bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Cognitive Change in the General Population: How Do Different Definitions Work?
Authors: Stephan Blossom C. M. , Matthews Fiona E. , McKeith Ian G. , Bond John , Brayne Carol ,   the Medical Research Council Cognitive Function and Aging Study
Published: September 2007

OBJECTIVES: To explore the application of existing classifications of mild cognitive impairment (MCI) and associated states in a large population sample.

DESIGN: Prospective cohort study, baseline phase (cross‐sectional analysis).

SETTING: Large‐scale multicenter study in the United Kingdom.

PARTICIPANTS: Thirteen thousand four individuals aged 65 and older from the Medical Research Council Cognitive Function and Aging Study. From this, a subsample of 2,640 individuals was selected and completed a more‐detailed cognitive assessment.

MEASUREMENTS: Information on sociodemographic status, general health, cognitive impairment (measured using the Mini‐Mental State Examination), and functional ability was collected in a structured interview at baseline. The Geriatric Mental State Automated Geriatric Examination for Computer‐Assisted Taxonomy and the Cambridge Cognitive Examination were used in assessment to determine cognitive status. Using a systematic literature review to collect all symptom classifications for nonnormal dementia states, these were then operationalized retrospectively. Each participant was classified according to each.

RESULTS: Population prevalence estimates were variable (range 0.1–42%), reflecting differences in the focus and content of each state. Limited overlap existed between states such that many individuals were concurrently classified as normal and impaired. This highlights the heterogeneity in classification as captured using different definitions.

CONCLUSION: Classification of cognitively impaired and cognitively normal individuals is dependent on the way criteria are defined and operationalized. Each classification captures a unique group of individuals, with little concordance. Given the importance of early detection of dementia and the calls for screening, and recruitment into pharmacological trials of cognitively impaired individuals, there is an urgent need for an agreed‐upon standard MCI case definition to use as a criterion standard.
Poststroke Urinary Incontinence: One‐Year Outcome and Relationships with Measures of Attentiveness
Authors: Pettersen Renate , Saxby Brian K. , Wyller Torgeir Bruun
Published: September 2007

OBJECTIVES: To investigate the prognostic effect of poststroke urinary incontinence (UI) on 1‐year outcome in relation to measurements of attention and mental processing speed.

DESIGN: Prospective observational study.

SETTING: Geriatric department (stroke and rehabilitation unit) in a university hospital.

PARTICIPANTS: Two hundred thirty‐five previously continent patients (median age 78) with an acute stroke.

MEASUREMENTS: Clinical stroke syndromes, subtypes of UI, pre‐ and poststroke cognitive function and activities of daily living, computerized assessment of attention and processing speed for 110 of the participants, mortality and accommodation at 1 year.

RESULTS: One hundred seventy patients remained continent, and 65 developed UI (27 with urge UI, 38 with UI with impaired awareness of the need to void (IA‐UI). Patients with urge UI had poorer power of attention and speed of memory than continent patients but similar continuity of attention (P<.001, .001, and .07, respectively). Patients with IA‐UI performed poorer in all categories than continent and patients with urge UI (all P<.01). In regression analyses, IA‐UI was the strongest predictor of mortality and nursing home residence after 1 year (odds ratio=15.7, 95% confidence interval=3.6–69.7). When deaths were excluded, IA‐UI and continuity of attention remained independent risk factors.

CONCLUSION: Patients with poststroke UI are less attentive than continent patients. Those with IA‐UI perform poorest. Sustained attention seems important for outcome and should be taken more into account in the rehabilitation process. In patients who recognize their incontinence, attention‐focused training might be the most effective measure of reestablishing bladder control.
The Bounds of Classical Risk Management and the Importance of a Behavioral Approach
Authors: Goto Shigeyuki
Published: September 2007

Abstract

Decisions under uncertainty can be influenced by individual subjective risk perceptions and biases. Subjective biases interfere with the ability or willingness of a decision‐maker to evaluate even objective probabilities, and can be even more detrimental when dealing with uncertain events. The effects of subjective bias are termed judgmental risk. Successful risk management must confront judgmental risk. There is no agreement on best practices to do this. This article suggests ways of controlling employee‐subjective biases and judgmental risk. Because the biases and risk are aspects of behavior, the approach is called “behavioral risk management.”
Loss Modeling Using Spreadsheet‐Based Simulation
Authors: Joaquin Domingo Castelo
Published: September 2007

Abstract

With the dramatic increase in the speed of personal computers and steep decline in the cost of computing, simulation has become one of the standard tools in the risk manager's toolbox and should now become one of the standard tools in the risk management and insurance student's toolbox. This teaching note aims to facilitate this process by showing how to create and run a simulation in a spreadsheet environment, and interpret simulation results to gain insight and understanding about a real‐world problem. Specifically, this teaching note provides step‐by‐step instruction for simulating the present value of payments for losses occurring within a 1‐year policy period. Losses are covered by an aggregate excess of loss treaty. The uncertainty lies in the frequency and severity of losses as well as in claim processing time, and also in the discount rate for calculating the present value of loss payments.
Scholars, scholarship, and nursing scholarship*
Authors: Leininger Madeleine
Published: October 2007

