bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic model for disease‐specific and overall mortality in newly diagnosed symptomatic patients with Waldenstrom macroglobulinaemia
Authors: Ghobrial Irene M. , Fonseca Rafael , Gertz Morie A. , Plevak Matthew F. , Larson Dirk R. , Therneau Terry M. , Wolf Robert C. , Hoffmann Randi J. , Lust John A. , Witzig Thomas E. , Lacy Martha Q. , Dispenzieri Angela , Vincent Rajkumar S. , Zeldenrust Stephen R. , Greipp Philip R. , Kyle Robert A.
Published: February 2006

We sought to define prognostic factors for survival in Waldenstrom macroglobulinaemia (WM). Of 585 patients diagnosed with WM and seen at Mayo Clinic between 1960 and 2001, 337 symptomatic patients met the inclusion criteria and were analysed for overall and disease‐specific survival. The median survival from the time of diagnosis was 6·4 years. The median disease‐specific survival was 11·2 years. Univariate analysis for overall survival identified the following adverse prognostic factors: age >65 years (P < 0·001), organomegaly (P < 0·001), elevatedβ2‐microglobulin (<0·001), anaemia (Hb < 10·0 g/dl) (P = 0·01), leucopenia (<4·0 × 109/l) (P = 0·03), thrombocytopenia (<150 × 109/l) (P = 0·01), serum albumin <40 g/l (P = 0·001), and quantitative IgM < 0·4 g/l (P = 0·04). On multivariate analysis, age >65 years and organomegaly were associated with poor prognosis. A prognostic model was built based on these two variables. Patients at high risk (1–2 risk factors, median survival 4·2 years) experienced worse survival than patients at low risk (0 risk factors, median survival 10·6 years),P < 0·001. The prognostic model was validated in 204 patients who were not included in the analysis cohort.β2‐microglobulin ≥4 mg/l was associated with a threefold increase in the risk of death when added to the prognostic model. We describe a simple prognostic model for overall survival for newly diagnosed patients with WM.
Bruising and bleeding in infants and children – a practical approach
Authors: Khair Kate , Liesner Ri
Published: February 2006

Bruising and bleeding are commonly seen in children and are usually associated with minor injury and trauma. However, in two groups of children the bruising may be more significant than expected: those with an underlying haemostatic abnormality, such as an inherited bleeding disorder, or those who have been subjected to non‐accidental injury (NAI). Diagnosing inherited bleeding disorders in children is fraught with difficulty, from venous access to interpretation of results; the possibility of NAI should be borne in mind, even in those children with proven significant bleeding disorders when the severity of the injury and the history are non‐compatible. We describe the investigation of the haemostatic system in children with bruising and/or bleeding with emphasis on the key haemostatic disorders that need to be excluded.
Abnormal bone remodelling and increased levels of macrophage inflammatory protein‐1 alpha (MIP‐1α) in Waldenström macroglobulinaemia
Authors: Terpos Evangelos , Anagnostopoulos Athanasios , Kastritis Efstathios , Bamias Aristotelis , Tsionos Konstantinos , Dimopoulos Meletios‐Athanassios
Published: February 2006

Serum levels of macrophage inflammatory protein‐1 alpha (MIP‐1α) and bone remodelling markers were evaluated in 38 patients with Waldenström macroglobulinaemia (WM) and correlated with clinical and laboratory variables. MIP‐1α was elevated in WM; untreated patients had higher MIP‐1α levels than patients in remission or with active disease after treatment. MIP‐1α correlated with increased bone resorption, β2‐microglobulin and splenomegaly. Receptor activator of nuclear factor‐κB ligand serum levels were elevated in WM patients; the subsequent increased bone resorption was balanced by a comparable elevation of osteoprotegerin production and bone formation. These findings may explain the absence of lytic lesions in WM patients and suggest a potential role of MIP‐1α in WM.
The inhibition of the human sperm phosphatidylinosytol 3‐kinase by LY294002 does not interfere with sperm/oocyte interaction
Authors: Barbonetti A. , Zugaro A. , Sciarretta F. , Santucci R. , Necozione S. , Ruvolo G. , Francavilla S. , Francavilla F.
Published: February 2006

