bluuebunny/crossref_metadata_2025_split huggingface dataset:
Music therapy for patients receiving spine surgery
Authors: Lin Pi‐Chu , Lin Man‐Ling , Huang Li‐Ching , Hsu Hsiu‐Chu , Lin Chiong‐Chu 
Published: February 2011

Aims and objectives.  The aim of this study was to evaluate the effects of music therapy on anxiety, postoperative pain and physiological reactions to emotional and physical distress in patients undergoing spinal surgery.Background.  Surgery‐related anxiety and pain are the greatest concern of surgical patients, especially for those undergoing major procedures.Design.  A quasi‐experimental study design was conducted in a medical centre in Taiwan from April–July 2006.Methods.  Sixty patients were recruited. The study group listened to selected music from the evening before surgery to the second day after surgery. The control group did not listen to music. Patients’ levels of anxiety and pain were measured with visual analogue scales (VAS). Physiological measures, including heart rate, blood pressure and 24‐hour urinalysis, were performed.Results.  The average age of the 60 patients was 62·18 (SD 18·76) years. The mean VAS score for degree of anxiety in the study group was 0·8–2·0, compared with 2·1–5·1 in the control group. The mean VAS score for degree of pain in the study group was 1·7–3·0, compared with 4·4–6·0 in the control group. The differences between the two groups in VAS scores for both anxiety (p = 0·018–0·001) and pain (p = 0·001) were statistically significant. One hour after surgery, the mean blood pressure was significantly lower in the study group than in the control group (p = 0·014), but no significant differences were found between the two groups in urine cortisol (p = 0·145–0·495), norepinephrine (p = 0·228–0·626) or epinephrine values (p = 0·074–0·619).Conclusions.  Music therapy has some positive effects on levels of anxiety and pain in patients undergoing spinal surgery.Relevance to clinical practice.  Complementary music therapy can alleviate pain and anxiety in patients before and after spinal surgery.
Self‐preservation in abortion care: a grounded theory study
Authors: Lipp Allyson 
Published: February 2011

Aim.  To seek an explanation as to why nurses concede and conceal their judgements towards women having an abortion.Background.  Recent advances in abortion techniques and pharmacology have resulted in a greater proportion of medical abortions occurring at a lower gestation than previously. As this technique demands more of nurses, it becomes important to ask whether they are equipped to deal with this greater involvement.Design.  A grounded theory approach using a recognised framework was used. Theoretical sampling was used in this study to increase the depth of focus from a previous study of nurses who were found to concede and conceal their judgement in abortion care.Findings.  Several important aspects of abortion care were elucidated as to why nurses concealed and conceded their judgements. Lower gestation of abortions was central in determining greater involvement of nurses in the abortion process. It was found that some nurses treated women the same and some treated women differently, but all strived for equitable care. Self‐preservation in the form of ‘switching off’ or ‘getting on with it’ was employed by nurses when they encountered the foetus or women who were blasé. Self‐preservation was found to be a key phenomenon and a major reason why nurses conceded and then concealed their judgement.Conclusions.  In rapidly advancing abortion care, there needs to be positive ways of ensuring self‐preservation in nurses without compromising care.Relevance to clinical practice.  Abortion care demands specific skills of nurses, and this is likely to increase in the near future. Self‐preservation needs to be embedded into nurses’ professional development by the use of positive strategies such as guided reflection in providing a productive woman‐centred service.
Why is pain still not being assessed adequately? Results of a pain prevalence study in a university hospital in Sweden
Authors: Wadensten Barbro , Fröjd Camilla , Swenne Christine L , Gordh Torsten , Gunningberg Lena 
Published: February 2011

Aim.  The aim of this study was to investigate the prevalence of pain and pain assessment among inpatients in a university hospital.Background.  Pain management could be considered an indicator of quality of care. Few studies report on prevalence measures including all inpatients.Design.  Quantitative and explorative.Method.  Survey.Results.  Of the inpatients at the hospital who answered the survey, 494 (65%) reported having experienced pain during the preceding 24 hours. Of the patients who reported having experienced pain during the preceding 24 hours, 81% rated their pain >3 and 42·1% rated their pain >7. Of the patients who reported having experienced pain during the preceding 24 hours, 38·7% had been asked to self‐assess their pain using a Numeric Rating Scale (NRS); 29·6% of the patients were completely satisfied, and 11·5% were not at all satisfied with their participation in pain management.Conclusions.  The result showed that too many patients are still suffering from pain and that the NRS is not used to the extent it should be. Efforts to overcome under‐implementation of pain assessment are required, particularly on wards where pain is not obvious, e.g., wards that do not deal with surgery patients. Work to improve pain management must be carried out through collaboration across professional groups.Relevance to clinical practice.  Using a pain assessment tool such as the NRS could help patients express their pain and improve communication between nurses and patients in relation to pain as well as allow patients to participate in their own care. Carrying out prevalence pain measures similar to those used here could be helpful in performing quality improvement work in the area of pain management.
A review of pain management interventions in bone marrow biopsy
Authors: Watmough Sarah , Flynn Maria 
Published: February 2011