Scholars are born and must be nurtured from the outset to provide dynamic inputs which most cultures of the world need for their growth and well‐being. (The Author)
THE JUDGMENT PROCESS IN NURSING
Authors: DOONA MARY ELLEN
Published: October 2007

I am committed to the diversity of nursing arising from its basic unity, that is, tender loving care. I am convinced that this domain is the unique province of nursing and that this is where nursing must focus its efforts. Unlike those who have reduced the concept to a trite, and therefore meaningless form, I am committed to its understanding as a complex entity, encompassing nursing's perceptive, cognitive and active domains. Accordingly, I have concentrated my inquiries and practice toward this understanding. My future work will be to continue my interest in the cognitive domain of nursing, especially with empirically testing my theory of judgment. In addition, I plan to investigate Polyanyi's concepts of tacit knowing and personal knowledge to determine their implications for nursing. The end result of these interests and studies cannot be predicted. I expect, however, my growth will continue to be informed by nursing's diversity, and that my creativity will be stimulated further.
FREEDOM OF ACCESS TO INFORMATION AND THE RIGHT TO PRIVACY
Authors: Rice George P.
Published: October 2007

The following address was delivered February 28, 1976, to the Association of College Honor Societies at its annual meeting in Indianapolis, Indiana. The presenter was Dr. George P. Rice, Jr., General Counsel to the Speech Communication Association of America and Professor of Speech in Butler University, Indianapolis, Indiana. It is included in response to many questions raised by chapters regarding access to records for determination of eligibility.
Excellence in Nursing
Authors: Hodgman Eileen C.
Published: October 2007

Ms. Hodgman's paper was presented at the first induction ceremonies at the Yale School of Nursing Honor Society, Yale University, New Haven, Conn. It has been edited for publication.
Mothers, Babies, Perception
Authors: Lotas Marilyn B. , Willging Judith M.
Published: October 2007

Findings of this study include evidence of the relationship between mothers having had a rooming‐in hospital experience and a higher incidence of breast feeding. There is also evidence that rooming‐in mothers in the immediate postpartum period expected less difficulty with some aspects of their infant's care. Both these findings indicate that there are some positive outcomes of rooming‐in. Future study might explore the amount of contact actually experienced by mothers and the kinds of activities in which they are involved with their babies in rooming‐in settings.

A finding of particular clinical consequence was that mothers having had five or more prenatal classes and who had natural childbirth had a more positive perception of their infants. Another interesting and expected outcome was that multiparae expected fewer difficulties with the care of their babies than did primiparae. This finding, as well as the positive effect of prenatal classes, may be a result of the mothers' ability to practice the mother role.
Proposed Metaparadigm for Nursing Research and Theory Development: An Analysis of Orem's Self Care Theory
Authors: Smith Mary Colette
Published: October 2007

A classification scheme is proposed to organize existing research and set directions for future studies and theory development in nursing. Orem's self‐care approach to nursing forms the basis of the scheme, with the recommendation to study the phenomena of the field through a constructivist methodology. Scholars, theorists, and researchers are invited to participate in examination and use of the scheme from a variety of perspectives.
A Publication Project At The Undergraduate Level
Authors: Brooten Dorothy A. , Tanis Julia , Brown Linda , Hollingsworth Andrea , Fischer Dorothy
Published: October 2007

Faculty and project leaders believe this project indicates that writing for publication can and should be included in the undergraduate nursing curriculum as part of socialization in the professional role. They agree with Styles (1978) who, in identifying reasons for nurses to publish, emphasized:

“The primary reason to publish is because the future of the profession depends upon it. (p. 29)
Evolution of Nursing Science: Implications For Nursing World Wide
Authors: Ahad Mohammed A.
Published: October 2007

This article uses the framework of professionalization and discussess one central criterion, generation of a unique body of knowledge, as a requirement for professional maturity. Following the lead provided by the nursing profession in the United States of America, the standards of nursing education and practice are steadily increasing around the world. However, success in this area of improving professional performance greatly depends on the generation of commensurate scientific knowledge. The writer pleads for systematic efforts for sharing and evaluating nursing theory across national boundaries, identifies additional possible channels, and hopes that the attempts of Sigma Theta Tau in this direction will be effective.
A Science of Nursing– To Be or Not To Be?
Authors: Feldman Harriet R.
Published: October 2007

This paper has presented: views of nursing science, based on readings in the basic and social sciences and nursing; an assessment of the present state of a science of nursing, using specific characteristics of science as a system; methods for facilitating the advancement of nursing knowledge; and, a research question that connects two phenomena of concern to nursing as prerequisite to prediction and prescription. A great deal of thinking and soul searching occurred in formulating and articulating views on nursing science; it is expected that this process will continue for many years.
Nursing Practice Conceptualized: An Interaction Model
Authors: Brodish Mary S.
Published: October 2007