It has recently been reported that the selective inhibition of phosphatidylinosytol 3‐kinase (PI3K) enhances human sperm motility. However, little information exists on a possible role of PI3K in other sperm functions involved in the fertilization process. In this study, we investigated whether LY294002 could affect human sperm ability to fuse with oocytes, by means of the hamster egg penetration test (HEPT). The effect on acrosome reactions (AR) and on sperm/zona pellucida (ZP) binding was also evaluated. The pre‐incubation with scalar doses of LY294002 (0.1, 1 and 10 μm) did not interfere with sperm ability to fuse with oocytes either in the conventional version of the HEPT or in the version enhanced with progesterone (P). No interference with the stimulatory effect on AR exerted by P or mannose–bovine serum albumin (mannose–BSA) was revealed. Finally, LY294002 had no effect on sperm/ZP binding. These results indicate that the inhibition of PI3K by LY294002 does not interfere with sperm interaction with oocytes. This is noteworthy in the view of a possible clinical use of LY294002 as an in vitro stimulator of the sperm motility of asthenozoospermic patients for assisted reproduction techniques.
Acrosome‐reacted human sperm in insemination medium do not bind to the zona pellucida of human oocytes
Authors: Liu D. Y. , Garrett C. , Baker H. W. G.
Published: February 2006

In the literature there is still confusion whether acrosome‐reacted sperm in medium can initiate primary binding to human zona pellucida (ZP). The ability of acrosome‐reacted sperm to bind to ZP in vitro can be deduced by measuring the acrosome reaction (AR) of ZP‐bound sperm compared with sperm in medium after incubation under different conditions inhibiting the ZP‐induced AR. Motile sperm from fertile men, normospermic men and infertile men diagnosed with disordered ZP‐induced AR (DZPIAR) were selected by swim‐up (2 × 106 in 1 mL medium) and incubated for 1–2 h with four oocytes from failed in vitro fertilization (IVF). The acrosome status of sperm was assessed using pisum sativum agglutinin labelled with fluorescein. The ZP‐induced AR was inhibited in experiments using sperm from DZPIAR patients, hyper‐osmotic medium (400 mOsm/kg) and medium containing soybean trypsin inhibitor (SBTI; 4 mg/mL). Pre‐treatment with calcium ionophore was used to create a sperm population with elevated AR. In all experiments with factors inhibiting the ZP‐induced AR, the AR was significantly lower for ZP‐bound sperm compared with sperm in medium: DZPIAR patients 4% vs. 15%, hyper‐osmotic medium 3% vs. 12%, SBTI 2% vs. 12% and SBTI 3% vs. 23% after treatment with calcium ionophore. In conclusion, acrosome‐reacted sperm in vitro have significantly reduced, in fact probably zero ability to bind to the ZP.
Paediatric day surgery: day‐case unit admission compared with general paediatric ward admission
Authors: While Alison E. , Wilcox Victoria K.
Published: February 2006

A small exploratory study (n= 20) is described which compares the experience of children admitted to a day‐case unit with that of children admitted to a general paediatric ward. Both samples received inadequate amounts of information, particularly prior to discharge. The care offered in the day‐case unit was found to be woefully deficient in many areas and the wisdom of utilizing occasional sessions in an adult day‐case unit is questioned. The crucial role of skilled nurses trained in the care of sick children is emphasized.
Effect of the use of sleep medication in Dutch hospitals on the use of sleep medication at home
Authors: Halfens Ruud , Cox Karen , Kuppen‐Van Merwijk Annette
Published: February 2006

Insomnia is an important nursing problem in hospitals. Although the use of sleep medication is often criticized, it is one of the commonest interventions with regard to sleep problems. In this study, the effect of the administration of sleep medication in Dutch hospitals on the use of sleep medication at home is investigated. Only patients were included who had never used sleep medication before admittance in hospital. Results show that patients who used sleep medication for at least 5 days in hospital (n=233) used sleep medication more often at home after discharge than patients who did not use sleep medication in hospital (n=55). Furthermore, the study showed that those patients who used at least 5 days' sleep medication, especiaIly those patients who used sleep medication more often in hospital, also used sleep medication more often at home. This is in line with the addictive effects of sleep medication. From these results it can be concluded that the administration of sleep medication is not without danger. Therefore, it is recommended to search for alternative interventions, especially for patients who are in hospital for a longer period.
Visiting hospitalized patients
Authors: Whitis Grace
Published: February 2006

Visiting policies in acute care institutions affect patients and families. The study sought to answer these questions: What are current hospital visiting policies and accompanying provisions for families? How are nurses implementing these policies? A questionnaire was developed, and reliability and content validity were established. The questionnaire was mailed to a randomly selected, stratified sample of 125 approved hospitals in 10 US states, with a 40% return rate. Consent and anonymity were explained in an accompanying covering letter. Results indicated that there was a wide range of general hospital visiting hours. Limitations on general visiting hours were primarily due to hospital policy (age, children, number of visitors) and nursing judgement (visitor illness, length of visit). General visiting hours and intensive care area visiting hours for paediatric patients were more extensive than for adult patients. Factors which influenced exceptions to visitation policies in intensive care areas focused on patient acuity and patient needs. Recovery room visiting was limited. If the patient was in a private room, visiting hours and provisions for family members were extensive. Provisions for family members of intensive care patients were minimal. Nursing judgement significantly influenced implementation of. visitation policies.
The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomized clinical trial
Authors: Dale Ailsa , Cornwell Sheila
Published: February 2006