Aims.  This review was designed to evaluate the evidence relating to pain management interventions for patients having bone marrow biopsy.Background.  Bone marrow biopsy is an invasive procedure causing considerable pain and anxiety for adult patients, yet there are no guidelines to inform effective nursing care. Although this is an under‐researched area, a range of pain interventions have been tested on this patient group, but this evidence has not been synthesised.Design.  Structured evidence review.Method.  The Cochrane Library and databases Medline, Scopus and Cinahl were searched for original research reports. Reference lists of retrieved papers were hand‐searched and researchers in the field were contacted. Retrieved papers were analysed using the CASP framework. A narrative data synthesis considered the strengths and limitations of included studies and findings were collated and interpreted.Results.  No systematic reviews of evidence have been undertaken and the search strategy identified twelve research studies eligible for inclusion in the review. Hand‐searching did not identify any additional studies, and emails to researchers confirmed this is an under‐researched field. Analysis shows three main interventions, intravenous midazolam, premedication with analgesia and/or anxiolysis and the use of Entonox™ are used to manage the pain experience for patients undergoing a bone marrow biopsy.Conclusions.  Evidence is inconclusive and provides little guidance for practice. There is an urgent need for research into effective interventions for pain management in bone marrow biopsy and in understanding the patient experience.Relevance to clinical practice.  Nurses have a central role to play in the assessment and management of the pain and anxiety associated with bone marrow biopsy. There is little evidence to guide this aspect of care, but it is important that nurses involved with bone marrow biopsy are aware of the best evidence to facilitate the most effective management of their patients’ pain.
Dignity in care in the hospital setting from patients’ perspectives in Taiwan: a descriptive qualitative study
Authors: Lin Yea‐Pyng , Tsai Yun‐Fang , Chen Hsiu‐Fang 
Published: February 2011

Aim.  The aim of this study was to explore dignity in care from patients’ perspectives in Taiwan.Background.  Dignity is a core element of nursing care. In nurses’ clinical practice, maintaining the dignity of patients is an important issue because a lack of dignity in care can affect the health and recovery of patients. In Western countries, patient dignity has been well researched, but only one study has examined this topic in an Asian country.Design.  Descriptive qualitative methods were used in this study.Methods.  Interviews were conducted with 40 patients purposively sampled at a teaching hospital in eastern Taiwan from May–August 2009. Audiotaped interviews were transcribed verbatim, and data in transcripts were coded and analysed by content analysis.Results.  The major findings revealed that many hospitalised patients were satisfied with the maintenance of their dignity. Six themes that contribute to the preservation of their dignity were identified: sense of control and autonomy, being respected as a person, avoidance of body exposure, caring from the nursing staff, confidentiality of disease information and prompt response to needs.Conclusions.  The findings can help nurses better understand dignity in care because it is described from the patient viewpoint.Relevance to clinical practice.  By identifying the most important factors from patients’ perspectives that contribute to dignity, nursing interventions in clinical practice can be further developed and improved.
The Mental Health Nurse Incentive Program: desirable knowledge, skills and attitudes from the perspective of nurses
Authors: Happell Brenda , Palmer Christine , Tennent Rebeka 
Published: February 2011

Aim.  To enhance the understanding of the skills and attitudes of mental health nurses working in the Australian Mental Health Nurse Incentive Program.Background.  The Mental Health Nurse Incentive Program places qualified mental health nurses alongside community‐based general practitioners, private psychiatric practices and other appropriate organisations to provide clients with mental health conditions with a more integrated treatment plan.Design.  An exploratory, qualitative approach was undertaken, given the paucity of relevant research in this area.Methods.  Exploratory individual interviews were conducted with ten mental health nurses working in this scheme. Data analysis was organised and managed using QSR NVivo qualitative analysis software.Results.  Respondents identified specific skills and attitudes required for practice under the Mental Health Nurse Incentive Program. Eight areas of skill and attitude were identified as essential for mental health nurses working in this field. This study highlights that many of these skills and attitudes are specific to the setting where mental health nurses are working.Conclusion.  Mental health nurses working under this programme have a role to play in the dissemination of knowledge about their practice. More needs to be done by governments and other institutions to ensure that general practitioners and other health professionals understand the role played by mental health nurses in the provision of care.Relevance to clinical practice.  The extent to which the Mental Health Nurse Incentive Program becomes a sustainable strategy to promote quality and accessible mental health care will depend to some degree on the capacity to identify the skills and attitudes necessary for practice. The findings presented in this paper provide a significant contribution to articulating the essential characteristics required for this area of practice.
A systematic review of variability and reliability of manual and automated blood pressure readings
Authors: Skirton Heather , Chamberlain Wendy , Lawson Caroline , Ryan Helen , Young Emma 
Published: February 2011

