘difficult’ patients in mental health services¶ Although there is increasing recognition of the existence of ‘difficult’ patients who present particular challenges to mental health nurses, no research has been conducted into their perceptions of services and their experiences of care. This study identifies mental health service users who are defined by nurses as ‘difficult’ and explores their perceptions of their care experience. The results support earlier studies which suggested that ‘difficult’ patients challenge nurses’ competence and control: despite their different roles both nurses and ‘difficult’ patients were aware of the struggle to gain or retain a notion of control. Respondents were able to identify the qualities of nurses and nursing interventions which had a positive effect on their care experience. Where nurses were perceived to demonstrate respect, time, skilled care and a willingness to give patients some control and choice in their own care, feelings of anger were reduced. These findings are discussed within the conceptual framework of ‘power over’ and ‘power to’ and implications for practice and research are considered.