bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group support for couples coping with a cardiac condition
Authors: Stewart Miriam , Davidson Karina , Meade Darlene , Hirth Alexandra , Weld‐Viscount Patty 
Published: August 2010

Group support for couples coping with a cardiac condition Background/Rationale. Support groups of peers were designed to convey support specific to stressful situations encountered by persons with a first‐time myocardial infarction and by their spouse or partners. There were no previous published support intervention studies focused on the couple. Survivors and spouses (n=28) participated in a pilot study which tested the effect of a 12‐week support group intervention. Design. The support groups for couples were cofacilitated by a peer and professional. The facilitators recorded field notes, while participants completed weekly diaries about the intervention activities. Following the intervention, participants were interviewed individually and facilitators were interviewed jointly about the perceived effect of the intervention and influencing factors. This article focuses on the facilitators’ and participants’ perceptions of intervention processes and outcomes. Findings. Support processes in the group included social comparison, social learning, and social exchange. Three types of support – emotional, information, and affirmation – were provided. All participants were satisfied with the support intervention and referred to the positive effect on their coping, confidence, outlook, and spousal relationship. Factors that influenced the intervention effect were participant input, cofacilitation, similarity of group members, and the provision of information and support. Conclusions. Future interventions could consider similarity of peers, leadership, and optimum timing and duration.
The symptom experience of women with chronic illness
Authors: O’Neill Eileen S. , Morrow Laura L. 
Published: August 2010

The symptom experience of women with chronic illnessAim of the study: This integrative review examined how women interpret, cope with, and manage chronic illness symptoms.Background: Women with chronic illness report more symptoms and poorer physical health than men. They also enter the health care system later and sicker than their male counterparts. One possible reason for their increased morbidity and mortality is gender differences in interpreting and managing symptoms.Method: The inclusion criteria that guided this review were that: (a) the study was published between January 1, 1990 and December 31, 1999; (b) participants were women with at least one chronic health problem; and (c) the study addressed symptom perception, symptom evaluation, and/or symptom management. Databases were searched using women, symptoms, chronic illness, coping, and research as key words.Findings: One hundred and ten published studies were reviewed, yielding 35 journal articles reporting on 32 separate studies that met the inclusion criteria. The analysis identified important gender differences in symptom experience. While studies of coping with symptoms are well represented in the literature, symptom strategies and the cultural meaning of symptoms are understudied.Conclusions: Five categories of practice implications emerged from the data. These included physical functioning, coping, self‐care, roles and relationships, and socio‐cultural issues. Within each category specific directions for nursing practice were developed.
Relaxation and music to reduce postsurgical pain
Authors: Good Marion , Stanton‐Hicks Michael , Grass Jeffrey A. , Anderson Gene Cranston , Lai Hui‐Ling , Roykulcharoen Varunyupa , Adler Patricia A. 
Published: August 2010

Relaxation and music to reduce postsurgical pain Aims: We investigated the effects of relaxation, music, and the combination of relaxation and music on postoperative pain, across and between two days and two activities (ambulation and rest) and across ambulation each day. This secondary analysis of a randomized controlled trial was conducted from 1995 to 1997. Background: After surgery, patients do not always receive sufficient relief from opioids and may have undesired side‐effects. More complete relief (10–30%) was found recently with adjuvant interventions of relaxation, music, and their combination. Comparison of effects between days and treatments have not been examined longitudinally. Methods: With a repeated measures design, abdominal surgery patients (n = 468) in five US hospitals were assigned randomly to one of four groups; relaxation, music, their combination, and control. With institutional approval and written informed consent, subjects were interviewed and taught interventions preoperatively. Postoperative testing was at ambulation and rest on days 1 and 2 using visual analogue (VAS) sensation and distress of pain scales. Results: Multivariate analysis indicated that although pain decreased by day 2, interventions were not different between days and activities. They were effective for pain across ambulation on each day, across ambulation and across rest over both days (all P < 0·001), and had similar effects by day and by activity. Conclusions: Nurses can safely recommend any of these interventions for pain on both postoperative days and at both ambulation and rest.
Clinical supervision and support for nurses: an evaluation study
Authors: Teasdale Kevin , Brocklehurst Neil , Thom Natasha 
Published: August 2010

