bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining The Psychological Experiences of Infertile Couples with Adopted ChildrenMarieh Dehghan(Ph.D.)1, Mohammad Hossein Fallah(Ph.D.)2, Najmeh Sedrpoushan(Ph.D.)3,
Authors: Dehghan Marieh , Fallah Mohammad Hossein , Sedrpoushan Najmeh , Mohammadi Fatemeh
Published: November 2024

Introduction: Having children has always been the best way to complete the family and evolve the couple's identity. Couples who were unable to have children due to infertility have used alternative paths. The aim of the present study was to investigate the psychological experiences of infertile couples with adopted children in Yazd.
Methods: This study was of a qualitative type, with an exploratory nature. 18 infertile couples suffering from hormonal disorders, anatomical problems, infections and old age in women and sperm disorders and infections in men, who did not have children and had adopted children through the welfare of Yazd city, were identified in 1401 by targeted sampling method. And with a semi-structured interview, their information was collected, recorded and recorded and reached complete saturation.
Rusults: The analysis of the lived experiences of the participants showed that out of a total of 154 semantic units, 10 main themes were obtained: accepting the role of parenting; infertility difficulties; encouraging the idea of adoption; difficulties and failures following adoption; Successes and facilitators following adoption; educational challenges and characteristics of adopted children; experiencing a crisis when a child enters the house; interactions with others; and matching tools; psychological changes in family life and relationships.
Conclusion: Psychological changes in life and family relationships are one of the most important experiences of infertile couples. Lack of awareness and treatment can cause problems for the mental health of couples. It is suggested that therapists and counselors interpret the life experiences and psychological changes of people more deeply and use the themes obtained in this research in therapeutic interventions.
A Comparative Study of Legal Regulations on the Distribution and Use of High-Sugar Packaged Beverages in Indonesia and Singapore to Protect Consumers
Authors: Sandy Dhammawan Yosua , Sewu Pan Lindawaty Suherman
Published: November 2024

The ease of purchasing packaged beverages can impact public health, especially when there is little information available about the health risks of high-sugar drinks. This study compares the laws regulating high-sugar beverages in Indonesia and Singapore to suggest improvements for Indonesian regulations. With growing awareness of health issues related to food and drink consumption, this research examines the effectiveness of existing regulations and aims to strengthen consumer protection. The study highlights the importance of clear and honest product information through an analysis of Indonesia's Consumer Protection Law and Health Law No. 17 of 2023. Suggestions include adopting measures like Singapore’s Nutri-Grade system and sugar taxes to raise public awareness and reduce risks of non-communicable diseases. This research aims to provide recommendations for Indonesia's health policies to enhance the quality of life for its people.
(Re)Positioning the Swahili Language in Cultural Diplomacy Under the Capacity of African Ubuntu In Tanzania
Authors: Lembuka Meinrad Haule
Published: November 2024

The article used the documentary analysis method guided by the Ujamaa Intersections Model in (re) positioning the Kiswahili language in cultural diplomacy through the Ubuntu Panorama. Ujamaa is among the core values of African Ubuntu that was integrated into Tanzania’s policy framework in the 1960s under the influence of the Kiswahili language. Kiswahili is among the oldest and major lingua franca in African history, despite being undocumented in Ubuntu capacity it has a direct linkage with African Ubuntu throughout the history of the continent. Tracing back, Ubuntu is an African philosophy from pre-colonial times that guides all the major aspects of the continent including social economic, cultural, and political. Dr. Julius Kambarage Nyerere (Ubuntu Champion 2014) (who preferred to be called Mwalimu meaning a teacher) embraced Ubuntu philosophy through the Kiswahili language as a soft tool to spread Ujamaa into cultural Diplomacy in Africa and beyond. Dr. Nyerere engaged existing Ujamaa intersections in the community to develop, maintain, and promote the Kiswahili language ultimately influencing the international platforms. In the African Ubuntu capacity, a community is made up of various Ujamaa Intersections comprising primary family, extended families, neighborhood, local leadership, ecology, spirituality, and wider attributions, etc. Over time, Kiswahili became a tool for the decolonization, unification of Africa, and related cultural diplomacy. To mention a few, Kiswahili was the first African language in the United Nations and later it secured various positions as a working language in international organizations including EAC, SADC, COMESA, AU, UNESCO, etc. Moreover, Kiswahili entails more than 200 million speakers Worldwide, several countries have established Swahili radio stations including Germany, Japan, the UK, China, and the USA, etc. To date, Kiswahili continues to render opportunities toward transmission, acceptance, inclusion, hospitality, humanism, peace, equality, love, and coexistence of cultural diversity relevant to nurture cultural diplomacy. It represents African Ubuntu in cultural diplomacy with the relevant capacity to speak about Africa's past, present, and sustainable future in international relations.
Edaravone’s Hepatoprotective Effects Against Oxidative Stress in Valproic acid –induced rat model
Authors: Hacıhasanoğlu Çakmak Neziha , Yanardağ Refiye
Published: November 2024

