bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘The real stuff’: implications for nursing of assessing and measuring a terminally ill person’s quality of life
Authors: Annells Merilyn , Koch Tina 
Published: August 2010

• Two quality of life (QoL) assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL) questionnaires, were trialled within district nursing palliative care to test usefulness and feasibility for holistic intervention selection, individualized palliative care planning, and measurement of the quality of dying.• The specific focus of this paper is to discuss the less tangible outcomes of the trial, which illuminate the partly ‘hidden’ value and nature of clinical nursing.• These outcomes include awareness that the use of such tools may: by actual administration of the tool be, in and of itself, a therapeutic nursing action; focus on ‘the real stuff’ from the client’s perspective, that which matters most to the terminally ill client, but may not be classically considered as prompting nursing intervention; and facilitate ‘the real stuff’ of nursing, perhaps known but not usually articulated by nurses, and which usually does not feature on care plans nor in time allocation schedules.
Developing a module for nursing documentation integrated in the electronic patient record
Authors: Hellesø R. , Ruland C. M. 
Published: August 2010

• Norway’s regional teaching hospitals are working together on a project to develop an interdisciplinary electronic patient record (EPR).• This paper presents the results of a project to develop nursing documentation as part of an integrated EPR to improve the quality and continuity of patient care.• The project used a consensus process as a working norm.• The most important result is that the five hospitals have agreed on a framework for nursing documentation, and on the main components that need to be implemented in the electronic patient record.
A comparison between EASI system 12‐lead ECGs and standard 12‐lead ECGs for improved clinical nursing practice
Authors: Lancia Loreto , Pisegna Cerone Marina , Vittorini Pierpaolo , Romano Silvio , Penco Maria 
Published: August 2010

Aims and objectives.  This study was carried out to verify the accuracy of 12‐Lead ECG, obtained through a continuous ECG monitoring system with five cables positioned in EASI mode, to identify basic ECG alterations.Background.  This study concerns continuous ECG monitoring systems in Coronary Care Units. Continuous ECG monitoring is an important device for nursing surveillance and is useful in decreasing adverse events.Design and method.  Thirteen patients admitted consecutively to the Coronary Care Unit for Acute Myocardial Infarction underwent daily and simultaneous recording of a12‐lead ECG using both procedures: EASI ECG and STANDARD ECG. A sample of 1164 ECG leads acquired in EASI mode was compared with a sample of as many ECG leads acquired using the standard procedure with a traditional cardiograph.Results and conclusions.  In the Coronary Care Unit, Continous ECG monitoring with five cables positioned in EASI mode is a valid alternative to the standard 12‐lead ECG for cardiac rhythm abnormalities detection and for acute myocardial ischemia and old myocardial infarction assessment. Therefore, the EASI system might be advantageous for long‐term patient monitoring.Relevance to clinical practice.  The EASI system represents a valid device for the nursing surveillance of patients who need continuous ECG monitoring, improves clinical nursing practice in Coronary Care Units, supports the reduction of adverse events such as cardiac arrest and reduces the hospital costs.
A systematic review of empirical studies between 1966 and 2005 of patient outcomes of total hip arthroplasty and related factors
Authors: Montin Liisa , Leino‐Kilpi Helena , Suominen Tarja , Lepistö Jyri 
Published: August 2010

