bluuebunny/crossref_metadata_2025 huggingface dataset:
Malnutrition, Dehydration, and Starvation in the Midst of Plenty: The Political Impact of Qualitative Inquiry
Authors: Kayser-Jones Jeanie
Published: July 2003

The author presents findings from studies investigating the factors that influence the quality of care in nursing homes. The findings disclose that multiple factors, such as lack of individualized care, inattention to problems such as dysphagia and oral health care, and especially inadequate staffing and lack of professional supervision contribute to malnutrition, dehydration, and weight loss among nursing home residents. She describes how these qualitative studies had a significant impact on long-term health care policy. She urges investigators to publish research in the public realm accessible to those who can effect change and thus prevent pain and suffering among nursing home residents. Furthermore, she emphasizes the importance of publishing qualitative findings in a language understandable by the media, policy makers, governmental agencies, politicians, and the lay public.
Enhancing the Usefulness of Qualitative Inquiry: Gaps, Directions, and Responsibilities
Authors: Morse Janice M.
Published: July 2003

Although qualitative researchers have often complained that our research is not funded, that our articles receive unfair reviews, and that our findings are not implemented, as a discipline we have been slow to develop criteria for review of articles, are just beginning to develop criteria for review of proposals, and have not yet suggested mechanisms for the transference of qualitative findings into practice. In this keynote address, using the example of a project conducted at a summer camp for ventilator-dependent children, the author examines these issues of review and utilization and explores the responsibility of qualitative researchers. She argues that by meeting these needs, qualitative researchers will expedite qualitative inquiry and hence will legitimize the discipline.
How do we Talk to Each other? Writing Qualitative Research for Quantitative Readers
Authors: Belgrave Linda Liska , Zablotsky Diane , Guadagno Mary Ann
Published: July 2003

The growth of qualitative research holds the potential for vastly enriching our understanding of phenomena in the health sciences. However, the potential of this trend is hampered by a widespread inability of quantitative and qualitative researchers to talk to each other. The authors’ concern in this area grows out of our experience reviewing small grant applications for the National Institute on Aging, where they frequently find qualitative research proposals scoring worse than do those using quantitative approaches. This article addresses practical problems in communicating qualitative research to readers whose training and experience is primarily quantitative. Two themes running through the discussion are the need for detail and the explicit tying of methodological strategies to research goals.
Experiencing Chronic Illness: Cocreating New Understandings
Authors: Ironside Pamela M. , Scheckel Martha , Wessels Constance , Bailey Mary E. , Powers Sharon , Seeley Deana K.
Published: July 2003

This study was conducted as part of a research course in which new partnerships with area citizens and community-driven programs of research were developed. Working together, the teachers, students, and citizens were able to document their practical knowledge through conducting a study of the lived experiences of chronic illness using Heideggerian hermeneutical phenomenology. The pattern, Experiencing Chronic Illness: Cocreating New Understanding, and three themes emerged during the analysis of the data (a) focusing on functional status doesn't adequately account for the experience of chronic illness, (b) decentering the focus on the treatment of symptoms makes way for equally important discussions of meaning making in the context of chronic illness, and (c) the objectified language of healthcare covers over how chronic illness is experienced.
Turning Points and Protective Processes in the Lives of People With Chronic Disabilities
Authors: King Gillian , Cathers Tamzin , Brown Elizabeth , Specht Jacqueline A. , Willoughby Colleen , Polgar Janice Miller , Mackinnon Elizabeth , Smith Linda K. , Havens Lisa
Published: July 2003

In this qualitative study, the authors examined the nature of resilience in people with chronic disabilities. Fifteen people with disabilities identified the factors that helped or hindered them at major turning points, and the triggers and resolutions to these turning points. Turning points were emotionally compelling experiences and realizations that involved meaning acquired through the routes of belonging, doing, or understanding the self or the world. The major protective factors were social support, traits such as perseverance and determination, and spiritual beliefs. Three new protective processes were identified: replacing a loss with a gain (transcending), recognizing new things about oneself (self-understanding), and making decisions about relinquishing something in life (accommodating). These protective factors, processes, and ways in which people with disabilities draw sense and meaning in life have important implications for service delivery.
Community Care for People With Disability: Blurring Boundaries Between Formal and Informal Caregivers
Authors: Allen Susan M. , Ciambrone Desiré
Published: July 2003

Health care for individuals with disability is increasingly shifting from institutional settings to the "community," with assistance by those in the formal sector. In this article, the authors examine 5 case studies illustrating interactions and relationships between people with disability and their caregivers, using qualitative data collected as part of a community study of disability conducted in a medium-sized city in the northeastern United States. Employing the task specificity framework, they explore the implications of using either formal care providers to fill needs that are more typically met by family and friends or family caregivers to provide care that is best provided by the formal sector. Although our narratives illustrate the negative implications of mismatched care substitution, we conclude that the framework is less applicable to emerging systems of community care.
Survivorship as Craft and Conviction: Reflections on Research in Progress
Authors: Frank Arthur W.
Published: July 2003