In this experimental study, the effect of edaravone (EDA) on liver damage caused by valproic acid (VPA) was investigated. The antioxidant, oxidative stress, and inflammation indicators such as glutathione (GSH), total lipid (TL), sialic acid (SA), aspartate (AST) and alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione-S-transferase (GST) were examined. Male Sprague Dawley rats were used in the experiment and randomly divided into 4 groups. The experiment lasted for 7 days. Group I: control group rats; Group II: rats receiving 0.5 g/kg VPA intraperitoneally daily. Group III: rats receiving 30 mg/kg EDA intraperitoneally daily. Group IV: rats receiving 0.5 g/kg VPA and 30 mg/kg EDA intraperitoneally daily (at the same time). On day 8, all animals were sacrificed under anesthesia, and liver tissues were removed. VPA caused the decreases in GSH, CAT, SOD, GPx, GR, and GST values and the increases in AST, ALT, ALP, GGT, sialic acid, and total lipid values. EDA reversed the in all values. These results suggest that EDA administration potentially reduces liver injury in VPA-induced hepatotoxicity.
Clinical and neurological specifics of the vertebrogenic lumbosacral radiculopathy course in the patients with RS1143627 polymorphism of the IL-1β gene
Authors: Statinova Elena A. , Fominova Natalya V. , Kishenya Maria S.
Published: November 2024

Rationale: Vertebrogenic lumbosacral radiculopathy (VLSRP) is a consequence of exposure to physical exertion, back injuries, and smoking. Genetic polymorphism of the cytokine IL-1β contributes to the progression of VLSRP due to its increased production in certain genetic variants.
Aim: To establish an association between the rs1143627 polymorphism of the IL-1β gene with VLSRP, as well as with clinical and neurological specifics of VLSRP during its treatment.
Methods: The study involved 121 patients with VLSRP aged 22 to 66 years (median, 41 [35; 49] years; men, 110 (90.91%)), treated in the in-patient Department of Neurology from January 2023 to February 2024, and 100 age- and gender compatible healthy subjects. Based on the results of clinical and neurological assessments, the indices of the Digital Rating Scale, Oswestry and Roland-Morris questionnaires were determined. The rs1143627 polymorphism was identified by real-time polymerase chain reaction (IQ5 amplifier (Bio-Rad, USA)) with the SNP-express (IL-1β-31C/T) test system (Litech, Russia).
Results: VLSRP was associated with the distribution of alleles (χ2 = 3.93; p = 0.049) and genotypes according to the dominant model (χ2 = 4.7; p = 0.032) of the rs1143627 polymorphism of the IL-1β gene. The minor T allele increased the odds ratio for VLSRP (OR 1.51; 95% CI 1.004–2.26) in the dominant model; the sum of CC + CT genotypes was also associated with increased VPSRP odds ratio (OR 1.814; 95% CI 1.056–3.115). The DRS scores under treatment showed the significant predominance of pain in the T (CT + TT) allele carriers (p 0.001). As assessed by the Oswestry and Roland-Morris questionnaires, the minor T allele in CT + TT genotypes demonstrated prevailing everyday life activities and less effective results after a treatment course (p 0.001). In the study subjects of ≤ 41 years of age, the multiplicative model showed a higher risk of VLSRP with the minor T allele by 1.8-fold (OR 1.80; 95% CI 1.02–3.19). In the dominant model, the sum of genotypes with the minor T allele (CT + TT) was associated with a 2.23-fold higher risk of VLSRP (OR 2.23; 95% CI 1.05–4.72).
Conclusions: We were able to find the association between the rs1143627 polymorphism of the IL-1β gene with VLSRP, with a higher risk of the disease in the patients of ≤ 41 years of age, higher DRS, Oswestry, and Roland-Morris questionnaire scores, which was related to the presence of a minor T allele and CT + TT genotypes.
Relationship between Empathy and Burnout Levels of Professionals Working in Special Education and Rehabilitation Centers
Authors: Kaçan Havva , Sakız Halis
Published: November 2024

