bluuebunny/crossref_metadata_2025 huggingface dataset:
An Exemplar of a Positive Perspective of Being Dependent on Care
Authors: Strandberg Gunilla , Norberg Astrid , Jansson Lilian
Published: November 2024

This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger data set derived from 10 patients, interviews with one severely ill patient, her daughter and two of her professional nurses were selected to illuminate a “positive” meaning of being dependent on care. The interviews were tape-recorded and transcribed verbatim and followed by interpretation of transcripts using a phenomenological-hermeneutic approach inspired by Paul Ricoeur’s philosophy. The interpretation discloses the meaning of being dependent on care as balancing between being free and negotiating when receiving care. Whether or not dependency on care is negotiated about seems to be about how the power that lies in the existing differences in ability is used. When ability, that is, power, is used to compensate inability, the patient appears free to be dependent on care. Dependency on care is accepted for what it is, when it is. When dependency on care is negotiated about, the differences in ability, that is, power, risk setting limits for what dependency on care is to be. There is a risk that dependency on care will be limited within the frame of what is regarded as polite, appealing and pleasing.
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 die 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.
Life-Span Development: Refreshing a Theoretical and Practice Perspective
Authors: Rankin Sally H.
Published: November 2024

Although the life-span development framework has been utilized by social scientists since the 1970s, the discipline of nursing is overdue in recognition and use of this theoretical and methodological framework. The framework’s unique focus on biological (normative age-graded), sociohistoncal (normative history-graded), and non-normative influences (events occurring out of synchrony) provides a constructive approach to research with both individuals and families.
The Relationship of Education and Moral Reasoning to Ethical Practice: A Meta-Analysis of Quantitative Studies
Authors: Ketefian Shaké
Published: November 2024

This meta-analytic article of quantitative studies is aimed at summarizing knowledge gained on ethical practice for the period of 1987 to 1997 and at suggesting directions for future research. It specifically investigated the relationships of education and moral reasoning to ethical practice, with ethical practice as the dependent variable. The sample consisted of eight studies that investigated the relationship between education and ethical practice, and five studies that addressed the relationship between moral reasoning and ethical practice. A small to medium relationship between education and ethical practice was found, with an overall mean for effect sizes,d =.44,p= .000. To test the relationship between moral reasoning and ethical practice the Pearson product moment coefficientrwas used as the effect size estimate, as each of the studies in this group reported correlation analyses. A small but significant relationship was found between moral reasoning and ethical practice (overallrof .2,p =.000). These results are evaluated in comparison to those of a decade earlier and overall trends are identified. As before, the majority of the studies are in the form of dissertations, and few of their authors have published their work in the general scientific literature. Similarly, clarity has not yet been achieved with regard to the conceptual and operational definitions of ethical practice. Theoretical, measurement, and policy issues are discussed in highlighting the implications of the study.
Feminism and Public Health Nursing: Partners for Health
Authors: Leipert Beverly D.
Published: November 2024

It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.
Development of Instruments to Measure Appraisal of Care Among Japanese Family Caregivers of the Elderly
Authors: Yamamoto-Mitani Noriko , Sugishita Chieko , Ishigaki Kazuko , Hasegawa Kiyomi , Maekawa Noriko , Kuniyoshi Midori , Hayashi Kunihiko
Published: November 2024

The purpose of this study was to develop two instruments for the evaluation of positive and negative appraisal of care among family caregivers of elderly Japanese care recipients within the framework of caregiver adaptation. The positive appraisal of care instrument (PAC) includes domains of relationship satisfaction, role confidence, consequential gain, and normative fulfillment. The negative appraisal of care instrument (NAC) includes domains of role exhaustion, isolation, relationship difficulty, and symptom management difficulty. The PAC and NAC are self-administered questionnaires and were developed from data collected from 337 family caregivers of relatives aged 65 years and over who were using visiting nursing services from 21 organizations in multiple areas of Japan. Out of 87 items, 21 PAC items and 14 NAC items were selected based on content and construct validity and internal consistency examination. Results show evidence of validity and reliability for the PAC and NAC, although some NAC domains may benefit from further refinement. The PAC and NAC will be useful research tools for examining elder caregiving experience and evaluating nursing care for elders.
Measuring Attitudes Toward Persons With AIDS: The AAS-G as an Alternate Form of the AAS
Authors: Froman Robin D. , Owen Steven V.
Published: November 2024