The choice of some illness survivors to engage in service to other ill people, and thus to focus their lives on illness longer than their own treatment requires, is not self-evident. The author describes alternative cultural narratives of survivorship, proposes an understanding of survivorship as a form of craft, and considers the societal morality that is reflected in survivors' accounts of their service work.
The Body in Health and Illness
Authors: Corbin Juliet M.
Published: July 2003

In this keynote address, the author discusses perception of the body in the context of chronic illness compared with that of health. She describes changes that occur in illness with respect to time, space, morality, aesthetics, morality, technology, information, and interpersonal relationships using examples from her research, and explores the construction of illness and health identities.
The Paradox of Ambiguous Information in Collaborative and Competitive Settings
Authors: Eylon Dafna , Allison Scott T.
Published: July 2003

This research explored people’s willingness to share ambiguous and nonambiguous information in collaborative and competitive organizational settings. Using a resource-based perspective, we hypothesized (a) people will be more likely to share ambiguous information with their collaborators and nonambiguous information with their competitors and (b) their willingness to share ambiguous information with their collaborators will be moderated by task familiarity so that they will share more ambiguous information as their familiarity with the task increases. The results of five experiments supported these hypotheses. Paradoxically, participants tended to judge ambiguous information as less important than nonambiguous information despite preferring to share ambiguous information with their collaborators. Finally, a correspondence emerged between the task context and participants’ preference for sharing information: For concrete tasks, participants preferred to share nonambiguous information with their collaborators but for ambiguous tasks, participants preferred to share ambiguous information with their collaborators. Theoretical and practical organizational implications are discussed.
Discrepancies in Self/Subordinates’ Perceptions of Leadership Behavior
Authors: Becker Jeffrey , Ayman Roya , Korabik Karen
Published: July 2003

The focus of this study was on how a leader’s gender, the organizational context (in-role vs. out-of-role), and self-monitoring ability related to discrepancies between the leader’s self-perceptions and group members’ perceptions of the leader’s consideration and initiating structure behaviors. Forty-nine male and 49 female leaders from industrial and educational settings, as well as members of their work teams, participated in this survey research. Results indicated greater discrepancies for women leaders in industrial settings (e. g., banking, accounting, and manufacturing) than for female leaders in education and male leaders in industry. In addition, discrepancies in perceptions of initiating structure were highest for high self-monitoring female leaders in industry. These results were explained from actor-observer difference, expectation states, and gender stereotype perspectives.
Leadership and Ethics in Work Groups
Authors: Schminke Marshall , Wells Deborah , Peyrefitte Joseph , Sebora Terrence C.
Published: July 2003

This study explored the relationship between leadership style and individual ethics in work groups. We present a model of how active leadership affects conformity in members’ ethical decision frameworks (formalism and utilitarianism). We tested this model by examining 36 work groups over a 12-week period. Results supported the hypothesis that more active leadership would lead to greater conformity in both types of ethical frameworks. A second hypothesis, that group cohesion would mediate this relationship between leadership style and ethical conformity, was partially supported. Implications of these findings for leadership, groups, and ethics research are discussed.
The Role of Golem, Pygmalion, and Galatea Effects on Opportunistic Behavior in the Classroom
Authors: Rowe W. Glenn , O’Brien James
Published: July 2003

The concept of opportunism from transaction cost and agency theories suggests that in a normal class of students, there may be a few who will engage in opportunistic behavior, and to identify who they are will be virtually impossible. Therefore, professors engage in practices to keep students from engaging in opportunistic activities such as cheating. This article explores the possibility that some of these practices may be creating a “destructive Golem effect” in those students who would not otherwise engage in opportunistic behavior and explores ways to create Pygmalion and Galatea effects in the classroom.
Encouraging Community Service through Service Learning
Authors: McCarthy Anne M. , Tucker Mary L.
Published: July 2003

Increasingly, faculty members are incorporating service-learning projects into their courses, resulting in enhanced student learning and development. However, does service learning encourage subsequent student involvement in the community? This study investigates the effect faculty professionals can have through service learning on their students’intentions to participate in community service. A modified version of the Solomon four-group design analysis as well as a hierarchical regression were used to assess the change in student intentions after exposure to three service-learning treatments. Findings indicate that service learning has a significant impact on students’intentions to participate in community service. In particular, by adding a lecture to the standard service-learning format, faculty members can increase student intentions to participate in community service.
Managerial Skills Teaching: Ten Questions and Twelve Answers
Authors: McEnrue Mary Pat
Published: July 2003