Clinical supervision and support for nurses: an evaluation study Aim. To assess the effects of clinical supervision and informal support on qualified nurses. Rationale. Earlier small‐scale research studies have provided conflicting evidence about the impact of clinical supervision, hence the need for this larger‐scale study. Design. Survey design drawing on an opportunity sample of 211 qualified nurses from 11 randomly selected hospital and community NHS Trusts in one region in England. Quantitative data collection used the Maslach Burnout Inventory (MBI) and the Nursing in Context Questionnaire (NICQ), while qualitative data were based on written critical incidents. The analysis compared supervized with unsupervized nurses. Findings. The critical incident analysis revealed that supervized nurses continued to use informal support networks as well as their supervision sessions to discuss clinical issues. The MBI found no significant differences in levels of burnout between supervized and unsupervized nurses. However, the NCIQ detected some statistically significant differences, with supervized nurses reporting a more listening and supportive management, coping better at work and feeling that they had better access to support than unsupervized nurses. Closer analysis found that this positive finding was particularly strong among the more junior supervized nurses. Conclusion. Where resources are limited, it is better to concentrate on providing clinical supervision to more junior grades of nurses as a valued form of support during their early years as qualified practitioners.
Development and evaluation of a moral distress scale
Authors: Corley Mary C. , Elswick R. K. , Gorman Martha , Clor Theresa 
Published: August 2010

Development and evaluation of a moral distress scaleAim of the study:This methodological research developed and evaluated the moral distress scale from 1994 to 1997.Background/Rationale:Although nurses confront moral questions in their practice daily, few instruments are available to measure moral concepts. The methodological design used a convenience sample consisted of 214 nurses from several Unites States hospitals. The framework guiding the development of the moral distress scale (MDS) included Jameton’s conceptualization of moral distress, House and Rizzo’s role conflict theory, and Rokeach’s value theory. Items for the MDS were developed from research on the moral problems that nurses confront in hospital practice. The MDS consists of 32 items in a 7‐point Likert format; a higher score reflects a higher level of normal distress.Results:Mean scores on each item ranged from 3·9 to 5·5, indicating moderately high levels of moral distress. The item with the highest mean score (M=5·47) was working where the number of staff is so low that care is inadequate. Factor analysis yielded three factors: individual responsibility, not in the patient’s best interest, and deception. No demographic or professional variables were related to moral distress. Fifteen percent of the nurses had resigned a position in the past because of moral distress.Conclusions:The results support the reliability and validity of the MDS.
Arguments for ‘British Pluralism’ in qualitative health research
Authors: Johnson Martin , Long Tony , White Alan 
Published: August 2010

Arguments for ‘British Pluralism’ in qualitative health research Aims of the study. This paper examines the argument that certain qualitative research methods can be used in ‘pure’ forms. Whilst rigid adherence to particular published procedures might be possible, we argue that in many cases this is neither necessary nor more likely to increase the validity of the research outcome. Methodological purity. In examining the works of well‐known claimants to particular research approaches such as grounded theory and phenomenology we show that purity of method is uncommon. In particular it is possible to demonstrate that all published qualitative methods are subject to their own underlying relativist philosophy. The implication of this is that all are social constructions and that their execution will necessarily be negotiated in time and context. Conclusion. We conclude that analysis of varied examples of qualitative research shows methods to be more flexible than is often admitted. What we describe as ‘British Pluralism’ is an attempt to accept this reality whilst maintaining rigour through integrity, clear accounts, reflexivity and constructive critique of one’s own work and that of others.
Patients referred to a pain management clinic: beliefs, expectations and priorities
Authors: Allcock Nick , Elkan Ruth , Williams Jacky 
Published: August 2010

AbstractTitle.  Patients referred to a pain management clinic: beliefs, expectations and priorities Aim.  This paper is a report of a study to explore patients’ pain‐beliefs and emotions at the point of referral to a pain clinic, their expectations of the clinic and their priorities for improvement in aspects of their lives affected by pain.Background.  Chronic pain is a common experience and, although the percentage of people with pain referred to pain clinics is increasing, they often experience complex journeys through the healthcare system. Patients’ beliefs about pain have been shown to influence their experience of pain and treatment outcomes, with a focus on the organic cause of pain reported.Methods.  Three focus groups were convened with 18 participants. Ten statements about pain were distributed to each participant and ranked according to their priorities. The data were collected in 2002–2003.Findings.  The participants’ beliefs were dominated by the search for a firm diagnosis and cure. Participants held three main beliefs; that the cause of the pain must be established; that other people do not believe in the pain of a person without a firm diagnosis; and that painkillers are a way of ‘fobbing you off’. Participants had little knowledge and few concrete expectations of the pain clinic. Their main priorities for improvement were ‘less pain’, ‘some pain free times’, and being able to do more ‘everyday things’.Conclusion.  Staff delivering pain management services must understand patients’ beliefs and expectations and explain their own perspectives in order to provide a sound basis for working together.
Nurses’ experiences of drug administration errors
Authors: Schelbred Anne‐Berit , Nord Randi 
Published: August 2010