This paper presents a broadly based conceptualized model of nursing practice. Nursing is defined as the therapeutic use of self for the benefit of others after first having acquired the knowledge and skill necessary to identify need. Essential to nursing is the interaction of nurse with client(s). Interactions can be diagnostic, therapeutic, educative, or supportive, and can address four categories of client needs: health, developmental, emotional, and interpersonal.
Boundaries of Personal Space
Authors: Meisenhelder Janice Bell
Published: October 2007

For the hospitalized individual, personal space can be the only remaining evidence of identity and integrity. This article reviews the concept of boundaries and some research on proxemics, and suggests the importance of these findings in nursing practice.
Questioning the Mailed Questionnaire as a Valid Instrument for Research in Nursing Education
Authors: Woolley Alma S.
Published: October 2007

A steadily increasing number of requests to participate in mailed questionnaire surveys was the impetus for an investigation of what nursing research texts say about this methodology as well as what the communications field has discovered about it. The body of knowledge about nursing education will not be expanded through reliance on the data collected by this spurious methodology.
The Contributions of Dickoff and James to Theory Development in Nursing
Authors: Ohashi Julianne P.
Published: October 2007

This paper is an analysis of a number of articles on nursing by lames Dickoff and Patricia James. The analysis includes their speech given at the Nurse Educators Conference in 1978. Three major content areas are identified: (a) theory as a practice discipline, (b)the role of research, and (c) beliefs and values. There is discussion of how these ideas have changed and developed over time. Other characteristic themes are addressed as well. It is concluded that the greatest contribution of Dickoff and lames to theory development in nursing has been to generate controversy and equilibrium
Research Priorities in Gerontologic Nursing for Long‐Term Care
Authors: Brower H. Terri , Crist Mary Ann
Published: October 2007

A four‐round Delphi survey was carried out to identify the impressions of practitioners as to research priorities in long‐term care. The fixed sample was drawn from 59 nursing homes and 40 home health agencies in Southeast Florida.

In addition to completing a demographic data form, subjects were asked to identify five current nursing research issues during Round I. These items were sorted and categorized into 41 discrete items, which subjects were requested to rate on a five‐point scale during Round II. Items were rated in three discrete categories in relation to the importance of the research for patient welfare, nursing education, and nursing practice; and items were rated in three impact statements concerning patient welfare, older people in the state, and older people in the United States. Round III gave the subjects an opportunity to change their rating on being provided with their own rating as well as a group mean on all items for each of the six categories. A total of 50% of the subjects from Round I completed all rounds. The identified priorities can be viewed as a step toward identifying research needs by those in the practice setting and can direct researchers to conduct studies that practicing nurses might be more apt to adapt to their practice settings.
Faculty As Doctoral Students: Policies of Doctoral Programs in Nursing
Authors: Brown Kathleen C. , Dashiff Carol , Henry Beverly M. , Horns Phyllis N.
Published: October 2007

The purpose of this study was to describe and analyze existent policies of doctoral programs in nursing with respect to the dual assumption of the student and faculty member roles. A 7‐item instrument was developed to ascertain policies used by doctoral programs in nursing. All of the 22 programs surveyed responded. The majority of schools had doctoral students in nursing who were also on the faculty in their own program. Equal proportions of the sample (40.9%) either prohibited enrollment of faculty members in the doctoral programs at their schools or permitted enrollment with restrictions in at least one of the following areas: number of dual faculty/ students, rank, credit hours, and limitations to undergraduate teaching only. Each of the four schools having no regulation on the dual role were in private universities and had less than 9% of their faculty enrolled in their doctoral programs. Stringent policies were more likely to be found in public institutions and to have emanated from university regulations. The results indicated that the issue of dual role had achieved policy agenda status in schools of nursing with doctoral programs and that the concern is of such magnitude that it has resulted in policy formulation university‐wide. A variety of enrollment policies appear to have been accepted and valued.
Contexts for Scientific Creativity: Applications to Nursing
Authors: Murphy Susan O.
Published: October 2007

This paper explores the internal process of scientific creativity as described by scholars and scientists and identifies contextual factors that support this process, including institutional setting, scientific collegiaiity, mentorship, freedom of ideas, and avoidance of overcommitments. The author relates this discussion to the discipline of nursing and identifies factors within nursing that foster or hinder creative work. The integration of personal and contextual factors as well as a deep commitment to one's scientific pursuit are proposed as the highest manifestation of creative science and scholarship within a discipline.
Self‐Esteem in Women: The Influence of Employment and Perception of Husband's Appraisals
Authors: Meisenhelder Janice Bell
Published: October 2007