This article describes and illustrates how to effectively answer 10 questions that experts in the field have raised concerning the content and process of teaching managerial skills. In addition, it demonstrates how to deal with two other issues that have been largely neglected in the literature: culture and course evaluation. The author describes how to incorporate culture into a course designed to enhance managerial skills and how to measure results achieved against multiple learning criteria sought. The article offers a set of 12 creative, practical, and pretested ideas that both neophyte and experienced instructors can apply either separately or packaged together to meet the skill-building needs of their students.
Gifting the Organization
Authors: Ferris William P.
Published: July 2003

This article describes the use of an original experiential exercise inspired by Leading with Soul (Bolman & Deal, 1995, 2001). Through giving gifts from the heart to our coworkers and reports, we can give our own lives meaning and express our spiritual selves. In this exercise, students reflect on the gift they would like to give to an organization of which they are a member, possibly write a short paper or take notes about it, participate in a small group exercise and role-play in which they share their gifts, then engage in a large group discussion on the same topic. All directions and context along with samples of student gifts and reactions to the exercise are included.
Case-Based Structured Conflict: A Means for Enhancing Classroom Learning
Authors: Pearce Robert J.
Published: July 2003

This article advances the concept of case-based structured conflict as one means for enhancing learning in the undergraduate classroom. First, the central roles of using the case method, problem-centered learning, and structured conflict are addressed. Discussion then turns to case selection and the construction of a course outline. Finally, ideas and suggestions for managing the structured conflict process are developed.
Undergraduate Management Skills Courses And Students’ Emotional Intelligence
Authors: Clark Sue Campbell , Callister Ronda , Wallace Ray
Published: July 2003

In this paper, we draw parallels between teaching undergraduate management skills and the emotional intelligence movement: both address the need for personal and interpersonal skills to help one succeed in work and in life, both identify a comprehensive set of skills which can be learned by adults, and both identify various reflective and self-monitoring techniques to learn and teach these skills. Using a pre-test/post-test experimental design, we provide evidence that current methods of teaching management skills to undergraduates also build emotional intelligence. Results of our study show that 121 students taking an undergraduate management skills course significantly improved their emotional intelligence scores during a 16 week semester, while a control group of 113 students taking other business courses did not. We discuss the implications of our results and call for more research and discussion about undergraduate management skill courses and emotional intelligence.
Beyond Critical Thinking And Decision Making: Teaching Business Students How To Think
Authors: Smith Gerald F.
Published: July 2003

Teaching students how to think is a universal goal of educational institutions. Business schools have addressed this goal by injecting critical thinking activities into their programs, and by offering courses on managerial decision making. This paper reviews these efforts, and concludes that they are not adequate to the challenge of teaching business students how to think effectively. It proposes a comprehensive thinking skills program that includes critical thinking and decision making content, but also addresses the many other thinking tasks managers perform. The paper discusses programmatic issues and provides pedagogical advice pertaining to the teaching of thinking skills in business schools.
Government, Public Relations, And Lobby Groups: Stimulating Critical Reflections On Information Providers In Society
Authors: Dyer Suzette
Published: July 2003

The exercise presented in this article has been designed to illustrate the sometimes conflicting goals of business, government, and lobby groups to sway public opinion through information management. The exercise draws on the seemingly technical and common sense issue of infant and childhood immunization. It provides students with an opportunity to critically engage in understanding the impact of the creation, management, and dissemination of information on decision making. The influence of managed information on decision making and the implications this has for the unbiased information needed for full democratic participation more generally are explored throughout the exercise.
Teaching The Cultural Aspects Of Negotiation: A Range Of Experiential Techniques
Authors: Weiss Stephen E.
Published: July 2003

This article presents 5 main experiential techniques for teaching about negotiation and culture. They are symmetric acting (prescribing negotiating styles for a role-play), interacting with “real Romans”, concentrating on implicit cultures in the class, multicultural negotiating, and culture in (complex) context. Interacting with Romans may involve featured guests, multiple cultural representatives, or negotiations in their language. The article illustrates and evaluates each technique, and closes with general pedagogical considerations such as participants’ backgrounds, deroling/debriefing, and the capacity to effect behavioral change.
Emotions And Behavior: Exercises In Emotional Intelligence
Authors: Brown Randall B.
Published: July 2003

This article describes “emotional intelligence” and shows how to integrate emotional intelligence, and emotional skills training, into an undergraduate course. It provides background information on emotions and behavior that is useful in understanding emotional intelligence, how emotions may affect people’s behavior, and the relevance of this topic to interpersonal and organizational behavior. Incorporating examples from classroom activities, the article describes three teaching exercises that have proven useful in conveying a sense of the basic precepts of emotional intelligence to students and in helping students develop skills in emotionally intelligent behavior.
Risk Factors Associated with Postoperative Pulmonary Complications Following Total Abdominal Hysterectomy
Authors: Brooks-Brunn Jo Ann
Published: July 2003