For most of the score of years that the Acquired Immune Deficiency Syndrome (AIDS) has been with us, we have been concerned with the care of and attitudes toward AIDS patients. As the treatment and face of AIDS changes, not all of those suffering with the disease are considered patients. Many are active community members, young and old, male and female. The AIDS Attitude Scale (AAS) is a widely used measure of health professionals’ attitudes toward persons with AIDS who are patients. That scale was developed with the intended audience of respondents being nurses or others dealing directly with AIDS patients. This research details the development and validation of an alternate form of theAAS, theAAS-G, intended for use with the general public. The AAS-G may be completed by lay members of the community and is not limited to assessing attitudes toward patients alone. Reliability and validity information, Classical Test Theory estimates and Generalizability Theory estimates for psychometrics on theAAS-Gare reported. These estimates are compared to the same estimates available for theAASin order to make informed decisions about the utility of the newAAS-G. TheAAS-Gappears to be a promising, efficient instrument for measuring the attitudes of lay individuals toward persons with AIDS.
The Development and Psychometric Testing of an Instrument to Measure Diabetes Management Self-Efficacy in Adolescents With Type 1 Diabetes
Authors: Moens Amber , Grypdonck Mieke H. F. , van der Bijl Jaap J.
Published: November 2024

Adherence to treatment is a major issue for people with diabetes mellitus, and attention has been given to improving self-management in persons with this chronic disease. Most studies show that knowledge alone will not improve self-management behavior. Self-efficacy, a concept introduced by Bandura, has been shown to be an important variable in improving health behaviors. In order to determine whether self-efficacy can influence self-management of diabetes, however, instruments to measure self-efficacy are needed in native languages at an appropriate developmental level, and with good psychometric properties. The study reported here was part of a larger project in the Netherlands, Belgium and the United States in which several instruments, measuring diabetes management self-efficacy, have been developed, both in English and Dutch, for different types of diabetes and different age groups. This article reports on the development and psychometric testing of an instrument measuring self-efficacy in adolescents with type 1 diabetes mellitus. Initially 30 items for the instrument were generated through focus group interviews and their relevance was judged by a team of 10 experts on self-management behavior in adolescents. The final instrument contained 26 items. The sample for psychometric testing consisted of 90 patients with type 1 diabetes who were between 12 and 18 years old. Cronbach’ s alpha of the instrument was 0.86. An exploratory factor analysis produced two factors which reflect general and more difficult diabetes self-management situations.
Self-Efficacy Targeted Treatments for Weight Loss in Postmenopausal Women
Authors: Dennis Karen E. , Tomoyasu Naomi , McCrone Susan H. , Goldberg Andrew P. , Bunyard Linda , Bing Qi Bing
Published: November 2024

Matching behavioral treatment programs to different types of obese clients is a rarely studied strategy, thus guidelines for identifying who might benefit most from which program remain elusive. This study categorized the weight control self-efficacy beliefs of obese, postmenopausal women, and determined the effects of self-efficacy targeted versus non-targeted (control) treatment on weight loss outcomes (body habitus, physical conditioning, affect, and eating behaviors). Obese (BMI 33 ± 5), postmenopausal (60 ± 6 years old) women (n= 59) participated in a 6-month weight loss program. The 37 women categorized by Q methodology as Assured (self-confident, independent) were randomized to Assured (AT) or Non-Targeted (NT) treatment; the 22 Disbelievers (doubtful, wavering) were randomized to Disbeliever (DT) or NT treatment. At baseline, the Assureds had significantly smaller body girths and reported significantly greater self-esteem, fewer symptoms of binge eating, and less negative affect overeating than the Disbelievers. Improvement in these variables with weight loss erased significant differences between the groups and was a desired outcome. Treatment delivery type may have influenced attrition rate, since significantly more Assureds dropped from NT than AT and significantly more Disbelievers dropped from DT than NT. Thus, the self-efficacy type may serve as a means to identify different types of treatment needs (flexible vs. rigid) to sustain women’s adherence and success in the program. The significant weight loss outcomes for women in all groups argues for the incorporation of strategies to enhance self-efficacy but not the need for specific treatments that directly target self-efficacy types.
An Intervention to Increase Quality of Life and Self-Care Self-Efficacy and Decrease Symptoms in Breast Cancer Patients
Authors: Lev Elise L. , Daley Karen M. , Conner Norma E. , Reith Margaret , Fernandez Cristina , Owen Steven V.
Published: November 2024

