bluuebunny/crossref_metadata_2025 huggingface dataset:
A conceptual model of adaptation to illness and quality of life for cancer patients treated with bone marrow transplants
Authors: Molassiotis Alexander
Published: March 2003

A conceptual model of adaptation to illness/treatment and quality of life in cancer and especially bone marrow transplant patients is presented. The process from the diagnosis of a life–threatening disease to adaptation to it is divided into five stages. This process starts with the initial stimuli (stressor) and the appraisal/perception of that as a threat (stage I), and continues with the reaction to the stressor, if it is perceived as a threat (stage II). This is the time that, if manipulation of the stressor with appropriate interventions occurs, prevention of ineffective coping and/or maladjustment to illness is possible. The third stage refers to the coping with the illness (adaptive or maladaptive coping), followed by the degree of adaptation to illness and satisfaction with daily life (quality of life). Depending on interventions applied at this stage, the outcome can be either adjustment to illness or maladjustment and low quality of life (final stage). In every stage of the process, certain physiological, psychological, social and developmental variables are important, and these are described, based on research findings. Assessment of these variables is necessary for more effective planning of care and application of nursing interventions. Such a model can provide a conceptual framework for the assessment and evaluation of quality of life in cancer/bone marrow transplant patients and can help health professionals, and nurses in particular, to develop their own assessment tools and plan care and/or interventions based on such a holistic assessment.
The Teaching Nursing Homes innovation: a literature review
Authors: Chilvers J.R. , Jones D.
Published: March 2003

Since the recent shift of emphasis away from long‐stay hospitalization for elderly people the availability of clinical placements for student nurses to gain experience in caring for elderly people has been reduced. This paper explores the potential value of Teaching Nursing Homes, already well established in the United States, as a possible alternative placement to facilitate learning. In analysing the models of affiliation in current use critically the authors conclude that the concept of Teaching Nursing Homes offers vast potential, not only to nursing education in the United Kingdom, but in raising the profile of care of the elderly, provided that the most appropriate form of affiliation model is adopted.
Distress, stress and coping in first‐year student nurses
Authors: Jones Martyn C. , Johnston Derek W.
Published: March 2003

Levels of affective distress, sources of stress and coping strategies reported by first‐year student nurses in Tayside, Scotland, were measured using the General Health Questionnaire (30‐item version), the Beck & Srivastava Stress Inventory (BSSI) and a modified ‘Ways of Coping Questionnaire’. Screening showed that, around the time of an initial series of hospital placements, 50.5% of students in cohort 1 (n=109, week 40) and 67·9% of students in cohort 2 (n=111, week 24) suffered significant affective distress. This exceeds levels reported in published studies of degree nursing students, fourth‐year medical students, and the general female population. Distressed students reported the same sources of stress as the non‐distressed students, but suffered them more intensely. Many BSSI items were seen as common sources of stress; however, the frequency with which an item was reported to be stressful was not related to whether scores on that item predicted overall distress. In both cohorts, the use of direct coping was associated with lower levels of distress, and with lower total stress scores on the BSSI. The use of fantasy and hostility was associated with high levels of distress and stress, in both groups. This screen of 220 first‐year student nurses suggests that there is a problem with student distress around an initial series of general/ surgical and psycho‐social ward placements. The possible determinants of this distress are complex, and it is unlikely that presenting information alone will be sufficient to reduce this distress.
An oral history project in mental health nursing
Authors: Russell David
Published: March 2003

The main aim of this study was to produce material which would support, or alternatively challenge the content of a piece of historical writing, based largely on primary archival sources. The method chosen was to replicate and develop an earlier oral history project, which was carried out to discover and report on trained nurses who could offer their impressions of both the practical and theoretical frameworks of psychiatric care. The work described here took that project a stage further by focusing on a single organization, and developing the line of inquiry by adding topics of contemporary interest, such as gender issues, ethnicity, the management of violence and nurses' roles in treatment. Apart from comparisons and contrasts with the previous study, a subsidiary interest was to reflect on the intrinsic value and continuing relevance of the material, or the lack of it. The process section considers the problems and dynamics of the interview situation, and how this may have affected the material produced and what this implied for the interpretation. The study confirms an assumption of the usefulness of oral history, as a record, additional to the written documents, which enriches the descriptions of historical processes.
Implementing health promoting nursing: the integration of interpersonal skills and health promotion
Authors: Benson Anne , Latter Sue
Published: March 2003