The purpose of this descriptive correlational study was to describe the relationships between risk factors and the development of postoperative pulmonary complications (PPCs) following total abdominal hysterectomy (TAH). As part of a large, prospective study, data were analyzed on a subset of women who had undergone TAH. Data collection included a preoperative interview and chest exam followed by a daily postoperative interview, chest exam, and review of the medical chart. A multicriteria definition of PPC was used for atelectasis/pneumonia. This study describes the incidence of PPCs in a TAH surgical population and provides foundational work to begin identifying important risk factors to guide pulmonary care.
Outcome Indicators for Direct and Indirect Caregiving
Authors: Schoenfelder Deborah Perry , Swanson Elizabeth A. , Specht Janet K. Pringle , Maas Meridean , Johnson Marion
Published: July 2003

Informal caregiving and outcomes for caregiving are an important part of health care and of particular importance in nursing. The purpose of this research is to report the results of a survey mailed to nursing experts for validation of the outcome labels Caregiver Role Performance: Direct Care and Caregiver Role Performance: Indirect Care and their accompanying indicators. Experts were asked to rate how important the identified indicators were for assessing those two outcomes. In addition, the respondents were asked to what extent nursing interventions influence the achievement of each identified indicator for Caregiver Role Performance: Direct Care and Caregiver Role Performance: Indirect Care. In general, the validity of the concept analysis work by the caregiver focus group was supported. Ten indicators for Caregiver Performance: Direct Care were retained, 1 was dropped that was considered most appropriate for indirect care, and 3 new indicators were added to reflect the nurse experts surveyed. For Caregiver Performance: Indirect Care, all of the indicators were retained.
Is Arm Span an Accurate Measure of Height in Young and Middle-Age Adults?
Authors: Brown Jean K. , Whittemore Kirsten Trost , Knapp Thomas R.
Published: July 2003

Height is used to determine many important clinical measurements, but height may be difficult or impossible to measure accurately in some patients. The purpose of this study is to determine the accuracy of arm span as a measure of height in young and middle-age adults. A sample of 83 people between the ages of 20 and 61 years participated in this anthropometric study. Height and arm span were measured with a metal rule. A prediction equation was derived from regression analysis. Arm span is a valid measure of height in young and middleage adults, and the accuracy is improved when using the prediction equation.
Cognitive Function and Quality of Life in Interferon Therapy for Melanoma
Authors: Bender Catherine M. , Yasko Joyce M. , Kirkwood John M. , Ryan Christopher , Dunbar-Jacob Jacqueline , Zullo Thomas
Published: July 2003

The purpose of this pilot study was to describe short and long-term changes in cognitive function and quality of life in patients with melanoma receiving interferon (IFN) -2b. This study used a three-group, repeated measures design in which cognitive function and quality of life were evaluated prior to initiation of treatment at 3-month intervals during treatment and 3 months following the completion of treatment. The sample consisted of 16 adults with Stage II or III melanoma, randomized to one of three treatment groups. Participants in Arm A received high-dose IFN -2b, those in Arm B received low-dose IFN• -2b, and those in Arm C received no therapy (control). No significant changes in cognitive function were detected. In participants in ArmA, there was a significant deterioration in the physical well-being dimension of quality of life from baseline to 3 months after beginning therapy.
Reproductive Health Consequences of Intimate Partner Violence
Authors: Campbell Jacquelyn C. , Woods Anne B. , Chouaf Kathryn Laughon , Parker Barbara
Published: July 2003

Intimate partner violence is widespread and results in significant negative mental and physical health outcomes for women. This article is a review of nursing research on intimate partner violence and women’s reproductive health and focuses on studies published since 1995, building on prior reviews. We begin with research on forced sex and the resulting physical and emotional trauma as well as implications for contraception, STD/HIV prevention, and condom use negotiation. We then discuss several approaches to the study of abuse during pregnancy, including several studies of nursing interventions. We conclude with the clinical implications of these studies.
Depression, Psychosocial Resources, and Functional Ability in Older Adults
Authors: Badger Terry A. , Collins-Joyce Patricia
Published: July 2003

The purpose of this study was twofold: to examine the differences between two groups of older adults (depressed, nondepressed) for physical health impairment, psychosocial resources, and functional abilities, and to describe the impact of depression, physical health impairment, and psychosocial resources on functional ability. Seventy-eight community-dwelling older adults, age 60 to 75 years, were divided into two groups based on their depression scores. Depressed and nondepressed participants were not significantly different for demographic and illness characteristics, except for income. Depressed participants reported greater physical health impairment, decreased social resources, diminished feelings of economic well-being, and decreased functional abilities when compared to nondepressed participants. Mastery, physical health impairment, and social support were significant predictor variables of functional ability. Mastery was a particularly salient psychological resource for total functional abilities and interventions should be targeted to increasing mastery in older adults.
Caregiving in Nursing Homes
Authors: Schirm Victoria , Albanese Terry , Garland T. Neal , Gipson Genevieve , Blackmon Dorothy J.
Published: July 2003

