bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the impact of training community psychiatric nurses to educate relatives about schizophrenia
Authors: BROOKER CHARLES , BARROWCLOUGH CHRISTINE , TARRIER NICHOLAS 
Published: November 2007

Summary

An experimental group of community psychiatric nurses (CPNs) were trained to undertake psychosocial intervention with families caring for a sufferer from schizophrenia. Intervention consisted of a detailed assessment of all the needs of each family member, health education and family stress‐management programmes. Outcome was compared with a control group of families who received standard CPN care.
This report concerns the evaluation of one component of the intervention, namely, health education. A key relative's functional knowledge about schizophrenia was assessed at pre‐test, post‐test and 6‐month follow‐up using the Knowledge about Schizophrenia Inventory (KASI). The KASI is a tape‐recorded and semi‐structured interview schedule which is scored by reliable raters and which yields a global knowledge score from six subscales. Both the control and experimental CPNs were trained to administer the KASI.
Analysis revealed that the KASI scores of the control group of relatives did not significantly change over the 12‐month period of the study. However, global KASI scores in the experimental group improved significantly both post‐test and at 6‐month follow‐up. These results are discussed in relation to the ‘stress‐vulnerability’ model of schizophrenia and the implications for CPNs (and other community based mental health professionals) are considered. It is argued that there are both sound theoretical and practical reasons for providing families with information about schizophrenia which should be addressed by appropriate educational/training programmes.
Central line infection: a review
Authors: HALLER LORRAINE T. , RUSH KATHY L. 
Published: November 2007

Summary

There is increasing and widespread use of central line catheterization in clinical practice. Nevertheless, there is a growing awareness and concern about the escalating rate of infection related to central lines, especially in those patients receiving total parenteral nutrition.
This paper reviews selected studies which have identified factors contributing to central line infection.
Factors relating to all areas of catheter management, including insertion, maintenance and removal have been implicated in central line infections.
Nurses who are involved to varying degrees in all phases of central line management, play an important role in infection control.
An understanding of infection‐related factors is the first step needed to effect changes in procedures and protocols in the care of patients with central lines.
Post‐operative patients' views of sleep, pain and recovery
Authors: CLOSS S. JOSÉ 
Published: November 2007

Summary

One‐hundred patients who had undergone abdominal surgery were interviewed about their experiences of pain and sleep.
Pain was the most common cause of disturbed sleep and half of the patients felt that pain was worse during the night.
More than one‐third of the sample felt that tiredness affected post‐operative pain, for the most part making it worse.
One‐third felt that sleep reduced pain intensity, three‐quarters felt that sleep helped them to cope with their pain and almost all believed that sleep enhanced recovery from surgery.
For the post‐operative patient, therefore, pain and sleep cannot be considered separately.
Methods for the effective assessment and control of pain at night (leading to associated improvements in sleep) require development by nurse researchers and practitioners.
Ownership and the harmonious team: barriers to developing the therapeutic nursing team in primary nursing
Authors: JOHNS CHRISTOPHER 
Published: November 2007

Summary

The paper assumes the significance of the therapeutic team to enable staff in primary nursing roles to seek and receive support in working therapeutically with patients and to deal effectively with conflict that impairs this aim.
Two particular phenomena, ownership and the harmonious team, are identified and described; these arc both derived from the impact of introducing primary nursing into traditional nursing teams that appear to act as barriers to establishing the therapeutic team in practice. The importance of understanding these phenomena is emphasized.
An analysis of the changes involved in the introduction of the nursing process and primary nursing using a theoretical framework of loss and attachment
Authors: MEAD DONNA , BRYAR ROSAMUND 
Published: November 2007

Summary

The nursing process is an innovation which has had a great effect on nursing practice.
Primary nursing is an innovation currently having profound effects on the delivery of nursing care.
In this article a theoretical framework of loss and attachment (Marris, 1985) is used to analyse these innovations.
Data from studies of the nursing process (Bryar, 1985) and primary nursing (Mead, 1991a) are used to argue that changes in working practices may result in a period of loss and mourning. Nurses must have time to work through this period of mourning if change is to be successfully implemented.
The nutritionally vulnerable patient: a pilot study to compare nurses' assessment of intake with actual intake
Authors: GASKILL DEANNE , PEARSON ALAN 
Published: November 2007