This study examined the influence of five variables on self‐esteem—perceived reflected appraisals of the husband, employment, occupational prestige, husband's preference for his wife's work role and woman's preference for her work role. A random sample of 192 women, aged 25 to 45, married and with children living in the home, was drawn from a suburban resident list. Questionnaires containing Rosenberg's Self‐Esteem Scale and Barrett‐Lennard's Relationship Inventory were mailed to the subjects; 163 (85%) were returned. The results show that the perceived reflected appraisals of the husband was a remarkably strong predictor of self‐esteem for all women but was three times more influential for homemakers than for employed women. Although homemakers and employed women were alike in their self‐esteem, full‐time employed women had significantly higher self‐esteem than did part‐time employed women. Strength of religious beliefs was a positive contributor to the self‐esteem of employed women. The work environment appeared to influence self‐esteem. Nursing interventions to increase self‐esteem in clients are suggested.
Critical Care of Nursing in Nebraska
Authors: McShane Carol McCrann , Wiese Ruth A. , Munn Dawneane F. , Kolbe Mary R. , LaFayette Michael E. , Seidl Lucinda , Dannehl Ann N. , Fritz Lori A.
Published: October 2007

(Ed. note) The University of Nebraska School of Nursing has two campuses: one, the Medical Center in Omaha; the other, the Lincoln Division campus, an hour or so away. The worsening economy of Nebraska agriculture forced the State to examine its expenses, and the Chancellor proposed elimination of the Lincoln nursing program. The Regents voted not to close it. The details of the issues and the concepts of strategy and negotiation used by the College of Nursing to effect this change of policy will be published in Nursing and Health Care in articles by the Dean, Rosalee Yeaworth, and the then Associate Dean, Nancy Langs ton. In an unusual editorial collaboration, IMAGE presents the rest of the story in this piece by the faculty and students—the “grassroots.”
Hospice Policy and Patterns of Care
Authors: Hays Judith C.
Published: October 2007

Hospice providers and policy makers are currently evaluating the emerging patterns of hospice care, especially regarding cost containment considerations. This study compared patterns of care for two groups of hospice homecare clients–one group, which received only homecare services for the duration of the hospice career; the other, which received both hospice homecare and inpatient services. The groups were significantly different on clinical parameters, number of homecare episodes, survival rate, and place of death. The impact of policy structures on continuity of care and service equity are discussed.
Computer Competence for Nurse Educators
Authors: Armstrong Myrna L.
Published: October 2007

The Delphi technique, with an evaluation panel of 56 educators from 28 states during Round One and 55 in Round Two, was used as a method of collecting and organizing judgments of present and future needs for computer competence. Competence statements covered psychomotor, cognitive and affective issues in using the computer and related technology in nursing practice and teaching. Judged to be highly important were 45 of the 68 possible present needs and 44 of the 64 future needs. It was concluded that the most pressing needs for nursing educators are for knowledge of computer technology, information on how to use the computer as an instructional tool, recognition of the nurse's role and issues of computer use in health care and use of the nursing process in the development of computerized care plans.
The Effect of Didactic Teaching on Spiritual Attitudes
Authors: Carson Verna Benner , Winkelstein Marilyn , Soeken Karen , Brunins Maruta
Published: October 2007

The effectiveness of an elective course on spirituality in altering student attitudes was evaluated. A demographic data questionnaire about religious practices and a standardized Religious Belief Questionnaire were completed by 176 junior baccalaureate nursing students. Those students enrolled in a spirituality elective increased their mean scores on four of the seven subscales of the second questionnaire. When compared to students in the other nursing electives, students who had completed the spirituality course also scored higher on four subscales. There were no significant differences in perceptions of religiosity between student groups.
Knowledge Deficit: Not a Nursing Diagnosis
Authors: Jenny Jean L.
Published: October 2007

This paper challenges the conceptual validity of the approved nursing diagnosis “Knowledge Deficit (specify).” The concept is examined in relation to four criteria for legitimate nursing diagnoses: appropriate conceptual focus, necessary diagnostic attributes, theoretical validity and clinical utility. Using these criteria, the author concludes that knowledge deficit is not a legitimate diagnosis and suggests that it can be dropped from the taxonomy. This would encourage clinicians to focus on patients' Problem state using lack of knowledge as a risk factor, etiology or defining characteristic. Patient outcomes would then be defined in terms of state resolution rather than knowledge increment alone.
Pain and Coping
Authors: Geach Barbara
Published: October 2007

Two concepts—pain and coping—are explored. The first part of this paper argues for a circumscribed definition that distinguishes pain from coping or any other element of reaction to it. The second part evaluates a pain‐coping typology in light of this argument and other issues raised.
Studying and Using Conceptual Models of Nursing
Authors: Jacobson Sharol F.
Published: October 2007

This national survey used an investigator‐developed questionnaire to explore how and when graduate nursing students and faculty members learned about conceptual models of nursing and how they regarded them. Of the 691 respondents, 477 (69%) were familiar with 3 or more models. Formal course work, independent studies and continuing education programs were the most frequent sources of knowledge about models. The students reported exposure to models earlier in their educations than did the faculty members. Users of models in practice and research were enthusiastic about their value. Most respondents (87%) regarded the development of conceptual models of nursing as being highly important to the advancement of nursing.
Nursing's Window of Opportunity
Authors: Maraldo Pamela J. , Solomon Sally B.
Published: October 2007