This study tested effects of a nurse-administered self-efficacy intervention given on five monthly occasions and designed to enhance patients’ self-care self-efficacy. The hypotheses were that at four months and eight months after beginning chemotherapy the efficacy-enhancing experimental group would have significantly higher scores on quality of life and self-care self-efficacy than the control group and significantly less symptom distress. Fifty-six women receiving chemotherapy for breast cancer were randomized to the experimental and control groups. Outcome variables were quality of life, measured by the Functional Assessment of Cancer Treatment-Breast (FACT-B), symptom distress, measured by the Symptom Distress Scale (SDS), and factors of self-care self-efficacy, measured by Strategies Used by Patients to Promote Health (SUPPH). The interaction effects for the FACT-B ranged from small for functional concerns (eta square = .03) to large for social concerns (eta square = .110); effects for the SDS were large (eta square = .140), and for factors on the SUPPH effect sizes ranged from small (eta square = .01) for Enjoying Life and Stress Reduction to medium (eta square = .089) for Coping, and large (eta square = .141) for Making Decisions. Interventions to promote self-efficacy may increase quality of life and decrease symptom distress for women diagnosed with breast cancer.
Perspectives on Knowing: A Model of Nursing Knowledge
Authors: Jacobs-Kramer Maeona K. , Chinn Peggy L.
Published: November 2024

In the premiere issue ofAdvances in Nursing Science(October, 1978), Barbara Carper detailed a typology of nursing knowledge. Carper’s ideas have been appreciated and commented upon extensively in the nursing literature, with little extension of her work. This article describes a model of nursing knowledge that builds from Carper’s initial formulation. The model begins with an interpretation of Carper’s four original knowledge patterns: empirics, ethics, esthetics, and personal. Each pattern is considered in relation to: (1) developmental processes and product outcomes associated with its creation; (2) expressions of the pattern; and (3) process context for assessing credibility of knowledge associated with the pattern. The position taken is that all knowledge patterns must be integrated to enable deliberate clinical choices. A failure to integrate knowledge patterns impedes choice and produces negative care outcomes.
Theory Development in Community Health Nursing: Issues and Recommendations
Authors: Hamilton Patricia A. , Bush Helen A.
Published: November 2024

Although community health nursing celebrated its centennial in this country in 1986, a lack of conceptual clarity and a relative paucity of theory development persist in this field of nursing. Without conceptual clarity regarding the nature of community health nursing, progress in theory development in the field will encounter significant barriers.

Progress can be aided by systematic analysis and critique of a variety of strategies for developing community health nursing theory. This article focuses on the consequences of initiating community health nursing theory development from the points of view of theory, practice, or research. In addition, eight sources of ideas and data relevant to community health nursing are proposed.
Virtue Ethics, Caring, and Nursing
Authors: Brody Jane K.
Published: November 2024

Virtue ethics is proposed as an alternative method for evaluating nursing practice. Unlike deontological and utilitarian ethical theories, which center on the action and outcome of moral behavior, respectively, virtue ethics focuses on the nature of the agent as the determining factor in analyzing ethical conduct. A historical development of virtue ethics traces its religious roots, its fall from favor by moral philosophers, and the renewed interest in the field.

Caring is identified as the central virtue for nursing. Three perspectives on the virtue of caring are presented: virtue as an attribute; virtue as individual actions reflective of the agent’s nature; and virtue as meeting the obligations of role. The implications of each for nursing practice are explored.

If nursing is to be considered virtuous, caring must be demonstrated through the care given by nurses. This is a professional commitment toward which nurses must work collectively.
Critical Theory: A Foundation for the Development of Nursing Theories
Authors: Holter Inger M.
Published: November 2024

The increasing awareness of the importance of establishing a philosophical foundation for the development of nursing theories has led to an evaluation of the philosophical orientations which implicitly, if not explicitly, form its current basis. This article questions whether empiricism and phenomenology, two popular philosophical orientations in nursing literature, are appropriate as foundations for theory development given the holistic nature often ascribed to nursing. A further question is raised as to whether or not the above orientations have led to a gap between nursing practice and nursing theory development. Critical theory, as propounded by Jurgen Habermas, is delineated and proposed as a more appropriate theoretical foundation for nursing theory development due to its holistic orientation.
Emergency Department Nurses’ Encounters with Suicide Attempters: A Qualitative Investigation
Authors: Pallikkathayil Leonie , Morgan Susan A.
Published: November 2024

This article describes the encounters of 20 emergency department (ED) nurses with suicide attempters obtained from semistructured interviews, producing the following findings. ED nurses’ contact with suicide attempters often generated angry feelings toward the attempters and stimulated thoughts about the suicidal act, the suicidal individual, suicidal intent, and themselves. ED nurses dealt with their feelings and thoughts through a range of behaviors such as nursing assessments or interventions, self-care behaviors, conditional responses, and nontherapeutic behaviors. They reported inadequate time and staffing, abusive behavior by the attempter, ineffective disposition or follow-up, value conflicts, and the dynamics of the attempter’s family as frequent stressors in caring for suicide attempters, and suggested increasing knowledge and using resource persons as potentially helpful strategies for decreasing stress. Finally, the nurses’ opinions about suicide attempters centered on values, the attempters themselves, the suicidal act, and intervention.
Environmental Lighting, Behavioral State, and Hormonal Response in the Newborn
Authors: Grauer Theodora T.
Published: November 2024