Objective: The aim of this study is to examine the relationship between empathy and burnout levels of professionals working in special education and rehabilitation centers.
Method: The sample of this descriptive-correlational study included 120 employees who agreed to participate in the study and worked in three special education and rehabilitation centers located in a city center in Northern Turkey in the 2022–2023 academic year. Data were collected using an employee identification form, the Emphatic Tendency Scale (ETS) and the Maslach Burnout Inventory (MBI).
Results: Empathic tendency increased the level of emotional exhaustion (ß =.558) and depersonalization (ß =.516) but decreased the level of sense of personal accomplishment (ß=-0.655). There was a significant positive moderate relationship between the ETS score and the MBI emotional exhaustion and depersonalization subdimension scores and a significant negative moderate relationship between the feeling of personal accomplishment subdimension of MBI.
Conclusion: High empathy in employees can improve the quality of support provided to students with special needs, but it can also bring challenges such as emotional exhaustion and decreased personal accomplishment.
ReVisions in Knowledge Development: A Passion for Substance
Authors: Meleis Afaf I.
Published: November 2024

Members of the nursing community have been engaged in numerous debates, some of which are related to the roles of holism and particularism in the care of clients and in the development of nursing knowledge. Others center on most and least congruent methodologies for nursing research. These healthy debates have played a significant role in invigorating the discipline of nursing. If they continue without special attention to nursing’s substance, however, they may detract from its knowledge development. By refocusing the debates on substance, that is, on the major phenomena and theoretical propositions considered central to nursing, progress in the development of nursing knowledge will be enhanced. Other revisions include co-opting some existing methods in knowledge development that are congruent with feminist approaches and not limited to certain strata of populations or certain nations, thus highlighting international nursing as an arena for the generation of gender-sensitive and culture-sensitive theories. Finally, the commitment to revisions in knowledge development means a personal commitment of nursing scholars to health care in general and to the discipline of nursing in particular.
Dyspnea: A Clinical Perspective
Authors: Gift Audrey G.
Published: November 2024

Dyspnea is the subjective experience of shortness of breath, which can be very distressing to the person experiencing it. It is a growing health care problem in the United States today because of the continued rise in the incidence of respiratory disease. Patients turn to their health professionals in the hope of obtaining relief. Physicians administer medications in an attempt to relieve the underlying physiological abnormality, but often this is inadequate. Few nursing interventions have been proposed for the relief of dyspnea. Part of the reason for this may be the lack of a perspective on dyspnea. Now, however, adequate data are available for this to begin. Differing perspectives in relation to dyspnea are presented here and evaluated for their relevance to nursing. Suggestions are made for future nursing research regarding dyspnea interventions.
Toward Holistic Inquiry in Nursing: A Proposal for Synthesis Of Patterns and Methods
Authors: Schultz Phyllis R.
Published: November 2024

The nursing literature continues to reflect the intent of nurse inquirers to develop holistic approaches to the systematic study of nursing phenomena toward the goal of knowledge generation for practice. This article continues the conversation with a proposal for synthesis of patterns of knowing and methods of inquiry by invoking several arguments from the literature of postpositivistic, pragmatic philosophy. Roderick Chisholm’s particularist epistemology is used as the basis for defining truth and justification of knowledge claims. It is proposed that synthesis of inquiry can occur through using both the qualitative and quantitative paradigms to generate or obtain evidence, which canthenbe combined in a single text. Procedures such as comparing and contrasting, pattern identification, reasoning through dialogue, dialectics, and hermeneutics yield a synthesis of meaning. Conclusions or knowledge claims may be justified by applying Chisholm’s levels of epistemic preferability.
Infant Feeding Practices of Vietnamese Immigrants to the Northwest United States
Authors: Henderson Shirley M. , Brown Julia S.
Published: November 2024

Employing the perspective of acculturation theory, this research describes and compares infant feeding practices of 20 Vietnamese mothers before and after immigration to the United States. The semistructured interviews revealed: (a) a dramatic change occurred from breast-feeding in Vietnam to bottle-feeding in the United States, (b) few changes occurred in type or time of introduction of solids into infants’ diets, (c) in either country, mothers who breast-fed their infants did not differ markedly from those who bottle-fed with respect to selected cultural, demographic, socioeconomic, and social support characteristics, and (d) women’s infant feeding behavior appeared influenced mainly by perceived custom, together with the desire for freedom and convenience.
Structuring the Nursing Knowledge System: A Typology of Four Domains
Authors: Kim Hesook S.
Published: November 2024

A typology divides the universe of interest so that empirical events considered to be important for the given discipline can be placed within the classification scheme. Assuming that nursing is actively involved in delineating the sphere of nursing phenomena, it is important to develop a typology that can be used to systematize research and ever-cumulating knowledge in nursing. A typology of four domains is proposed as a conceptual “map” of nursing and as a “sensitizing” scheme for further research. The typology includes the client domain, the domain of environment, the client-nurse domain, and the practice domain.
Empathy and Nursing Care Outcomes
Authors: La Monica Elaine L. , Wolf Richard M. , Madea Anita R. , Oberst Marilyn T.
Published: November 2024

