bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncovering the features of negotiation in developing the patient–nurse relationship
Authors: Stoddart Kathleen , Bugge Carol 
Published: May 2014

This article describes a study that set out to explore the interaction between patients and nurses in community practice settings, in order to understand the social meanings and understandings brought to the interaction and at play within it. Method: The study used a grounded theory methodology with traditional procedures. Driven by constant comparative analysis, data were collected by non-participant observation and informal and semi-structured interviews in four community health centres. Eighteen patients and 18 registered practice nurses participated. Results: Negotiation was found to be a fundamental process in patient–nurse interaction. Navigation, socio-cultural characteristics and power and control were found to be key properties of negotiation. The negotiation processes for developing understanding required patients and nurses to draw upon social meanings and understandings generated from within and beyond their current interaction. Conclusion: Social meanings and understandings created within and beyond the health-care setting influence negotiation. The developmental nature of negotiation in interaction is an important dimension of the patient– nurse relationship in community practice.
Dressing challenging anatomical areas: the Allevyn Gentle Border range
Authors: Stephen-Haynes Jackie , Greenwood Michelle , Merrick Jola , Callaghan Rosie 
Published: May 2014

Wound care is a complex area, and there are several factors that can influence the choice of dressing. These factors include: the care setting, type of wound, desired frequency of dressing change, and estimated duration of treatment. Further, dressing choice can be influenced by complications such as wound infection. In addition, when choosing a dressing, clinicians providing wound care need to consider the following factors: wound bed characteristics; ease of dressing application and removal; conformability; exudate management; dressing wear time; and tolerability by the patient, including the effect on lifestyle and quality of life. If all these factors are taken into account, patients are more likely to be concordant with treatment and a positive outcome achieved. For these reasons, a holistic approach to care can inform dressing selection. There are six case studies of patients presenting wounds that showed improvement after treatment with dressings from the Allevyn Gentle range.
When patients refuse treatment
Authors: Nazarko Linda 
Published: May 2014

Mrs Janet Johnston is refusing medication, failing to comply with her diabetic diet and refusing to mobilize following a repair of fractured neck of femur. If she does not improve, Mrs Johnston will be discharged immobile, with a large package of care and long-term health needs. Using a holistic approach can enable staff to see the person behind the problems and develop a partnership with Mrs Johnston to enable her to heal and become well again. This article will use the fictional Mrs Johnston as an example of a patient refusing care.
Post-stroke psychological and communication issues
Authors: Ross Sarah , Barton Jane , Reading Jennifer 
Published: May 2014

This article describes the development, content and evaluation to date of an in-service, interdisciplinary training programme on psychological and communication problems after stroke. The training is open to all staff but is particularly focused towards qualified and unqualified nursing staff and therapy assistants who work in acute stroke care and rehabilitation both in hospital and community settings. Content: The programme, developed by the authors whose backgrounds include speech and language therapy, occupational therapy, and clinical psychology, aims for all staff to develop an integrated, patient-centred approach to care, and addresses issues such as improving the patient and carer experience of rehabilitation, as well as reducing the negative psychosocial consequences of stroke. Service users are involved in delivering the training. Informal evaluation highlighted improvements for trained staff in knowledge and perceived confidence in the recognition and basic management of communication, cognitive and emotional problems after stroke. Conclusions: Limitations in evaluation in terms of design, methodology and data are acknowledged, however, preliminary findings highlight the benefits of this programme in holistic stroke care delivery. Suggestions are made regarding future more empirically rigorous research into longer-term effects of the training both for staff and patient outcomes..
Mary Seacole: nursing care in many lands
Authors: Anionwu Elizabeth N 
Published: May 2014

Mary Seacole, a Jamaican/Scottish nurse and businesswoman, was a celebrated Victorian heroine, due to her bravery in nursing soldiers in the Crimean War (1853-6). She was also admired for her use of Creole herbal remedies to relieve the symptoms of infectious illnesses such as cholera in Jamaica and Panama. .
Role of HCAs and APs in the evolving protection landscape
Authors: Yeomans Paul 
Published: May 2014

The landscape of protection is changing and HCAs/APs must be confident of their place in it in order to work effectively. Each devolved and neighbouring jurisdiction of the UK has its own guidance for children and young people (CYP) and for vulnerable adults (VAs) (or adults ‘at risk’). If abuse is suspected or reported, you are in the realm of criminal investigation and it may be necessary to contact the police immediately. Besides the substantive offences, HCAs/APs should be confident with disclosure and information-sharing between agencies and professionals. All health staff need to know how to contact others (designated health lead or expert, social services, NSPCC, police, probation). As part of professional development, there may be monitoring issues for colleagues, as well as ensuring that signs of abuse are acted upon appropriately. Regulations, guidance and government responses to failings and scandals also influence public awareness and opinion, which can affect cooperation and disclosure too.
Consensus and contention: doctors’ and managers’ perceptions of the doctor-manager relationship
Authors: Davies Huw T.O. , Hodges Claire-Louise , Rundall Thomas G 
Published: May 2014

