bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of preoperative uncertainty and anxiety on short‐term recovery after elective arthroplasty
Authors: Kagan Ilya , Bar‐Tal Yoram 
Published: February 2008

Aims and objectives.  This study examined the effect of preoperative anxiety and uncertainty on short‐term physical and mental recovery after elective arthroplasty.Background.  Uncertainty and anxiety accompany all medical procedures. Although preoperative uncertainty plays a central role in the development of stress, only a few studies explicitly examine this issue in terms of its impact on postoperative recovery.Design.  Quazi‐experimental study.Methods.  Two self‐administered questionnaires were used to collect data, before and five to six days after surgery. Participants (n = 87) admitted for elective arthroplasty completed the study.Results.  Preoperative anxiety negatively affected postoperative recovery variables and preoperative uncertainty negatively affected mental and physical recovery after surgery. Furthermore, postoperative symptoms were related to the patients’ subjective readiness to be discharged.Conclusions.  Separately, reduction of preoperative anxiety and uncertainty could have a positive impact on postoperative recovery and on perceived readiness to be discharged.Relevance to clinical practice.  The unique contribution of each preoperative variable (uncertainty and anxiety) to postoperative recovery emphasizes the need for clinical and educational interventions that separately relieve uncertainty and anxiety.
Improving the patient's experience of a bone marrow biopsy – an RCT
Authors: Johnson Helen , Burke Debbie , Plews Caroline , Newell Rob , Parapia Liakat 
Published: February 2008

Aims.  To compare nitrous oxide 50%/oxygen 50% (N2O/O2– entonox) plus local anaesthetic (LA) with placebo (oxygen) plus LA in the management of pain experienced by patients undergoing a bone marrow biopsy.Background.  Bone marrow biopsies are a common procedure for many haematological conditions. Despite the use of a LA, pain during the procedure has frequently been reported by patients. Previous research in pain management of other invasive diagnostic procedures (e.g. sigmoidoscopy) has reported N2O/O2 as an effective alternative to LA.Design.  Double‐blind randomized controlled trial.Methods.  Forty‐eight patients requiring a bone marrow biopsy were randomized to receive either N2O/O2 or oxygen in addition to their LA. Participants were asked to complete a pain score and comment on their experience of the procedure.Results.  Although the overall pain scores were moderate, there was a wide range of scores. N2O/O2 resulted in significantly less pain for men, but not for women. All patients who had had previous biopsies reported significantly more pain, regardless of the gas used. There were no significant adverse effects in either group.Conclusion.  N2O/O2 is a safe, effective, easy‐to‐use analgesic which merits further investigation in potentially painful diagnostic (and other) interventions.Relevance to clinical practice.  Relief of pain is an important issue for nurses. Appropriate assessment of pain experience is a key issue. Nurses should reflect on their own area of practice and identify what is known about the effectiveness of pain management from their patient's perspective. Individual differences may be important, and careful instruction regarding appropriate administration of analgesic agents, such as N2O/O2 may enhance their effectiveness.
The two‐step Mini Nutritional Assessment procedure in community resident homes
Authors: Wikby Kerstin , Ek Anna‐Christina , Christensson Lennart 
Published: February 2008

Aims and objectivities. The aims were to test internal consistency and interrater reliability of Mini Nutritional Assessment during implementation of Mini Nutritional Assessment in community residential homes and to test sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment‐short form vs. Mini Nutritional Assessment.Background. There is a need in clinical practice to assess nutritional status in older people and to identify those who could benefit from early intervention.Methods. The two‐step Mini Nutritional Assessment procedure (Mini Nutritional Assessment‐short form and Mini Nutritional Assessment) was used in 127 older people admitted to eight residential homes. In three of those homes (A, B and C), registered nurses simultaneously performed the assessment procedure, after receiving education and training. The intention was to offer the registered nurses a tool for independent practice use.Results. Internal consistency was 0·68 (Cronbach's alpha) (n = 127). In residential home A, B and C, the registered nurses carried out Mini Nutritional Assessment in 45 residents out of 68. The agreement level between the author's and the registered nurses’ assessments was 62% (kappa 0·41). In residential home A, B and C, the agreement level was 89%, 89% and 44%, respectively. Sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment‐short form vs. Mini Nutritional Assessment were 89%, 82% and 92%, respectively.Conclusions. The two‐step Mini Nutritional Assessment procedure seems to be a useful tool to identify residents in need of nutritional interventions, despite the registered nurses not carrying out Mini Nutritional Assessment in all residents and the low agreement in residential home C. It indicates that to implement and use Mini Nutritional Assessment in nursing care demands the creating necessary staff resources, such as adequate staffing, sufficient education and continual supervision.Relevance to clinical practice. Because of the high sensitivity of Mini Nutritional Assessment‐short form and Mini Nutritional Assessment, Mini Nutritional Assessment‐short form alone might be sufficient for practice use, as its simplicity might increase its usefulness.
Nurses’ development of professional self – from being a nursing student in a baccalaureate programme to an experienced nurse
Authors: Björkström Monica E , Athlin Elsy E , Johansson Inger S 
Published: February 2008