This experimental study was designed to investigate the effects of constant and intermittent light on newborn infants. Changes in levels of salivary cortisol were utilized as indications of increased pituitary-adrenal activity. The sample consisted of 99 babies who were classified as state predominance sleep (Group A) babies or state predominance awake (Group B) babies following a 3-hour observation period for each infant. The experimental group was subjected to intermittent light and the control group to constant overhead lighting on two consecutive nights. A 2×2 ANOVA utilizing absolute change salivary cortisol scores revealed a statistically significant interaction between light and state. The findings suggest that the effects of different light conditions are related to individual response differences. In intermittent light, the absolute change salivary cortisol scores may reflect a previously assumed unobservable cortisol rhythmicity in Group B babies and a diminution of stress in Group A babies.
Self-Reports of Differentiation of Self and Marital Compatibility as Related to Family Functioning in the Third and Fourth Stages of the Family Life Cycle
Authors: Richards Eleanor
Published: November 2024

Using Bowen’s, Olson’s, and general systems frameworks, this investigator tested relationships among individual, marital, and family functioning in the stressed childrearing stages of the family life cycle. Sixty volunteer married couples completed the Level of Differentiation of Self Scale (LDSS), Locke-Wallace Marital Adjustment Test(MAT), and Family Adaptability and Cohesion Evaluation Scales (FACES) III. A significant canonical correlation was found among differentiation of self and marital compatibility as they both relate to family functioning. Subsequent canonical correlations were significant for wives but not for husbands, indicating gender differences in relationships among perceived individual, marital, and family phenomena. The concept of adaptability as proposed by Olson’s Circumplex Model of Marital and Family Functioning was not supported. A revised model is proposed.
Recovery: A Phenomenon Extending Beyond Discharge
Authors: Baker Carol A.
Published: November 2024

The purpose of this study was to conceptualize and order theoretically the process of recovery. Intensive telephone interviews were carried out at 2, 4, and 6 weeks postoperatively to elicit descriptions of postdischarge experiences from 25 subjects who had experienced uncomplicated hospitalizations for cholecystectomy surgery. Post-discharge recovery was a process of returning to normal as defined by preillness comparative standards of physical, social, and psychological well-being that progressed sequentially in three phases: passivity, activity resumption, and stabilization. Decisions concerning phase progression were made by integrating physiological and health professional cues with self-imposed and situational pressures. Subjects who perceived negative physical symptoms, especially fatigue, and who were unable to respond to pressures expressed frustration with the recovery process. Implications for nursing practice include providing patients with individualized anticipatory guidance and interventions that build endurance.
Infant Care Self-Efficacy
Authors: Froman Robin D. , Owen Steven V.
Published: November 2024

As attention in health care turns to prevention and health promotion, identification of populations at risk for avoiding care becomes increasingly important. The Infant Care Survey (ICS) is a scale to assess self-efficacy expectations for infant care tasks.

Reliability and validity estimates for the ICS are supportive. Descriptions of content, factorial, and construct validation are given. Finally, ongoing research is described, and suggestions for use of the ICS are offered.
Valsalva Response During Progressive Relaxation: An Extension Study
Authors: Herman JoAnne
Published: November 2024

This was the second study in a series to investigate the impact of muscle-tension time and breathing pattern on initiation of the Valsalva response during four tense/relax cycles of progressive relaxation. Thirty-three healthy adult subjects performed the hand, upper arm, forehead, and abdomen tense/relax cycles of a standard progressive relaxation procedure while their heart rate and breathing patterns were monitored. Occurrence of the Valsalva response was determined by dividing peak tachycardia during tension by maximum bradycardia following release of the tension. A Valsalva ratio greater than 1.5 indicates presence of the Valsalva response. Eighteen percent of the sample exhibited a Valsalva ratio score > 1.5 in one or more of the tense/ relax cycles. In a previous study, 43% of the subjects exhibited the Valsalva response. When compared with the findings of the previous study, these present findings indicate that controlling breathing pattern and decreasing tensing time may decrease the occurrence of the Valsalva response during progressive relaxation.
Responsible Subversion: A Study of Rule-Bending Among Nurses
Authors: Hutchinson Sally A.
Published: November 2024