The relationship between clinicians and managers is central to the success of health care reform and improvement. This paper assesses how they see each other. This paper expands and elaborates on survey data originally published as a ‘short report’ in the BMJ (BMJ 2003;326:626-8). Data reproduced with permission.
A study of the burden of caring for patients with amyotrophic lateral sclerosis (MND) in Japan
Authors: Akiyama Miki Onishi , Kayama Mami , Takamura Soichi , Kawano Yuri , Ohbu Sadayoshi , Fukuhara Shunichi 
Published: May 2014

Objective: The purpose of this study was to explain the experiences of caregivers of patients with amyotrophic lateral sclerosis (ALS) receiving invasive ventilation in Japan. Methods: Subjects were 12 primary caregivers of ALS patients receiving invasive ventilation. Subjects were selected by theoretical sampling. Semi-structured interviews were undertaken with each subject. The data were analyzed using a grounded theory approach. Results: Caregivers tried to ‘find a meaning in prolonging life,’ which represented a core category. Two subcategories relate directly to the core category. These were ‘hesitation and regret over the decision’ and ‘feeling of being supported’. Each subcategory had four internal dimensions: ‘uncertainty of the future’, ‘communication’, ‘maintaining their own life’ and ‘support’. Conclusions: The process of caring for ALS patients is dynamic. The success or failure of continuing care depends on ‘finding a meaning of prolonged life’. It is important for nurses to be aware of that. Further investigation is required into appropriate intervention for caregivers of ALS patients.
Identity construction and meaning-making after subarachnoid haemorrhage
Authors: Berggren Elisabeth , Sidenvall Birgitta , Muhli Ulla Hellström 
Published: May 2014

Aim The aim was to analyse people's accounts of subarachnoid haemorrhage (SAH) and to describe how they initiate and create meaning for the onset and events surrounding the SAH. Background Being struck by a SAH is a dramatic event, often followed by unconsciousness. There is therefore a special need for a patient to try to create some kind of meaning for the event during recovery and afterwards. Method Nine interviews were carried out in home settings and discourse analysis was used to interpret the data. Findings People stricken by SAH seem to be able to judge from memory for when they were becoming ill. Critical events related to SAH were existential threats and existential insights; and time as ‘waiting’ and time as ‘structuring meaning’. The reconstruction of the illness event may be interpreted as an identity-creating process. Conclusions The reconstruction of the illness is a tool that can be used by nurses and other health professionals to understand a patient's self-positioning and identity-construction.
Recognition of stroke symptoms by stroke survivors
Authors: O’Connell Elizabeth , Hartigan Irene 
Published: May 2014

Background: Stroke remains a leading cause of death and disability, and patient outcomes are dependent on early access to emergency treatment. However, despite public education campaigns, many patients and carers fail to recognize the symptoms of stroke and often delay accessing medical services Aim: This paper reports first-time stroke patients’ description of their symptoms and the sequence of events which lead them to seeking medical treatment. Methods: Secondary data analysis was conducted on transcripts (n=10) exploring patient perceptions of their stroke experience. Results: Seven of the ten participants failed to recognize their symptoms as those associated with stroke. Limb weakness was the symptom most easily recognized by the participants as that of a stroke. Only three of the ten participants immediately recognized that their symptoms were that of a stroke. When symptoms were recognized either by the patient or a family member, participants accessed medical treatment promptly. Conclusions: The study found that the majority of participants could not identify stroke warning signs. Furthermore, the participants descriptions of the event is conveyed in a language different to that used in various awareness campaigns. Further research is needed to explore the language used in stroke awareness campaigns and the language used by patients themselves interpretating their symptoms.
Choice of a scan: how much info do women receive before ultrasound
Authors: Proud Jean , Murphy-Black Tricia 
Published: May 2014

In order to discover the amount of information given to women so that they can make a choice as to whether to have a scan or not, a questionnaire was sent to 100 maternity units. Ninety-four units responded; out of these a subsample of 45 were sent a further, more detailed questionnaire. Analysis of the results revealed that 48% of the initial sample units gave information to women of the scan's potential to detect anomalies; of these only 26% gave the information before the first scan. Eighty-three per cent of the midwives asked knew that anomalies can be detected at any scan. The value of scanning as a screening procedure was only discussed with women in 10 units in this sample, 83% of the midwives seemingly confused about its use in this respect. It was found therefore that the minority of units in this sample gave comprehensive, unbiased, information to aid women in their choice of whether or not to undergo ultrasound in pregnancy.
Screening for Down's syndrome: what the women think
Authors: Fairgrieve S 
Published: May 2014