Aromatherapy is a movement growing in popularity, but lacking scientific justification in the field of practice, although laboratory experiments are in evidence. Lavender oil is frequently selected for aromatherapy as having antiseptic and healing properties. More specifically, it has been used as a bath additive postnatally to reduce perineal discomfort. A blind randomized clinical trial is described, involving three groups of mothers, one using pure lavender oil, one a synthetic lavender oil and one an inert substance as a bath additive for 10 days following normal childbirth. Analysis of daily discomfort scores revealed no statistically significant difference between groups. It cannot be concluded that current practice results in a reduction of postnatal perineal discomfort at the dilution levels used. However, there is some consistency in results between the 3rd and 5th days, with those women using lavender oil as a bath additive recording lower mean discomfort scores. This is a time when the mother usually finds herself discharged home and perineal discomfort is high. A total of 635 women participated and no side‐effects were found.
Cardiopulmonary resuscitation decision making in long‐term care: a role for the nurse?
Authors: Dianne Godkin M. , Toth Ellen L.
Published: February 2006

In many long‐term care settings, cardiopulmonary resuscitation (CPR) is regarded as an available treatment option. However, for the majority of long‐term care residents the expected outcome following CPR is poor. This descriptive study explored the CPR decision‐making process in two long‐term care institutions. This was accomplished through the administration of questionnaires to nursing staff, residents, residents' family members and through completion of a chart review of deceased individuals. This paper primarily addresses the role of nurses in the CPR decision‐making process in long‐term care. Nurses were rarely explicitly involved in the CPR decision‐making process. Knowledge deficits of nurses concerning the CPR policy at the institutions and the expected outcomes of CPR were identified. Also noted were inconsistencies between policy and practice, with CPR being withheld in practice more often than dictated by protocol. Strategies to facilitate the CPR decision‐making process in long‐term care settings are suggested, and specific roles for nurses in relation to CPR decision making are presented.
Nursing as a career choice for women in Pakistan
Authors: French Susan E. , Watters Derek , Ralph Matthews David
Published: February 2006

This paper reports on semi‐structured interviews with 114 Pakistani nurses. This sample comes from a larger long‐term study examining the impact of advanced training in Canada on the lives and careers of nurses and lady health visitors from Pakistan. The data reported here were drawn from the first interview with all nurses, and focuses on how and why they chose a career in nursing. Demographically, the respondents (Rs) were more urban and more highly educated than the average Pakistani woman. Compared to the national population, Ismailis and Christians were over‐represented and non‐Ismaili Muslims under‐represented in our sample. Although these ratios are also true of Pakistan's nursing population, the bias has been exaggerated by the convenience nature of our sample drawn primarily from the Aga Khan University Medical Centre. Most Rs found out about nursing through a relative or friend who was also a nurse. Eighty per cent of Rs (n=92) reported having made the decision to pursue nursing by themselves, illustrating the increasing ability of women to control their own lives in this traditionally patriarchal society. ‘Professionalism’ was the predominant reason why Rs (or others) decided on nursing, followed by ‘Altruism’. These findings are compared to other studies on the career choice of nurses done in non‐Islamic societies. Over 90% of Rs reported receiving support from at least one friend or relative for their decision to enter nursing. Nonetheless, over half (58%) also reported that someone, most often a male relative, had opposed their career choice. Our results are discussed in terms of the status of women and nursing in Pakistan.
Making research useful to the practising nurse*
Authors: Akinsanya Justus A.
Published: February 2006

This paper examines the problem of developing research in nursing and the challenge of establishing its relevance and usefulness to the practising nurse. It is accepted that considerable progress has been made worldwide in recent years in the development of nursing research but nurses remain generally remote from the intellectual challenge of an evolving research‐based profession. The publication of research reports is examined in the light of the acknowledged need for dissemination of research findings and differences in their presentation are noted as evidence of an apparent discouragement of the practising nurse from sharing in the accumulated nursing knowledge through research. It is argued that learning about research should be brought into the centre of basic nursing education and the growth in clinical research should be encouraged as a means of demonstrating the usefulness of research to the practising nurse.
The curriculum revolution: can educational reform take place without a revolution in practice?
Authors: Spence Deborah G.
Published: February 2006