SummaryThis pilot study was designed to assess the relationship between nurses' assessment of nutritionally vulnerable patients' dietary intake with their actual intake.Between one in three and one in four patients from a medical ward in a large regional hospital in Victoria, Australia, were identified as being nutritionally compromised.Individuals were selected if they fulfilled a minimum of two of the following five criteria: low total protein or serum albumin; significant weight loss in the past 6 months; had a high‐risk diagnosis; were underweight; or had a history of poor food intake for at least 5 days.Nursing staff need to consider protein energy malnutrition when assessing patients on admission to hospital.The study highlights the importance of nurses' involvement with patients during meal times.Paying attention to the amount and type of food patients eat, difficulties with eating, and the assimilation of readily available information about weight, high‐risk diagnosis, and biochemical tests when available, have the potential to make improvements in both quality of life and cost‐effectiveness in patient care.
A revised conceptualization of social support
Authors: GIBSON CHERYL H. 
Published: November 2007

Summary

Very few people can live without some kind of social relationship with others. The need for social support is universal–to deal not only with day‐to‐day events but also with times of crisis, change, or transition.
A critical component of nursing practice is to provide support to promote health and wellness functioning in individuals, families, and the community at large.
To date, there is no unified conceptualization and operationalization of social support and its relation to health‐related outcomes. Furthermore, an understanding of the process of social support remains elusive (Heller et al., 1986).
This paper is a description of the concept of social support based on a selected review of the literature on social support.
A brief overview of the interest in the concept of social support is highlighted and the functional, structural, interactional, and other components of the concept arc described. Finally, a revised conceptualization of social support is discussed along with directives for future research.
Exploring the knowledge of nursing practice
Authors: VAUGHAN BARBARA 
Published: November 2007

SummaryThis paper describes the very personal experience of a senior nurse's struggle to try to come to understand the nature of nursing knowledge more clearly. Miss Vaughan was working as a Senior Lecturer in the School of Nursing Studies at the University of Wales, and this paper reflects her attempt to bring together the experience of practice with those concepts that were being presented to her through the formal literature. The paper:

commences with an honest description of the dilemmas which were facing her at the time and her concern that she had begun to lose touch with the real world of nursing.
she then identifies her personal reflections through the use of a daily diary.
finally the relationship between theoretical concepts relating to clinical nursing and her personal perceptions and feelings in practice is explored.
What can be the relevance of the psychiatric nurse to the life of a person who is mentally ill?
Authors: DAVIDSON BEN 
Published: November 2007

Summary

Mental illness is popularly conceived as a disorder located in the individual. This is a misconception. An alternative view is proposed, based around the writings of Smail and referring to Laing's work and the author's professional and personal experience.
The concepts and techniques of psychiatry and associated disciplines pathologize individuals. The theme that they therefore do more harm than good is developed.
In place of these techniques we should implement the process of ‘taking care’ described by Smail. This process is explained as demystification and comfort, and some of its benefits and difficulties are examined in relation to clinical practice.
Finally, the role of the psychiatric nurse in clinical work with individuals and issues of professional identity are considered. The merits of a reformulation of our role and identity in line with the preceding analysis are emphasized.
The use of cognitive behavioural therapy with people with schizophrenia
Authors: GARDNER BOB , THOMPSON STEVE 
Published: November 2007

Summary

The role of cognition as one aspect of the stress‐vulnerability model of schizophrenia is discussed, and the use of cognitive therapy reviewed.
A holistic approach to the development of schizophrenia is explored.
The stress vulnerability model is explained and the way in which individuals suffering from schizophrenia are vulnerable to attentional, perceptual and cognitive difficulties, are discussed.
Using case examples, it is demonstrated that the use of cognitive behavioural techniques can be used by nurses to effectively reduce client problems associated with schizophrenia.
The death drive exemplified in a case of alcohol dependence
Authors: HOLDEN ROBYN J. 
Published: November 2007

Summary

When Freud first advanced the death drive it was considered a highly controversial theoretical idea. However, with the passage of time it has been slowly gaining support in certain psychoanalytical quarters.
This paper aims to demonstrate the clinical usefulness of this theory in accordance with the Freudian and Kleinian model.
Although the case history to be discussed is a severe case of alcohol dependence which had, previously, been unresponsive to treatment, many other maladies, both mental and physical, can be better understood in the context of the death drive being the principal motivating factor.
A programme to audit the use of urinary catheters
Authors: CURRAN EVONNE 
Published: November 2007

Summary

This paper describes the development of a tool to audit the use of urinary catheters on surgical wards; the overall objectives being a reduction in the inappropriate use of urinary catheters, and in the number of urinary tract infections.
The literature is reviewed to determine the criteria necessary to audit urinary catheters effectively. The implementation of an audit of urinary catheters on one surgical ward over 6 weeks showed that 27 catheters were used. All catheters passed in the ward were of the appropriate size, balloon and lumen. Significant bacteriuria was found in 5/18 (28%) of catheters in situ for 3 days. All three catheters which remained in situ longer than 10 days had significant bacteriuria. The results were favourable; this was possibly due to the patient population and the individual reasons for catheterizations.
The need for the results of audit tools such as this to be interpreted on a ward‐to‐ward basis, and not to compare wards with each other is highlighted. This audit tool could be used by other surgical wards.
Intuition: concept analysis and application to curriculum development. I. Concept analysis
Authors: McCORMACK BRENDAN 
Published: November 2007