An audit of womens views was undertaken in an attempt to improve the Downs sydrome screening programme. The findings highlight the key contribution of midwives and indicate womens need for more explanation and information about the test. The audit cycle was completed by a repeat questionnaire to assess the impact of recommendations introduced following the preliminary audit. This showed significant improvements in the levels of satisfaction with the screening programme.
Duration of breastfeeding in young women: psychological influences
Authors: Bailey Jacqueline , Clark Marie , Shepherd Richard 
Published: May 2014

Breastfeeding rates for young mothers are lower than for older mothers and are poorer at four months than at initiation. Therefore the aim of this study was to discover which psychosocial factors influence breastfeeding duration and which factors are different between age groups. Fifty-seven participants aged 16–24 and 25–40 completed the following measures antenatally and postnatally: a self-esteem-scale, a parent expectations survey, a general self-efficacy scale (GSES), an attitudes to breastfeeding scale, a breastfeeding support scale and a breastfeeding self-efficacy scale (BSES). Duration of breastfeeding varied from 0 days to 4 months. There was a significant difference in attitudes between the age groups with the older women having more positive attitudes. Multiple hierarchical regression analysis showed that the GSES scores and the BSES scores significantly predicted duration independently of age. Breastfeeding self-efficacy decreased overall after giving birth and to a greater extent in younger mothers who had significantly lower scores on postnatal breastfeeding self-efficacy, which perhaps accounts for younger mothers giving up breastfeeding sooner.
Postpartum MMR immunization uptake in non-immune women
Authors: Yung Chee , Skidmore Sue , Lord Sharon 
Published: May 2014

The percentage of rubella susceptible pregnant women has increased recently. Main approaches to postpartum measles, mumps and rubella (MMR) immunization are either immunization before discharge or a recommendation to attend GPs for vaccination after discharge. As there is no national surveillance of MMR uptake postpartum in non-immune women, an audit was carried out in two delivery units using different approaches. In the unit using referral to GPs, only 29% (22/76) of women could be confirmed as having received MMR immunization six months post delivery. The approach offering MMR immunization in the delivery unit postpartum showed a confirmed uptake of 60% (26/43). Therefore the latter approach is more effective and likely to result in better uptake than referring women to their GPs. It should be used to provide immunization to vulnerable women since this would lead to a reduction in the number at risk of acquiring rubella during pregnancy.
Managing demand: telephone triage in acute maternity services
Authors: Cherry Alison , Friel Ruth , Dowden Barbara , Ashton Kim , Evans Rhian , Pugh Yeasmin , Evans Yvonne 
Published: May 2014

A project providing triage in acute maternity settings was developed to better manage demand and ensure the right service was available at the right time and in the right place. Data collected prior to implementing the telephone triage project identified that a significant number of women accessed the labour ward as their first point of contact for advice with maternity services resulting in an unnecessarily high volume and throughput where labour ward was in effect gate-keeping other clinical areas. The project was designed and introduced to maximize the use of the clinical expertise possessed by a group of practice development midwives. Early results suggest that demand and patient flow is better managed following the introduction of the telephone triage service. The development of a telephone triage service within an acute maternity service is beneficial and can result in a reduction in inappropriate admissions. There are benefits at a client, clinician, service and organizational level.
Antenatal anxiety in pregnant women from rural Cambodia
Authors: MacLellan Jennifer 
Published: May 2014

This article is a report of a grounded theory study of pregnancy and childbirth experiences of women in rural Cambodia. Antenatal anxiety and depression have been linked to adverse outcomes of preterm delivery and low birth weight in the baby. Recent study findings from Cambodia reveal high levels of clinically significant antenatal anxiety and depression with consequent links to low birth weight in the infant. Thirteen in-depth interviews with rural pregnant women were conducted in December 2008 over 3 days during the midwifery outreach service to the villages. The research process followed the principles of grounded theory methodology. Four core categories were identified during the interview analysis: fear of childbirth, lack of information, traditional versus allopathic practice, and access to the government midwife. Childbirth causes fear, largely owing to a lack of knowledge about the normal physiological process and fear of death in the case of complications due to poor access to health services. Traditional and allopathic practice largely ran in parallel or in contradiction to each other but there were some examples of successful integration. Most of the interviewees wanted more contact with the government midwife. This could be an opportunity to share information in a confidential, non-threatening but informative relationship while reducing anxiety and consequences for the mother and her child. These categories can be extrapolated to the wider context highlighting complex barriers to women accessing midwifery care, while emphasizing the negative impact of anxiety on fetal wellbeing and the role of accurate information and professional support.
Do midwives give adequate information to women about instrumental birth?
Authors: Goyder Karen , Bahl Rachna , Ford Jenny , Strachan Bryony 
Published: May 2014