Health promoting nursing practice is seen as the way forward for the nursing profession. This paper outlines the meaning of health promotion and distinguishes between a traditional and new paradigm approach. The research examining the extent to which a new paradigm approach is practised demonstrates that, to date, nurses predominantly adopt the traditional approach to health promotion. It is argued that the integration of interpersonal skills and health promotion within nursing curricula is crucial in enabling the transfer of theoretical concepts into practice. The ways in which this integration has been approached within one college of nursing are described. The difficulties encountered in attempting this integration and accomplishing a philosophical shift from a traditional to a new paradigm approach to health promotion are discussed and critiqued. Specifically conflicts that occur at an interpersonal, organizational and societal level are identified and proposed as explanations for the slow implementation of health promoting nursing.
Reflection and nursing education
Authors: Pierson Wanda
Published: March 2003

The notion of reflection has become a significant concept within nursing education. What is it? How is it learned/taught? How is it implemented in practice? This paper explores reflection as both a technique and a purposeful inter‐subjective process. Some of the current theoretical underpinnings of reflection, with particular attention to a Heideggerian perspective, are examined. It is suggested that the Heideggerian notion of reflection as the integration of calculative and contemplative thinking is an effective way to consider the concept of reflection.
Difficulties in the measurement of outcome in people who have serious mental health problems
Authors: Repper Julie , Brooker Charlie
Published: March 2003

In the present drive towards evidence‐based health care it is essential for nurses to be able to define and measure their contribution in the health services and thereby ensure that resources are deployed to provide maximum improvement in the health of the population. Yet there exist few rigorous studies which examine the impact of the nursing contribution on patient health gain. One explanation for this is the sheer complexity of outcome measurement. This paper considers the multitude of factors which must be taken into account when designing studies to measure the impact of interventions for people with serious mental health problems. The heterogeneous nature of the population, the range of services these people might use, the composite of possible interventions and the paucity of adequate measurement tools are among the issues to be tackled. Although no single methodology can be prescribed, a number of principles are offered to guide study design.
Nursing education in Sweden: development from vocational training to higher level education
Authors: Kapborg Inez
Published: March 2003

Recent decades have seen several changes within Swedish nursing education. The length of Swedish nursing education was previously 2 years; today, however, it has been adapted to the rules laid down by the European Union, which means that it covers 3 years. Swedish nursing education was raised to university college level as early as 1977; however, it is only in recent years that the education can be said to meet the requirements placed on it. The requirement that the education should be scientifically based entails that the teaching staff should include teachers not only with nursing experience but also with a doctor’s degree in nursing. The county councils are the authorities responsible for nursing education with the exception of three university colleges of nursing education which are independent. During the past year, however, seven nursing programmes have gone over to State control, and several more are discussing co‐operation. A central evaluation made of Swedish university colleges of nursing education shows that 10 colleges provided education which could not be considered to correspond to the required level of higher education. No university college of nursing education has yet been accorded the right to provide education for the bachelor’s degree. The future of the Swedish nurse is uncertain due to a large extent to the reorganization that has taken place within the health services.
Non‐English speaking background high school students’ attitudes towards the nursing profession
Authors: Rossiter Joh Chin , Bidewell John , Chan Po Tai
Published: March 2003

Australia is a multicultural nation with its population coming from over 120 different cultural backgrounds. With the arrival of new immigrants from South‐east Asia, China, Korea and Lebanon over the last 20 years, issues such as the recruitment of bilingual and cross‐cultural knowledgeable nurses have become a high priority within the health care system. However, recruiting these skilled professionals has been difficult. This study aimed to examine (1) non‐English speaking background (NESB) high school students’ career preferences in relation to nursing; and (2) whether nursing is perceived differently by the Korean, Lebanese, Vietnamese and mainland Chinese high school students. A convenience sample of 162 NESB high school students with parents from Korea, Lebanon, Vietnam and China was recruited from Sydney, New South Wales, Australia. Data were collected by a questionnaire to measure students’ knowledge about, attitudes towards and intention to study nursing and their demographic details. Descriptive and inferential statistics were used to describe students’ demographic background, their career preference and to compare knowledge, attitudes and intention scales among the NESB groups. Results indicated that less than 10% of students included nursing among their preferred career options. Korean students scored lower than the other NESB groups on attitude and intention towards nursing. The findings provide clues as to how nursing can be better promoted to NESB school leavers. Limitations of the study were discussed and recommendations were suggested for future research.
The Tredgold Model of Nursing
Authors: Dennis Sharon
Published: March 2003