This investigation is a qualitative study of the views held by 36 licensed nurses (25 registered nurses and 11 licensed practical nurses) and 40 nursing assistants regarding caregiving in nursing homes. Because these care providers are most directly involved in the delivery of care, their views are important as determinants of quality of care. Study findings focus on the extent to which nurses and nursing assistants agree on what contributes to good care and how they perceive the work that each does. Also reported are their perceptions regarding factors that make care delivery easy or difficult. Results suggest that nurses and nursing assistants share selected perceptions about the division of labor in the nursing home. Also evident are areas of less agreement among these members of different status sets. A discussion of how these caregivers can work together as effective team members is presented.
Fluctuations in Established Infant Pain Behaviors
Authors: Fuller Barbara F.
Published: July 2003

This study compares behaviors that differed across levels of established (e.g., nonprocedural) infant pain with those that differed between periods of greater and lesser distress within any level of infant pain. Sixty-four videotaped infants of two ages (0 to 3 months and 7 to 12 months) and four levels of established infant pain (none, mild, moderate, and severe) were used. Pain was from medical or surgical causes. Behaviors were compared between the most distressed (HI) and the least distressed (LO) video segments per infant and across the four levels of infant pain using a two-level (distress and level of pain) MANOVA. Many behaviors were indicative of high levels of established pain and greater distress. Others increased with greater distress but lower levels of pain. Findings suggest that many behaviors indicative of high distress that constitute the immediate infant pain response are not good indicators of levels of established infant pain.
Family Role and Work Adaptation in MI Women
Authors: Varvaro Filomena F.
Published: July 2003

The purpose of this longitudinal, randomized clinical study was to assess if family role functioning and work role adaptation in women following a myocardial infarction was improved by a nursing instructional intervention. The 122 participants entered the study at their discharge phase of hospitalization. The treatment group, who received the nursing instructional program, demonstrated increased adaptation related to family role over time, had less symptoms and concerns with sexual activity, and had higher adaptation scores in resuming the paid work role. For both groups, the role most impacted across time was the homemaker role. Nursing implications for assessing role disruption in women with myocardial infarction are described.
Effects of Performance Feedback on Patient Pain Outcomes
Authors: Duncan Kathleen , Pozehl Bunny
Published: July 2003

The purpose of this study was to examine the effects of an individual feedback intervention provided to nurses on selected patient outcomes related to postoperative pain management. Individual performance feedback served as the intervention. Thirty orthopedic staff nurses received feedback information on their past performance of recommended pain management practices. Data were collected preintervention and postintervention on selected patient pain outcomes from the medical records of 240 patients who had undergone total knee arthroplasty. The patient outcome measures were mean 4-hour pain intensity ratings, mean highest pain intensity ratings, mean number of times pain ratings exceeded patients’ acceptable level of pain, mean administered morphine equivalents, and mean pain ratings on reassessment following analgesia administration. An improvement was noted in all pain outcomes following the feedback intervention. Results indicate that providing nurses with feedback on their past performance of pain management practices may contribute to decreased postoperative pain.
Developmental Evolution of Expertise in Diabetes Self-Management
Authors: Paterson Barbara , Thorne Sally
Published: July 2003

The following is a description of the findings of a longitudinal exploratory and descriptive research study of 22 persons nominated as expert self-managers of Type 1 diabetes. It entailed an initial interview about previous experiences with self-management, self-recorded taped diaries about self-management decisions for 1 week each, and face-to-face interviews following each weeklong recording of self-management decisions. The study generated a grounded theory about the development of expertise in diabetes self-management. The development of expertise was found to occur as transition through two or more phases, to be individualized, and to involve a complex interplay between social, contextual, and personal factors, including the individual’s developmental age. The research findings challenge the traditional understanding of rebellion in self-management as a manifestation of adolescence, behaviors other than active control as testimony to ineptitude in self-management, metabolic control as the indicator of selfmanagement ability, and the role of others as collaborators in self-management.
Cognitive Function in Patients with Cushing Syndrome
Authors: Dorn Lorah D. , Cerrone Paula
Published: July 2003

The purposes of this study were to examine the level of improvement of cognitive function 12 months posttreatment in adult patients with Cushing syndrome (CS), the relationships of cognitive function to duration of CS or recovery of the hypothalamic pituitary adrenal (HPA) axis, and depression and improved cognitive functioning. Thirty-three patients with CS and a matched comparison group were enrolled. IQ, depression, and endocrine factors were measured during the active phase of CS and at 12 months posttreatment for CS. Results show no group differences in cognitive function across time but a trend for CS patients to have lower IQ scores at baseline. Individual differences in performance were striking. For some subscales of IQ there was a positive relationship with recovery of the HPA axis and a negative relationship with duration of CS as well as an improvement if depression had decreased. Limitations of the study are cited along with clinical implications and directions for future research.
Nurse Comforting Strategies
Authors: Hawley M. Patricia
Published: July 2003