The objectives of this research were to investigate the effects of nurse empathy training on the client outcomes of anxiety, depression, hostility, and satisfaction with nursing care and the impact of group instruction on the empathy levels of nurses. All registered nurses on two units were presented with an empathy training program (n= 56) or a control program (n= 53). Clients (N= 656) on the units, all of whom had cancer, were assessed before and after staff development programs with the Multiple Affect Adjective Check List and the La Monica/Oberst Patient Satisfaction Scale. Clients cared for by nurses in the experimental group showed significantly less anxiety and hostility than clients cared for prior to the experimental treatment; mean differences on depression and satisfaction with care were in the hypothesized direction. These effects were not evident in the clients of the control group. Client and self-report empathy scores did not show significant changes as a result of either program, perhaps due to ceiling effects.
Coping With Conflicting Agendas: The Bathing Experience of Cognitively Impaired Older Adults
Authors: Kovach Christine R. , Meyer-Arnold Elizabeth A.
Published: November 2024

The behaviors of 33 clients with cognitive impairment were examined during bath time using grounded theory methods. Analysis revealed that 73% of the adults displayed agitated behaviors during personal hygiene care. Subjects and caregivers were faced with conflicting agendas and attempted to cope by using a variety of verbal and nonverbal strategies. The strategies used by cognitively impaired older adults included: attaining control, sharing control, resigning control, and regaining inner control. Results of this study suggest that older adults with cognitive impairment have a repertoire of coping mechanisms that are used when environmental demands challenge the person’s deteriorating cortical abilities.
The Essence of Enduring and Expressions of Suffering: The Reformulation of Self
Authors: Morse Janice M. , Carter Barbara
Published: November 2024

In this study, biographical narratives of illness experiences were used to explicate the concepts of suffering and enduring. Three types ofenduringwere identified:enduring to survive(which occurs during physiological jeopardy),enduring to live(which occurs with untenable psychological stressors), andenduring to die(which occurs with inevitable degenerative and terminal disease). Suffering is defined as an emotional response to that which was endured, to the changed present, or to anticipating the altered future. Finally characteristics that differentiate enduring from suffering are delineated. The relationships between the two concepts are explored. Individuals move from enduring to suffering when they are able to acknowledge that which is being endured, and when they are emotionally strong enough to experience the emotional onslaught of suffering. If the latter is overwhelming, individuals may retreat to enduring. Once they have suffered enough and are able to accept the changed reality, individuals gain new insight and appreciation for life as areformulated self.
Tools of the Trade: Analyzing Technology as Object in Nursing
Authors: Sandelowski Margarete
Published: November 2024

Key components of nursing practice are the things nurses use in their work. Despite the importance that technological objects have played in both practicing and representing the practice of nursing, they have received only tangential attention in empirical and ethical studies of nursing practice and in theories of nursing. In this paper, technology is analyzed in its mode of manifestation as “object.” An analytic emphasis on technology as object is necessary to draw attention to and garner respect for the independent force that objects exert in human/machine interactions. In addition, giving conceptual primacy to the material manifestation of technology can help to clarify (even as it raises other questions about) the long-standing and somewhat bittersweet relationship between nursing and technology.
The Effects of Music Interventions on Postoperative Pain and Sleep in Coronary Artery Bypass Graft (CABG) Patients
Authors: Zimmerman Lani , Nieveen Janet , Barnason Susan , Schmaderer Myra
Published: November 2024

The purpose of this experimental study was to determine the effects of second and third day postoperative music interventions (music, music video) on pain and sleep in 96 postoperative patients having CABG surgery. The Verbal Rating Scale scores obtained before and after each 30-minute session showed that pain decreased over time for all three groups with no difference across groups. The McGill Pain Questionnaire (MPQ) was administered before session 1 and after session 2, and results indicated that Sensory, Affective, and Present Pain Intensity subscales showed no group difference for pain; however, pain decreased from Day 2 to Day 3 for all three groups. For the evaluative component of pain, those in the music group had significantly (F[2,93] = 4.74,p< .05) lower scores on postoperative Day 2 than the rest period control group. Effects of the intervention on sleep as measured by the Richard Sleep Questionnaire indicated that the video group had significantly (F[2, 92] = 3.18,p< .05) better sleep scores than the control group on the third morning. These findings lend some support for selected music interventions.
Concept Development: Exploring Undocumentedness
Authors: Hilfinger Messias DeAnne K.
Published: November 2024

Concept development involves multiple processes, one of which is concept exploration. The purpose of this paper is to present the process of concept exploration as exemplified in the case of undocumentedness. This particular exploration of undocumentedness was grounded in the discipline of nursing and approached from a feminist perspective. The exploratory process of the concept included personal reflexivity, the construction of definitions, examination of the historical, social, political, and legislative context of undocumented immigration in the United States, exploration of the meanings and implications of the concept, discussion of the relationship of undocumentedness to nursing and health, and identification of the needs for research to further develop the concept of undocumentedness for nursing.
Concept Analysis in Nursing Research: A Critical Appraisal
Authors: Morse Janice M. , Hupcey Judith E. , Mitcham Carl , Lenz Elizabeth R.
Published: November 2024