A nursing model is a framework upon which nurses can base their approach to care. A model may expand a philosophy into the abstract as it encompasses the nurses’ beliefs about their role, the patient’s involvement and the meaning of the interactions between the two. On Tredgold ward we decided to write our own model as established frameworks did not entirely reflect our approach. We used the elements of British nursing models as described by Brown (1989) as the basis for our work and in doing so additionally wrote our own definition of nursing. The process has led to a more cohesive and confident team with a clearer sense of direction. This has increased our standing with colleagues and educationalists.
Attitudes of professionals, students and the general public to HIV/AIDS and people with HIV/AIDS: a review of the research
Authors: Välimäki Maritta , Suominen Tarja , Peate Ian
Published: March 2003

This paper provides a review relating to the attitudes of health care professionals, students and the general public to HIV/AIDS and people with HIV/AIDS. This is done by describing the literature on attitudes to HIV and AIDS in three fields of research: medicine/nursing, psychology and the social sciences. In addition, we look at the countries in which research has been conducted in these issues and at the variety of tools and methodological approaches used and at the participants studied. The review shows that, during the 1990s, the research interest in issues related to HIV/AIDS attitudes has rapidly increased. Most of the work on HIV and AIDS has been done in the United States, with the main focus on empirical research using questionnaires. The attention has mostly been on students and their attitudes to AIDS/HIV and sexual behaviour, but increasing interest has also been shown in the attitudes of health care personnel and students. As it seems that attitudes have been highly resistant to change, more consideration needs to be given to finding appropriate ways of educating the general public, students and health care professionals. A comprehensive analysis is also needed of the different tools used in measuring attitudes and in international comparisons of the attitudes of adolescents, health care professionals and students towards AIDS and AIDS patients.
Fruits without labour: the implications of Friedrich Nietzsche’s ideas for the caring professions
Authors: Nolan Peter W. , Brown Brian , Crawford Paul
Published: March 2003

Seldom is the work of philosophers invoked by health professionals when examining aspects of care from a philosophical perspective. Instead, students of health care, especially nurses, have been introduced to ‘philosophies’ which are often superficially examined and poorly understood. This practice fails to develop in students an appreciation of the work of philosophers or to acquire the art of critical thinking. The introduction of models and theories of nursing in the past three decades has alerted nurses to the importance of possessing critical skills in order to identify sound theory and implement good practice. This paper goes beyond mere philosophising and examines aspects of mental health care from the perspectives of one of nineteenth century Europe’s most notable philosophers, Friedrich Nietzsche. It argues that understanding his work can enhance one’s ability to reflect on nursing practice, as well as bringing a new dimension to how we analyse ‘mental health’ problems. His work provides many insights into how we can improve our understanding of the effect of mental illness and mental health care on the individual, and how we conceptualise the process of care. This paper provides an overview of his life’s work, his impact on the history of ideas and develops some of the more provocative implications of his work for mental health care.
Perception of causes of omissions in the assessment of patients with chest pain
Authors: Meurier  , Vincent  , Parmar
Published: March 2003

Perception of causes of omissions in the assessment of patients with chest pain¶There is growing evidence that errors and omissions often occur in the nursing assessment and care of patients. As yet, the impact of audit has been insufficient to correct these deficiencies, possibly because audit does not primarily focus on the causes of deficiencies. The purpose of this study was to examine the perceived causes of omissions in the assessment of patients with chest pain and to compare these with omissions detected in an audit of the assessment records. The type of attributions nurses used to explain the causes of the omissions was also investigated. Following an audit of the assessment records of patients with chest pain, 88 nurses were invited to answer a 51‐item questionnaire relating to the types of omissions which occurred in the assessment of patients with chest pain. The results showed a marked discrepancy between the frequency of reported omissions and those found in the assessment records. The most common causes of omissions reported by the nurses were patients’ condition, work overload, lack of time, poor assessment documentation, not realizing that the assessment had not been fully carried out and different nurses being involved in the assessment of patients. Nurses overwhelmingly attributed the causes of omissions to external or environmental factors rather than internal ones such as lack of knowledge or fatigue, which have implications for the types of strategies that might be used to improve care.
Cut from the right wood: spiritual and ethical pluralism in professional nursing practice
Authors: Cusveller Bart
Published: March 2003