AbstractTitle.  Nurses’ experiences of drug administration errors Aim.  This paper is a report of a study to describe the experiences of nurses who had committed serious medication errors, the meaning these experiences carry, and what kind of help and support they received after committing their error.Background.  Medication administration is an important nursing task. Work overload, combined with increased numbers and dosages of medication prescribed, puts nurses at risk of making serious errors. A drug error has the potential for disastrous consequences for patients. What is sometimes disregarded is the effect on the nurse involved. The majority of research on nurses and medication errors is framed within biomedicine, law and management.Methods.  An explorative, descriptive design was adopted and 10 in‐depth interviews were conducted in 2003 with nurses who had committed a medication error. The text was analysed using a phenomenological method.Findings.  Serious medication errors can have a great impact on nurses, both personally and professionally. Reactions from significant others were central to the final outcome for nurses who made drug errors. They wanted to share their experiences, but this required confidence and trust. Nurses were generally willing to accept responsibility for their errors.Conclusion.  Strategies should be developed so that errors can be managed in a constructive manner, which includes exploring underlying causes and the counselling and support needs of the nurses involved.
Nursing and patient safety in the operating room
Authors: Alfredsdottir Herdis , Bjornsdottir Kristin 
Published: August 2010

AbstractTitle.  Nursing and patient safety in the operating room Aim.  This paper is a report of a study to identify what operating room nurses believe influences patient safety and how they see their role in enhancing patient safety.Background.  Research in health care shows that work experience, communication and the organization of work are key factors in patient safety. This study draws on Reason’s definitions of active and latent errors to conceptualize the complex issues that affect patient safety in the operating room.Method.  The study reported here is part of an action research project at a university hospital in Iceland. Semi‐structured interviews were conducted in 2004 with eight nurses, followed by two focus groups of four nurses each in 2005. Data were analysed using interpretive content analysis.Findings.  Securing patient safety and preventing mistakes were described as key elements in operating room nursing by all survey participants. In the interviews, the nurses identified the existing culture of prevention and protection that characterizes operating room nursing as crucial in enhancing safety. The organization of work into specialty teams was considered essential. Increased speed of work in an environment where enhanced productivity is imperative, as well as imbalance in staffing, was identified as the main threats to safety.Conclusion.  Operating room nurses have a common understanding of the core of their work, which is to ensure patient safety during operations. The work environment is increasingly characterized by latent error, i.e. system‐based threats to patient safety that can materialize at any time. Interventions to enhance patient safety in operating room nursing are needed.
Improving decision‐making in caring for people with epilepsy and intellectual disability: an action research project
Authors: Vallenga Dineke , Grypdonck Mieke H.F. , Tan Francis I.Y. , Lendemeijer Bert H.G.M. , Boon Paul A.J.M. 
Published: August 2010

AbstractTitle.  Improving decision‐making in caring for people with epilepsy and intellectual disability: an action research project. Aim.  This paper is a report of an action research study aimed at improving decision‐making concerning risks in people with epilepsy and intellectual disability and the empowerment of participants to sustain this improvement.Background.  Residents of long‐stay units in specialized epilepsy centres suffer severe epilepsy and are often intellectually disabled. Professional caregivers have to find a balance between risk‐taking and protection, as both can have a negative effect on quality of life. Clients, their representatives and caregivers are involved in this decision‐making process.Method.  A participative action research project was conducted. Data were gathered continuously over a 22‐month period in 2004–2006 by interviews, observation, written reports of meetings and personal stories.Findings.  The action research resulted in an ongoing process of improvement. Problems in decision‐making about risk were clarified. The importance of consensus about risks and commitment to risk management between all involved became apparent. Phases in risk management were discerned and used to adjust caregiving to clients’ needs and capacities Assessment of client risk became more systematic and ‘steps to an individual framework for decision‐making’ were developed as a tool for a systematic approach.Conclusion.  Using an action research model to improve decision‐making provided the preconditions for improving decision‐making and risk management and suggesting a way to improve this process in this and other institutions.
Establishing a new service role in tuberculosis care: the tuberculosis link worker
Authors: Craig Gillian M. , Booth Helen , Hall Jo , Story Alistair , Hayward Andrew , Goodburn Ann , Zumla Alimuddin 
Published: August 2010

