bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the correspondence of theoretical and real interpretations of health promotion
Authors: Irvine Fiona 
Published: February 2007

Aims and objectives.  The aim of the research was to identify how the development of concept analyses have influenced practising nurses’ understanding of health promotion. More specifically the aim gives rise to the objective of establishing how they translate their understanding into practice.Background.  The acknowledgement that nurses are confused about health promotion has led to attempts to define the term through the production of concept analyses, which aim to clarify the term for nursing education, research, policy and practice.Design and methods.  A qualitative approach, using semi‐structured interviews was undertaken with a purposive sample of 21 district nurses, based throughout Wales. Thematic content analysis was used to order, describe and interpret the data.Results.  Generally the respondents gave definitions of health promotion that were confined to the traditional conceptualization of health promotion, comprising actions aimed at changing the behaviour of individuals. These interpretations were translated into practice, where district nurses adopted a mainly reactive and individualistic approach to health promotion.Conclusions and relevance to clinical practice.  The paper concludes that the more contemporary definitions of health promotion that focus on empowerment, community development and socio‐political action are yet to reach practising district nurses. Considerable effort is required from educationalists and practitioners if nurses are to include these ‘new paradigm’ approaches to health promotion in their practice.
Hand hygiene among nurses in Turkey: opinions and practices
Authors: Akyol Asiye D. 
Published: February 2007

Aims and objectives.  This study aims to identify nurses’ practices and opinions of handwashing during routine patient care.Background.  Transmission of microorganisms from the hands of healthcare workers is the main source of cross‐infection in hospitals and can be prevented by handwashing.Design and methods.  A questionnaire survey was used for this study. A total of 129 clinical nurses at University of Ege Faculty of Medicine Application and Investigation Hospital at Internal Medicine Clinics was surveyed with a response rate of 100%. Data analysis was carried out using SPSS version 10.Results.  The study revealed that nurses have a poor level of knowledge concerning quality of hand washing. All nursing actions related to ‘clean’ and ‘dirty’ activities were evaluated using the Fulkerson scale. The majority of nurses reported that they always wash hands after contact with contaminated and non‐contaminated patients, equipment and environment. It was found that they did need to wash their hands often but that they were not able to do this because of dense working conditions, insufficiency of necessary materials and drying and sore of hands after frequent washing.Conclusion.  To improve hand hygiene and quality of handwashing compliance, additional factors must be considered. These factors include improving healthcare workers – especially nurses’– skin conditions, hand hygiene techniques and disinfections substantially.Relevance to clinical practice.  Hospitals need to develop and implement innovative educational and motivational programmes tailored to specific groups of health personnel.
An exploration of best practice in multi‐agency working and the experiences of families of children with complex health needs. What works well and what needs to be done to improve practice for the future?
Authors: Carter Bernie , Cummings Julie , Cooper Lorraine 
Published: February 2007

Aims and objectives.  This Appreciative Inquiry study aimed to explore appreciatively examples of best multi‐agency working practice with families (mothers, n = 20; fathers, n = 7; children, n = 1) and people working with children with complex needs (n = 41), to determine what works well, why it has worked well and what best practice in the future could be.Background.  The term ‘children with complex health needs’ encompasses a diverse group of children and this population is increasing. This diverse group of children often requires high levels of physiological, psychological and social care which brings them and their families into therapeutic contact with a wide range of health, social and education professionals and people from other agencies.Design.  The study used appreciative interviews, nominal group workshops and consensus workshops to develop a set of 10 ‘best practice’ guidelines that reflected the views of all participants. Two of these are discussed in detail in this article. All participants were seen as co‐researchers whose expert contributions were vital to understanding of what works well and what needs to be done in multi‐agency working practice.Results.  The study resulted in ‘best practice’ statements that illuminated ‘what works well’ in multi‐agency working practice that spanned issues including information, decision making, communication, accessibility, collaboration, respect and sharing a common vision.Conclusions.  The guidance that results from this study suggests that parents need the opportunity to share and receive support from other parents who understand the lived reality of caring for a child with complex needs. Parents and people from across various agencies need to work together to ensure that the most appropriate person acts in the role of a long‐term coordinator, where the family wants this aspect of support. This study adds a multi‐disciplinary and appreciatively oriented focus on what works well in complex care. It contributes to an understanding of the value of an Appreciative Inquiry approach within health‐care research.Relevance to clinical practice.  The guidelines arose from and are grounded in practice and as such they provide clear, workable directions for enhancing practice and for considering what already does work well.
The experiences of older people on discharge from hospital following assessment by the public health nurse
Authors: McKeown Fiona 
Published: February 2007