The key questions to be asked in shaping a vision for nursing should be, What are the overall goals that direct the flow of nursing practice? What is nursing's own health policy agenda for the American people? Like any strategic planning effort, shaping our vision makes us gather data about the environment; analyze, examine and reexamine the data; and then link these opportunities and problems to the mission of nursing. The window of opportunity for nursing is now open.
Food for Thought
Authors: Carter Susan L.
Published: October 2007

An actual account of a nursing student's experience on an ordinary morning when she leaves her doctoral studies and the enjoyment of ideas to face the hungry in a neighborhood food pantry and then returns to her studies.
Methods of Pain Control: Review of Research and Literature
Authors: Whipple Beverly
Published: October 2007

This article reviews methods of pain control to help the nurse gain an awareness of various interventions suggested by research. An overview of the neurophysiology of pain and the gate‐control theory of pain are presented. Considered are such interventions as medications, stimulation of the brain, cutaneous stimulation, stress‐induced analgesia, vaginal stimulation‐produced analgesia, acupuncture and acupressure, hypnosis, placebos, imagery, behavior modification, biofeedback, distraction and relaxation. Individualization of the nursing caw plan is encouraged to include patients as active participants who suggest alternative methods of pain control that they have found effective.
An Analysis of the Phenomenon of Deterioration in the Critically Ill
Authors: Smith Sheila K.
Published: October 2007

An exploratory clinical investigation using qualitative methodology was conducted to identify and characterize the phenomenon of “deterioration” as it occurs among critically ill patients. Six purposively selected, critical care nurses were interviewed regarding their personal, practice‐based experience with deterioration. Subjective and objective manifestations of the phenomenon emerged, suggesting a recognizable pattern of empirical descriptors. Deterioration may be identified as a significant process of transition and health‐illness patterning, indicating a change in an individual's trajectory toward death. This change can be perceived and is often acted on by experienced critical care nurses.
Nurses' Reactions to Difficult Patients
Authors: Podrasky Debra L. , Sexton Dorothy L.
Published: October 2007

The purpose of this study was to determine whom nurses identify as difficult patients and how nurses might react to them emotionally and behaviorally. Participants (N = 73) responded to a self‐report questionnaire that contained hypothetical situations involving difficult patients. Frustration and anger were the most common reactions. The traits or behaviors that nurses reported as belonging to the most difficult patients were characteristics that are potentially modifiable. In the majority of cases the nurses' reports of their reactions were classic fight/flight responses.
Diabetes Self‐Management and Hospitalization
Authors: Germain Carol P. , Nemchik Rita M.
Published: October 2007

This descriptive survey sought to determine the desires, concerns and experiences of persons with diabetes regarding retention of self‐management during potential and prior hospitalization. Seventy‐three members of an American Diabetes Association chapter completed a questionnaire consisting of both closed‐ended and open‐ended items. Although the subjects were generally self‐managing and compliant at home, they held a diversity of beliefs about self‐management during hospitalization. Those who had been hospitalized had most diabetes care activities performed by the staff members. Assessing desires, competence and readiness of persons with diabetes for self‐management during hospitalization and possible nursing and hospital system changes are suggested to support self‐management when indicated.
Nurses' Attitudes Toward Impaired Colleagues
Authors: Cannon Barbara L. , Brown Julia S.
Published: October 2007

This study describes the attitudes of Oregon nurses toward substance abuse, substance abusers in general and impaired nurses in particular. Questionnaires were mailed to 500 randomly selected nurses, and 396 replied. Overall, nurses' attitudes, as measured by Chappel's Substance Abuse Attitude Survey (SAAS), were positive, as were their attitudes toward impaired colleagues. Regarding alcohol‐impaired nurses, 77 percent of the respondents were willing to confront them, 67 percent favored their return to practice and 85 percent would accept them as co‐workers if hired. Corresponding percentages for drug‐impaired colleagues were 76 percent, 54 percent, and 73 percent. Nurses less approving of treatment interventions, more optimistic about treatment, employed for fewer years and with a baccalaureate or higher degree were more positive and supportive of impaired nurses than were their counterparts.
Colonial Heritage and Nursing Leadership in Trinidad and Tobago
Authors: Hezekiah Jocelyn
Published: October 2007

The present report analyzes the development of indigenous nursing leadership in Trinidad and Tobago within a political and economic context. Psychological and administrative factors inherited from the nation's colonial past persisted in the postindependence period (1956‐1986). Discussed in the report are political and economic factors that both promoted and hindered the development of indigenous nursing leadership as well as international nursing perspectives that have relevance to the issue.
Rationale for Clinician Self‐Disclosure and Research Agenda
Authors: Coolidge Young Jane
Published: October 2007