Aims.  To investigate how baccalaureate degree nurses conceive their professional self over time, by following them from being students until some years after graduation.Background.  Competence and professional development in nursing has been studied and discussed in many research studies. However, how baccalaureate degree nurses judge themselves and their own competencies as professionals over time remains a topic for further research.Design.  Quantitative and longitudinal.Methods.  Respondents were students entering the three‐year academic nursing programme 1993–1995 at a Swedish university. The Nurse Self‐Description Form was used at the beginning of the education programme (n = 163), just before graduation (n = 124) and 3–5 years after graduation (n = 82). Data were analysed using parametric and non‐parametric procedures.Results.  Generally, the respondents rated their professional self highly and rather stably over time on items related to humanistic values, practical, affective and social skills. Six of the 19 items increased significantly during the transition from student to nurse. The rating of the components ‘Knowledge mastery’ and ‘Desire to contribute through research’ decreased over time after graduation. Gender, previous studies in health care and participation in development or research work as nurses, influenced the results in some parts.Conclusion.  In the transition from novice students to experienced nurses, the participants saw themselves well equipped compared with others regarding traditional components of nursing competence. However, their self‐judgement decreased in components related to the new demands of a professional nurse. The findings illuminate an urgent need to search for further understanding about reasons why nurses decrease in self‐judgement concerning these components.Relevance to clinical practice.  As the judgement of professional self is of importance to good performance in nursing, this study shows the need for further collaboration between the nursing education and the health care sector, in which nurses practice and also supervise nursing students.
The lived experience of the diabetes nurse specialist regular check‐ups, as narrated by patients with type 2 diabetes
Authors: Edwall Lise‐Lotte , Hellström Anna‐Lena , Öhrn Ingbritt , Danielson Ella 
Published: February 2008

Aim.  The aim was to elucidate the lived experience of regular diabetes nurse specialist check‐ups among patients with type 2 diabetes.Background.  Diabetes care with diabetes nurse‐led clinics in primary care has been established in Sweden since the 1980s. Information about patients’ lived experience of these regular check‐ups is important in the further development of diabetes nursing in primary care.Methods.  Narrative interviews were conducted with 10 women and 10 men with type 2 diabetes regarding their lived experience in everyday life and the regular check‐ups by the diabetes nurse specialist. A phenomenological‐hermeneutic method inspired by Ricoeur was used in the analysis.Results.  Patients’– with type 2 diabetes – lived experience of regular check‐ups showed an overall positive influence on the patients’ way of living with the disease by underpinning and developing their understanding and management of daily life. This influence was interpreted as an interlinked chain comprising the following elements; being confirmed, being guided within the disease process, becoming confident and independent and being relieved. Every link contained a positive influence from being dependent‐independent, autonomous and a feeling of freedom in patients striving for an everyday life with a disease under control.Relevance to clinical practice.  The development of diabetes‐nurse‐led clinics from the perspective of the patient must consider the patient's individual need for support and continuity with the diabetes nurse specialist. Consultations with collaborative partnership and specific expertise that is easy to access implied autonomous disease self‐management in terms of patients’ own control of the disease over time. In view of the increasing number of patients with diabetes, this could positively impact the availability of diabetes nursing care.
State and trait anxiety levels before coronary angiography
Authors: Uzun Senay , Vural Huriye , Uzun Mehmet , Yokusoglu Mehmet 
Published: February 2008