Aims and objectives.  The aim of the study was to explore the experiences of older people on discharge from hospital following assessment by the public health nurse. The objectives of the study were to: (i) identify needs as perceived by older people, (ii) examine if older people felt that these needs were met, (iii) examine the support/care/services received by older people, and (iv) explore any unmet needs of older people.Background.  A review of the literature revealed that discharge from hospital remains an area of concern as older people had varying degrees of met and unmet need following discharge from acute hospital.Design/methods.  A qualitative study using a phenomenological approach was undertaken. The researcher carried out interviews with a purposive sample of 11 older people in their homes two weeks following discharge from acute hospital. Data were analysed using Colaizzi's method.Results.  Older people experienced a wide variety of difficulties in managing aspects of their own care. A reassuring finding of this study is that older people received assistance in this initial discharge period, i.e. they experienced significant informal support complemented by statutory and voluntary support. Even though these older people were assessed by the public health nurse, their need to access services, for statutory service provision, social aspects of their lives and safety measures in their environment were not met. Older people expressed the wish to remain in their own homes.Conclusion.  Assessment of older people by the public health nurse is meaningful to identify the needs of older people and provide for the needs of older people though this does not necessarily mean that all the needs of older people can be met by the public health nurse. This study supports the findings of other studies of the problems after discharge and provides an understanding of the experiences of older people on discharge from hospital following assessment by the public health nurse from their perspective.Relevance to clinical practice.  The study will provide information that will contribute to current public health nurse practice and will contribute to the understanding of public health nurse practice.
Findings from non‐participant observational data concerning health promoting nursing practice in the acute hospital setting focusing on generalist nurses
Authors: Casey Dympna 
Published: February 2007

Aim.  This paper reports on the non‐participant observational findings from a study, which examined hospital‐based nurses’ health promoting nursing practice in an acute setting.Background.  Nurses are considered to have a key role in health promotion. However, the development of the role of the generalist hospital‐based nurse in health promotion has been slow and is not well‐understood.Method.  The conceptual framework used was based on the Ottawa Charter (WHO 1986). A single qualitative embedded case study, employing data source and methodological triangulation was used. A framework for identifying nurse's use of health promotion methods was developed and used to collect non‐participant observations on a purposive sample of eight nurses working on an acute hospital ward. Following the observations a semi structured one‐to‐one interview was conducted with each observed nurse. One randomly selected patient that the observed nurse had cared for during the observations was also interviewed. Qualitative data analysis based on the work of Miles and Huberman was employed.Results.  Two categories were identified ‘health promotion strategies and content’ and ‘patient participation’. The findings indicated that, overall, the strategies used by nurses to promote health were prescriptive and individualistic. The main strategy observed was information giving and the content was ‘preparatory information’. Predominantly, nurses practised traditional health education. Overall, patient participation was limited to minor personal aspects of care as nurses focused on the routine and getting the tasks completed. There was no evidence of a ward culture which valued health promotion.Conclusions.  Ward managers are key in creating a culture for health promotion. A review of the methods of organizing nursing care is warranted.Relevance to clinical practice.  Nursing programmes must highlight health promotion as integral to practice and emphasis the socio‐political dimensions of health promotion.
Nurses’ feelings and thoughts about using physical restraints on hospitalized older patients
Authors: Chuang Yeu‐Hui , Huang Hui‐Tzu 
Published: February 2007