Throughout nursing’s history, comfort has been a desired outcome in the provision of nursing care. Yet, attempts to understand comfort and comforting have only recently emerged. To date, few studies have explored comfort and comforting from patients’ perspectives. The purpose of this qualitative exploratory study was to describe nurse comforting strategies as well as the outcomes of nurse comforting strategies from the perspective of emergency department (ED) patients. The study took place in a rural Canadian acute care regional hospital. A volunteer sample of 14 hospitalized patients who had received initial treatment in the ED were interviewed. Interviews were transcribed and content analysis performed. Participants described nurses’ comforting strategies under the following categories: immediate and competent technical/physical care, positive talk, vigilance, attending to physical discomforts, and including and attending to family. The comforting strategies used by nurses had a positive impact on the physical and emotional well-being of the participants.
Facilitating and Constraining Factors on Autonomy
Authors: Proot Ireen M. , Crebolder Harry F.J.M. , Abu-Saad Huda Huijer , Macor Ton H.G.M. , Meulen Ruud H. J. Ter
Published: July 2003

This article describes a model “changing autonomy” which was developed in a grounded theory study among stroke patients on admission into nursing homes for rehabilitation. Three dimensions of autonomy were identified: self-determination, independence, and self-care. On admission, patients’ conditions (disabilities, multimorbidity, emotional state, and feeling like a layperson) and patients’ strategies (waiting and seeing, and acting as a subordinate) constrain autonomy. Several environmental factors facilitate patient autonomy. The nursing home sustains patient autonomy by providing a hopeful atmosphere and room for autonomy. The health professionals facilitate autonomy by giving therapy, support and information, attentiveness and respect, paternalism and teamwork. Facilitating strategies of the family encompass emotional and instrumental support. Care routines, lack of privacy, an unfamiliar environment, waiting periods, boredom, and lack of information were identified as constraining environmental factors. Developing guidelines and multidisciplinary courses regarding the approach to patient autonomy on admission is recommended.
Comparison of Different Methods of Obtaining Orthostatic Vital Signs
Authors: Lance Robyn , Link Mary E. , Padua Magdalena , Clavell Liccy E. , Johnson Georgia , Knebel Ann
Published: July 2003

The purpose of this study was to compare two lying and standing procedures for measuring orthostatic vital signs. Thirty-five normotensive participants (mean age 21.6 years) participated in a randomized crossover study. Measures of blood pressure (BP), heart rate, and dizziness were collected at different lying and standing times. All subjects participated in a standardized walk paced at 4 miles per hour prior to lying. Using analysis of variance (ANOVA) with post hoc contrasts, the mean systolic BP differed between 5 and 10 minutes of lying (F = 21.33,p < .001) and the mean diastolic BP tended to differ between those time points (F = 5.23,p < .03). The mean standing systolic BP and dizziness rating were different between 0 and 2-minute intervals (F = 8.36,p < .01 andF = 7.15,p < .10). In normotensive participants following standardized exercise, orthostatic vital signs stabilized after lying 10 minutes.
A Typology of Consumers of Institutional Respite Care
Authors: Smyer Tish , Chang Betty L.
Published: July 2003

In this descriptive ethnography, a typology of consumers of institutional respite care and phases of respite care were formulated from the data collected over a 1-year period at a 24-bed hospital-based skilled nursing facility in the western United States. The sample was drawn from facility billing records, which verified the type of care under the term respite care. Using anthropological fieldwork methods, data were obtained from 14 caregiving dyads plus two care recipients who did not have family caregivers. The identified caregiver categories were depletion, maintenance, caregiver surgery or illness, and no available family caregiver. Phases of respite care provided information regarding the caregivers’ experience in the process of decision making, transitioning to time away from the care recipient, and postrespite adjustment. This model has implications for the structure and process of respite care design and decision making. This may provide a promising avenue in the respite care research arena.
Testing a Model of the Nursing Assessment of Infant Pain
Authors: Fuller Barbara F. , Neu Madalynn , Smith Maureen , Vojir Carol P.
Published: July 2003

The purpose of this study was to test whether elements of an infant pain assessment model interacted as postulated by the model. The elements are the infant’s response to comfort measures and the principle of consolability. Four different scenarios for each of 16 videotaped infants were prepared. Each scenario represented one of four different combinations of likelihood of pain and consolability and consisted of a videotape plus written clinical information. Forty-eight volunteer pediatric nurses assessed infant pain of 16 scenarios, each depicting one of the 16 infants. Mean level of assessed pain was highest for the “high likelihood of pain and difficult to console” group, second highest for the “high likelihood of pain and easily consoled” group, third highest for the “low likelihood of pain and difficult to console” group and least for the “low likelihood of pain and easily consoled” group. Findings supported the infant pain assessment model.
Behavioral Responses Newborns of Insulin-Dependent and Nondiabetic, Healthy Mothers
Authors: Pressler Jana L. , Hepworth Joseph T. , Lamontagne Lynda L. , Sevcik Rose Harcar , Hesselink Laura Fein
Published: July 2003