Aim.  To determine patient outcomes of total hip arthroplasty and the research methods used to produce knowledge of use to clinical nursing and for purposes of health education. The review consists of three parts. Firstly, it describes the patient outcomes of total hip arthroplasty. Secondly, it addresses the factors related to the patient outcomes and thirdly the research methods used are explored.Background.  Previous research has identified that total hip arthroplasty is a very common procedure to reduce pain and improve physical function in patients with osteoarthritis. The greatest improvements have been found in reduction in pain.Methods.  Two databases, Medline and CINAHL were searched from 1966–2005. Studies were eligible for review and included if they met the following criteria: (1) publication in English, (2) empirical research and (3) the indication for total hip arthroplasty was osteoarthritis; 17 studies met the criteria.Results.  Total hip arthroplasty resulted in pain relief, improved physical function and enhanced health‐related quality of life regardless of patients’ characteristics, type of operation or type of prosthesis. The only factor affecting patient outcomes was patients’ poor pre‐operative function. These patients were more likely to have postoperative pain and low postoperative physical function. Long‐waiting time for surgery may reduce quality‐adjusted life years. Different kinds of questionnaires were used in the studies reviewed leaving out patients’ perceptions concerning the outcomes of total hip arthroplasty.Conclusions.  Patients’ perceptions should be assessed more closely in further research to gain subjective knowledge about the outcomes of total hip arthroplasty. This could be achieved by using qualitative methods also.Relevance to clinical practice.  The findings can be seen as a challenge for nurses to plan patients’ education. It is also important that the outcomes of total hip arthroplasty correspond to patients’ expectations. Patients’ preoperative function should be taken into consideration when planning the timing of surgery so that the best possible outcomes were attainable.
Care dependency of children in Egypt
Authors: Tork Hanan , Dassen Theo , Lohrmann Christa 
Published: August 2010

Aims.  This study aimed to modify the Care Dependency Scale so that it could be used for children, to apply its Arabic version to Egyptian children to test the reliability and validity of the modified scale and to compare the care dependency of disabled and non‐disabled Egyptian children.Background.  A higher dependence of children in their daily tasks undoubtedly places a greater burden on their caregivers. To estimate the extent of the problem of care dependency, data from different countries and proper standard instruments are required.Method.  The Care Dependency Scale was modified for children by Delphi technique. This study assessed the care dependency of non‐disabled children compared with children with physical and mental disabilities using the modified version of the Care Dependency Scale for paediatrics. The total sample included 260 Egyptian school‐age children (50·8% of whom were disabled and 49·2% were non‐disabled).Results.  Reliability was examined in terms of internal consistency using Cronbach's alpha (0·91). Inter‐rater reliability revealed moderate to very good Kappa statistics between 0·57–0·89. Content validity and criterion validity were evaluated. Differences regarding care dependency were found between disabled and non‐disabled children.Conclusion.  The psychometric properties of the Care Dependency Scale for paediatrics support its usefulness in measuring the care dependency of children in Egypt. This study provides an Arabic version of the Care Dependency Scale for paediatrics that is easy to administer and may be useful to measure the care dependency in various Arabic countries.Relevance to clinical practice.  The findings raise concerns regarding the extent to which disabled and also non‐disabled school‐age children are care dependent leading to an increased burden of care on nurses or on caregivers in general. The Care Dependency Scale for Paediatrics can help nurses conduct an appropriate assessment of children's care dependency so that any nursing care can be planned according to the children's needs.
Construction of masculinities among men aged 85 and older in the north of Sweden
Authors: Aléx Lena , Hammarström Anne , Norberg Astrid , Lundman Berit 
Published: August 2010

Aim.  The aim was to analyse the construction of masculinities among men aged 85 and older.Background.  All societies have a gender order, constructed from multiple ideas of what is seen as feminine and masculine. As the group of men aged 85 and older is increasing in size and their demand for care will increase, we must recognize the importance of studying these men and various discourses of masculinities.Design.  Qualitative explorative.Methods.  Qualitative content analysis was used to analyse thematic narratives. Masculinity theories provided the point of departure for the analysis.Results.  The analysis coalesced into three masculinities. ‘Being in the male centre’, developed from subthemes as: taking pride in one's work and economic situation; being in the centre in relation to others; regarding women as sexual objects; and belonging to a select group. ‘Striving to maintain the male facade’ developed from subthemes as: emphasizing ‘important’ connections; having feelings of loss; striving to maintain old norms and rejecting the fact of being old. ‘Being related’ was formulated from subthemes as: feeling at home with domestic duties; being concerned; accepting one's own aging; and reflecting on life.Conclusions.  Our study indicates the importance of being aware of the existence of multiple masculinities, in contrast to the generally unproblematic and unsubtle particular healthcare approaches which consider men as simply belonging to one masculinity.Relevance to clinical practice.  Diverse masculinities probably affect encounters between men and healthcare providers and others who work with an older population and therefore our results are of importance in a caring context.
The lived experience of losing a loved one to a sudden death in KwaZulu‐Natal, South Africa
Authors: Brysiewicz Petra 
Published: August 2010