Patient self‐disclosure is essential for effective, individualized health care. Since it is not necessarily forthcoming, health professionals must use communication strategies to facilitate patient self‐disclosure. Therapist self‐disclosure has become firmly established within the psychological literature as a facilitator of patient self‐disclosure. Theoretically, clinician self‐disclosure is supported within the framework of the helping relationship, operationalizing genuineness and perhaps empathy as well as decreasing the social distance. Historically, health professionals have been educated to avoid self‐disclosure with their patients. Perhaps health professionals have been deliberately suppressing a potentially powerful communication technique.
Role Modeling versus Mentoring in Nursing Education
Authors: Bidwell Alice Susan , Brasler Mary L.
Published: October 2007

Role modeling, an accepted strategy for transmitting professional attitudes and behaviors from nursing instructor to students, and mentoring, a newer strategy in nursing education, are compared and contrasted. Possibilities for research and implications are discussed.
Models for Moral Response in Care of Seriously Ill Children
Authors: Dormire Sharon L.
Published: October 2007

This paper presents a discussion of three models for provision of care to seriously ill infants and their families. The statistical, the wait until near‐certainty and the individual models are defined and compared. Comparisons were based on quality of life, legality, responsibility, withdrawing/withholding treatment and potential injury. The individual model offers the most humane and legally sound basis for care. Suggestions to redefine the model of care in the United States are offered with nursing leading the way.
Nursing In A Hospital‐Based Hospice Unit
Authors: Samarel Nelda
Published: October 2007

The purpose of this ethnographic study was to describe and analyze the ways in which registered nurses interacted with those terminally ill and acutely ill patients typical of a hospital‐based hospice unit. Participant observation and informal interviews were used to collect data. Field notes were analyzed systematically using a constant comparative method of qualitative analysis. Data analysis revealed that patients' responsiveness rather than “acute,” or “terminal” labels determined the quality of the nurses' interactions with them. Humanistic caring was found to be the unifying focus of care for both acutely ill and terminally ill patients.
Managing Vulnerability : Nursing Treatment for Heroin Addicts
Authors: Chenitz W. Carole
Published: October 2007

Grounded theory methodology was used to study nursing interventions in a methadone maintenance clinic. Participant‐observation as a clinic stay nurse over four months was the principal method of data collection. A substantive theory called “managing vulnerability” was developed to describe nursing treatment of heroin addicts during methadone maintenance. Managing vulnerability has three parallel stages for the client and nurse. These stages are (a) learning to be vulnerable, (b) living with vulnerability and (c) beyond vulnerability. Basic conditions for this process are dispensing (giving) medication; therapeutic neutrality, which is the attitude assumed by the nurse; effective staff communication and clear clinic policy. Managing vulnerability illustrates the complexity of a therapeutic psychological nursing process.
Critical Multiplism: A Research Strategy for Nursing Science
Authors: Coward Doris D.
Published: October 2007

This paper describes critical multiplism from the perspective of the world views and models of scientific inquiry that frequently guide the work of nurse scientists. Nurse scientists may wish to consider critical multiplism as a research strategy within a dialectical model of scientific inquiry to study the multiple realities of interest to nurses. This approach to nursing knowledge development may enhance the usefulness of nursing research findings in nursing practice.
Meaningful Life Experience to the Elderly
Authors: Trice Lucy Bland
Published: October 2007

The purpose of the study was to identify the basic structure of an experience from life through which or during which the elderly derive the sense that life is meaningful, as a manifestation of the human spirit. A phenomenological methodology was used, with participants being interviewed until common themes emerged. Protocols obtained from the interviews were analyzed according to the seven‐step method developed by Colaizzi (1978). An exhaustive description of the meaningful experience was obtained; it includes four common themes. The themes and the implications for nursing practice are discussed.
An Update on Nursing Research and HIV Infection
Authors: Larson Elaine , Ropka Mary E.
Published: October 2007

More than 16,000 citations related to AIDS and HIV infection between May 1987 and June 1990 (38 months) were surveyed to summarize nursing research related to HN infection; 731 non‐research and 54 research articles, averaging about 20/month, were found. However, only 20 of the research articles addressed the five topic areas set as priority by the National Center for Nursing Research Priority Expert Panel (physiological and psychosocial aspects of care, prevention of transmission, care delivery systems, and applied ethics). There is a continued gap in the research literature related to the care aspects of HIV infection. This gap needs to be filled by nursing investigation.
The Lived Experience of Survival and Bereavement Following the Death of a Lover from AIDS
Authors: Sowell Richard L. , Bramlett Martha H. , Gueldner Sarah H. , Gritzmacher Deborah , Martin George
Published: October 2007

This phenomenologic study explored the lived experience of survival and bereavement following the death of a lover from AIDS. The sample (N=8) included individuals who had lost a her/partner to AIDS within the 18 month period prior to interview. Respondents were asked to reply to the following question: “Please describe your experience of losing a lover to AIDS. Describe events and feelings which you experienced both prior to and after the death of your lover.” Themes were identified, analyzed, sorted into theme clusters and then categorized. Categories of Isolation/Disconnectedness, Emotional Confusion, and Acceptance/Denial were identified. A statement of the essential nature of the experience of surviving the death of a lover/partner from AIDS is presented.
A Taxonomic Structure for the Concept Comfort
Authors: Kolcaba Katharine Y.
Published: October 2007