The purpose of this study was to compare the behavioral responses of term newborns of insulin-dependent diabetic mothers (NDMs) with newborns of nondiabetic, healthy mothers. The research design involved matched controls with repeated measures. Participants included 40 NDMs matched with 40 newborns of nondiabetic, healthy mothers. The main outcome measures were the seven dimensions of the Neonatal Behavioral Assessment Scale (NBAS) and the modal response score. The results showed that NDMs performed significantly poorer than their matched controls on motor processes and reflex functioning. For all newborns, motor processes, autonomic stability, reflex functioning, and the modal performance score were better on Day 2 than Day 1. It was concluded that although NDMs’ behavioral responses improved by Day 2, their overall pattern of responses could be described as listless or sluggish. Due to their poorer motor and reflex responses, NDMs may require increased efforts to facilitate sensitive maternal responding during their first days of life.
A Comparison of Fatigue and Energy Levels at 6 Weeks and 14 to 19 Months Postpartum
Authors: Troy Nancy Wieland
Published: July 2003

It has been assumed that women recover from pregnancy and childbirth within 6 weeks. Recent research shows that women’s fatigue levels are the same, or higher, at 6 weeks postpartum as at the time of delivery. This study determined the differences in primiparous women’s fatigue and energy levels at 6 weeks and 14 to 19 months postpartum. Determinations of how some contributing factors and outcomes of postpartum fatigue relate to each other and to fatigue and energy at 14 to 19 months postpartum were also made. Analyses revealed that women are more fatigued and less energetic at 14 to 19 months than they were at 6 weeks postpartum. Quality of sleep did not correlate with fatigue or energy. At 14 to 19 months postpartum return to full functional status is almost complete, with household and infant care responsibilities being most complete. The women were experiencing mild life crises of various sorts, were somewhat depressed, and were gratified in the mothering role.
Nurses' Knowledge of Pain Assessment, Pharmacologic and Nonpharmacologic Interventions
Authors: Coyne Mary Louise , Reinert Bonita , Cater Kay , Dubuisson Wanda , Smith Jane F. H. , Parker Madelyn M. , Chatham Cynthia
Published: July 2003

This study compared differences in knowledge of pain assessment and pharmacologic and nonpharmacologic pain management strategies among 232 L.P.N.s and R.N.s from three hospitals. Twenty-three adult medical, surgical, and special care units were represented. The “Knowledge of Pain Management” tool measured knowledge of pain assessment, drug and nondrug strategies, and was based on AHCPR guidelines. Scores ranged from 24% to 92%. There were significant differences in scores across hospitals and between R.N.s and L.P.N.s. The mean score was 72% for L.P.N.s and 75% for R.N.s. There was a significant difference in pharmacologic scores between L.P.N.s versus A.D./A.A.-R.N.s, B.S.N-R.N.s, and M.S.N.-M.S.-R.N.s but not between L.P.N.s and diploma-R.N.s. There were significant differences in overall knowledge scores between L.P.N.s versus B.S.N.-R.N.s but not A.D./A.A.-R.N.s, diploma-R.N.s, and M.S.N./M.S-R.N.s. Findings suggest the need for aggressive nursing education programs offered in academic and clinical settings to assist nurses in effectively managing the universal phenomenon of pain.
Impact of an Instructional Program on Nurses' Accuracy in Capillary Blood Glucose Monitoring
Authors: O'Neill Kathleen L. , Ross-Kerr Janet C.
Published: July 2003

This experiment examined the accuracy of capillary blood glucose monitoring using the visual glucose oxidase strip (Chemstrip) procedure. Also, the effects of a certification program for nurses on the accuracy of glucose oxidase strip monitoring by registered nurses were analyzed. Seventy nurses and 123 patients participated. Data were collected from nurses’ recordings of visual Chemstrip procedure results and from the concurrent laboratory blood glucose determinations for 3 months. The data included 70 Chemstrip recordings and 70 concurrent laboratory blood glucose recordings in the experimental group and 68 Chemstrip and 68 concurrent laboratory glucose recordings in the control group. Data analysis revealed that the accuracy of the nurses’ performance of the glucose oxidase strip procedure was inadequate. A certification program did, however, dramatically improve the accuracy of the procedure. Proximity of time between the certification program and the performance of the glucose oxidase strip procedure did not affect accuracy.
Patient-Controlled Analgesia
Authors: Ellis Jacqueline A. , Blouin RenÉe , Lockett Jean
Published: July 2003

