bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myocardial infarction: psychosocial aspects, gender differences and impact on pre‐hospital delay
Authors: Løvlien Mona , Schei Berit , Hole Torstein 
Published: June 2008

AbstractTitle.  Myocardial infarction: psychosocial aspects, gender differences and impact on pre‐hospital delay. Aim.  This paper is a report of a study to explore gender differences in psychosocial aspects in the year prior to first‐time myocardial infarction, and the association between these aspects and pre‐hospital delay.Background.  The time from symptom onset to hospital admission is critical for patient survival; therefore influences on pre‐hospital delay are of interest. The prevalence of stressful psychosocial factors is higher among patients before acute myocardial infarction than among healthy controls.Method.  Patients diagnosed with first‐time acute myocardial infarction were recruited from five Norwegian hospitals over a 13‐month period in 2003–2004. Of 738 eligible patients, 149 women and 384 men completed a self‐administered questionnaire (response rate 72%).Findings.  Depression, high family stress, high work stress and major life events had no statistically significant impact on patient delay or total pre‐hospital delay. Depression, sleep disturbances and high family stress were reported among more women than men in the year prior to the event. Women and men aged 65 years and younger were more likely to report major depression and major life events than those older than 65. Low education and low partner education predicted prolonged patient delay in men but not in women. Low partner education also predicted prolonged total pre‐hospital delay in men.Conclusion.  The process between symptom onset and hospital admittance is complex, and more knowledge about factors influencing this process is vital to reduce pre‐hospital delay. Significant others should be included in information‐giving in relation to myocardial infarction as they seem to play a vital role in patients’ decision‐making processes.
Letting go before a death: a concept analysis
Authors: Lowey Susan E. 
Published: June 2008

AbstractTitle.  Letting go before a death: a concept analysis Aim.  This paper is a report of a concept analysis of letting go within the context of family caregivers and end‐of‐life care.Background.  The term ‘letting go’ has been used in an informal manner by nurses and other clinicians working with patients and families with terminal illnesses to depict a lack of acceptance of a loved one’s impending death.Data sources.  The CINAHL, Ovid Medline and PsychInfo databases were searched for the period of 1995–2007 for literature published in English in peer‐reviewed journals from a variety of disciplines, using the specific keywords letting go or to let go.Methods.  The Walker and Avant method of concept analysis was used, and the study was guided by Zerwekh’s family caregiving model of core competencies for hospice nurses.Results.  Letting go before the death of a loved one involves a shift in thinking in which there is acknowledgement of impending loss without impeding its natural progression. An emotional attachment and recognition that everything has been carried out usually precede the concept, followed by a peaceful death and acknowledgement of change.Conclusion.  The concept of letting go has been explored in many contexts but the core essence of the awareness and work towards the acceptance of an impending loss appears to be a universal domain. Research is needed to further explore and identify patterns of this phenomenon in family caregivers in the context of death of a loved one.
Impressions of nursing before exposure to the field
Authors: O’Brien Frances , Mooney Mary , Glacken Michele 
Published: June 2008

Aims and objectives. This paper reports on non‐mature general nursing students’ perceptions of nursing as a career prior to their first clinical placement.Background. It is widely recognised that the first clinical practice experience serves a dual role, that of validating students’ choice of career and shaping their perceptions of nursing. This study sought to explore 23 first year non‐mature (<23 years) nursing students’ perceptions of nursing as a career prior to their first clinical exposure. The students accessed the programme via two different modes of recruitment.Method. This qualitative descriptive study used focus group interviews as a means of data collection. Interviews were held within 10 weeks of entry into nursing. Data were analysed using the five stages of framework analysis. Ethical approval was obtained.Results. Mode of recruitment did not influence students’ perceptions of nursing. The students unanimously identified caring as the essence of nursing. They also acknowledged the role of the media in shaping theirs and society’s perception of nursing. Male students expressed concern regarding the negative connotations associated with their career choice. Student participants could not appreciate the totality of the curriculum content at this stage of their course.Conclusions. Caring remains the essence of nursing. Educators need to take cognisance of first year students’ abilities to appreciate the link between theory and practice. This may be enhanced by the employment of teaching strategies that role‐model this link for students. Recruiters must be proactive in addressing the challenges facing males in choosing nursing as a career.Relevance to clinical practice. An insight into how nursing students perceive nursing prior to their first clinical placement is important for clinicians. This information is valuable in terms of providing registered nurses with an understanding of the students’ perspective and the associated supports required by nursing students on first clinical placements.
Hand hygiene practices: nursing students’ perceptions
Authors: Barrett Rachael , Randle Jacqueline 
Published: June 2008