Aim.  The aim of this study was to describe the lived experiences of families in KwaZulu‐Natal, South Africa, who had lost a loved one to a sudden death.Background.  Sudden death implies a natural or unnatural death which is unexpected; occurs without warning; and in some cases, could have been prevented. It usually occurs out of hospital, in the emergency department, or shortly after handing the client over to either critical care or operating theatre personnel. A sudden death has the capacity to leave the bereaved emotionally damaged and may exaggerate the responses to grief.Method.  An interpretive hermeneutic phenomenological research approach was chosen for this study, as this allows the researcher to describe a phenomenon as experienced and to attempt to provide an understanding of the internal meanings of a person's experiences in the lived world.Sample.  The sample included five bereaved family members who had lost a loved one to a sudden death and who were all members of a bereavement support group held in Durban, South Africa.Results.  Bereaved families interviewed described five themes namely: ‘cold reception’ of the hospital staff, lack of closure, acknowledgement of loss, ‘loneliness of grief’ and helping others.Relevance for clinical practice.  This qualitative study provides rich data regarding what bereaved family members view as important in their care during this time of crisis. The value of simple, small gestures by the health professional is enlightening. This information can be used to ensure that health professionals purposely direct their interventions and interactions with the bereaved family to ensure that they are managed in the most therapeutic way possible.
Service needs of residents in community‐based long‐term care facilities in northern Taiwan
Authors: Huang Jing‐Juin , Lin Kuan‐Chia , Li I‐Chuan 
Published: August 2010

Aim.  The purpose of this study was to quantify the service needs of residents in community‐based long‐term care (LTC) facilities and to determine their predictors.Background.  Disabled older family members in Taiwan are often eventually sent to community‐based LTC facilities. Many service needs of these residents are likely to go unmet.Methods.  A cross‐sectional survey was used. This involved purposive sampling of 132 residents from 10 LTC facilities in Taipei City. A previously developed LTC service need assessment scale was used to collect information about the residents’ needs in terms of five kinds of LTC services, namely health education, skilled nursing services, referral services, activities of daily living (ADL) assistance and instrumental activities of daily living assistance.Results.  The mean age of residents was 75·2 years. The average period of institutionalization was 21·93 months. Overall, 70% of the residents had either complete or partial ADL function dependency. Among the specific ADL function dependencies of the residents, inability to take a bath was the most common. The most significant predictors of service needs were health status, age, number of children, number of medical diagnoses and whether the stay is self‐choice. These combined variables explained between 25·5% and 41·6% of the variance of the need for LTC services.Conclusion.  The findings of this study show that age, health status, number of children, number of medical diagnoses and whether the stay is self‐choice are significant determinants of residents’ needs in terms of LTC. Assessment of the extent to which facilities meet the residents’ needs is the first step in providing the most cost‐effective allocation of scarce resources.Relevance to clinical practice.  It is suggested that, if reimbursement by the National Health Insurance system of physician visits, including psychiatric visits, to LTC facilities were allowed, this would improve quality of care.
Patients’ attitudes towards, and information needs in relation to, nurse prescribing in rheumatology
Authors: Berry Dianne , Bradlow Anthony , Courtenay Molly 
Published: August 2010