Aim.  To explore nurses’ feelings and thoughts about physically restraining older hospitalized patients.Background.  The use of physical restraints is still highly prevalent in hospitals; furthermore, older patients are most likely to be so restrained. Studies in acute care settings have focused mainly on nurses’ knowledge, attitudes, or practice concerning physical restraints, on physical restraint reduction programmes, on nurses’ perceptions about the use of physical restraints, or on elderly patients’ experiences with physical restraints. To the best of our knowledge no studies have been conducted on hospital nurses’ feelings and thoughts about the use of physical restraints in Taiwan.Design and methods.  A qualitative approach was used to understand this phenomenon. Semi‐structured interviews were carried out, from August 2002 to March 2003, with 12 nurses working in three hospitals. The interviews were audiotaped and transcribed verbatim; content analysis was used to analyse the data.Results.  Nurses reported a variety of emotional responses regarding the use of physical restraints, including sadness, guilt, conflicts, retribution, absence of feelings, security, and pity for the restrained older people. Rationalization, sharing with colleagues, and compensating behaviours were ways that nurses used to manage their negative feelings.Conclusions.  Most nurses had negative feelings towards the use of physical restraints. Among these nurses there was a struggle between patients’ autonomy and the practice of care. However, other nurses said they had ‘no feelings’ or ‘feeling of security’ while using physical restraints.Relevance to clinical practice.  The findings of this study may contribute to filling the gaps in nursing knowledge, to improving protocols for physical restraint use in hospitals, and may also assist nurse managers to create a supportive practice environment. It is recommended that in‐service training programmes should cover misconceptions regarding physical restraint use, ethical issues and how to cope with feelings while using physical restraints.
The effects of different maternal positions on non‐stress test: an experimental study
Authors: Aluş Merlinda , Okumuş Hülya , Mete Samiye , Güçlü Serkan 
Published: February 2007

Aims and objectives.  To determine the effects of different maternal positions on non‐stress test results and the preferences of mothers for involving positions.Background.  The non‐stress test (NST) has become a common tool in diagnosing fetal risks. The major problem encountered in the application of the non‐stress test has been obtaining erroneous non‐reactive non‐stress test results when, indeed, the fetus is healthy and oxygenation is sufficient.Study design.  Experiment design with randomly assigned four positions: supine, left lateral, semi‐fowler and sitting up. The sample included 408 women in a university hospital in Turkey. Women were randomly assigned to four groups in equal numbers of 102.Data collection and analysis.  Data were collected through two instruments: Demographic and Pregnancy History Form and NST tracing. Main outcome measures were percentage of reactive NST and number of minutes for reactivity in each position.Results.  There were significant (P < 0·05) differences among four groups. Supine position showed the least fetal reactivity. In terms of time to reactivity, there were no statistically significant differences. Qualitative data showed that pregnant women were least comfortable in supine position reporting back pain and shortening of breath.Conclusion.  Supine position yields the lowest non‐reactivity in tandem with physical discomfort such as back pain and difficulty in breathing.Relevance to clinical practice.  Sitting up, semi‐fowler and left lateral positions are recommended to be used during the non‐stress test. In addition, the preferences of the pregnant women should be determined before the test to minimize discomfort which, when it occurs, may signal physiological alterations experienced during the test.
Falls in German in‐patients and residents over 65 years of age
Authors: Heinze Cornelia , Halfens Ruud JG , Dassen Theo 
Published: February 2007

Aims and objectives.  The aim of the present study was to describe the first fall rates in hospitals and nursing homes throughout Germany. Relationships between age, gender, care dependency, medical disciplines, bed confinement and falls were investigated.Background.  Little is known about fall rates in German hospitals and nursing homes.Method.  Prevalence studies were conducted in the year 2002 and 2004. Forty hospitals and 15 nursing homes took part in 2002 (3923 patients and 1252 residents older than 65 years) and in 2004 there was a total of 39 hospitals and 29 nursing homes (4451 patients and 2374 residents older than 65 years). Staff nurses used a standardized instrument to collect data about falls in the last two weeks in their institutions and also about other patient problems. Descriptive and inferential statistics were used as well as logistic regression.Results.  The first fall rate in 2002 (2004) in the hospitals was 4·7 (4·2) and in the nursing homes 4·5 (5·1) per 1000 patient/resident days. Most of the hospital patients fell on geriatric wards. The high care dependent patients fell more often than the low care dependent patients. In 2002, mobile nursing home residents were at a higher risk of falling than residents confined to bed, but those results could not be confirmed in 2004.Conclusions.  Falls of patients over 65 years of age are as much of a problem in German hospitals as they are in German nursing homes.Relevance to clinical practice.  Fall preventive methods should be implemented both in nursing homes and hospitals. Care dependency is a stable risk factor for falls in hospital patients.
Children's nurses and nurse prescribing: a case study identifying issues for developing training programmes in the UK
Authors: Pontin David , Jones Susan 
Published: February 2007