The four major methodological approaches to concept analysis (Wilson-derived methods, qualitative methods, critical analysis of the literature, and quantitative methods) are compared. The authors suggest that qualitative methods and methods that critically analyze the literature may be selected according to the level of the maturity of the concept and the purpose of the analysis. These methods have the ability to facilitate inquiry for concept development, delineation, comparison, clarification, correction, and identification. Quantitative methods may be used for exploring concepts (e.g., delineating conceptual boundaries), and quantitative instrumentation may be used for concept validation, operationalization, and measurement, thus complementing concept analysis methods by moving inquiry into another level of investigation. The authors conclude by presenting criteria for the selection of an appropriate research approach for concept analysis and criteria for evaluating concept analysis research.
Postpartum Fatigue: Clarifying a Concept
Authors: Milligan Renee , Lenz Elizabeth R. , Parks Peggy L. , Pugh Linda C. , Kitzman Harriet
Published: November 2024

This paper describes the multifaceted approach employed to clarify the concept of postpartum fatigue. The process began with a literary analysis, which gave rise to questions about the defining characteristics of postpartum fatigue and its differentiation from related concepts such as tiredness and depression. A series of qualitative and quantitative studies were carried out to examine new mothers’ characterizations of their fatigue, the indicators and predictors of postpartum fatigue, and the differences between fatigue and depression. The evolving concept clarification suggests that postpartum fatigue is most effectively conceptualized as a multidimensional concept with physical and mental aspects that is different from tiredness and can be differentiated from postpartal depression or milder “baby blues,” with which there is some overlap.
Development of a Conceptual Model of Quality of Life
Authors: Ferrans Carol E.
Published: November 2024

Quality of life is a critically important concept for health care that has been developed predominantly in the past three decades. Conceptual clarity is extremely important, because differences in meaning can lead to profound differences in outcomes for research, clinical practice, and allocation of health care resources. This paper describes the development of the Ferrans conceptual model of quality of life. The model was developed based on the adoption of an individualistic ideology, which recognizes that quality of life depends on the unique experience of life for each person. Individuals are the only proper judge of their quality of life, because people differ in what they value. Consistent with this ideology, quality of life was defined in terms of satisfaction with the aspects of life that are important to the individual. The model was developed using qualitative methodology. Factor analysis of patient data was used to cluster related elements into domains of quality of life. The resulting model identifies four domains of quality of life: health and functioning, psychological/spiritual, social and economic, and family. Subsequent cross-cultural work with African Americans and Mexican Americans has provided evidence that the elements of the model appropriately reflect quality of life for segments of the population not sampled in the original work. The Ferrans and Powers Quality of Life Index was developed based on this model.
The Perceptual Aspect of Nursing Art: Sources of Accord and Discord
Authors: Johnson Joy L.
Published: November 2024

Many authors have argued that nursing art involves a perceptual aspect. Perception is said to allow the artful nurse to see, or envision, possibilities and to apprehend meaning in patient encounters. Although many nurses appear to agree that nursing art involves a perceptual ability, there is no apparent agreement about the nature of that ability. Indeed, a philosophical analysis revealed that sources of discord about the perceptual aspect of nursing art center on questions regarding the focus of the perceptual ability, the purpose of nursing art, whether foreknowledge is required, and whether the artful nurse’s perceptions are verifiable. The debate regarding the perceptual aspect of nursing art has been constructed with the hope that it will foster further debate and analysis about nursing art. Ultimately, the resolution of the sources of discord will assist in decisions about how the art of nursing is best pursued and developed.
A Transactional Perspective on Critical Thinking
Authors: Gendrop Sylvia C. , Eisenhauer Laurel A.
Published: November 2024

The quality of thinking has received much attention within the last decade. The scientific inquiry models introduced by Dewey, Dressel and Mayhew, and Watson-Glaser have been expanded to incorporate such aspects as reflection, development, attitude, skill, and knowledge domain. Dichotomies between critical and creative thinking have been eased. While this scholarship on thinking has been impressive, current pedagogy remains focused on scientific inquiry and on received knowledge. In nursing the learning paradigm has been similarly focused for the past 3 decades on a scientific inquiry model and received knowledge. The major cognitive approach to education and practice has been the nursing process, a linear problem-solving paradigm equivalent to the scientific method. This linear approach does not fully account for how nurses think and make judgments in clinical practice. The Transactional Model of Critical Thinking presented in this paper addresses the complexity of critical thinking in nursing. The model provides an educative and novel vision of thinking based on a transactional view of the individual, personal attributes, and the environment. Components and elements of the model are described and suggestions made for teaching-learning and for evaluation of critical thinking in nursing.
Chronic Sorrow in Persons With Parkinson’s and Their Spouses
Authors: Lindgren Carolyn L.
Published: November 2024