Aim.  To investigate the factors that are related to increased anxiety before elective coronary angiography.Background.  Anxiety before coronary angiography is an important factor for complications. To know the factors for increased anxiety, it is important for nurse to prevent complications.Design.  A cross‐sectional study design was used. The study included 88 consecutive patients waiting for coronary angiography.Methods.  A data‐collecting form, which included questions about demographic features, health history and angiography, was completed by the participants on the day of coronary angiography. The level of state and trait anxiety was measured by Spielberger's State‐Trait Anxiety Inventory. Multivariate Analysis was performed to disclose the independency of the relation between state anxiety and factors.Results.  Both trait and state anxiety levels were found to be moderate (age = 46, SD = 9, 24–67 years and age = 40, SD = 10, 21–65 years, respectively). There was a significant relation between state and trait anxiety levels (r = 0·56, p < 0·001). Among the investigated factors, only the trait anxiety (p < 0·001) and time on waiting list (p = 0·020) were found to be independent. For predicting high level of state anxiety, the cut‐off value of trait anxiety was found to be 48 with a sensitivity of 67% and specificity of 67% and cut‐off value of time on waiting list was found to be seven days with a sensitivity of 83% and specificity of 52%.Conclusions.  The time on waiting list and trait anxiety levels are the most important factors for state anxiety level. To prevent high level of coronary angiography‐related anxiety, those patients with trait anxiety level >48 and time on waiting list >7 days should be managed specifically. The preventive measures should be specifically focused on the connection between state and trait anxiety.Relevance to clinical practice.  Nursing planning should be focused on patients especially those on a long‐time waiting list and on patients with high trait anxiety level prior to coronary intervention.
Congenital anomalies: parents’ anxiety and women's concerns before prenatal testing and women's opinions towards the risk factors
Authors: Sahin Nevin Hotun , Gungor Ilkay 
Published: February 2008

Aims.  The aims of the study were to determine parents’ anxiety and women's concerns before prenatal testing and women's opinions towards the risk factors for congenital anomalies.Background.  Undergoing prenatal screening or diagnostic tests cause potential distress and worry for parents. Little attention has been paid to the psychological aspect of such testing in clinical and research areas.Design.  This descriptive study was conducted in a prenatal diagnosis unit in a university hospital in Istanbul. The convenience sample of the study consisted of 200 women and 104 partners who applied for prenatal screening or diagnosis tests.Methods.  Women were interviewed by the researcher before they underwent prenatal screening or diagnostic procedures. Data were gathered through interviews using an interview form that addressed women's evaluations for causes of fear and their opinions towards the risk factors for congenital anomalies. Spielberger State Anxiety Inventory was used to assess parents’ anxiety before prenatal testing.Results.  Anxiety scores of women and their partners were higher in invasive tests group and suspicious findings group. The possibility of a malformation detected and of it being missed were major concerns of women. Receiving insufficient information about the procedure, undergoing this test for the first time, smoking and lower education was associated with increased anxiety scores in women. Although women knew about some certain risk factors for congenital anomalies like drug use, smoking and malnutrition, their knowledge about other risks were not sufficient.Conclusion.  Prenatal tests, both routine screening and prenatal diagnosis, cause anxiety for parents. Understanding women's concerns and awareness of risk factors are important for providing care and counselling.Relevance to clinical practice.  Nurses can provide appropriate information and support at each step in the screening and diagnosis process so that parents’ psychological stress is minimised.
Embedding nursing and therapy consultantship: the case of stroke consultants
Authors: Burton Christopher R , Bennett Bev , Gibbon Bernard 
Published: February 2008

Aims and objectives.  As the basis for the design of career development opportunities for current and aspiring nursing and therapy consultants, we aimed to explore the factors that shape how these roles have embedded in UK stroke services.Background.  The non‐medical consultant role has been introduced into UK health care services to provide opportunities for experienced practitioners to progress their careers in clinical practice. Whilst there have been evaluations of the impact of the role on service delivery, little attention has been paid to the pathways towards consultantship.Design.  An exploratory design, incorporating focus group discussions, was used to address the research questions. Participating consultants, both nurses and allied health professionals, worked in stroke services, although it is anticipated that the results will have wider application.Methods.  Two focus groups were held with non‐medical consultants in stroke from across the UK. Participants had the opportunity to comment on an interim paper prior to publication of the results. Thirteen consultants took part in the study.Results.  A lack of consensus about the nature of clinical expertise and a diverse range of pathways towards consultantship were identified. Health care policy had presented the opportunity for consultants to be entrepreneurial in the development of stroke services, although this had limited the scope for the development of professional knowledge. Inflexible programmes to support aspiring consultants may limit the opportunities to develop these entrepreneurial skills.Conclusions.  This study challenges health care organizations and the education and research departments that support them to think creatively in the way that the non‐medical consultant role is embedded, and that this should draw on the commitment of existing consultants to support succession planning.Relevance to clinical practice.  The identification of those aspects of career pathways that current consultants have found to be helpful will be useful in designing opportunities for aspiring consultants.
Norton, Waterlow and Braden scores: a review of the literature and a comparison between the scores and clinical judgement
Authors: Anthony Denis , Parboteeah Sam , Saleh Mohammad , Papanikolaou Panos 
Published: February 2008