Today, different cultures and contexts of nursing adhere to different codes of ethics. This pluralism may be traced back to differing beliefs about the nature of man and the world, involving different approaches to, and understandings of, spirituality. How significant is this pluralism of beliefs surrounding spirituality for proper nursing practice? I argue that certain introductory nursing textbooks perceive the significance of spirituality for nursing practice as marginal, because of certain assumptions as to what constitutes a proper, or professional, practice. After arguing that such assumptions are problematic, especially from an ethical point of view, I will advance an alternative understanding of professional practice, by drawing upon Alasdair MacIntyre’s work. The aim is to give the spiritual dimension of nursing care its rightful place.
The participants’ views of childbirth education: is there congruency with an enablement framework for patient education?
Authors: Stamler Lynnette Leeseberg
Published: March 2003

The participants’ views of childbirth education: is there congruency with an enablement framework for patient education?¶Although nursing research literature in the area of patient education is rich in number, methodologies used have limited generalizability and cohesiveness. Previous theoretical work has suggested an enablement framework for patient education across content areas. This study approaches patient education from the participant’s view and engages the recipients in describing their goals for the process. Seven primiparous women taking childbirth education were asked about their reasons/goals for attending, anticipated roles and tasks during the birth process, and whether or not the educational experience assisted them in meeting their self goals. Semi‐structured interviews were used, with each woman being interviewed three times, allowing comparison of data across time, and pre‐ and post‐birth. Content categories were identified, and found to be consistent across time. Implications for practice and research are provided.
Men as caregivers: reciprocal relationships or obligation?
Authors: Neufeld Anne , Harrison Margaret J.
Published: March 2003

Men as caregivers: reciprocal relationships or obligation?¶This study explored reciprocity in the relationships of men caregivers of cognitively impaired older adults. Reciprocity is a dimension of social support that is important in caregivers’ ability to sustain supportive relationships. Equity theory predicts that inequitable (non‐reciprocal) exchanges will result in termination of relationships. The objective of the study was to identify the context in which reciprocity was present or absent, the characteristics of reciprocity in caregivers’ relationships with the care recipient, family and friends, and the men’s feelings about reciprocal social support during caregiving. Twenty‐two men caregivers were interviewed three times over 18 months. Study findings were confirmed in a focus group discussion with seven caregivers. Three variations in reciprocity in the men’s relationship with the care recipient were identified: waived reciprocity, generalized reciprocity and constructed reciprocity. Those experiencing constructed or generalized reciprocity described positive feelings, whereas men identifying waived reciprocity described either positive or negative feelings. When reciprocity was absent the men described giving care on the basis of obligation with either mixed or negative feelings. Reciprocity in relationships with friends and family is also described. The study findings support the assumptions of equity theory about reciprocity; however, perceptions of obligation may be better understood in the context of the principles of justice and caring.
Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong Kong
Authors: Lee Diana T.F. , Chan  , Tam Ellen P.Y. , Yeung Winky S.K.
Published: March 2003

Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong Kong¶ A qualitative study was designed to explore nurses’ perceptions of the use of physical restraints on elderly patients in Hong Kong. Content analysis of semi‐structured interviews with 20 registered nurses working in medical and geriatric settings of two regional hospitals revealed that although nurses generally had mixed feelings about the use of physical restraints on elderly patients, they did not question this ‘routine’ practice and their knowledge about the consequences and alternatives to the use of restraint was limited. It was found that nurses had an overriding concern in ensuring elderly patients’ physical safety and using restraints therefore provided them with a sense of security. The deleterious impact of restraint on the care received by elderly patients was largely unrecognized. Implications for practice and future studies are discussed in the light of these findings.
Cost comparisons between family‐based care and nursing home care for dementia
Authors: Chiu Lian , Tang Kwong‐Yui , Liu Yu‐Hua , Shyu Woei‐Cherng , Chang Ta‐Pang
Published: March 2003

Cost comparisons between family‐based care and nursing home care for dementia¶A prospective study was carried out in Taiwan to measure the family cost of caregiving at home for 289 patients newly diagnosed with dementia (106 with senile‐type dementia , 171 with vascular‐type dementia). Their families were first interviewed in the outpatient department and then followed for 1 month after the dementia diagnosis was made. Simultaneously, the costs for providing nursing home care to patients with dementia were calculated using accounting data reported from six nursing homes. Comparisons were made between the amount and type of cost encountered by families and by nursing homes to determine whether family‐based care was cheaper and more appropriate than nursing home care for dementia patients with different functional levels. The results showed that higher costs were encountered for caregiving at home when the patients had severe dependence. This tendency was more evident for patients with senile dementia than for patients with vascular‐type dementia. The cost of labour was an important expense for families caring for patients at home (at least 85% of family costs). Our findings suggest that, when family labour cost is considered, nursing home care is less expensive than family‐based care for long‐term care, especially for dementia patients with severe or moderate dependence. Nursing home care is also a better choice when patients have great need for multiple health services.
Progress's Pilgrim: a critical narrative of research in progress
Authors: Tilley Stephen , Pollock Linda , Ross Linda , Tait Louise
Published: March 2003