Aims and objectives.  The present study examines nursing students’ perceptions of hand hygiene practices in clinical settings. The objectives were to investigate any factors that affect students’ perceptions of their own and healthcare workers’ (HCWs) hand hygiene compliance, and to make recommendations for future practice and hand hygiene training in preregistration nursing courses.Background.  Effective hand hygiene decontamination can lower the prevalence of healthcare‐associated infections (HCAIs); unfortunately, the prevalence of HCAIs continues to rise and so poses challenges to healthcare providers to reduce such infections. Previous studies have shown that hand hygiene compliance in HCWs is generally low and that any increase in compliance is difficult to sustain. Several barriers to hand hygiene compliance have been identified in the literature.Design.  A qualitative interpretive design was used to examine nursing students’ perceptions of hand hygiene practices.Methods.  Ten preregistration students participated in semi‐structured qualitative interviews, which were analysed thematically.Results.  Hand hygiene compliance was perceived to be effected by specific barriers which included: time and busyness; clinical procedure; skin condition; lack of knowledge and glove use. Importantly, students perceived other HCWs as being the influencing factor for hand hygiene compliance resulting from the perception that they should ‘fit in’ with those working in the clinical area.Conclusions.  The findings support previous literature and found that respondents emphasised the importance of fitting into the clinical area and role models in shaping hand hygiene compliance.Relevance to clinical practice.  For nursing students, the influence of other HCWs as role models should not be underestimated.
Chronic illness: the process of integration
Authors: Whittemore Robin , Dixon Jane 
Published: June 2008

Aim. The aim of this study was to explore how adults with a chronic illness integrate the illness experience into their life context.Background. Adults with chronic illnesses are challenged to learn self‐management strategies to prevent complications and achieve an acceptable quality of life. Integration represents the process undertaken by an individual to achieve a sense of balance in self‐managing a chronic illness and living a personally meaningful life.Design. A mixed‐method descriptive design was employed to recruit English‐speaking adults with a chronic illness. A semi‐structured interview was completed, transcribed verbatim and content analysed. Descriptive data were collected on demographics, co‐morbidity and depressive symptoms. The research was undertaken in Connecticut, USA.Results. The sample (n = 26) was diverse with respect to age (25–80 years), education (8–24 years), duration of illness (1–39 years), gender (63% female) and ethnicity (63% white). Participants reported a mean of four chronic illnesses and 31% of the sample had increased depressive symptoms. The process of integration was complex and multifactorial. Themes of integration included: shifting sands, staying afloat, weathering the storms, rescuing oneself and navigating life. Numerous factors including treatment side effects, a progressive or uncertain illness trajectory, co‐morbidity, bad days, financial hardships and interpersonal/environmental challenges contributed to a disruption or difficulty in the integration process.Conclusion. All participants made considerable effort to integrate the illness into their life context and participate in a personally meaningful life. However, it was easy to be consumed with ‘living an illness’ as the daily tasks, the changing symptoms and the fluctuating emotions could be overwhelming. There was a complex co‐existence between ‘living a life’ and ‘living an illness’.Relevance to clinical practice. There were numerous challenges to the process of integration and ongoing self‐management, psychosocial, vocational and existential support appears indicated, particularly with individuals with multiple chronic illnesses, progressive chronic illnesses and limited resources.
Nursing care in the chronic phase of COPD: a call for innovative disciplinary research
Authors: Jónsdóttir Helga 
Published: June 2008

Aim.  The literature on nursing care in nurse clinics that focus on chronic management of chronic obstructive pulmonary disease (COPD) is analysed and synthesised with the purpose of advancing research of practice in nurse clinics.Background.  Along with the rising prevalence of COPD and a growing recognition of long‐lasting, comprehensive and complex healthcare needs of people with COPD and their families, nurses are challenged to restructure their practice.Methods.  An integrated review was conducted. The databases searched were NCBI’s PubMed database, Scopus, CINAHL and Web of Science from 1996 to 2006. Terms searched were ‘COPD’ and ‘nurse managed clinic’ with all subheadings. A nurse had to be primary in managing and providing the services and the methodological approach was inclusive.Results.  Of 385 potentially relevant papers, 20 papers reporting 16 studies met the inclusion criteria. The methodological approach was diverse with randomised controlled trials being most common. Significant benefits from experimental treatments were seldom demonstrated. Nursing care in the chronic phase of COPD has mainly been conceptualised as: home‐based respiratory care; self‐management educational programmes and telephone service with influences of specialisation in respiratory nursing care on patients’ outcomes as an emphasis as well. Family focus was not found in any of the studies.Conclusion.  Research on nurse clinics that focus on the chronic phase of COPD is in its infancy. Innovative research that addresses the structure and content of the nursing care is essential.Relevance to clinical practice.  Nursing care in nurse clinics that focus on the chronic phase of COPD needs to be based on nursing knowledge, evidence based, comprehensive, family‐centred, focused on health and the health experience and be situated within the service system. Diversity, creativity and nursing values should prevail when developing nurse clinics for the purpose of creating possibilities to attend to the whole of patients’ and their families’ needs and experiences.
Changes of satisfaction with appearance and working status for head and neck tumour patients
Authors: Liu Hsueh‐Erh 
Published: June 2008