Aims and objectives.  To consider the validity and reliability of risk assessment scales for pressure ulcers.Background.  Pressure ulcers are a major problem worldwide. They cause morbidity and lead to mortality. Risk assessment scales have been available for nearly 50 years, but there is insufficient evidence to state with any certainty that they are useful.Design.  A literature review and commentary.Methods.  Bibliographic databases were searched for relevant papers, a critical review was completed on relevant papers.Results.  There is contradictory evidence concerning the validity of risk assesment scales. The interaction of education, clinical judgement and use of risk assessment sakes has not been fully explored. It is not known which of these is most important, nor whether combining them results in better patient care.Conclusions.  There is a need for further work. A study exploring the complex interaction of risk assessment scales, clinical judgement and education and training is introduced.Relevance to clinical practice.  Nurses may be wasting their time conducting risk assessment scoring if clinical judgement and/or education are sufficient to assess pressure ulcers risk.
Mental health: patients’ experiences of patient education during inpatient care
Authors: Hätönen Heli , Kuosmanen Lauri , Malkavaara Heikki , Välimäki Maritta 
Published: February 2008

Aims and objectives.  This study aimed to explore psychiatric patients’ experiences of patient education on psychiatric inpatient wards.Background.  Patient education seems to be an effective way to support psychiatric patients’ capacity for independent living, compliance and insight. Despite the development of various patient education interventions there is still a lack of coherent information on how to improve patient education in the field of psychiatric care, especially from patients’ own perspectives.Design and method.  Data were collected through interviews with 51 inpatients during their discharge process. This exploratory study employs a mixed methods design in data collection and analysis. The structured questions were analysed using descriptive statistics (percentages, frequencies, Mann–Whitney U‐test, t‐test). Open‐ended questions were analysed using inductive content analysis.Results.  Patients perceived different informational areas to be important for them, although some variation was found. However, patient education was not realized in these same areas. Problems related to patient education described by patients were lack of information, problems in patient–staff interaction and a lack of prerequisite knowledge among patients and staff. Patients’ suggestions for future development of patient education were more innovative methods in patient education, paying attention to patient–staff interaction and personnel's professional knowledge. A majority of patients wanted to receive information through discussions with staff. However, other patient education methods were also suggested.Conclusions.  Patient education in psychiatric hospitals is an important area to be developed, therefore, more innovative methods should be developed and their effectiveness should be tested.Relevance to clinical practice.  Development of patient education can be implemented through tailoring patient education to patients’ individual needs and provide patient education using more innovative methods.
Adherence to pressure ulcer prevention guidelines in home care: a survey of current practice
Authors: Paquay Louis , Wouters Renild , Defloor Tom , Buntinx Frank , Debaillie Roseline , Geys Ludo 
Published: February 2008

Aims and objectives.  To investigate the pressure ulcer prevalence in home nursing patients and to evaluate guideline adherence of measures for the prevention of pressure ulcers and the participation of informal carers in pressure ulcer prevention.Background.  Since 2002, the Belgian Guideline for the Prevention of Pressure Ulcers was published on the Internet, but no information was available on guideline adherence in home care.Methods.  A cross‐sectional survey of pressure ulcer prevalence and guideline adherence was performed in a cluster randomized sample of 2779 clients of nine regional nursing departments in Flanders, Belgium. The Belgian Guideline for the Prevention of Pressure Ulcers was the reference standard for the evaluation of the guideline adherence.Results.  There were 744 subjects at risk for developing pressure ulcers. The overall prevalence of pressure ulcers for the total sample population was 6·8%. The age‐, sex‐ and risk‐standardized prevalence per regional department varied between 4·9% and 9·1%. Of the 744 subjects at risk, 33 (4·4%) received preventive measures, which were in adherence to the Belgian Guideline for Prevention of Pressure Ulcers, 482 persons (64·8%) were administered measures, which did not adhere to the Belgian Guideline for Prevention of Pressure Ulcers and in 229 subjects (30·8%) at risk for developing pressure ulcers, prevention was lacking. For subjects with at least one pressure ulcer, the proportions were: 4·8% adherence, 76·6% no adherence and 18·6% no prevention. A proportion of 22·2% of the patients at risk and their informal carers were informed and motivated by the home care nurse to participate in the pressure ulcer prevention and their actual participation in the prevention was 21·4% of all risk cases.Conclusions.  The adherence of nurses and clients to the guideline for pressure ulcer prevention was low.Relevance to the clinical practice.  The study demonstrates a detailed evaluation of guideline adherence to pressure ulcer prevention in an individual patient situation, with special attention for materials and measures, which are not adequate and not recommended by the Belgian Guideline for the Prevention of Pressure Ulcers.