Progress's Pilgrim: a critical narrative of research in progress

There is increasing interest in the use of stories to develop nursing and health care practice. This paper reports on how we used story to understand and develop research on nursing practice. Story (or narrative) and science can be seen as distinct but complementary paradigms. We have found that a story framework can help researchers to reflect on a process of social scientific investigation, and to consider how to `go on' in that process. In a study on `Community psychiatric nurses' empowerment of people with enduring mental disorders in the community: involving users to develop services' we have encountered a number of interesting and challenging issues related to design and use of methods. We present these issues within a framework of story analysis, focusing on issues related to empowerment. This analysis draws on Burke's `pentad' of story elements as a framework for narrative analysis. We present the elements of the `story of the study‐as‐funded' and as it was carried out through the pilot stage, and outline the story of developments in the main study. `Trouble' in a story centres on a problematic `ratio' of story elements. The `trouble' at this stage in the progress of our study relates to lack of fit between some parts of the instruments (the methods) and the goal (empowerment), and to the status of the CPNs as actors or agents. Narrative analysis sensitizes us to these issues of `trouble' and provides a means of addressing them. Like John Bunyan's Pilgrim, we have learned through our progress; unlike Pilgrim, we know not our end.
The changing nature of nurses’ job satisfaction: an exploration of sources of satisfaction in the 1990s
Authors: Tovey Elizabeth J. , Adams Ann E.
Published: March 2003

The changing nature of nurses’ job satisfaction: an exploration of sources of satisfaction in the 1990s

This paper focuses on the changing nature of nurses’ job satisfaction. It compares the major sources of satisfaction and dissatisfaction experienced by acute ward nurses in the English National Health Service (NHS) in the early 1990s, with sources identified in previous research. In the light of findings from a pilot study, the suitability of existing research approaches and measurement tools for portraying nurses’ contemporary work experiences is examined. The study comprised content analysis of a random sample of 130 nurses’ comments about ward organizational issues, collected as part of a national survey. Findings suggest that new measurement tools need to be developed, because new sources of satisfaction and dissatisfaction emerged, directly associated with change arising out of the introduction of the NHS internal market. These include pressures associated with new roles, role conflict, lack of job security, ‘tight’ resources, using new technology, a perceived lowering of standards of patient care, coping with increased amounts of paperwork, and the experience of working in a rapidly and constantly changing environment. Findings also suggest that the nature of nurses’ job satisfaction is increasingly being shaped by their position within the organization, denoted by clinical grade, and the organizational culture of individual NHS Trusts. Ward leaders experience dissatisfaction as a result of role conflict and strain, while nurses of lower clinical grades are increasingly concerned with managerial and resource constraints on their ability to provide good quality care. Nurses’ satisfaction with management and morale were found to be significantly different between NHS Trusts. While findings may be specific to England, it is argued that they have relevance for the wider, international nursing community. This is because developing an understanding of the changing nature of nurses’ job satisfaction may help to resolve recruitment and retention problems.
Adolescents and HIV: theory‐based approaches to education of nurses
Authors: Stewart Katharine E. , DiClemente Ralph J. , Ross Dana
Published: March 2003

Adolescents and HIV: theory‐based approaches to education of nurses

HIV infection is increasingly prevalent in adolescents, and primary prevention programmes have been most effective when based on existing theories, including social cognitive theory (SCT). Nurses play an important role in assessing adolescents’ risk for HIV infection and in recommending preventive behaviour change, if their comfort with these activities is increased. Practising nurses (n=88, mean age=40·8) from a university medical centre and surrounding hospitals participated in either a didactic or SCT‐based workshop and a vignette‐based assessment. Utilizing a randomized controlled design, this study compared the effectiveness of the two types of workshops by measuring HIV‐related knowledge and attitudes, as well as comfort with and intent to perform HIV‐related risk assessments. Differences in comfort and intent based on target patients’ cultural descriptors were also evaluated. The SCT‐based workshops yielded more positive results for all four outcome variables at the 8‐week follow‐up (F2,71=4·27, P < 0·02). Cultural stereotyping also appeared to play a role in nurses’ intent to perform assessments (F2,74=11·81, P < 0·001). Suggestions for improving the workshops and incorporating other theory‐based approaches are discussed.
Perceived family dynamics of persons with chronic pain
Authors: Smith A. Ann , Friedemann Marie‐Luise
Published: March 2003