The purpose of this qualitative field research was to explore and describe how nurses bend the rules for the sake of the patient. Responsible subversion is the construct that describes such behaviors. The research purpose and initial data were derived from participant-observation and interview data from a study of unprofessional behavior in hospital-based nurses. In-depth interviews with 21 nurses from four clinical areas provided additional data. The grounded theory method was used for data analysis. Data analysis revealed that given certain conditions—knowledge, ideology, experience—nurses engaged in responsible subversion. Responsible subversion involves four phases: (1) evaluating, (2) predicting, (3) rule-bending, and (4) covering. This conceptualization raises important issues in the area of ethics and the socialization of nurses.
The Relationship of Attitude, Subjective Norm, and Behavioral Intent to the Documentation Behavior of Nurses
Authors: Renfroe Darlene H. , O’Sullivan Patricia S. , McGee Gail W.
Published: November 2024

Ajzen and Fishbein’s theory of reasoned action was used to assess the relationship of nurses’ attitude, subjective norm, and behavioral intention to their documentation behavior. Attitudes, subjective norms, and behavioral intentions toward documentation were elicited from 108 staff nurses. Documentation behavior was based on what should be documented inartyhospitalized patient’s chart during a shift.

This exploratory model was analyzed with LISREL VI. The overall fit of the final model to the data was good, as judged by a chi-square (df= 7,p= .845). The total coefficient of determination for the structural equation was .461.

Attitude toward documentation did not relate significantly to intention to document optimally. Subjective norm did have a significant effect on behavioral intent. Attitude and subjective norm accounted for 46.1% of the variance in behavioral intent. Behavioral intent had a significant effect on documentation behavior, accounting for 15.2% of the variance.

It appears that subjective norm, which is the influence of others, is what directs the intention to document and thus relates to subsequent documentation. Recommendations for practice include the communication of high ideals and expectations of important others to the staff nurse in order to improve the quality of documentation.
Violent Psychiatric Inpatients in a Public Hospital
Authors: Morrison Eileen F.
Published: November 2024

Violence in inpatient psychiatric settings is a clinically significant and relevant problem requiring attention by the psychiatric community. Despite the prevalence of research on violent behavior, few nursing studies have been conducted that explore the components of nursing care that may influence the amount of violence occurring in inpatient psychiatric settings. The purpose of the study was to identify the characteristics of violent patients and the components of nursing care that are related to violent patient behavior.

A qualitative study was conducted using participant observation and grounded theory methodology. Data were collected in a metropolitan public hospital over a 9-month period. Six categories of violent patients were identified during data analysis: (1) the user, (b) the outlaw, (c) the rebel without a cause, (d) the little big man, (e) the child, and (6) the vamp. Implications of the study for clinicians working in inpatient psychiatric settings are discussed.
Personal Control and Other Determinants of Psychological Well-Being in Nursing Home Elders
Authors: Bowsher Juanita E. , Jo Gerlach Mary
Published: November 2024

The purpose of this correlational study was to identify predictors of psychological well-being in nursing home elders. Predictors considered were two dimensions of personal control, physical health, functional health, socioeconomic status, length of stay in the nursing home, and interaction variables. The nonrandom sample consisted of 302 cognitively intact nursing home elders with poor to excellent self-rated physical health. Instruments used included the Life Satisfaction Index A, Affect Balance Scale, Desired Control Measure, The Index of Activities of Daily Living, and The Two Factor Index of Social Position. Regression analysis demonstrated that dimensions of personal control and self-rated physical health explained 33% (p<.001) of the variance of psychological well-being. Findings suggested predictor variables to guide the promotion and maintenance of psychological well-being in the subjects of this sample.
Determining Cold-Stress in Full-Term Newborns Through Temperature Site Comparisons
Authors: Bliss-Holtz Jane
Published: November 2024

A secondary analysis of data from 120 full-term infants was performed to determine whether temperature relationships between sites could be used to identify cold-stress prior to core temperature decrease. Axillary and rectal temperature readings were taken every 30 seconds with standardized mercury-in-glass thermometers, and the highest reading for axillary and rectal temperatures was used in data analysis. Three groups were identified when temperature site readings were compared: infants whose rectal temperature was higher than their axillary (group 1), infants who had equal axillary and rectal temperatures (group 2), and those whose axillary temperature was higher than the rectal reading (group 3). Further findings from data analysis suggested that infants whose rectal temperatures were within normal limits were either in a relatively neutral environmental state (group 1) or were maintaining their core temperatures through brown adipose tissue metabolism (group 3).
Nurses’ Experiences Giving Postmortem Care to Patients Who Have Donated Organs: A Phenomenological Study
Authors: Wolf Zane R.
Published: November 2024