Nursing scholars from around the world have written extensively in the past decade of the need to transform current health care systems and of the role of nursing education in achieving this goal. Proposals for change abound in the literature and are beginning to emerge in practice but not without difficulties. Having examined new curricular developments, this paper will discuss barriers to further progress. It is suggested that emphasis on reforming schools of nursing and teaching practices has tended to overlook broader institutional influences, in particular the clinical settings in which 50% of nurse education occurs. This paper will outline the major themes of the curriculum revolution, examine the ways in which educational institutions, health care settings and nursing organizations hinder the progress of curricular reform, and discuss possible solutions and their limitations.
Therapeutic intimacy in nursing
Authors: Kadner Kathleen
Published: February 2006

Capturing essential elements of the client‐nurse relationship is an ongoing quest for nursing theorists and practitioners. The concepts which can describe this relationship may in fact have a long history of study in nursing and related disciplines. The concept of intimacy does have a trail of previous study. Giving credence to this work, in preference to developing a new lexicon, enables nurses to see interpersonal relationships with clients in the context of interdisciplinary, indeed human endeavour. In this article, the concept of intimacy is reviewed as it has been studied from a variety of perspectives. Selected aspects of intimacy in client‐nurse relationships are also explored.
Hospital staff's perceptions of risk associated with the discharge of elderly people from acute hospital care
Authors: Macmillan Maureen S.
Published: February 2006

As part of the exploratory work for a project on discharge planning of elderly people (75 + years of age) from acute care, the concept of risk was discussed with a sample of consultants; ward sisters; staff nurses; a social worker; occupational therapist; pharmacist; and some physiotherapists. The factors which they identified as being relevant to ‘risky discharges’ were organized under seven headings: medical factors; mobility; social surroundings; personality; habits; social support; and external factors. These findings are presented within the context of a review of relevant literature and some conclusions are drawn.
A comparative study of internal customer management practices within service sector firms and the National Health Service
Authors: Chaston Ian
Published: February 2006

In responding to the UK government's market forces model, some National Health Service (NHS) managers have introduced private sector concepts such as ‘customer care’ and ‘total quality management’ (TQM). Private sector firms find that success of these techruques is dependent upon creating an internal marketing orientation across the entire organization. To determine how internal marketing is being applied, a comparative survey of UK service sector hs and NHS units was undertaken using a modified version of Parasuraman's SERVQUAL model. All respondents indicated existence of type 1, 2, 3 and 4 gaps in the internal customer management process within their organizations. Major influencers of service gaps include departments placing internal efficiency ahead of internal customers and insufficient understanding of internal customer requirements. The survey indicated that, in certain areas of managing service quality, the NHS is performing better than its private sector counterparts. Nevertheless, opportunity for enhancing service quality in the NHS is possible through improving the flow of dormation between departments, stronger orientation towards meeting customer needs, upgrading provision systems and changing intradepartmental culture. The constraint facing the NHS manager is the limited availability of resources. One solution is to allocate resources in relation to service priorities. A duectional planning matrix is presented as a tool for developing an optimum internal customer management strategy within an NHS unit.
The written nursing process: is it still useful to nursing education?
Authors: Fonteyn Marsha E. , Flaig Cooper Lisa
Published: February 2006

As nursing practice becomes more complex, and patient care more variable, it will be crucial for nurse educators to teach students to think creatively and to develop a repertoire of strategies to resolve patient problems. The written nursing process has been the primary tool that nurse educators use to teach students to identify patient problems and plan for their resolution, but is it still useful? We combined a review of the literature with an informal survey of BSN nursing students to examine the usefulness of the nursing process from three perspectives: as a problem‐solving tool, as a means of fostering the art and creativity of nursing, and as a method of individualizing patient care. Current nursing literature and students' comments about the nursing process suggest that this approach may no longer be realistic or germane to current practice needs.
Lessons from America? US magnet hospitals and their implications for UK nursing
Authors: Buchan James
Published: February 2006

This paper examines possible implications of the US ‘magnet hospital’ concept for the UK nursing labour market. Magnet hospitals have been researched in the US and have been demonstrated to exhibit lower nurse turnover and higher levels of reported job satisfaction than other hospitals. Key characteristics include a decentralized organizational structure, a commitment to flexible working hours, an emphasis on professional autonomy and development, and systematic communication between management and staff. The paper examines the labour market characteristics of UK nurses and US nurses and finds many sirmlarities. Detailed case studies of employment practice in 10 US hospitals and 10 Scottish hospitals are reported, with specific attention to remuneration practice, methods of organizing nursing care, establishment‐setting and flexible hours. The paper concludes that there are features of the magnet hospital concept which are of relevance and applicable to the UK nursing labour market, but that piecemeal importation of ideas is unlikely to be beneficial.
An analysis and reflections on the quality of nursing research in 1992*
Authors: Smith Lorraine N.
Published: February 2006