Perceived family dynamics of persons with chronic pain

This qualitative study was conducted to gain an understanding of the experiences of persons with chronic pain and their relationships with family members and the family as a whole. The framework of systemic organization was used to define the areas of investigation guiding the formulation of broad questions relative to family functioning. Thirty persons with chronic pain (age 31–82 years, 73% women, 83% married, 83% European‐American, 17% African‐American) participated in the study. A semi‐structured interview was conducted to elicit narrative descriptions of the participants’ perspective of the pain experience and family functioning. The data were analysed using a constant comparison method of analysis described by Strauss. The dominant themes that emerged included: (i) emotional distress, (ii) distancing from family members, (iii) inability to share difficult feelings, (iv) intense mutual involvement with family members and identification with others’ problems, (v) family isolation from community, and (vi) attempt at healing. A mid‐range theory developed out of the data and explicated with the framework of systemic organization, was one of balancing and counterbalancing connectedness (spirituality) with personal autonomy or separateness (control) in order to find congruence for the family and individuals within. The pain sometimes acted as a mechanism regulating the distance and closeness among family members. Based on this information, nurses can facilitate better understanding among family members, encourage autonomy, assist individuals to express feelings and needs more directly, and facilitate members to respond to each other.
Model for the self‐care of home‐dwelling elderly
Authors: Backman Kaisa , Hentinen Maija
Published: March 2003

Model for the self‐care of home‐dwelling elderly

The aim of this study was to develop a model to clarify the existing knowledge concerning the self‐care of home‐dwelling elderly people. The data were collected in Oulu, a medium‐sized city in northern Finland, by interviewing 40 home‐dwelling elderly persons aged 75 or more. Data were analysed using the constant comparative method of the grounded theory approach. The model consists of four modes of self‐care with different conditions for action and different meanings: responsible self‐care consists of responsible activity by the elderly person based on a positive orientation towards the future and a positive experience of ageing. The meaning of responsible self‐care is a desire to continue living as an active agent. Formally guided self‐care consists of uncritical observance of instructions and routine performance of daily tasks. This approach is based on life experiences of taking care of others and realistic awareness of the effects of old age. The meaning of formally guided self‐care is a tendency to accept life as it comes. Independent self‐care is based on the person’s desire to listen to his/her own internal voice. These persons aim to manage in life independently and deny the prospect of growing old. The meaning of independent self‐care is an attempt to maintain the constancy of life. Abandoned self‐care is characterized by helplessness and lack of responsibility. It involves bitterness and a negative attitude towards ageing. The meaning of abandonment is a desire to ‘give up’. According to this study, self‐care is not a separate part of old men’s or women’s lives, it is associated closely with their past life and with the future. As an activity, self‐care is not just a rational way to maintain health. It also reflects the person’s overall attitude towards health care, illnesses and manner of living.
Providers’ and consumers’ perspective of nurses’ caring behaviours
Authors: Hegedus Kathryn Stewart
Published: March 2003

Providers’ and consumers’ perspective of nurses’ caring behaviours

The primary purpose of this article is to discuss the development and testing of a scale designed to examine nurses’ caring behaviours. A pilot study was conducted with a convenience sample (n = 81) of 42 nurses (providers) and 39 patients (consumers). The setting was two community hospitals in the New England Region. The respondents were able to assign a rank of the items (nurses’ caring behaviours) with a spread of mean values from 3·5 to 16·7. There was agreement on the most caring behaviour, ‘The nurses treat me as an individual’, on the behaviour in the middle range of caring, ‘The nurses comfort me by their silent presence’, and on the least caring behaviour, ‘The nurses did not talk about how my illness might affect my life’. The Wilcoxon two‐sample rank‐sum test was used to test the difference in rank of the 20 items between the providers and the consumers. There was a significant difference between the providers and the consumers in the ranking of nine of the 20 items. The consumers valued behaviours that recognized their individual perspective as well as that of their family and behaviours that helped them anticipate and prepare for change. The providers placed a greater emphasis on the behaviours that were more geared towards the comforting aspects of care by encouraging patients to express and vent their feelings. These findings allow clinicians to be sensitized to their caring behaviours by increasing their realization of how behaviours are perceived by patients. The instrument needs minor revision and then further testing is indicated.
Normal labour: a concept analysis
Authors: Gould Debby
Published: March 2003