This study examined nurses’ experiences in giving postmortem care to organ donors. A descriptive, phenomenological approach was used. Operating room, organ procurement agency, and critical care nurses were interviewed; audiotaped interviews were transcribed verbatim. Text-based analysis according to Colaizzi’s (1978) approach was employed. Postmortem care took place in the context of the gift of the organs by the family, the tragedy of traumatic injury and resulting brain death of a young, healthy person, and procurement surgery. Nurses were saddened by the death of a donor, and viewed postmortem care as the opportunity to achieve closure with the patient. Nurses became temporary kin with the family and the patient. They respected the body, and saw giving after-death care as providing comfort even after death. As they cared for the patient throughout the experience, nurses confronted the dilemma of maintaining the brain-dead patient on life support until donor surgery.
Adaptability: A Personal Resource for Health
Authors: Jones Patricia S.
Published: November 2024

Adaptation theories from the social and biological sciences have served well as building blocks for theory development in nursing. Recent consideration of the theories and their assumptions, however, has pointed to incongruencies with broadened conceptualizations of health and well-being. This paper reviews the development of stress, adaptation, and coping theory, and identifies congruencies and inconsistencies with the mission of nursing. The concept of adaptability is presented as a personal resource for health and self-care, a positive force for change, and empowerment for growth.
The Trajectory of Cancer Recovery
Authors: Dorsett Diane S.
Published: November 2024

In response to the Corbin and Strauss illness trajectory framework, this paper offers arecovery modelas a more relevant trajectory for cancer as a specific chronic disease and as a general framework for clinical science. As counterpoint, the course of recovery is considered as a separate but influential continuum vis-á-vis the course of illness. The text presents an overview of the nature and meaning of cancer as a chronic disease, an operational definition of the recovery model, and a comparison and contrast of the illness and recovery trajectory frameworks in terms of their philosophic nature, therapeutic approach and research and educational and health policy-making emphases with regard to the cancer experience. When fully grounded in recovery science, the recovery trajectory model is predicted to be the more therapeutically effective clinical approach for professionals who care for patients diagnosed with cancer and their families.
Applying the Chronic Illness Trajectory Model to HIV/AIDS
Authors: Nokes Kathleen M.
Published: November 2024

The Corbin and Strauss chronic illness trajectory model is particularly helpful in explaining the different phases of HIV (Human Immunodeficiency Virus) disease, since this infectious process is characterized by both phases and subphases. The model is not particularly helpful in identifying when the illness trajectory begins, since the model starts with the onset of symptoms, and HIV disease is characterized by a long, symptomless phase. The importance of politics and economics is also underestimated when applying this model to HIV disease. While this model presupposes the existence of support systems as being significant others, HIV disease is unique in that whole family systems may be eliminated by this infectious process, i.e., the typical pattern of HIV disease in the 1990s is that of a father dying from AIDS, a mother sick with HIV disease, one or more siblings infected, and one or more siblings coping with tremendous losses at a very young age.
Chronic Mental Illness: The Timeless Trajectory
Authors: Rawnsley Marilyn M.
Published: November 2024

Mental illness encompasses many dimensions. While the etiology of most major disorders remains unclear, their devastating effects are readily apparent. The substantive and practical value of the trajectory model of chronic illness is examined in relation to the characteristics of major mental disorders. Two clinical vignettes illustrating the timeless trajectory of chronic mental illness are analyzed with reference to the model’s components. The potential utility of this model for revitalizing research and practice in psychiatric-mental health nursing is discussed.
Quantification of the Effects of Listening to Music as a Noninvasive Method of Pain Control
Authors: Whipple Beverly , Glynn Nahama J.
Published: November 2024

This study quantified the effects of listening to music as a noninvasive nursing method of pain control. The effects of soothing and stimulating music on pain and tactile thresholds, heart rate, and blood pressure were determined on healthy female volunteers (N = 10) in a laboratory setting. Data were analyzed by ANOVA for repeated measures and post hoc comparison tests. Soothing music significantly elevated pain thresholds but not tactile thresholds. Stimulating music significantly elevated pain thresholds as well as tactile thresholds. Neither stimulating nor soothing music had a significant effect on autonomic activity. Based on the results of this laboratory study and other studies, the effects of listening to music on people in pain warrants further examination.
A Critical Review of Prenatal Attachment Research
Authors: Muller Mary E.
Published: November 2024

Prenatal attachment is a construct not only intriguing for nurse researchers, but also the object of attention from the lay public and popular media. Promoting prenatal attachment is assumed to have benefits particularly for children. Pregnant women are admonished that development of a successful mother-child relationship begins before birth and is their responsibility. The prenatal attachment research literature was reviewed to determine if the last statement could be supported. The current state of this body of literature is presented in this article along with a critique of the research studies and suggestions for future research.
Caregiving Demands: Their Difficulty and Effects on the Well-Being of Elderly Caregivers
Authors: Wallhagen Margaret I.
Published: November 2024