Aims and objectives.  (1) To develop an insight into the opportunities and barriers to nurse prescribing for a case study of children's nurses. (2) To consider the implications of independent nurse prescribing for children's nurses and the potential for nurse prescribing to be developed in acute children's care settings. (3) To use research data to develop a training strategy.Background.  Nurse prescribing in the UK is evolving and current initiatives aim to extend the range and scope of prescribing. Children's nursing presents interesting challenges because of off‐license drugs. Successful nurse prescribing lies in practice area preparation, local policy and practice development and identifying precourse training needs.Design.  Case study.Research questions.  (1) What opportunities do children's nurses identify as being appropriate for nurse prescribing? (2) Can children's nurses identify the benefits of patient group directives and the different levels of nurse prescribing? (3) What preparation do children's nurses need for nurse prescribing?Methods.  Focus group of health visitors/district nurses to inform a survey of 500 nurses working in acute and specialist care settings in a large Children's Hospital.Results.  Focus group main themes – training, supervision and the development of confidence, record keeping, benefits of nurse prescribing, autonomous practice, the formulary and its use in practice. Response rate was 27%. Senior nurses and specialists identified potential benefits for their practice. Course content needed to focus on children, i.e. children's physiology and pharmokinetics. Children's nurses frequently advise junior medical colleagues on prescribing issues. Patient group directives are a useful alternative to prescribing.Conclusions.  The results provide an insight into the training needs of children's nurses and specialist nurses which may be used to develop nurse prescribing training and practice. Training may need to be targeted at senior nurses/specialist nurses initially to develop a critical mass to change organizational culture.Relevance to clinical practice.  Pertinent for senior nurses responsible for developing children's nursing practice and services for children in acute settings.
The prevalence of enduring postnatal perineal morbidity and its relationship to type of birth and birth risk factors
Authors: Williams Amanda , Herron‐Marx Sandy , Knibb Rebecca 
Published: February 2007

Aims and objectives.  To investigate the prevalence of perineal morbidity at 12 months postnatal and its relationship to type of birth and birth risk factors.Background.  It is well documented that women endure short‐term postnatal perineal morbidity following childbirth (e.g. incontinence, perineal pain and sexual morbidity). However, to date, very little research has been carried out on the long‐term effects of perineal morbidity and its relationship to the type of birth the women experienced and other birth risk factors (e.g. ethnic origin, age, parity, length of labour, epidural anaesthesia).Design.  A retrospective, cross‐sectional community survey of postnatal women within two maternity units in Birmingham.Methods.  A total population sample of 2,100 women were surveyed using a self‐administered postal questionnaire. The questionnaire included self‐assessment of perineal pain, perineal healing, urinary incontinence, flatus incontinence, faecal incontinence, sexual morbidity and dyspareunia. Demographic details, type of birth and birth risk factors were taken from the hospital's computerized maternity information system.Results.  Four hundred and eighty‐two women responded to the questionnaire (23·3%). Overall, a high level of enduring perineal morbidity was reported with 87% complaining of at least one index of morbidity. Instrumental births were associated with higher levels of certain types of perineal morbidity than women following a caesarean section or normal vaginal birth (stress and urge urinary incontinence, flatus incontinence, sexual morbidity and dyspareunia). In particular, women following a forceps birth reported higher levels of morbidity than normal or ventouse birth (continual, stress and urge urinary incontinence and flatus incontinence), even when comparing with the same degree of perineal trauma. Increasing age, increasing birth weight, length of labour and particularly Asian ethnic origin were also identified as risk factors for certain types of perineal morbidity.Conclusions.  The study concludes that enduring perineal morbidity in women following childbirth is common, especially with women following a forceps birth and certain birth risk factors (i.e. age, ethnic origin, length of labour and birth weight).Relevance to clinical practice.  These findings highlight the need for further research and provide a number of challenges for health‐care services and health‐care professionals.
Gallstone disease
Authors: Marschall H.‐U. , Einarsson C. 
Published: February 2007

Abstract.Gallstone disease is one of the most prevalent gastrointestinal diseases with a substantial burden to health care systems that is supposed to increase in ageing populations at risk. Aetiology and pathogenesis of cholesterol gallstones still are not well defined, and strategies for prevention and efficient nonsurgical therapies are missing. This review summarizes current concepts on the pathogenesis of cholesterol gallstones with focus on the uptake and secretion of biliary lipids and special emphasis on recent studies into the genetic background.