The concept of comfort is an important one for nursing, but because of its complexity, it has not been analyzed, operationalized or structured for nursing science. In this paper, three technical senses of the term are derived from: (a) contemporary and archaic lexical entries; (b) analysis of how the concept is used in contemporary and historical nursing literature; and (c) theoretical support found in the disciplines of nursing and ergonomics. Next, the contexts of patients' needs are explored and four contexts are derived from the nursing literature on holism. When the three senses and the four contexts of needs are juxtaposed, a 3 × 4 grid with 12 elements emerges that encompasses the total domain of patient comfort. Each element describes an aspect of comfort from which empirical indicators, antecedents, consequents and test items can be developed. The grid represents a taxonomic structure of the concept that organizes the meanings of this complex concept. The structure can be used to develop comfort pretests as the nurse assesses possible needs in a given situation and to develop comfort post tests, to assess the effectiveness of comfort measures.
Rosemary Ellis' Views on the Substantive Structure of Nursing
Authors: Algase Donna L. , Whall Ann F.
Published: October 2007

According to the late Rosemary Ellis, the most pressing priority of nursing scholars is to explicate the substantive structure of our discipline. Drawing largely from her unpublished work, this paper summarizes the views of Ellis on the nature of nursing's substantive structure and raises implications for the development of nursing theory.
Thoughts About Nursing
Authors: Smith Dorothy M.
Published: October 2007

A graduate of Quincy City (Massachusetts) Hospital School of Nursing and holding the BS degree from Teachers College, Columbia University and the MS degree from Harvard University, Dorothy Smith was dean of the College of Nursing and chief of nursing practice at the J. Hillis Miller Health Center, University of Florida, Gainesville from 1956 to 1972. In that capacity, Smith pioneered the development of the unified model of nursing education and practice in which nursing faculty provided the clinical, scholarly and administrative leadership in the teaching hospital to create an environment for students to learn professional nursing practice by example. The unification model at the University of Florida has been replicated in varying degrees in many of the nation's leading health sciences centers. Dorothy Smith, probably more than any other single nurse leader in America, influenced nursing education's renewed commitment to clinical nursing—a commitment that eventually spawned clinical nurse specialists and nurse practitioners, organizational reforms in hospitals that promoted professional nursing practice, and the evolution of clinical nursing research.
An Assessment of Arab American Knowledge, Attitudes, and Beliefs about AIDS
Authors: Kulwicki Anahid Dervartanian , Cass Penny S.
Published: October 2007

An important component of an effective AIDS prevention program is the dissemination of relevant information concerning AIDS risk behaviors. The purpose of this study was to identify the knowledge, attitudes, and beliefs of 411 randomly selected Arab Americans. The results indicate a low level of self‐assessed knowledge about AIDS, a high number of misconceptions about the transmission of HIV, and a high level of anxiety about HIV infection.
Exclusion of Certain Groups from Clinical Research
Authors: Larson Elaine
Published: October 2007

Recent evidence indicates that certain groups such as women, ethnic minorities, the elderly, and the poor may be underrepresented in clinical research. A review was conducted of 754 approved research protocols from one tertiary care center over a 2‐year period (1989, 1990) to examine demographic characteristics of subjects. Most protocols (81.4%) included both men and women; 56.6% included people over age 65. About three‐fourths described exclusionary criteria. Exclusions for which a justification was least frequently explicated were for age (44.9%), socioeconomic status (42.9%), and race (38.1%). In nursing protocols, only 26.6% included a justification for age. In this study, the elderly, poor and ethnic minorities were found to be excluded without identifiable justification from research protocols. While such disparities must be corrected, there are certain research design considerations that should be taken into account to assure that research questions are answered in the most efficient manner for the most representative group.
Rethinking the Merger of the Clinical Nurse Specialist and the Nurse Practitioner Roles
Authors: Page Nancy E. , Arena Donna M.
Published: October 2007

The clinical nurse specialist (CNS) and nurse practitioner (NP) have been distinct and separate advanced nursing practice roles since the 1960s. The forces of economics and health care reform have fostered an interest in merging these two advanced practice roles. Economic and regulatory advantages have been noted in the literature for both roles. What is not so evident are the possible disadvantages. Several aspects of the merger issue are explored as is the recent background of the creation of the CNS and NP roles. Problems and questions are asked to stimulate future discussions in nursing's professional associations and in education and service settings.
Transitions: A Central Concept in Nursing
Authors: Schumacher Karen L. , Meleis Afaf lbrahim
Published: October 2007