This paper explores the quality of nursing research in 1992. A meta‐analysis of the nursing literature was conducted using the Journal of Advanced Nursing, the Infmational Journal of Nursing Studies and the Journal of Clinical Nursing. For comparative purposes the British Medical Journal was selected. The survey examined a number of research indicators such as sample size, sample selection, research methods, country of origin of author and types of study populations. The analysis indicates that nursing and medicine have some mutual concerns and that both professional groups could learn from each other in order to extend the effectiveness of their research.
Feminist method and qualitative research about midlife
Authors: Seibold Carmel , Richards Lyn , Simon Dawn
Published: February 2006

This paper identifies criteria seen as essential to feminist research. In light of these criteria, issues which have arisen during our current research on women and their experiences of midlife and menopause are discussed. Issues considered include the researchers' responsibilities to participants when exploring sensitive and highly personal issues relating to participants' life experiences, and less clear cut issues such as knowledge construction, power and control. In relation to the latter the balance of power in the research‐participant relationship, and the role and responsibilities of the researcher in knowledge construction, are explored. Foucault's notions of knowledge construction and power and control and the feminist researcher's position, are considered in terms of rigour in feminist research and dissemination of research reports. Issues which are seen as problematic and worthy of further debate are: the relations between interviewer and interviewee; the intellectual (the researcher) as the bearer of universal values and as truth teller; and the level of critical activism possible in research studies of this nature.
Power or the lack of it in nursing care
Authors: Raatikainen Ritva
Published: February 2006

Power is required to obtain professional goals. The aim of this study is to clarify the significance of power and the lack of it in the opinions of nurses and in prevailing nursing practice. The power of the nurse was measured by the nurse's own assessment of herkis capability to improve the quality of nursing care. The data were collected from all the registered nurses (n= 179) of five hospitals. The response was 70%. The powerful nurses had more knowledge, were better motivated, implemented policies more often, acted consciously towards nursing goals and collaborated better than the powerless nurses. The results demonstrated that nurses who had enough power possessed both wider and deeper cognitive and moral dimensions and had better skills in human interaction than did the powerless nurses.
Patient participation: what does it mean to nurses?
Authors: Jewell Sarah E.
Published: February 2006

Patient participation as a nursing philosophy and practice has grown in popularity. Research studies have reported the possible positive effects of involving patients in their health and care, while investigations interested in the meaning of participation have tended to concentrate upon the patient's perspective. However, little research has focused upon the practitioner's understanding of the concept or its execution. The aim of this ethnographic study was to uncover the perceptions of primary nurses towards the notion of patient participation, and represents early explorative work within a larger project devoted to discharge decision making. A group discussion was led by the author with four primary nurses working within a rehabilitation unit for elderly people. The data were subjected to a content analysis and two central themes or principles emerged. First, participation was regarded as having both a formal and informal meaning as well as a formal and dormal method or practice, and secondly, it was seen to involve mutual informing or negotiation between patient and nurse. Both these principles were regarded as closely linked to the concepts of nurse‐patient closeness and patient individuality.
Spiritual aspects of nursing
Authors: Ross Linda A.
Published: February 2006

In this paper the author relates how she initially became interested in spiritual care. A synopsis of a literature review is given in which the spiritual dimension is defined and evidence presented for its influence on health, well‐being and quality of life. Spiritual care is also presented as part of the nurse's role. However, it is acknowledged that there is a lack of guidelines for the practice of spiritual care. A conceptual framework for the latter is, therefore, proposed by the author. As little is currently known about how nurses perceive the spiritual dimension and their role in spiritual care, the findings from a doctoral study, which examined these issues, are reported and discussed. The descriptive study was part of the author's PhD thesis (Waugh 1992).
Knowledge and attitudes of older adults about sexuality in ageing: a comparison of two studies
Authors: Steinke Elaine E.
Published: February 2006

Two studies using separate samples sought to explore differences among male and female elders on their knowledge, attitudes, and sexual behaviour using a nonexperimental approach. Two different samples from separate health and wellness groups were surveyed using the Aging Sexual Knowledge and Attitude Scale (White 1982). Additional data were collected on sexual satisfaction, sexual activity, and demographic variables. In the first study, questionnaires were mailed to the homes of 759 members of the wellness group. The second study was conducted in a similar manner, but with random selection of 400 males and 400 females. Both groups showed a moderate amount of knowledge and permissive attitudes, with no significant differences observed between males and females. Reported sexual satisfaction was variable. Subjects were sexually active with activity varying from 0 to 30 times per month, with a mean of 4 times per month. Findings suggest that males and females are comparable on their knowledge and attitudes about sexuality in ageing and most are sexually active. Many are seeking further information on the impact of chronic illness and medications on sexuality.
An exploration into the role of humour in the nursing student‐nurse teacher relationship
Authors: Struthers John
Published: February 2006