Nurses assess situations involving elderly caregivers, yet data conflict on how caregivers perceive caregiving demands. To develop appropriate research-based interventions, more data are needed on specific aspects of these demands. Discussed are data from interviews with 60 elderly caregivers regarding tasks and personal demands. Results suggest that personal demands are perceived as more difficult than task demands and are associated to a greater extent with caregiver life satisfaction and depression. Issues are raised, however, regarding the measurement of expressed difficulty. Findings also support the adaptive capacity of these caregivers and their commitment to the caregiving role. Implications for nursing practice and nursing science are discussed.
Caring, Virtue Theory, and a Foundation for Nursing Ethics
Authors: Salsberry Pamela J.
Published: November 2024

The purpose of this paper is to critically examine the use of a framework of virtue theory as a foundation for a nursing ethic embodied in the caring ideal. The first section summarizes the problems identified with traditional moral theory as a foundation for a nursing ethic based on the caring ideal. From these problems, adequacy conditions that a foundation must meet are identified. In section two, the basic ideas of virtue theory are sketched and an account of how virtue theory can be used as a foundation for a nursing ethic based on the caring ideal is discussed. Finally, virtue theory as a foundation for a nursing ethic à la caring is assessed against the adequacy conditions delineated in section one. The conclusion of this paper is that virtue theory does not offer a viable alternative to duty-based theories. While virtue theory provides promise in meeting the identified adequacy conditions, serious secondary issues arise that can not be immediately nor easily resolved.
Physiological Nursing Research in Dyspnea: A Paradigm Shift and a Metaparadigm Exemplar
Authors: Breslin Eileen H. , Roy Callista , Robinson Connie R.
Published: November 2024

Dyspnea, the primary activity-limiting symptom in chronic obstructive pulmonary disease, is associated with respiratory muscle mechanisms. This leads to a paradigm shift from pulmonary processes to respiratory muscle function. Within the context of an integrative metaparadigm, basic and clinical nursing science are developed: to better understand physiological processes associated with dyspnea as presented in three physiological models of dyspnea, to identify respiratory muscle mechanisms associated with current treatment strategies for dyspnea, to eventuate clinical assessments of exercise endurance, and to generate treatment strategies in the promotion of positive life processes. The basic knowledge developed within this program provides a foundation for the generation of strategies to assess patients, to promote normal functioning of life processes, and to enhance positive coping with responses to illness. Thus, this research program provides a model for the development of substantive physiological and clinical knowledge for nursing practice.
1 Who Gets Care? Access to Health Care as an Arena for Nursing Action
Authors: Stevens Patricia E.
Published: November 2024

Access to health care in the United States is undeniably inequitable. What should nurses do in the face of increasing gaps in availability of services? The author addresses this question by framing access to health care in its broadest sociopolitical context, positing that access to care is an essential dimension of nursing theory, research, and practice. By offering a conceptual definition of equitable access, providing rationale for the significance of this concept, and critically exploring conditions that limit access to affordable, high quality, nondiscriminatory health care in the U.S., the author lays theoretical groundwork for more effective investigatory and practical action to assure equitable access.
Unwritten Knowledge In Nursing: Consider the Spoken as Well as the Written Word
Authors: O’Brien Bart , Pearson Alan
Published: November 2024

Knowledge has been defined as familiarity gained by experience or a person’s range of information and theoretical understanding (Sykes, 1982). The distinction is made to avoid confusion with the knowledge of scientism (Bullock, Stallybrass, & Trombley, 1988), where true or factual knowledge is held to be derivable only from the inductive methods of the natural sciences. Knowledge has its origins in a broader field of understanding than that of empirical measurement.
The Common Sense Model: An Organizing Framework for Knowledge Development in Nursing
Authors: Ward Sandra E.
Published: November 2024

The common sense model emphasizes the importance of persons’ perceptions or beliefs about their health and illness, and has potential for guiding knowledge development in nursing. This paper describes the model, reviews the existing relevant literature, and organizes the literature within the framework of the model. Suggestions are made as to how the model can be used for further research in nursing.
Nurse Practitioner-Patient Discourse: Uncovering the Voice of Nursing in Primary Care Practice
Authors: Johnson Rosemary
Published: November 2024

This study focused on nurse practitioner-patient conversations. The purpose was to uncover a process that might contribute to understanding the positive outcomes of nurse practitioner (NP) care. Transcripts from 24 audiotaped NP-patient conversations and three NP-researcher interviews, as well as 100 hours of field notes from observations, were analyzed using a combination of discourse and ethnographic analysis.
A Construct Validity Study of a Differentiation of Self Scale
Authors: Haber Judith
Published: November 2024