Transition is a concept of interest to nurse researchers, clinicians, and theorists. This article builds on earlier theoretical work on transitions by providing evidence from the nursing literature. A review and synthesis of the nursing literature (1986–1992) supports the claim of the centrality of transitions in nursing. Universal properties of transitions are process, direction, and change in fundamental life patterns. At the individual and family levels, changes occurring in identities, roles, relationships, abilities, and patterns of behavior constitute transitions. At the organizational level, transitional change is that occurring in structure, function, or dynamics. Conditions that may influence the quality of the transition experience and the consequences of transitions are meanings, expectations, level of knowledge and skill, environment, level of planning, and emotional and physical well‐being. Indicators of successful transitions are subjective well‐being, role mastery, and the well‐being of relationships. Three types of nursing therapeutics are discussed. A framework for further work is described
Conflict of interest in academia
Authors: Goldrick Barbara A. , Larson Elaine , Lyons Doris
Published: October 2007

Conflict of interest in academia has been increasingly recognized over the past decade. Yet, comparatively little is written in respect to this problem. The authors provide an overview of conflict of interest as it applies to nursing research and addresses how it can also affect practice and education. Resources for the development of guidelines to prevent conflicts of interest are presented.
Equal Team Partners? The Roles of Principal Investigators, Co‐Principal Investigators and Co‐Investigators on Federally Supported Research Grants
Authors: Cohen Felissa L. , Holm Karyn , Cloninger Lea
Published: October 2007

A survey of 188 NLN‐accredited graduate nursing programs was done to determine how the research roles of principal investigator (PI), co‐principal investigator (Co‐PI) and co‐investigator (Co‐I) are supported and to examine the similarities and differences in benefits for Pis, Co‐PIs and Co‐Is. Most schools did not provide salary supplementation in addition to the usual salary for any investigators. For other benefits, the PI was more likely than was the Co‐PI or Co‐I to receive direct access to indirect cost recovery dollars, the use of extra research assistants, and the reduction of teaching time commensurate with the time supported by their grant. If the team approach is truly valued, should not all investigators be rewarded in a like manner?
Schema Model of the Self‐Concept
Authors: Stein Karen Farchaus
Published: October 2007

The centrality of the self‐concept in maintaining physical and psychosocial well‐being is widely recognized in nursing. Despite its importance, progress in the development of an empirically‐supported and clinically‐relevant theoretical framework has been limited by difficulties in defining and measuring the construct. The schema model of the self‐concept is presented as a theoretical framework that has the potential for explaining how the self‐concept functions to influence emotional and behavioral responses to events relevant to health and well‐being.
Perceived Changes in Adult Family Members' Roles and Responsibilities During Critical Illness
Authors: Johnson Susan K. , Craft Martha , Titler Marita , Halm Margo , Kleiber Charmaine , Montgomery Lou Ann , Megivern Karen , Nicholson Anita , Buckwalter Kathleen
Published: October 2007

An exploratory design was used to study the effects of critical care hospitalization on family roles and responsibilities of adult family members and how these effects changed over time. A convenience sample of 52 subjects from pediatric, neonatal, surgical, medical, and cardiovascular intensive care units was used. Data were collected using an open‐ended question contained in the Iowa ICU Family Scale (IIFS). Using qualitative techniques, seven themes were identified: (a) Pulling together, (b) Fragmentation of families, (c) Increased dependence, (d) Increased independence, (e) Increased responsibilities, (f) Change in routine, and (g) Change in feelings. These findings indicate that nurses need to implement family‐centered interventions such as role supplementation programs or identification of support systems to decrease role strain and role overload in families during a crisis.
Reversal Theory's Mastery and Sympathy States in Smoking Cessation
Authors: O'Connell Kathleen A. , Gerkovich Mary M. , Cook Mary R.
Published: October 2007

Relapse is the most frequent outcome of smoking cessation attempts. This study tests the usefulness of the mastery and sympathy concepts of Apter's reversal theory to explain whether subjects lapse or abstain during highly tempting situations. Descriptions of the highly tempting situations of 57 individuals who were attempting to quit smoking were assigned to mastery or sympathy categories. Situations were also coded for availability of cigarettes. Log it modeling revealed that both the mastery/sympathy variable and the availability of cigarettes were necessary to fit the data. Being in the mastery state and having to exert effort to get cigarettes were significantly related to resisting the urge to smoke. The smoking status of 86% of the subjects was correctly classified using both variables. The usefulness of mastery/sympathy states in explaining relapses in behavior change is discussed
Enhancing the Role of Community‐Health Workers in Research
Authors: Hill Martha N. , Bone Lee R. , Butz Arlene M.
Published: October 2007

With recognition of the importance of meeting the needs of underserved communities and the shift to more primary care—community‐health workers need to be part of health teams. Community‐health workers, in voluntary and salaried positions, augment the roles of professionals through outreach and community‐based work and serve as liaisons between communities and institutions. This article describes the rationale for inclusion of community‐health workers in research; their roles and responsibilities; and issues in their selection, training, and supervision. Examples are given from the authors' experience with interventions by nurse and community teams. Inclusion of community‐health workers enriches the comprehensiveness of a holistic scientific approach to understanding health in a community.