Nurse teachers can often find themselves in various situations where they resort to using humour. An exploration of the role of humour within the educational relationship between nurse teachers and nursing students is the focus of this paper. Consideration is given to the nurse teachers' requirement to develop self‐awareness in their own understanding of humour in order to facilitate and recognize the reasons for the nursing students' use of humour. The development of the appropriate use of humour by nursing students may lead to enhanced nursing practice, thereby reinforcing the need for inclusion of the theory of humour in both teacher training and the nursing curriculum.
Discharge planning: issues and challenges for gerontological nursing. A critique of the literature
Authors: Jackson Marilyn F.
Published: February 2006

Families are rapidly becoming unpaid givers of complex care. Using McKeehan & Coulton's systems model, this critique reviews the evolution of the structure and processes of discharge planning programmes. It explores three common assumptions: discharge planning programmes are cost‐effective, allow for enhancement of patients' and families' quality of life, and ensure continuity of care between hospital and community. Funds are saved due to decreased lengths of initial hospital admissions and readmission rates. However, the cost of additional hospital and community resources is rarely considered. Little evidence supports the concept that discharge planning directly affects a patient's health status. Patients and families often do not perceive the same level of benefit from discharge planning as do health professionals. Several issues surrounding research methodologies used in the reviewed studies are identified. Of particular concern is the lack of qualitative research into patients' and families' experiences. The critique concludes with an exploration of ethical issues and challenges arising from increased emphasis on cost‐effective discharge planning. These include patients' rights, provision of sufficient human, social and financial resources, improved hospital–community communications, and control over hospital‐developed but community‐implemented programmes.
Use of formal community services by elders and their family caregivers 2 weeks following hospital discharge*
Authors: Bull Margaret J.
Published: February 2006

Early identification of elders who need care following hospitalization might enhance their health and the health of family members who help them with managing their care. The purpose of this study was to: (a) identify pre‐discharge predictors of resource use following hospitalization; (b) describe the formal community services used by elders and their family caregivers during the 2 weeks following hospitalization; and (c) determine whether there is a difference in hospital re‐admissions between elders who receive community nursing services compared with those who do not receive any services. The sample consisted of 185 elder/caregiver dyads in which the elders were hospitalized for an acute episode of a chronic condition. Both patients and family caregivers were interviewed before discharge and 2 weeks post‐discharge. The findings indicate that pre‐discharge functional ability and age are statistically significant predictors of home care services used 2 weeks post‐discharge. The findings also suggest that elders who receive visiting nurse services are less likely to be re‐admitted to the hospital.
Components of preoperative patient teaching in Kuwait
Authors: Dalayon Annie P.
Published: February 2006

Even before the invasion of Kuwait by the Iraqis in August 1990, the Ministry of Health (MOH) hospitals were overcrowded with patients. This overcrowding was very obvious on surgical floors. Two major reasons for the overcrowding were the high rate of admissions and the overstaying of some patients. The main reasons for overstaying were postoperative complications and patients' anxiety regarding their wounds, both of which could have been prevented or minimized through preoperative patient teaching. This study was done in order to identify the major components of a preoperative patient teaching programme as viewed by Arab and non‐Arab surgical nurses and patients, which will serve as a guide in formulating a structured teaching programme for surgical patients. It will also assess the adequacy of preoperative patient teaching done by nurses.
Determining nurse staffing levels: a critical review of the literature
Authors: Arthur Tony , James Nicky
Published: February 2006

This paper presents an overview of current methods for determining nurse staffing requirements. A range of methods is described and the strengths and drawbacks of each are discussed. There follows an examination of some of the wider issues raised by the use of particular methods for determining nurse staffing. The paper concludes that since a perfect workload measurement system is unlikely ever to exist, such systems can be used to facilitate, but not to dictate, decisions about nurse staffing.
Interviewing respondents who have English as a second language: challenges encountered and suggestions for other researchers
Authors: Marshall Sara L. , While Alison E.
Published: February 2006

The increasing proportion of culturally diverse groups within the United Kingdom has meant that the issue of language barriers in the research situation must be addressed. The recruitment of respondents with English as a second language (ESL) to research studies is essential if their potentially unique and valid perspective is to be acknowledged. This can, however, pose several difficulties for the researcher which need to be recognized and addressed if valid data are to be collected. This paper outlines some of the challenges encountered in one study and describes strategies which were employed to meet these challenges.
Nurse teachers' attitudes to research: a phenomenological study
Authors: Bassett Christopher C.
Published: February 2006