SummaryThis is the first of two articles which address the subject of intuition and its relevance in practice and to curriculum development.Few words used by philosophers and educators arouse as much confusion as the term ‘intuition’, yet it is recognized that few terms embrace such promising concepts. The nature of what is meant by intuition is discussed in this paper.The relevance of intuition to nursing is discussed and its importance in decision making addressed.
Nursing and rehabilitation: the interventions of nurses in stroke patient care
Authors: O'CONNOR STEPHEN E. 
Published: November 2007

Summary

The nature of the therapeutic interventions of nurses in the care of stroke patients is at the core of the debate over the exact role of the nurse in patient rehabilitation.
The nature of that intervention is explored in the terms of previous writers in the area through a review of the English language literature published.
The main conclusion is that even though the number and quality of publications has increased significantly, the nature of the nurse's specific interventions are still vague with the result that Henderson's claim for nurses to be the ‘rehabilitator par excellence’ still lies unfulfilled.
This lack of precision enhances the possibility that the nature of the nurse's interventions will be defined and hence potentially constrained by other professionals.
Pain in elderly orthopaedic patients
Authors: CLOSS S. JOSÉ , FAIRTLOUGH HELEN L. , TIERNEY ALISON J. , CURRIE COLIN T. 
Published: November 2007

Summary

This paper focuses on one aspect of a study of elderly orthopaedic patients, namely pain control.
One‐hundred patients aged 70 years and over were interviewed on up to five occasions during admission to an acute orthopaedic unit.
The majority of patients had significant post‐operative and/or post‐trauma pain, and backache and joint pain were reported frequently.
None of the patients received more than half of the maximum prescribed number of doses of opioid analgesics over a period of 48 h following surgery.
The well‐recognized problem of inadequate pain relief among hospital in‐patients is discussed, in particular its relevance to elderly orthopaedic patients.
An item analysis of a classification system for nurses' work methods
Authors: BOWMAN GERALD S. , MEDDIS RAY , THOMPSON DAVID R. 
Published: November 2007

Summary

This study describes how an item analysis of a classification system for nurses' work methods discriminates between wards operating either primary nursing or team nursing.
Four of the 13 items on the classification instrument were highly successful in discriminating between the two ward types. The four items concerned responsibility for nursing records, accountability, responsibility and authority for nursing care.
Possible reasons for why some items were more successful than others for discriminating between the ward types are discussed.
The relationship between semi‐professions in acute and long‐term care of elderly patients
Authors: REED JAN 
Published: November 2007

Summary

As part of a larger study into the assessment of patients' needs in care of the elderly wards, data were collected from observation and interviews with nurses and doctors, which demonstrated differences in the functioning of the multidisciplinary care team in acute and long‐term care wards.
The nurses acted as gatekeepers to other non‐medical members of the team, using a variety of strategies to exclude them from, or include them in patient care.
Interview data also revealed a difference in nurses' perceptions of these members in the different care settings.
The gatekeeping function of the nurses was not, however, an exercise of power and autonomy, it was rather a demonstration of their allegiance to medical models of care. The medical model, as it was interpreted by the nurses, dictated the perceived relevance of the other professions to patient care, in terms of whether they could contribute to the cure and discharge of patients.
The high value placed on cure in both settings was reinforced by consultants' behaviour and attitudes, and, whereas it could be argued that this enhanced the work of the multidisciplinary team in acute care, the impact in long‐term care settings was problematic, leading to conflicts between nurses and physiotherapists.
This paper calls for a closer examination of how semi‐professional groups in health care work together, as a strategy for developing alternatives to the medical model.
Learning through supervision: a case study of respite care
Authors: JOHNS CHRISTOPHER , BUTCHER KATHRYN 
Published: November 2007

Summary

In this paper a case study is used to explore critically the complexities of caring that faced one of us, K.B., as a relatively inexperienced primary nurse, in working with a ‘respite‐care’ family to achieve effective care.
The medium of reflection and supervision is used to describe this experience and the emerging issues.
Through the use of reflection, Kate was able to unravel the complexities of caring and learn to work therapeutically with this family.
If you are pregnant and smoke, admission to hospital may damage your baby's health
Authors: THOMSON ANN M. 
Published: November 2007