The purpose of this study was to establish construct validity of the Haber Level of Differentiation of Self Scale (LDSS) that measures selected aspects of the construct, differentiation of self, the key concept of the Bowen Theory. During stage one of this study, a 32-item Likert-type LDSS, which contained two subscales, Emotional Maturity, (EM), and Emotional Dependency (ED), was administered to 372 volunteer subjects. Factor analytic and correlational findings indicated support for a 24-item unidimensional rather than a 32-item two subscale instrument. Recalculation of coefficient alpha (.90) also supported the unidimensional structure of the LDSS. During stage two of this study, the revised 24-item LDSS was administered to 372 volunteer subjects, who also completed the State-Trait Anxiety Inventory, the Life Experience Survey, and the Behavior Checklist. Hypotheses predicted that there would be negative relationships between differentiation of self and trait anxiety, state anxiety, adult psychological dysfunction, and negative impact stress. Findings indicate support for all hypotheses at thep< .01 level of significance or greater. Data from this study suggest that the 24-item LDSS is a valid and reliable unidimensional family assessment tool that accurately measures specific aspects of the construct, differentiation of self. The LDSS can be used by nurses and other professionals to assess individual and family functioning in a variety of health care settings.
Experienced and Skilled Nurses’ Narratives of Situations Where Caring Action Made a Difference to the Patient
Authors: Åström Gunilla , Norberg Astrid , Hallberg Ingalill R. , Jansson Lilian
Published: November 2024

Forty-five skilled and experienced nurses working at long-term, medical and surgical care clinics narrated 88 caring situations. The aim of the study was to interpret these narratives concerning the nurses’ caring actions and the type of situations where they experienced that their caring made a difference to the patient. There were eight types of caring actions that were then condensed into three interaction and intervention approaches; 1) deliberate distanced interaction and intervention with the patient; 2) deliberate providing of prerequisites for interaction and intervention with the patient; and 3) deliberate deep interaction with the patient when intervening. These approaches were used when the nurses dealt with the following three types of caring situations: caring focusing on the nurse-patient relationship, on medical intervention, and on practical problem solving. The first two approaches occurred in situations focusing on acute medical intervention and on practical problem solving. All approaches occurred in situations focusing on the nurse-patient relationship. The finding that experienced and skilled nurses described situations where the depth of their contact with the patient varied can be expressed in the phrase “how I act depends on the situation.” The skill to find the right level of involvement seems important.
Women Recovering from Coronary Artery Bypass Surgery
Authors: Hawthorne Mary H.
Published: November 2024

Coronary heart disease is the leading cause of death among American women over 50, and women are undergoing surgical revascularization procedures in ever increasing numbers. There are, however, little research-based data upon which to guide the nursing care of these patients. This study explored the nature of the recovery process for women following coronary bypass surgery in order to extend our understanding of the posthospitalization phase of the recovery trajectory. Ten patients participated in semi-structured interviews that were analyzed using thematic analysis. Data reveal significant problems with caregiver recognition and access to care. Barriers to care may also exist due to women’s traditional subordinate role in American society and their use of gender specific interactive skills. Recovery for women was found to differ significantly from that: of men due to the later developmental stage when women are more likely to experience cardiac illness.
Nursing as Aesthetic Experience and the Notion of Practice
Authors: Katims Ide
Published: November 2024

The notion of practice, traditionally understood as the creative and skillful application of knowledge, can be broadened if nursing caregiving is viewed as a lived aesthetic experience. The philosophical connection between practice and aesthetic experience is rooted in the professional values of care and excellence. The Aristotelian meanings ofpraxis, the notions of which include skillful action, excellence in conduct, and moral and political accountability are explored. These foundational values of nursing, the “felt” qualities of which are richly aesthetic, conduce an experience that is capable of intensifying and furthering meaning, and bringing about heightened awareness of consummatory ideals. Nursing practice, then, is open to a whole new interpretation: one that bears the gift of the real possibility for a unified experience — an experience that would integrate one’s senses, thought, action, and the meaning and value of one’s work. This way of understanding the idea of practice provides a useful alternative in thinking about nursing work, professional life, and the professional community.
Practice Theories in Nursing and a Science of Nursing Practice
Authors: Kim Hesook S.
Published: November 2024

The claim that knowledge about clients, client problems, and nursing therapeutics is enough to make nursing practice scientific is refuted on the basis that practice theories in nursing must encompass not only theories addressing these aspects but also those dealing with practice issues pertaining to the nurse-agent in action. A comprehensive framework specifying two dimensions of focus for practice theories is proposed to examine different types of practice theories in nursing and it is further used to frame a science of nursing practice as a subset of nursing science at large. Knowledge development for a science of nursing practice is then examined within four possible paradigms founded on different ontological and epistemological views.