This research project looks at nurse teachers' attitudes to research. It addresses the question of how nurse teachers view their responsibilities and abilities to promote nursing research. The requirement for nursing practice to be founded upon a firm basis of research is increasing. It may be argued that nurse teachers are highly influential and may provide the linchpin to the future of nursing research in the clinical environment. This research, using a phenomenological approach, attempts to reveal what nurse teachers think and feel about their role in research.
An analysis of nursing's performance in the 1992 assessment of research in British universities
Authors: Tierney Alison J.
Published: February 2006

Nursing was rated as lowest of all 72 subjects reviewed in the 1992 assessment of research in British universities. Of the 29 academic nursing departments assessed, 17 received the lowest possible rating and only five were given an average or above average rating. Immediate coverage of these results in the nursing press was slow and superficial, and sometimes misleading. This paper explains how the Research Assessment Exercise (RAE) was carried out. It is argued that academic nursing departments are crucial to the profession in its current pursuit of an improved research capability and productivity and, therefore, that the results of the RAE should be of interest and concern to nurses. The analysis presented of nursing's results shows that the larger, longer‐established departments based in research‐strong old universities have more research‐active staff, and it was these departments that received the best ratings in the RAE. In contrast, most of the nursing departments assigned the lowest possible rating were small, recently established departments in ‘new’ universities that could not have been expected to distinguish themselves in their first research assessment. It is suggested, however, that any new academic nursing departments should be strategically placed in research‐strong universities. Although this paper is concerned with nursing in British universities, the general notion of research funding being allocated on the basis of performance is (or is likely to become) pertinent to other countries, especially those in Europe, North America and Australasia.
An exploration of women's perceptions of the major factors that contributed to their alcohol abuse
Authors: Long Ann , Mullen Brendan
Published: February 2006

The purpose of this research was to explore the interviewees' perceptions of the major factors that contributed to their alcohol abuse. The research was carried out by interviewing seven women who were identified by community mental health professionals. The research was qualitative and exploratory. The semi‐structured tape‐recorded interview technique was used as an enquiry tool. The tapes were then transcribed and coded, and the findings were scrutinized and scanned for emerging themes and concepts using an interactive and cyclical process of data‐reduction techniques, data display and verification of findings. The findings suggest that the majority of the interviewees could identify and isolate specific life events and past‐life crises that contributed to ‘an increase in their alcohol intake’. Results also indicate that there is a need to consider the efficacy of the current models of primary, secondary and tertiary care as well as relapse‐prevention programmes of care in order to facilitate women to have every opportunity to make informed and rational health choices about their drinking behaviours, and to maintain abstinence, for the promotion of positive mental health and for enhancing the quality of their lives.
An evaluation of communication strategies during the process of incorporating a college of health studies into a university
Authors: Whittaker Carol , Dickinson Hilary , Humphreys John , Ramsammy Roberta
Published: February 2006

This paper reports on an evaluation of communication strategies employed by management during the incorporation of a college of health care studies as a new faculty of a university. Mindful of the stress and anxiety that organizational change can evoke, from the earliest stages of the projected incorporation senior managers at the college and the university employed a wide variety of methods to communicate to staff in the college the changes that were in progress and at the same time to set up mechanisms for evaluating the effectiveness of the communication. The method of inquiry was a questionnaire to all the staff of the college in March and June of the year preceding incorporation. This was supported by interviews with a 10% sample of the college to explore in greater depth issues identified in the questionnaires. The findings indicated that in general communication had been perceived as effective; and that of the various methods used the two most valued by staff were: (a) a regular newsletter; and (b) an advisory and consultative committee of staff drawn from all areas of the work of the college up to and including senior lecturer.
Younger onset dementia: developing a longitudinal model as the basis for a research agenda and as a guide to interventions with sufferers and carers
Authors: Keady John , Nolan Mike
Published: February 2006

With the current emphasis on community care, the importance of dementia as an area for the interventions of community practitioners, especially nurses, cannot be overemphasized. However, despite being the subject of increasing research over recent times, a comprehensive model of the dementia experience from either the sufferer's or carer's perspective has yet to be developed. This is particularly noticeable in the case of people suffering from dementia below the age of 65. This situation is exacerbated by the lack of representative epidemiological studies which relate to the incidence or prevalence of younger onset dementia. In this paper, the current epidemiological literature on younger onset dementia is considered and the findings from previous work are used to suggest prevalence figures for Wales. A longitudinal model of the dementia experience from a sufferer's perspective is then presented as the basis for a research agenda. It is also suggested that this model, subject to empirical testing and refinement, could be used as a guide to interventions for practitioners working with the sufferers and their carers.
An application of nursing faculty practice: clinical camps
Authors: Arthur David , Usher Kim
Published: February 2006