Chronic sorrow is the grief experienced from continual loss during the trajectory of an illness or disability. The presence and nature of chronic sorrow were determined in a sample of six persons with Parkinson’ s disease and four of their spouse caregivers using the Burke NCRCS Questionnaire. Four of the afflicted individuals and two of the spouse caregivers reported symptoms of chronic sorrow that for half of them were more intense than at the time of diagnosis. Respondents used extensive problem-solving and emotive coping strategies to handle their sorrow. Most of the respondents described themselves within the context of the illness and the care required. Losses triggering their sorrow included loss of future plans, restricted social life, and inability to travel and participate in hobbies. Support from others was restricted mainly to physicians at the time of diagnosis and close family. Supportive nursing interventions for their grief are indicated.
Predicting Unpredictability: A Model of Women’s Processes of Predicting Battering Men’s Violence
Authors: Langford David R.
Published: November 2024

This paper proposes a theoretical model of how women predict men’s violence within the context of battering. The model was developed from a grounded theory study of 30 women. Participants were recruited using advertisements in free neighborhood newspapers. Interviews were conducted in small groups or individually. The analysis revealed that battered women developed sophisticated knowledge about and response patterns to their partners, violent behaviors. They identified specific changes in their partners’ eyes, speech, and tone of voice and described specific situations that served as warning signs of potential violence. Once able to identify warning signs, women responded with strategies of avoidance, engagement, fleeing, and enlisting the help of others to avert or delay violent incidences. These strategies provided temporary relief but did not usually result in the cessation of violence.
Diamond Necklaces: Perspectives on Power and the Language of “Community”
Authors: Drevdahl Denise
Published: November 2024

The relationship between power and the language of “community” is considered through findings from research conducted in a clinic in which clinic personnel and women who used the clinic discussed their understanding of “community.” Analysis of the data was informed by critical social theory such as the work of Foucault which was used to understand “community” as a place of oppression, while feminist theory was applied in order to understand “community” as a place of resistance. Women who used the clinic were created and defined consonant with clinic practices. The exercise of power was evident through the types of objectives pursued by the clinic, the establishment of power relations, the system of differentiation between clinic personnel and users, and the forms of institutionalization. Counter-discourses were also constructed that served as points of resistance. “Community” became a mechanism by which clinic users challenged various enactments of clinic power through their health care choices and the stories they shared among each other. Findings point to “community” as emphasizing boundaries and divisions rather than similarities and unity.
Response to “Diamond Necklaces: Perspectives on Power and the Language of ‘Community’”
Authors: Thompson Janice L.
Published: November 2024

Symbols, such as diamond necklaces, identify the boundaries of ‘community.’ These borders mark the beginning and end of ‘community,’ divide the similar from the dissimilar, tell us where we belong and where we’ re excluded (Drevdahl, 1998).
A Conceptual Model of Collaborative Nurse-Physician Interactions: The Management of Traditional Influences and Personal Tendencies
Authors: Corser William D.
Published: November 2024

In this article, the phenomena of “collaborative nurse-physician interactions” are analyzed as such encounters may be conceptualized in modern healthcare practice settings. The author observes that many writers have used either nonclinical or incomplete definitions when discussing nurse-physician collaboration, often paying little attention to the research which indicates that members of both groups consistently possess very different perspectives of what usually comprises collaboration.

A conceptual model is presented to comprehensively illustrate the salient variables that have been suggested in the professional literature as affecting the quality, rate, and outcomes of the fundamental unit of nurse-physician collaboration: the collaborative interaction. The author asserts that although many of the peculiarities of the traditional nurse-physician relationship are generations old, contemporary patients’ needs and modern practice conditions now mandate further conceptual development and research regarding these work encounters.
Language, Ideology, and Nursing Practice
Authors: Björnsdottir Kristin
Published: November 2024

This article explores the ways in which nursing practice is shaped by language and ideology. It is based on an ethnographic study conducted at two general surgical units in one of the main acute care hospitals in Iceland. The data used were qualitative: transcribed semistructured interviews with registered nurses on two acute care units, field notes from a participant observation on the two units and contextual information from written documents, such as yearly reports from the hospital and newspaper articles. The main findings revealed a stark contrast between the two discourses noticed. The public discourse, observed at team meetings in giving reports and in the written documentation, was characterized by objectivity and distancing from patients’ personal understandings. The style of presentation was distant and mechanical. The private discourse, which emerged in private discussions between staff on the units and in interviews with the researcher, reflected the nurses’ attempts to understand each patient’s situation and outlook on life. This discourse was much more engaged, reflecting the nurses’ energy and interest in being of assistance. By highlighting the difference between private and public discourses, this study provides important insight into the complex ways in which language and power interact to create different conditions for nursing practice. Based on these findings inferences are made as to how nursing practice is shaped by ideology.
Structuring the Nursing Knowledge System: A Typology of Four Domains
Authors: Kim Hesook Suzie
Published: November 2024