Aims and objectives.  To assess the level of confidence that rheumatology patients would have in nurse prescribing, the effects on likely adherence and particular concerns that these patients have. In addition, given that information provision has been cited as a potential benefit of nurse prescribing, the present study assessed the extent to which these patients would want an explanation for the selected medicine, as well as which types of information should be included in such an explanation.Background.  Nurse prescribing has been successfully implemented in the UK in several healthcare settings. Existing research has not addressed the effects on patients' confidence and likely adherence, nor have patients' information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction.Methods.  Fifty‐four patients taking disease‐modifying drugs for inflammatory joint disease attending a specialist rheumatology clinic self‐completed a written questionnaire.Results.  Patients indicated a relatively high level of confidence in nurse prescribing and stated that they would be very likely to take the selected medication. The level of concern was relatively low and the majority of concerns raised did not relate to the nurse's status. Strong support was expressed for the nurse providing an explanation for medicine choice.Conclusion.  This research provides support for the prescription of medicines by nurses working in the area of rheumatology, the importance of nurses providing a full explanation about the selected medicines they prescribe for these patients and some indication as to which categories of information should be included.Relevance to clinical practice.  Rheumatology patients who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood.
An observational study on the open‐system endotracheal suctioning practices of critical care nurses
Authors: Kelleher Sean , Andrews Tom 
Published: August 2010

Aim and objectives.  The purpose of this study was to investigate open system endotracheal suctioning (ETS) practices of critical care nurses. Specific objectives were to examine nurses’ practices prior to, during and post‐ETS and to compare nurses’ ETS practices with current research recommendations.Background.  ETS is a potentially harmful procedure that, if performed inappropriately or incorrectly, might result in life‐threatening complications for patients. The literature suggests that critical care nurses vary in their suctioning practices; however, the evidence is predominantly based on retrospective studies that fail to address how ETS is practiced on a daily basis.Design and method.  In March 2005, a structured observational study was conducted using a piloted 20‐item observational schedule on two adult intensive‐care units to determine how critical care nurses (n = 45) perform ETS in their daily practice and to establish whether the current best practice recommendations for ETS are being adhered to.Results.  The findings indicate that participants varied in their ETS practices; did not adhere to best practice suctioning recommendations; and consequently provided lower‐quality ETS treatment than expected. Significant discrepancies were observed in the participants' respiratory assessment techniques, hyperoxygenation and infection control practices, patient reassurance and the level of negative pressure used to clear secretions.Conclusion.  The findings suggest that critical care nurses do not adhere to best practice recommendations when performing ETS. The results of this study offer an Irish/European perspective on critical care nurses’ daily suctioning practices.Relevance to clinical practice.  As a matter of urgency, institutional policies and guidelines, which are based on current best practice recommendations, need to be developed and/or reviewed and teaching interventions developed to improve nurses’ ETS practices, particularly in regard to auscultation skills, hyperoxygenation practices, suctioning pressures and infection control measures.
Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan
Authors: Wang Tze‐Fang , Lu Chwen‐Hwa , Chen I‐Ju , Yu Shu 
Published: August 2010