A patient-controlled analgesia (PCA) program was established on a surgical unit with children age 7 years and older. The primary objectives for the PCA program were safety and efficacy. A retrospective evaluation of the first 30 patients enrolled in the program suggested that it was safe and adequately controlled pain for all but 4 patients. A chart review of these patients indicated that the relation between the number of failed administration attempts, the total hourly analgesic intake, and the pain intensity score was key to optimizing the use of PCA. Recommendations to strengthen the PCA program were implemented based on information gained from these 4 patients with poorly controlled pain.
Dietary Behaviors and Sources of Support in Hemodialysis Patients
Authors: Oka Michiyo , Chaboyer Wendy
Published: July 2003

Individuals with chronic renal failure generally have strict dietary guidelines. This descriptive study was designed to identify the relationship between sources of social support and dietary management by Japanese hemodialysis patients. A self-administered questionnaire was completed by a convenience sample of 325 adults receiving dialysis. Subjects 65 years and older received more support from family members, doctors, nurses, and technicians than younger subjects. Subjects who had been on dialysis for less than 3 years received more support from nurses and doctors than those who had been on dialysis for longer periods of time. Multiple regression analysis identified that support from family members and nurses were significantly related to dietary behaviors. Nurses working with dialysis patients should remember to use their influence to positively support their patients and to bear in mind that long-term dialysis patients, especially those who are young and unmarried, may benefit from ongoing nursing support and encouragement.
Adherent and Nonadherent Medication-Taking in Elderly Hypertensive Patients
Authors: Johnson Mary Jayne , Williams Mary , Marshall Elaine S.
Published: July 2003

Nonadherence to medications is a significant reason why patients fail to control their blood pressure. Little work has been attempted to conceptualize medication-taking behaviors from the patient’s perspective. This study examined factors that influence elderly hypertensive patients’ adherence or nonadherence to prescribed medications. Using a qualitative descriptive research design, 21 hypertensive elderly people were interviewed. Two domains of adherence were identified: purposeful use of the medication for the control of patient’s blood pressure and establishing and maintaining patterns of medicationtaking. Two similar domains also emerged for nonadherence: purposeful and incidental. Adherence behaviors were dependent on the person’s decision to take hypertension medication, access to medications, and ability to initiate treatment and maintain a medication-taking pattern. The timing and location of pills were integral parts of establishing patterns of taking medications. Inadequate access to medications or interruption of a person’s pattern were associated with the incidental missing of medications.
Tattooing and Body Piercing
Authors: Greif Judith , Hewitt Walter , Armstrong Myrna L.
Published: July 2003

Tattooing and body piercing are increasing, especially among college students. A study of 766 tattooed and/or body-pierced college students in 18 universities across the United States and one in Australia was conducted to discover the demographic characteristics, motivational factors, and health concerns. The traditional college time of 18 to 22 years of age (69%) was when they obtained their tattoo (73%) and/or body piercing (63%). More frequent health problems and impulsive decision making were noted for those with body piercing when compared to those tattooed. Three cases of hepatitis were reported. Health professionals should openly discuss body art with students, convey a nonjudgmental attitude, and assist with informed decision-making information to either reduce risks or dissuade. Open communication and applicable health education will be very important.
Sources of Midsleep Awakenings in Childbearing Women
Authors: Baratte-Beebe Kathleen R. , Lee Kathryn
Published: July 2003

Sleep disturbance is a complaint of childbearing women that has implications for perinatal health. A descriptive, longitudinal study examined the numbers and sources of midsleep awakenings in women prior to conception and during each trimester of pregnancy. A secondary analysis of data from a larger study of sleep during childbearing was performed for subjects (n = 25) who completed sleep diaries across the four measurement periods. There was a two-fold increase in the number of awakenings from pre-conception to the third trimester of pregnancy. Maintenance insomnia during pregnancy follows a pattern of prevalence that can be characterized by trimester. The predominant source of awakening during the first and third trimesters of pregnancy was due to the need to urinate. Parity and environmental circumstances can influence sources of awakenings. Nurses working with childbearing women can provide information and assistance with strategies to minimize or mitigate lengthy episodes of sleep disturbance.
Chinese Perspectives on the Important Aspects of an MBA Teacher
Authors: Thompson Edmund R.
Published: July 2003

As both indigenous and foreign universities increasingly move to satisfy China’s steeply growing demand for management education, an understanding of what Chinese students regard as being the most important aspects of an effective MBA teacher will be crucial. This is especially the case in view of traditional Confucianist informed Chinese teaching and learning approaches, which do not necessarily accord with Western, especially MBA, pedagogical methods. Using data from 113 Chinese MBA students in Hong Kong—a city argued by scholars to be used by Mainland China as a window on Western-derived educational practices—this article shows what are considered to be key aspects of an exceptionally good MBA teacher from a Chinese perspective. It also highlights significant differences in views by gender, age, and educational background.