A typology divides the universe of interest so that empirical events considered to be important for the given discipline can be placed within the classification scheme. Assuming that nursing is actively involved in delineating the sphere of nursing phenomena, it is important to develop a typology that can be used to systematize research and ever-cumulating knowledge in nursing. A typology of four domains is proposed as a conceptual “map” of nursing and as a “sensitizing” scheme for further research. The typology includes the client domain, the domain of environment, the client-nurse domain, and the practice domain.
Analysis and Evaluation of the Trajectory Theory of Chronic Illness Management
Authors: Cooley Mary E.
Published: November 2024

The development and testing of theories for use in nursing research and practice is essential for advancement of the profession. The Trajectory Theory of Chronic Illness Management is a middle-range nursing theory that has been proposed by Corbin and Strauss (1991a). Analysis and evaluation of this theory was performed using Fawcett and Downs’s (1992) guidelines. Theory analysis and evaluation are important first steps before using a theory for practical purposes. Theory analysis makes a theory more understandable and helps to identify the strengths and weaknesses of the theory. Evaluation extends the analysis process by making judgments about the potential contribution of the theory based on published data. Results of the theory analysis and evaluation suggest that the Trajectory Theory has theoretical and social significance but that further theoretical work is necessary to enhance the internal consistency and parsimony of the theory. Although several authors have suggested that the theory has pragmatic adequacy, evidence for empirical adequacy of the theory is needed. Before more empirical studies are conducted, further theoretical work is recommended.
Attentively Embracing Story: A Middle-Range Theory With Practice and Research Implications
Authors: Smith Mary Jane , Liehr Patricia
Published: November 2024

This paper describes the middle-range theory of attentively embracing story. Attentively embracing story is connecting with self-in-relation through intentional dialogue to create ease. The theory emerged in the context of the neomodernist and simultaneity paradigms as the authors shared situations in practice and research and linked these encounters to the story literature. Practice implications with a client who has hypertension and research implications with a pregnant adolescent are presented. The proposed middle-range theory is offered for critical examination by the nursing community as a guide for practice and research aimed at the promotion of human growth and change.
Evaluating the Outcomes of Parent-Child Family Life Education
Authors: Ruth Anderson Nancy Lois , Koniak-Griffin Deborah , Keenan Colleen K. , Uman Gwen , Duggal Barbara Rosendale , Casey Conerly
Published: November 2024

Conducted in diverse sociocultural communities in Los Angeles County, the project implemented and evaluated a family life education program designed to prevent the negative outcomes of risky sexual behavior. A sample of 251 male and female early adolescents 9 through 14 years of age participated with their parents in this abstinence-based adolescent pregnancy prevention program. The project sought to improve parent-child communications and delay the onset of sex-related behaviors through direct involvement of parents in the education process. Naturally occurring community groups were randomly assigned by site to treatment or delayed treatment conditions in a longitudinal quasi-experimental evaluation design. The evaluation demonstrated significant improvements in communication between parents and children immediately following the intervention; however, these improvements were no longer present 12 months postintervention. The process and outcome evaluation methods employed in the study triangulated qualitative and quantitative data collection and analysis procedures. This combination provided other sources of data than the traditional outcome measures used in most evaluation studies, thus addressing some of the gaps in present program evaluations. Descriptions of the process evaluation, integrated with the outcome data, are intended to heighten nurses’ awareness of the importance of this component of research and the rich qualitative data it may yield. The qualitative process components in the project captured the experience of the investigators when they encountered many of the complex challenges that confront researchers who implement and evaluate family life education programs among early adolescents. This experience provided the basis for suggested strategies that nurse clinicians and researchers can use in their work with early adolescents and their parents in clinical-, school-, and community-based settings.
Quality of Life for Persons With Developmental Disabilities
Authors: Faulkner Melissa Spezia
Published: November 2024