Aims and objectives.  The aim of this survey was to examine changes of satisfaction with appearance and working status of head and neck tumour patients after tumour excision and micro‐reconstructive surgery.Background.  Most research related to head and neck tumour reconstruction deals with surgical techniques and complications. No reports discussed impact on personal appearance and working status.Design.  This is a retrospective cross‐sectional study design with systematical sampling.Methods.  One questionnaire which included three instruments was mailed to patients selected systematically from a patient list; 525 questionnaires were mailed to the potential participants and 125 returned. However, only 97 effective questionnaires were analysed. Non‐parametric statistics such as Spearman correlation, Wilcoxon signed rank test, Kolmogorov–Smirnov Z test and Kruskal–Wallis test were performed as the data were not normally distributed.Results.  Participants reported that they were least satisfied with their face (mean = 2·88 SD 1·34). Compared with presurgery condition, the satisfaction with current appearance was significantly lower (Wilcoxon signed rank test, Z = −6·39, p < 0·001). A total of 35·8% employed participants changed their jobs after cancer treatments. Their major reason for job change was discomfort caused by cancer treatment. Gender, employment status, type of job, type of treatment, age, duration from last radiotherapy and number of treatment modalities had an impact on satisfaction with appearance.Conclusions.  Compared with presurgery, satisfaction with personal appearance did change negatively even after micro‐reconstructive surgery had been conducted. In addition, certain participants changed their jobs because of cancer treatments.Relevance to clinical practice.  We should include job rehabilitation and body image into the daily care of head and neck cancer patients. For example, participants could learn how to use cosmetic strategies to improve their facial appearance during OPD follow‐up. Thus, the negative impact might be reduced.
Social support and adaptation of Taiwanese adults with mental illness
Authors: Huang Chiung‐Yu , Sousa Valmi D , Tsai Chun‐Chin , Hwang Mei‐Yi 
Published: June 2008

Aims and objectives. The present study examined the relationships among contextual factors, dimensions of social support, adaptations and psychiatric symptoms among mentally ill Taiwanese adults in a mental health hospital in southern Taiwan. In addition, this study tested the effect of the dimensions of social support on adaptation as well as whether social support moderated the relationship between psychiatric symptoms and adaptation.Background. Social support enhances an individual’s ability to cope and adapt to daily life events and stressors. Although the relationships among social support, stress and adaptation have been widely studied in the general population, little is known among individuals with mental illness, especially in Taiwan.Design. A cross‐sectional, descriptive correlation design was used.Methods. The sample consisted of 129 adults, ranging in age from 21–67, who were diagnosed with a major mental illness (schizophrenia, bipolar disorder, depression, manic depression or organic mental disorder) and who could communicate in Chinese or Taiwanese. A demographic information sheet, the Interpersonal Support Evaluation List (ISEL), the Brief Psychiatric Rating Scale (BPRS) and the Life Skills Profile (LSP), were used to collect data. Data were analysed with Pearson’s correlation and multiple regressions.Results. The findings suggest that individuals who were older, male, independent and had higher education, a shorter duration of mental illness and fewer psychiatric symptoms had higher life skills. Three dimensions of social support (belonging, tangible and self‐esteem) moderated the relationship between psychiatric symptoms and number of hospitalisations.Conclusion. Life skills and social support play important roles in the adaptation of Taiwanese adults with mental illness in the community as well as in decreasing their psychiatric symptoms and number of hospitalisations.Relevance to clinical practice. The findings have implications for Taiwanese clinical nurses who provide care to mentally ill patients and their family. They can provide psycho‐education programs to teach life skills to mentally ill patients. Clinical nurses can also provide positive feedback on the behaviours displayed by mentally ill patients and assist them to develop better life skills to adapt to the community.
The Stroke Self‐Efficacy Questionnaire: measuring individual confidence in functional performance after stroke
Authors: Jones Fiona , Partridge Cecily , Reid Fiona 
Published: June 2008