AbstractTitle.  Establishing a new service role in tuberculosis care: the tuberculosis link worker Aim.  This paper is a report of a study to develop a social outreach model of care, including the role of a link worker in developing collaborative care pathways, for marginalized groups with tuberculosis.Background.  Social risk factors such as homelessness and substance misuse are associated with poor treatment outcomes. Models of interprofessional practice to address the health and social care of patients are needed to improve outcomes.Methods.  A process evaluation involving a prospective cohort study of 100 patients and interviews with eight agencies involved in their care was conducted in London between January 2003 and April 2005. Outcome measures included a profile of patient need to guide service development; referrals to care providers; goal attainment; social improvement and treatment outcomes; and agencies’ views on the benefits of link working.Findings.  The median age of the sample was 32·4 years and 62% were males. Reasons for referral to the link worker included housing need (56%); welfare benefits (42%); immigration (29%) and clinical management issues (28%). One‐third of the patients were referred to other agencies. Goals, as agreed in the care plan, were attained totally or partially for 88% (59/67) of patients and 78% of patients successfully completed treatment. Barriers to attaining goals included service criteria which excluded some groups of patients and, in some cases, a patient’s inability to follow a course of action.Conclusion.  Link workers can mitigate some of the social risk factors that complicate the treatment of tuberculosis by enabling integrated health and social care.
Scholarly nursing practice from the perspectives of experienced nurses
Authors: Riley Joan , Beal Judy A. , Lancaster Diane 
Published: August 2010

AbstractTitle.  Scholarly nursing practice from the perspectives of experienced nurses Aim.  This paper is a report of a study to describe scholarly nursing practice from the perspectives of experienced nurses.Background.  Theoretically, nursing scholarship has been well‐described in the literature and flourishes in academic environments. Nursing organizations and nurse leaders worldwide have embraced the value of and need for scholarship to advance the profession. However, the concept of scholarship has yet to be empirically examined within the practice setting from the perspectives of experienced nurses.Method.  A qualitative descriptive research design was used. Semi‐structured interviews were conducted with 36 experienced nurses purposively sampled from four acute care hospitals in north‐eastern United States of America. The focus of the interviews was to understand how these nurses viewed themselves and their practice. The data were collected between 2004 and 2006 and analysed using content analysis.Findings.  Participants clearly articulated personal attributes and professional behaviours that characterized scholarly nursing practice. Two overarching inter‐related categories emerged: ‘Who I Am’ and ‘What I Do’. Themes within ‘Who I Am’ were Active Learner, Out of the Box Thinker, Passionate about Nursing, Available and Confident. Themes within ‘What I Do’ were Being a Leader, Caring, Sharing Knowledge with Others, Evolving and Reflecting on Practice.Conclusion:  Scholarly nursing practice needs to be empirically examined worldwide. Additional studies should focus on scholarly nursing practice with nurses in varying stages of career development, in various types of practice settings, and in different cultures.
Nurse independent prescribing and nurse supplementary prescribing practice: national survey
Authors: Courtenay Molly , Carey Nicola 
Published: August 2010

AbstractTitle.  Nurse independent prescribing and nurse supplementary prescribing practice: national survey Aim.  This paper is a report of a survey to provide an overview of nurse independent prescribing and nurse supplementary prescribing across the United Kingdom.Background.  Evidence examining the frequency of prescribing by nurses is conflicting, and it is evident that several factors hamper prescribing practice. As of May 2006, legislative changes gave appropriately qualified nurses virtually the same independent prescribing right as doctors. However, there is currently no evidence available about the prescribing practices of these nurses.Method.  A random sample of 1992 qualified Nurse Independent/Nurse Supplementary Prescribers registered with the Nursing and Midwifery Council was sent a postal questionnaire in 2006. A total of 1400 (70%) questionnaires were returned, of which 1377 were completed.Findings.  Eight hundred and ninety‐one (65%) respondents worked in primary care, and 333 (24·3%) worked in secondary care. Three quarters of the sample had more than 5‐year clinical experience in the area in which they prescribed prior to entering the prescribing programme. One thousand one hundred and seven (87%) participants had used nurse independent prescribing and 568 (44·6%) nurse supplementary prescribing. Restriction of local arrangements, implementation of the Clinical Management Plan and access to doctors hampered or prevented prescribing.Conclusion.  The adoption of prescribing by nurses in the United Kingdom has increased patient choice with regard to access to medicines. A number of factors which hamper or prevent prescribing require further exploration.