A uniform and consensus definition for quality of life is not currently available. Although the topic of quality of life is pertinent for individuals with neurodevelopmental and related disabilities, the most appropriate means for assessing it as a basis for developing or evaluating programs need to be identified. A global viewpoint of one’s quality of life when emotional, physical, or cognitive limitations are manifested may be too narrow for capturing a realistic perspective for planning programs. A more holistic approach that includes both individual and parental or caregiver perceptions may better address the conceptualization of quality of life for persons with developmental disabilities. Models of quality of life for this population reflect lifespan challenges for achieving personal satisfaction in the following areas: (1) physical well-being or functional status, (2) social and emotional well-being, (3) material well-being, and, (4) developmental abilities. This paper addresses current models of quality of life and methodological considerations for investigating this concept with persons who have developmental disabilities. Multidimensional methods of measurement, possibly including proxies, are necessary for a comprehensive approach to studying such an elusive construct, particularly when cognitive function is limited.
Outcomes of Perceived Quality Nursing Care Reported by Oncology Patients
Authors: Radwin Laurel , Alster Kristine
Published: November 2024

At a time when health care quality is being defined by providers, administrators, and third-party payers, it is more important than ever to ensure that patients’ voices are heard. Patients can tell us not onlywhatmakes nursing care excellent; they can tell ushowthis care makes a difference. This article reports on the outcomes ascribed to quality nursing care by a group of purposively selected oncology patients who participated in a grounded theory study. One outcome was a sense of well-being comprising trust, optimism, and authenticity. A second outcome, increased fortitude, occurred when the patients felt that they had the readiness, strength, and stamina to undergo cancer treatment and bear its effects. The outcomes are described and discussed in relation to existing scholarly work.
Determinants of Health-Promoting Behavior Among Women Ages 65 and Above Living in the Community
Authors: Lucas Judith A. , Orshan Susan A. , Cook Frances
Published: November 2024

This study utilized Pender’s Health Promotion Model to investigate through canonical correlation analysis the role that select cognitive-perceptual factors (health self-determinism, learned helplessness, self-esteem, and perceived health) and modifying factors (age, race, marital status, education, and income) play in understanding participation of community-living older adult women (age ≥ 65) in the health-promoting behaviors of health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. These were measured by the Health-Promoting Lifestyle Profile II in a convenience sample of 107 community-living older adult women (mean age 76.7 years). Gender-specific benefits and barriers to participating in health-promoting behaviors were also explored using open-ended questions.

Two significant canonical variates were demonstrated. These indicated that age, marital status, race, education, and self-esteem and the two health-related factors of perceived health and health self-determinism made statistically significant contributions to the health-promoting behaviors of physical activity, nutrition, spiritual growth, and interpersonal relations. Benefits identified included better psychological well-being, coping with the general issues of aging, social interaction, improved function, and management of existing health problems. Internal barriers focused on perceived physical difficulties with all types of health-promoting behaviors; external barriers included aspects of the activity itself, lack of support from others and structural barriers. Study results suggest that older adult women (age ≥ 65) participate in health-promoting behaviors for both health enhancement and health management reasons and that barriers may be a more important determinant of older women’s health-promoting lifestyle behaviors than previously described in the model.
Insomnia, Fatigue, Anxiety, Depression, and Quality of Life of Cancer Patients Undergoing Chemotherapy
Authors: Redeker Nancy S. , Lev Elise L. , Ruggiero Jeanne
Published: November 2024

The purposes of this study were to examine: (a) the relationships between the symptoms of insomnia and fatigue and the psychological factors of anxiety and depression, and; (b) the relationships between these psychological and symptom variables and quality of life in cancer patients who were receiving chemotherapy. The Theory of Unpleasant Symptoms was the framework for the study. A descriptive correlational design was used in a secondary analysis of data obtained from a sample of 263 cancer patients who were undergoing chemotherapy. Insomnia, fatigue, depression, and anxiety were positively correlated with one another (r = .26 tor= .69,p <.001) and negatively correlated with quality of life (r=-.28 tor = -.63, p <.001). Women had more anxiety and fatigue and poorer quality of life than did men. Older age was associated with better quality of life and less insomnia, fatigue, anxiety, and depression. Multiple regression analysis revealed that the symptoms and psychological variables explained 47% of the variance in quality of life, with the largest proportion of the variance explained by depression. Fatigue and insomnia explained only 4% of the variance in quality of life in excess of that contributed by the psychological factors. Although overall depression levels were low in this sample, these findings suggest that insomnia and fatigue are related to depression and that depression is more closely associated with quality of life than are insomnia and fatigue.
Uncertainty in Childhood Illness: A Synthesis of the Parent and Child Literature
Authors: Stewart Janet L. , Mishel Merle H.
Published: November 2024

Uncertainty has increasingly been identified as an important construct in the clinical and empirical literature on families’ responses to serious childhood illnesses. Most of the work has focused on parents’ perceptions of uncertainty, but several recent studies have demonstrated that children are also affected by uncertainties inherent in the illness experience. Findings from 44 reports of parental uncertainty and 12 reports of children’s uncertainty were reviewed to determine what is currently known about uncertainty in the context of acute and chronic childhood illness. Pertinent conceptual and methodological issues are identified and directions for future research are suggested.