Aims and objectives. The aim was to develop a questionnaire for use by practitioners working in stroke care to measure self‐efficacy judgements in specific domains of functioning relevant to individuals following stroke.Background. The prevalence of stroke is set to rise across the developed world especially amongst the elderly population. Recovery and adjustment in the longer term can be affected by many different factors. Current objective measures of functional performance used in many stroke programmes may not fully explain the extent of personal levels of confidence that could ultimately influence outcome.Methods. Three separate studies were conducted to develop the Stroke Self‐Efficacy Questionnaire. A total of 112 stroke survivors, between 2 and 24 weeks, poststroke participated in the study. Development of the scale was undertaken between 2004 and 2006.Results. The final 13‐item Stroke Self‐Efficacy Questionnaire was found to have good face validity and feasibility to use in the recovery period following stroke. Cronbach Alpha was 0·90 suggesting good internal consistency, and criterion validity was high compared with the Falls Efficacy Scale,r = 0·803,p < 0·001. The Stroke Self‐Efficacy Questionnaire was also able to discriminate between those participants walking and not walking.Conclusions. Preliminary psychometric testing of the new Stroke Self‐Efficacy Questionnaire has indicated that it is a valid measure of confidence for functional performance and aspects of self‐management relevant for individuals recovering from stroke.Relevance to clinical practice. The Stroke Self‐Efficacy Questionnaire could assist clinicians and researchers working in acute stroke care and rehabilitation to screen levels of confidence of stroke survivors in relation to functional performance and self‐management. The Stroke Self‐Efficacy Questionnaire could be used as part of battery of stroke outcome measures to provide a more comprehensive overview of factors influencing performance in the individuals recovering from a stroke.
Allostasis and allostatic load: expanding the discourse on stress and cardiovascular disease
Authors: Logan Jeongok G , Barksdale Debra J 
Published: June 2008

Aim.  The aim of this discursive paper is to introduce allostasis and allostatic load, which are relatively new concepts proposed to explain physiological responses to stress, and to suggest ways in which allostasis theory can be applied to the development of clinical interventions to increase resilience for producing better health outcome.Background.  Common explanations of stress have failed adequately to explicate its association with health and chronic illness. Allostasis is the extension of the concept of homeostasis and represents the adaptation process of the complex physiological system to physical, psychosocial and environmental challenges or stress. Allostatic load is the long‐term result of failed adaptation or allostasis, resulting in pathology and chronic illness.Discussion.  The concepts of allostasis and allostatic load introduced the idea that external challenges initiate allostasis and chronic stress causes allostatic load that can be measured with multiple biomarkers. Finding from several studies suggests that higher allostatic load is associated with worse health outcomes. Resilience represents successful allostasis and strategies can be implemented to enhance resilience and thereby improve health outcomes.Conclusions.  This theoretical model provides a comprehensive explanation of the human body’s adaptation processes in response to stress and the results of failed adaptation over time. In addition, combining the concepts of allostasis and resilience may help us to understand and implement clinical strategies better to reduce or prevent the debilitating physiological and psychological effects of chronic stress and chronic illness.Relevance to clinical practice.  Clinical practice should be based on a solid theoretical foundation to improve health outcomes. Strategies to manage stress and increase resilience along with clinical interventions to manage the physiological responses to chronic stress are necessary to assist in preventing and controlling the detrimental effects of chronic disease on human life.
A concept analysis of health‐related quality of life in young people with chronic illness
Authors: Taylor Rachel M , Gibson Faith , Franck Linda S 
Published: June 2008

Aims.  To critique existing concept analyses of quality of life and develop a definition applicable for young people with chronic illness.Background.  Quality of life is a commonly used phrase but there is no universal definition. Five perspectives of quality of life have been proposed: sociological, economic, psychological, philosophical and ethical. However, health has emerged as an important but distinct perspective. The nursing profession has made a substantial contribution to the understanding of the interrelationship of health and quality of life.Design.  Literature review.Methods.  A search on electronic databases to April 2007 was made using the terms ‘quality of life’ and ‘concept analysis’. Papers were included in the review if they used a recognised method of concept analysis and were conducted by nurses. A new concept analysis was then performed specifically focusing on young people’s experiences of living with chronic illness.Results.  Eight concept analyses were identified, all of which had limitations. All the concept analyses were based on adult literature so did not take into consideration developmental changes, language level, or young people’s construction of health and illness. The new concept analysis found that young people living with chronic illness generally view themselves and their lives in the same way as their healthy peers. While their aspirations are often constrained by illness and treatment the relationship between illness and life cannot be seen in isolation of development.Conclusion.  Previous definitions of quality of life derived from concept analyses with adult populations do not adequately represent the experience of young people with chronic illnesses, but can be made more specific by incorporating important attributes such as developmental stage and the importance of peer group and family.Relevance to clinical practice.  The current analysis provides a clear definition of quality of life from the health perspective which is specific for use with young people with chronic illness to guide practice and research.