Normal labour: a concept analysis

Midwives practice within the normal childbirth paradigm. It is argued that midwives failure to define normality has allowed increasing technicalization and medicalization of the normal physiological process of birth because doctors so closely define abnormality. A concept analysis model is used to clarify what is meant by the term ‘normal labour’; the emphasis being on understanding what normal labour is as it applies to midwifery practice today. This analysis highlights the importance of movement and the sequential nature of normal labour, and reveals how this is implicit within the other uses of both the words normal and labour. The final definition of normal labour offered is intended to be complimentary to existing medical determinants of progress of normal labour, because as the body of the text stresses, medical knowledge is fundamentally enmeshed in midwifery care.
Learning dementia care in three contexts: practical training in day‐care, group dwelling and nursing home
Authors: Skog Margareta , Negussie Birgit , Grafström Margareta
Published: March 2003

Learning dementia care in three contexts: practical training in day‐care, group dwelling and nursing home

During the period 1996–1999, 18 licensed practical nurses (LPNs) received specialized training to become caregivers and mentors in the field of dementia care at the Silvia Home Foundation in Stockholm, Sweden. The aim of the study was to illuminate how the trainees utilized their practical training to learn about dementia care. The trainees gained practical training within three care models for elderly persons with dementia. The three forms of care and the context for practical training included the school’s integrated day‐care, a group dwelling and a nursing home. The findings show that the trainees made use of each training context in a similar fashion but there were differences between the contexts. A perspective of human dignity characterized the day‐care. This was an opportunity for the nursing philosophy taught by the programme to be put to practical use, and for reflection and experiences pertaining to the individual patient to be developed. In the group dwelling, the trainees encountered patients with different forms of dementia and studied how the care‐giving could be adapted to the individual patient’s symptoms — the disease perspective. In the nursing home, the trainees chose a staff perspective in which they focused on organization, management and working conditions as well as staff attitudes and the effects of these factors on patient care.
Myocardial infarction: survivors’ and spouses’ stress, coping, and support
Authors: Stewart Miriam , Davidson Karina , Meade Darlene , Hirth Alexandra , Makrides Lydia
Published: March 2003

Myocardial infarction: survivors’ and spouses’ stress, coping, and support

Despite evidence that spouses play an important role in the recovery of MI survivors, there have been few studies of pertinent psychosocial factors from the perspectives of both survivors and spouses. Accordingly, the aim of this study was to describe stress, coping strategies and social support experienced by survivors and spouses. This study was limited to first‐time MI to focus on a time of uncertainty and transition. Twenty‐eight persons (14 couples) participated. Both survivors and their spouses reported similar post‐MI stresses: emotional impact, lifestyle changes, encounters with health professionals, and their partners’ reactions. Spouses and survivors used diverse strategies to cope with the stresses of MI. Seeking informational support was prevalent. Both spouses and survivors engaged in ‘protective buffering’ of their partners. Couples described deficient support, conflict and miscarried helping efforts within their relationships. Spouses and survivors referred to inadequate informational support from health professionals.
Midwives’ support needs as childbirth changes
Authors: Kirkham Mavis , Stapleton Helen
Published: March 2003

Midwives’ support needs as childbirth changes

This paper reports on midwives’ support needs as they were described by midwives in a large study of the supervision of midwives in England. The data are derived from six sites: five, very different, National Health Service (NHS) sites, and one composed of midwives outside the NHS. In‐depth, ethnographic interviews were conducted with 168 midwives and a grounded theory approach was used for the analysis. The findings identified midwives’ many and varied support needs. Midwives also clearly described the culture of midwifery in the NHS. This culture inhibited midwives from arranging to have their support needs met and acted as an obstacle to progress in developing midwifery practice. The dilemmas and tensions inherent in this situation are explored and suggestions made as to the way forward.
The nurses’ power to detain informal psychiatric patients: a review of the statutory and common law provisions in England and Wales
Authors: Houlihan Gary D.
Published: March 2003

The nurses’ power to detain informal psychiatric patients: a review of the statutory and common law provisions in England and Wales