Aims.  We examined sexual activity and predictive factors among older people in Taipei, Taiwan. We aimed to characterize the older population engaged in sexual activity and determine influencing factors, exploring aspects of sexuality that may influence elders’ health and quality of life (QOL).Background.  Studies of sexual attitudes and behaviour have found that sexual difficulties are common among mature adults worldwide, influenced in men and women by physical health, ageing, psychosocial and cultural factors.Design and methods.  We conducted a community‐based retrospective study involving a random sample of 412 men and 204 women over age 65. A questionnaire on demographics and social situations was administered, along with a Sexuality Knowledge and Attitudes Scale; 34 questions evaluated sexual knowledge and 18 evaluated sexual attitudes.Results.  Two‐hundred and twenty participants were sexually active (35·7%), 185 mainly with spouses (84·1%); frequency was 21·4 (SD 16·9) times per year (range: 1–120). Multiple logistic regressions identified five significant predictors of sexual activity: gender, age, being with spouse, sexual knowledge and sexual attitudes. Sexual activity was significantly associated with higher education levels, lower stress and more self‐reported daily activities.Conclusions.  Our results agreed with Western studies linking sexual activity with better health and higher QOL in older adults. Older peoples’ stress and daily activity levels are recognized quality‐of‐life measures; lower stress and more daily activities among sexually active older people suggests a connection between sexual activity and higher QOL. Increasing knowledge and improving attitudes about sexuality may help older people build healthier relationships and enhance health and QOL.Relevance to clinical practice.  If healthcare professionals possess greater understanding of older peoples’ sexuality, healthcare systems may find ways to increase sexual knowledge and foster healthier attitudes and relationships to improve older peoples’ overall health and QOL.
Falls and fall risk among nursing home residents
Authors: Fonad Edit , Wahlin Tarja‐Brita Robins , Winblad Bengt , Emami Azita , Sandmark Helene 
Published: August 2010

Aim and objectives.  The aim of this study was to identify risk factors for falls in older people living in nursing homes.Background.  Impaired cognitive function and a poor sense of orientation could lead to an increase in falls among those with impaired freedom of movement. Many accidents occur while an older person is walking or being moved.Method.  The study was carried out over four years (2000–2003) and 21 nursing home units in five municipal homes for older people in Stockholm, Sweden, participated. A questionnaire was sent to staff nurses, including questions on fall risk assessments, falls, fractures, medication and freedom‐restricting measures, such as wheelchairs with belts and bed rails. The data were aggregated and not patient‐bound. The study covered 2343 reported incidents.Results.  There was a significant correlation between falls and fractures (r = 0·365, p = 0·004), fall risk and use of wheelchairs (r = 0·406, p = 0·001, safety belts (r = 0·403, p = 0·001 and bed rails (r = 0·446, p = 0·000) and between the occurrence of fractures and the use of sleeping pills with benzodiazepines (r = 0·352, p = 0·005). Associations were also found between fall risk and the use of anti‐depressants (r = 0·412, p = 0·001).Conclusion.  In clinical practice, patient safety is very important. Preventative measures should focus on risk factors associated with individuals, including their environment. Wheelchairs with safety belts and bed rails did not eliminate falls but our results support the hypothesis that they might be protective when used selectively with less anti‐depressants and sleeping pills, especially benzodiazepines.
Implementing child‐focused family nursing into routine adult psychiatric practice: hindering factors evaluated by nurses
Authors: Korhonen Teija , Vehviläinen‐Julkunen Katri , Pietilä Anna‐Maija 
Published: August 2010

Aims and objectives.  The aim of this study is to describe nurses’ evaluations of factors that are hindering implementation of child‐focused family nursing (CF‐FN) into adult psychiatric practice. In addition, it explains the nurses’ evaluations of the hindering factors related to the hospital organizational structure, the individual nurse, nursing and family.Background.  There is an increasing amount of families with dependent children in adult psychiatry. Although these families have long‐term benefits from preventive family interventions, implementation of CF‐FN is not routine mental health practice.Design and methods.  Data were collected via a questionnaire‐survey completed by Registered Psychiatric Nurses (n = 223) and practical Mental Health Nurses (n = 88) from 45 adult psychiatric units in five Finnish university hospitals. The response rate was 51%.Results.  Family‐related factors, such as families’ fears and lack of time, were considered as ‘most hindering’ to CF‐FN. Nurses who used a family‐centred approach and had further family education considered most of the factors as ‘less hindering’ in comparison to other nurses.Conclusion.  To meet the needs of the families in mental health services, it is essential to develop nursing intervention methods such as CF‐FN. There is a need for further education and use of family‐centred care to develop this preventive approach.Relevance to clinical practice.  The results of this study could be considered when developing mental health services and family interventions for families with parental mental illness.