The incorporation of clinical practice into nursing faculty role expectations has triggered much debate. Despite the urge for the incorporation of practice into faculty roles, past research has demonstrated that the majority of faculties do not in fact include clinical practice. Reasons given for the failure of nurse academics to practice include lack of time, the failure of academia to value the practice, and the failure to include the practice as criteria for tenure and promotion. For faculty practice to occur it has been argued that clinical practice needs to be more a matter of individual intent: adaptable, and creative. Clinical camps provide potential opportunities for clinical practice for faculties. These camps, it is argued, offer the possibility of clinical teaching, promotion of collegial relationships between faculty and health care agencies, development of positive faculty‐student relationships, and a valuable research site. For this reason, it is argued that clinical camps be considered a viable venue for faculty practice.
The management of sickle cell crisis pain as experienced by patients and their carers
Authors: Alleyne Jo , Thomas V.J.
Published: February 2006

This study sought to provide insights into the personal experiences of individuals with sickle cell disorder and nurses involved in the management of painful sickle cell crisis. The sample consisted of 10 patients who experienced hospitalization for the management of pain during sickle cell crisis and 10 nurses who have cared for patients during such crises. The method of data collection used a combination of group and individual interviews, utilizing a ‘guided conversation approach’. Data analysis consisted of content analysis of transcribed interviews which resulted in the identification of the following categories of problems: poor pain management, anxieties about pethidine, loss of control, lack of individuality and playing up. The results revealed that pain control during sickle cell crisis is often inadequate, with nurses admitting that they often have to resort to ‘trial and error’ strategy to manage pain. The findings are discussed in terms of attitulnal and knowledge factors and an individualized approach to pain management.
Nurse–patient negotiation: assumption or reality?
Authors: Tmobranski Philippa H.
Published: February 2006

The current socio‐political philosophy in the United Kingdom promotes the belief that consumers of health care should exercise choice and express opinions about the care they receive. This view challenges the traditional paternalistic approach to health care which espoused that ‘the professional knows best’. In association with general socio‐political trends, nursing is undergoing radical reform. The nursing literature widely promotes the importance of a nurse–patient relationship which fosters the involvement of the patient in negotiation and decision‐making regarding his care. Nurses who advocate individualized, holistic care must hold such an ideology as a central tenet to their philosophy. However, it is questionable whether this philosophy is widely expressed in the reality of clinical practice. There is also an absence of empirical evidence to support the assumption that patients wish to participate in decision‐making. This paper critically reviews some of the debate centred around the concept of nurse–patient negotiation. It is suggested that the issues are complex and that there remains a need for further research which takes into account multiple factors, including the social and organization context of nursing care.
Evaluating ethnography: considerations for analysis
Authors: Mackenzie Ann E.
Published: February 2006

The informed evaluation of ethnographic reports is essential to the practitioner who is working towards research‐based practice. It is also part of the process of developing and refining nursing knowledge. While there are features common to the critical examination of all research, an understanding of ethnographic design and, in particular, of issues of validity and reliability, is a prerequisite for evaluation of ethnographic research reports.
The health diary: an examination of its use as a data collection method
Authors: Richardson Alison
Published: February 2006

Use of a health diary has been common in nursing practice settings. Nurses have incorporated the diary as a means of helping clients to document their symptoms and factors which may have precipitated them, often with the aim of modifying particular health behaviours. To date there has been limited exploration of this tool in a nursing research context. Advantages and disadvantages associated with the diary when utilized as a research instrument in health settings are summarized and particular consideration is given to their use in nursing research with cancer patients. Features of the method such as completion and respondent co‐operation, format and issues surrounding data analysis are considered. The advantages of this method warrant further exploration in nursing research, despite conflicting and insubstantial evidence regarding the feasibility, validity and reliability of specific kinds of information reported in a diary.
Client education experiences in professional nursing practice — a phenomenological perspective
Authors: Morgan Adrian K.
Published: February 2006

This paper reports a small‐scale phenomenological study of registered nurses' experiences with their client education role. Its purpose was to investigate phenomena associated with actual experiences as they were encountered by participants. A review of the literature provides an overview of client education in terms of its definition and utility, and draws attention to the notion of compliance and the influence of power in health provider–client relationships. Phenomenology offers an appropriate methodological framework for investigating symbolic experiences, and three central concepts are yielded from aggregate data in the form of confirming experiences, disconfirming experiences and educational processes. Findings indicate that nurses' value the uniqueness of the client and, where possible, tend to initiate educational processes that actually empower individuals. However, disconfirming experiences are associated with demands on nurses' work schedules, low client motivation and non‐compliance. Physician interjection is also perceived as problematical, resulting in feelings which undermine the nurses' professional integrity, and which lead to a diminished sense of self‐worth.