One in four women in their first pregnancy will have an instrumental birth. Many women are traumatized by their experience of instrumental birth and feel they have been inadequately prepared. If this is the case are we, as a profession, falling short of providing women with the information they need to support them through these more challenging births? This study investigates the format and content of information given by community midwives about instrumental birth. The midwives were asked what training they had to support them and how they adapted their education classes to encourage women from all backgrounds to attend. A questionnaire survey was completed by community midwives from a University Teaching Hospital (Foundation Trust). The findings demonstrate that information about instrumental birth is not consistent and does not reach enough women. The study draws attention to the training needs of midwives and highlights their concerns regarding workload constraints and time pressures.
Maternal obesity: risk or resolution? A literature review—part 1
Authors: Williams Helen 
Published: May 2014

This article presents the first part of an extended literature review aiming to explore whether current antenatal care results in a missed health promotion opportunity to address the issue of obesity in pregnant women. This integrative literature review analysed 36 primary and secondary research studies. Both qualitative and quantitative studies were included. Five main themes emerged from the study: Resource implications around maternal obesity The value of measurement and monitoring of gestational weight gain The value and effectiveness of antenatal interventions Women and midwives understanding of the risks of obesity The links between maternal obesity psychological, and socio-economic factors. The first two themes will be discussed in part 1 of this review. The concluding part explores the other three themes and identifies recommendations for practice and further areas for research.
Antenatal care before caesarean section in rural Turkey
Authors: Okumus Filiz , Sohbet Rabia 
Published: May 2014

This cross-sectional study was conducted at the state hospital in Gaziantep, rural Turkey, to assess the quality of antenatal care in women who underwent caesarean section (CS). Data collected from 581 women admitted for CS between October and December 2005 were retrospectively analysed and found that Turkish women preferred obstetricians to midwives for their antenatal care. Obstetricians chiefly consider antenatal care as a follow-up to ultrasound, and procedures such as weight monitoring, blood pressure measurement and blood analysis, all of which help to facilitate timely diagnosis of complications, were mostly overlooked. The belief that antenatal care is only for women with complications could be abolished through education and may help to encourage vaginal delivery. Pregnant women who receive antenatal care from obstetricians are more likely to undergo CS, thus greater collaboration between obstetricians and midwives is necessary in future to promote normal births.
Improving the accuracy of medication history taking in a diabetic eye clinic
Authors: Tattersall Chris , Hartry Nicola , Ram AR Raghu 
Published: May 2014

Aim: To assess whether the use of a pre-visit medication questionnaire combined with clinical interview improves the accuracy of medication history taking when compared with direct questioning only, for new patients attending a diabetic eye clinic. Method: A service evaluation was undertaken using a retrospective case-control design. Fifty consecutive new patients visiting the clinic before a new pre-visit medication questionnaire was introduced were used as controls (group 1). New patients attending the clinic after the introduction of the questionnaire, who had been sent the questionnaire and completed it (group 2), were then matched to patients in group 1 over a 6-month period. The reported medication histories for both groups were then checked with the patients’ GP. Results: Forty-two matched pairs were identified. There was no significant difference (P=0.71) between the number of medications prescribed in group 1 (mean=6.2; standard deviation [SD]=3.8) and group 2 (mean=6.5; SD=2.9). However, there was a highly significant difference in the number of errors in the stated medication lists between groups 1 and 2: this favoured group 2, who completed a preclinic questionnaire before attending the clinic. Conclusion: The use of a pre-clinic questionnaire combined with clinical interview provides a significantly more accurate assessment of a patient’s current medication list than interview alone.
Perceptions of a clinical psychology support group for spinal injury
Authors: Fleming Pete , King Lorraine , Royle Jane 
Published: May 2014

Background: A service evaluation was performed exploring nurses' perceptions of a clinical psychology facilitated peer support group in a spinal injury rehabilitation setting. Aims: To determine whether staff found the meetings useful while, more broadly, to highlight the need to support and supervise nursing staff in psychological care appropriately. Method: A questionnaire was developed and distributed to the 30 members of staff who worked on the ward. Seventeen questionnaires were returned (57%). Data was analysed using thematic analysis. Results: The meetings were viewed as a place to discuss issues, and a safe protected space to share stresses. Staff felt the meetings aided team cohesion and helped them share ideas and draw up clinical strategies. Meetings aided stress management and confidence building. Staff considered the meetings to increase their psychological awareness and understanding. Conclusion: Staff involved in the acute care and rehabilitation of spinal injured patients are consistently exposed to highly demanding and stressful clinical environments. Support meetings where staff can discuss patient and ward issues are invaluable. Other clinical nursing areas would benefit from similar support systems.