This paper explores the extent to which nurses can use statutory and common law provisions as lawful authority to detain informal psychiatric patients. The power of a nurse to detain informal psychiatric patients received statutory recognition for the first time in the Mental Health Act (1983). Section 5(4) of this Act, the ‘Nurses Holding Power’, provides for nurses of the ‘prescribed class’ to detain informal psychiatric patients for up to 6 hours. Further statutory authority that may be invoked with respect to the detention of patients is laid out in the Criminal Law Act (1967) and the Police and Criminal Evidence Act (1984). These statutes set out the circumstances whereby a nurse can use reasonable force to detain a patient. One of the most confusing areas in law is the extent to which common law powers can be used by nurses to detain or restrain informal psychiatric patients, including those who lack mental capacity. The detention of those patients who lack the mental capacity to express an informed desire to leave hospital has caused uncertainty and difficulties for nurses caring for them. These difficulties relate to whether it is lawful to detain and give treatment to informal patients who lack the capacity to express a choice. The principles derived from the case law are discussed in relation to detention, clinical practice and patients rights.
Women’s experience of suffering repeated severe attacks of acute intermittent porphyria
Authors: Wikberg Agneta , Jansson Lilian , Lithner Folke
Published: March 2003

Women’s experience of suffering repeated severe attacks of acute intermittent porphyria

The aim of this study was to elucidate the experiences of the women with severe, recurrent attacks of porphyria and how they coped with them successfully. A total of five women were interviewed and were encouraged to describe their experiences. Thematic content analysis was used to interpret the significance of their narratives. The result demonstrated that the women’s experience was of living in deepest darkness with inexpressible pain, both physical and mental. Coming into contact with health care had its good and bad points. It was often difficult to cope with life during severe periods of the disease. The process of maturation towards a more positive existence seemed to follow a pattern of accepting the disease, continuing the fight until it was finally possible to discover a pattern and meaning in life that suited the individual concerned.
Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviours
Authors: Yarbrough Suzanne S. , Braden Carrie J.
Published: March 2003

Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviours

Aim. The purpose of this study was to assess the utility of HBM as a theoretical guide for predicting breast cancer screening and therefore for guiding intervention studies.

Background. Breast cancer is the leading cause of death for middle age women (35–50) and the second leading cause of cancer deaths in all women in the United States (US). Early detection of breast cancer through screening is the only option available to women. However, less than half of all women in the US participate in screening. The health belief model (HBM), which specifies interactions of values and beliefs about health and their influence on choices, has been widely used to explain screening behaviour.

Methods. An integrative research review analysed 16 published descriptive studies employing HBM. Literature was located through a search of research based studies listed in Cumulative Index of Nursing and Allied Health (CINAHL), Medline, and cancer literature databases and studies cited in other references between 1990 and 1999.

Findings. Application of HBM was inconsistent. No study tested nonlinear relationships between variables as specified in the model. At best, the model explained 47% of the variance in screening behaviour when socioeconomic status was included. Otherwise predictive power was low, ranging from 15 to 27%.

Conclusions. While the model provides some description of the values, beliefs and behaviours of middle‐aged women primarily, HBM does not appear to have the power to consistently predict behaviours. Further research is needed to provide more thorough depiction of the social, nonhealth care meaning of breast cancer.
Menopause‐associated problems: types and magnitude. A study in the Ain Al‐Basha area, Jordan
Authors: Al‐Qutob Raeda
Published: March 2003

Menopause‐associated problems: types and magnitude. A study in the Ain Al‐Basha area, Jordan

Rationale. To begin to fill the information gap on the health of menopausal women in developing countries.

Objectives. Objectives were three fold: to establish an approximate age of onset of menopause for women in the study area; to report on the physical presence of certain physical conditions; and, to record the self‐reported frequency of signs/symptoms of menopause in the 6 months prior to the study.

Methodological design. A descriptive study of women randomly sampled from the study community.

Research methods. Women’s homes were randomly sampled from the residential blocks surrounding the local community health centre. Women agreeing to the first phase of the study were also asked to consent to the second phase, then revisited to complete this second phase.

Instruments. The first phase of the study involved an in‐depth semistructured questionnaire and the second phase, a general and pelvic examination with laboratory tests.

Outcome measures. To gather the information as set out under Objectives.

Results. One hundred and thirty seven women were included in the study. The median age of menopause was 49 years. Women either reported or were found to be suffering from a variety of health problems including: urinary incontinence (37%), urinary tract infections (UTI) (11%), reproductive tract infections (RTI) (39%), and genital prolapse (41%).

Conclusions. Menopausal women suffer from an appreciable level of morbidity as they approach menopause. Also, the level of health awareness of these women lags behind the identified prevalence of the studied conditions.