Aims and objectives.  To compare the accuracy and appropriateness of auscultatory (manual) and oscillometric (automated) devices for measuring blood pressure in clinical settings.Background.  Accurate measurement of blood pressure is integral to early recognition of deterioration in the condition of a patient. Despite recommendations regarding the use of auscultatory devices in situations where treatment decisions are made dependent on blood readings, the use of automated machines is becoming common practice.Design.  Systematic review.Methods.  A search of the Medline, CINAHLPlus and The Cochrane Library databases was undertaken for papers published in English between January 1997–May 2009. Sixteen studies were identified that fulfilled the inclusion criteria. After quality assessment, all were included in the review. Results are presented in tabular and narrative form.Results.  In 10 of the studies reviewed, the authors came to the conclusion that oscillometric devices were less accurate than auscultatory devices. However, in most cases the oscillometric device appears sufficiently accurate for clinical use, the exceptions being use with hypertensive patients, patients with arrhythmia and after trauma. Only two studies assessed the comparative accuracy of aneroid devices, and these indicated that they were more accurate than oscillometric devices, but the differences were not clinically important.Conclusions.  There are situations where the substitution of oscillometric for auscultatory devices could have particularly serious repercussions for the patient, such as when the patient is either hypertensive or hypotensive. However, further research is required on the use of aneroid sphygmomanometers as a replacement for mercury devices.Relevance to clinical practice.  Practitioners should be made aware of the need to use auscultatory devices in specific circumstances, such as in management of hypertension, after the patient has experienced trauma or where there is significant potential for deterioration in the patient’s condition.
Biopsychosocial risk factors for preterm birth and postpartum emotional well‐being: a case–control study on Turkish women without chronic illnesses
Authors: Gungor Ilkay , Oskay Umran , Beji Nezihe Kizilkaya 
Published: February 2011

Aims and objectives.  The study aimed to determine bio‐psycho‐social risk factors for preterm birth in a sample of Turkish women without chronic illnesses and evaluate their anxiety and depression in early postpartum period.Background.  Preterm birth is a devastating event with long‐term health and social implications. Studies have identified several risk factors; however, the contribution of these causes differs by ethnic groups.Design.  This case–control study was conducted in a tertiary hospital in Istanbul over one year. In total, 149 preterm mothers were included in the case group and 150 term mothers who delivered in the same day with a case group woman were included in the control group. Chronic illnesses and anomalies were excluded.Method.  Data were gathered using a form that addressed risk factors for preterm birth. Multidimensional Scale of Perceived Social Support, Beck Depression Inventory and Spielberger’s State‐Trait Anxiety Inventory were administered within 24–72 hours after birth.Results.  Logistic regression analysis revealed that partner’s lower education (≤8 years), history of preterm birth, antenatal hospitalisation, genitourinary infection and irregular prenatal care were significant risk factors. Perceived social support from family and friends were significantly lower in preterm group. Preterm mothers experienced significantly more anxiety and depressive symptoms in early postpartum.Conclusion.  Many of the socio‐economical and obstetric causes of preterm births were similar to other countries with higher preterm birth rates. Preterm births were associated with lower social support along with more anxiety and depressive symptoms in early postpartum.Relevance to clinical practice.  Women who have established risk factors can be targeted for more intensive antenatal care for the prevention of preterm birth. Increased maternal anxiety and depression reveal the necessity of emotional support immediately after birth.
Difficulties in the daily life of patients with osteoarthritis of the knee: scale development and descriptive study
Authors: Tanimura Chika , Morimoto Michiko , Hiramatsu Kimiko , Hagino Hiroshi 
Published: February 2011