Summary

It is recognized that smoking adversely affects the outcome of pregnancy. However, clinical experience suggested that women admitted to hospital during pregnancy smoked more than when they were at home.
Forty‐one women who were over 20 weeks pregnant, who smoked and had been in hospital for 2 days or more were interviewed using a structured schedule.
The women had made a significant reduction in their cigarette consumption during pregnancy but on admission to hospital the number of cigarettes smoked had almost returned to the pre‐pregnancy level. Boredom was seen as the main factor contributing to this increase.
Strategies for reducing the effects of admission to hospital on smoking behaviour are suggested.
Advanced clinical practice—how do we promote it?
Authors: KÄPPELI SYLVIA 
Published: November 2007

Summary This paper aims to examine the promotion of advanced clinical practice. It addresses questions such as:

what is advanced clinical practice?
what is the relevance of knowledge to clinical practice?
what is the relevance of research to clinical practice?
what is the relevance of the culture to clinical practice?
what is the role of the clinical nurse?It does not present ready answers. Rather, it attempts to highlight difficulties and ambiguities originating from the contradictory goals and requirements of nursing education, research and practice.
The experience of long‐term gastrostomy tube feeding: a phenomenological case‐study
Authors: WILSON DONNA 
Published: November 2007

Summary

A 1991 phenomenological case‐study investigated the effect of long‐term gastrostomy tube feeding on an incompetent patient and her surrogate decision maker. In this case, a daughter chose tube feeding for her severely debilitated mother after she had become aphasic. The report includes the daughter's perceptions of (a) her relationship and experience with a tube‐fed mother, and (b) her mother's experience with tube feeding.
The experience of tube feeding differed from what the daughter had expected. The daughter perceived that tube feeding reduced her mother's quality of life. Taste sensations and pleasures of eating were lost. Tube feeding also negatively influenced the daughter's activities and subsequent relationship with her mother. Tube feeding, however, did extend life and did allow ongoing visits by the daughter and her children.
The mother could still continue to fulfil the role of a mother and grandmother to a certain extent. Most significantly, however, tube feeding was perceived to prolong death. Concern over whether her mother would have chosen tube feeding for herself prevailed.
The experience of motherhood and the development of depression in the postnatal period
Authors: McINTOSHMA JAMES 
Published: November 2007

Summary

This paper reports on an investigation of women's experience of motherhood as a possible factor in the development of postpartum depression.
Several aspects of the experience of motherhood were found to be associated with depression in a sample of 60 first‐time mothers. These included:

the social impact of motherhood,
the extent to which expectations of motherhood were met,
the adequacy of support received from partners or from the mothers' wider social networks.

It is argued that these findings, while tentative, are consistent with a social model of depression.
Implications for health professionals and other care providers are discussed.
Shiftwork and quality of care
Authors: WHALE ZOE 
Published: November 2007

Summary

This article reviews the literature on shiftwork in nursing and relates this to quality of care issues.
The implications of a fully rotational shift system are discussed.
The biological effects of working shifts are reviewed, but there appear to be other factors, such as social circumstances and autonomy, which moderate these effects.
It is suggested that tasks, formal and informal structures, and staff needs vary widely between nursing shifts, and that this should be taken into account when quality initiatives are introduced.
It is concluded that claims that increasing the number of nurses who work fully rotating shifts results in an improved quality of care for patients are premature, as quality issues in nursing have not been addressed on a 24‐hour basis.
Evaluating the effectiveness of the coronary care nurses' role in smoking cessation
Authors: CLARK J. MACLEOD , ROWE K. , JONES K. 
Published: November 2007

Summary

The aim of this small‐scale study was to assess the feasibility and impact of an individualized smoking cessation intervention among clients admitted to a coronary care unit with severe angina or a first time myocardial infarction.
The intervention involved in‐depth nursing assessment interviews related to client beliefs, motivation and experiences of smoking, culminating in an individualized cessation plan. Participants were offered follow up support during the first year post‐intervention.
The findings are highly encouraging with a 77% smoking cessation rate for surviving clients within the intervention group at the end of the first year, and with 75% continued successful smoking cessation amongst surviving clients 2 years post‐intervention.
The use of medical equipment by Australian registered nurses
Authors: McCONNELL EDWINA A. , NISSEN JUTTA H. 
Published: November 2007

Summary

Registered nurses in Australia are the primary users of medical equipment in the direct care of patients. The cross‐sectional survey reported in this paper explores how and what registered nurses working in a large hospital in a South Australian city initially learn about the medical equipment they use in direct patient care, as well as the consequences of equipment use for both patients and staff.
Equipment use had positive and negative aspects both for registered nurses and patients, the central issue of which was quality patient care. Inherent in this issue was knowledgeable and proficient device use, which, it is argued, hinges on equipment education.
The two most frequently identified methods of initial learning were reading the user/instruction manual and consulting the policy and procedure manual. At least 90% of respondents indicated they initially learned how to operate equipment and its purpose and function.
Medical equipment use caused nearly half the nurses to feel stressed, but only 9.4% had used medical equipment that had harmed a patient.