Aim.  The aim of this study was to develop an instrument to assess difficulties in daily life experienced by patients with osteoarthritis of the knee and to investigate factors influencing difficulties in daily life.Background.  Osteoarthritis of the knee is commonly associated with clinical symptoms and disabilities. No scale has been available to assess the comprehensive and subjective difficulties felt in daily life by patients affected in social and cultural lifestyle. Therefore, little is known about difficulties in osteoarthritis of the knee patients and supportive care necessary for them.Design.  A scale development and descriptive study.Methods.  The participants consisted of 362 patients with osteoarthritis of the knee. The scale development involved several phases including item development, reliability testing, criterion‐related validity testing and construct validity testing.Results.  The exploratory factor analysis included three domains: ‘suffering in social life’, ‘hardship in activities in daily life’ and ‘apprehension about the future life’. A confirmatory factor analysis confirmed validity of the construct, with a demonstrated good fit between the factor structure of the new scale and the observed data. Difficulties in daily life scores were significantly influenced by pain, loss of balance, muscle weakness, stiffness and swelling.Conclusion.  We developed a reliable and valid scale for the measurement of difficulties in daily life experienced by patients with osteoarthritis of the knee. It is important for healthcare professionals to understand these difficulties in daily life experienced by patients with osteoarthritis of the knee and to educate patients with practical information and self‐management strategies.Relevance to clinical practice.  This new scale could provide useful information to guide clinical practice in assessing and managing difficulties in daily life experienced by patients with osteoarthritis of the knee.
A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long‐term feeding
Authors: Lin Li‐Chan , Li Mei‐Hui , Watson Roger 
Published: February 2011

Aims.  To investigate why patients do not choose percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy as a route for long‐term feeding.Background.  Home enteral tube feeding is well recognised as a valuable therapeutic option for patients requiring nutritional support following discharge from hospital. The number of patients discharged from hospital and receiving home enteral tube feeding increases annually in Taiwan.Design.  A cross‐sectional study.Method.  Participants (n = 607) were chosen from one free‐standing home care agency and three hospital‐based home care departments in Taipei. A review of the patients’ records to gather demographic data, medical diagnosis, length of home care and length of intubation prior to the home visit was conducted. A face‐to‐face interview was conducted at the time of the home visit.Findings.  The prevalence rate of home enteral tube feeding was 70·3% (n = 427). Of the 427 tube‐fed subjects, 93·4% were fed with a nasogastric tube. The most common reasons for refusing to use percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy were ‘too old to suffer from an operation’, ‘worried about wound infection or leakage after performing percutaneous endoscopic gastrostomy’ and ‘to keep subjects’ body integrity’. Stroke, no dementia, poor activities of daily living and poor cognitive status were significant predictors of being tube‐fed, while higher education and better cognitive status were significant predictors of percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy use.Conclusion.  The reasons patients refused to use percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy reflect the influence of cultural values and the level of patients’ education, which home health care nurses need to discuss with patients in detail.Relevance to clinical practice.  Investigating patients’ perspective on the meaning of ‘body’ in Taiwanese culture and the decision‐making processes related to home enteral tube feeding is recommended for nurses to provide better care and support when home enteral tube feeding in an option.
Facing death, facing self: nursing students’ emotional reactions during an experiential workshop on life‐and‐death issues
Authors: Liu Ying‐Chun , Su Pi‐Yu , Chen Chih‐Hao , Chiang Hsing‐Hsing , Wang Kwua‐Yun , Tzeng Wen‐Chii 
Published: February 2011

Aim and objectives.  This study presents the findings of a qualitative study exploring the experiences of undergraduate nursing students imagining the possibility of their own death during a workshop on life‐and‐death issues.Background.  Didactic instruction in end‐of‐life care is a critical element of nursing education and for most health professions training in general. Properly implementing this often‐overlooked educational process requires providing students with opportunities to reflect on death and dying along with guidance during nursing practice in coping with emotional reactions to caring for dying patients.Design.  An interpretive descriptive design was adopted.Method.  Data were gathered from the text of 20 students’ reflective journals and workshop evaluations and researchers’ field notes on observations during the workshop at a Taiwan university in August 2007.Results.  Students experienced a process of dying, death and rebirth. Students not only expressed emotional responses that included surprise, reluctance to let go and gratitude but also realised the importance of cherishing the present, committing to the nursing profession and valuing their own lives.Conclusions.  Students can learn their fear of death and possible emotional reactions towards dying patients through self‐reflection during a workshop on life‐and‐death issues. The foundation for facilitating students’ self‐awareness is a safe environment for them to gain experiential knowledge of the dying process and end‐of‐life care. Experiential education not only helps students grow personally but also increases their motivation to learn.Relevance to clinical practice.  Students’ ability to recognise and manage their own emotional reactions towards death and dying patients should be included as part of end‐of‐life education. A workshop on life‐and‐death issues can help students discover that they are not alone and that they can support each other and learn how to manage their own emotions.