bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maintaining Client Safety and Scientific Integrity in Research with Battered Women
Authors: Lutz Kristin F. 
Published: June 2007

Purpose: To increase awareness of considerations of privacy and safety as well as the potential for scientific misconduct in research with battered women and other groups especially vulnerable to these concerns. Research with such vulnerable populations demands consideration of privacy and safety of participants in order to limit any potentially negative consequences while also ensuring scientific integrity.Organizing Framework: Maintaining scientific integrity and protecting vulnerable groups are important but potentially contradictory. Battered women are the examples to illustrate instances of conflict in which protecting participants may undermine scientific integrity.Sources: Literature on scientific integrity and misconduct, battered women, and vulnerable populations, and socially sensitive topics from nursing, other biomedical and social sciences, and the U.S. Public Health Service, 1978–1998.Method: Integrative literature review.Findings: Conducting research with battered women in an ethically responsible manner that maintains scientific integrity without compromising advocacy or safety is possible when scientists are aware of potential conflicts and methods to ensure integrity.Conclusions: Nurses frequently do research with vulnerable groups such as battered women. Being proactive can help promote scientific integrity, avoid scientific misconduct, and decrease negative outcomes.
Adults Seeking Presymptomatic Gene Testing for Huntington Disease
Authors: Williams Janet K. , Schutte Debra L. , Evers Catherine A. , Forcucci Chris 
Published: June 2007

Purpose:To describe the expectations of those seeking presymptomatic gene testing for Huntington disease (HD). Identification of the gene for HD makes it possible to conduct testing to determine if a healthy person with a family history of HD has a mutation in this gene. Presymptomatic gene testing reveals the likelihood that a person will develop an inherited disease in the future. Understanding expectations allows for more complete assessment and counseling before presymptomatic gene testing for genetic diseases.Design:Descriptive qualitative. The population was people with a family history of HD. The sample was 17 asymptomatic adults with a positive family history of HD who requested presymptomatic gene identification atone tertiary genetic counseling program, 1995 to 1996.Methods:Semi‐structured interviews concerning expectations of adults seeking presymptomatic genetic testing were conducted by telephone. Interviews occurred after the individuals had requested presymptomatic gene identification but before results were reported. Content analysis was used to identify the expectations and questions of those who had decided to seek presymptomatic testing.Findings:Common expectations included anticipating relief from uncertainty, hoping to plan for their future health care and life decisions, wanting to know if their children were at risk of developing HD, anticipating loss of family support from relatives, expecting relief from self monitoring, venturing into the unknown, and planning for disclosure. Participants attempted to avoid their loss of genetic privacy by withholding the decision to seek testing from their primary care providers.Conclusions:Participants seeking presymptomatic HD gene testing consider the effect of gene identification on themselves and their families. A desire to limit insurance or employment discrimination contributes to subjects not seeking input from health care providers in their decision making.
Effects of Home Care on Caregivers' Psychosocial Status
Authors: Jepson Christopher , McCorkle Ruth , Adler Diane , Nuamah Isaac , Lusk Edward 
Published: June 2007

Purpose:To examine changes in the psychosocial status of caregivers of post‐surgical patients with cancer, and how their status was affected by (a) whether caregivers had physical problems of their own, and (b) whether the patient received a home care intervention. Many studies in this area to date have not included sufficient measurement points to identify fluctuations in psychosocial status over time. In addition, many have used caregiver health as an outcome rather than a predictor.Design:Longitudinal, randomized trial using a sample of 161 caregivers of cancer patients being treated at one large university hospital in the northeastern United States, 1993‐1996. Half the patients were randomly assigned to receive a standardized home‐care nursing intervention. The population of interest was caregivers of patients who were (a) diagnosed with a solid‐tumor cancer within the past 2 months, (b) age 60 or older, (c) hospitalized for surgical treatment of the cancer and expected to live at least 6 months, and (d) had a complex problem at hospital discharge. All caregivers were living with the patient at time of discharge.Methods:Data were collected in structured interviews administered at the time of the patients' discharge and approximately 3 and 6 months later. Psychosocial status was measured using the Caregiver Reaction Assessment and the CES‐Depression scale. A repeated‐measures analysis of variance was performed for each psychosocial measure, using as factors Time (i.e., interview 1, 2, or 3), Group (treatment and control), and Caregiver Physical Problem.Findings:Overall, psychosocial status improved from baseline to 3 months, and was about the same at 6 months. Among caregivers with physical problems, the psychosocial status of those in the treatment group declined compared to those in the control groups in the 3 months after discharge; an opposite pattern was observed in the following 3 months.Conclusions:People who are caregivers for cancer patients and have physical problems of their own are at risk for psychologic morbidity, which may have a delayed onset. This delay may reflect the replacement of an initial optimism with discouragement as the reality of long‐term illness sets in. Home care may create a situation in which caregivers are required to confront the realities of long‐term caregiving quickly, cutting short their initial optimism, but also preparing them for what is to come.
Ethnomethodologic Analysis of Accounts of Feeding Demented Residents in Long‐Term Care
Authors: Pierson Charon 
Published: June 2007

Purpose:To describe the self‐organizing activities and the unspoken knowledge that nursing assistants employ in performing the work of feeding as a routine part of their activities. In U.S. long‐term care facilities, activities related to medical and nursing care are frequently based on the ability of nursing assistants to successfully accomplish the work of feeding. Nurses are not always aware of the difficulties involved in feeding nor the means by which food is offered and intake calculated.Design:Qualitative phenomenologic.Methods:Observations were conducted during 12 weekday mealtimes, October and November 1994. Data were collected using participant observation of mealtimes in the congregate dining room of one licensed long‐term care facility. Data were analyzed using the framework of ethnomethodology to indicate the methods nursing assistants used to make sense of their interactions with demented residents.Findings:Nursing assistants used several common behaviors: grouping the “difficult feeders” together; “marking the borders” by maintaining a tidy tray; and “loading the spoon” to maximize the amount of food given at one time. Estimations of the quantity of intake varied according to ideas about the nutritional content of various foods.Conclusions:Unsuccessful feeding interactions have implications for the quality of life for the demented. When inadequate intake leads to significant weight loss, medical and nursing interventions should be implemented.
A Model for Cognitive‐Behavioral Interventions in Cancer Pain Management
Authors: Kwekkeboom Kristine L. 
Published: June 2007

Purpose:To propose a model for predicting success with cognitive‐behavioral interventions in cancer pain management. Practice guidelines are useful, however nurses currently have little theoretic or empiric basis for choosing one particular strategy over another. Moreover, nurses have no way of knowing if a particular intervention is likely to work.Organizing construct:The model indicates characteristics of a person in relation to interventions including skill and ability, outcome expectancies, perceived credibility, history of use, preferred coping style, and pain outcomes.Sources:The model was developed using sources identified through a literature search of relevant topics in MEDLINE, CINAHL, and Psychlit (1996‐1997), as well as through clinical experience.Conclusions:Continued empiric testing of the model is necessary to confirm proposed relationships and to assess accuracy of the model's predictions with various cognitive‐behavioral interventions. With this testing, the model can help nurses select appropriate interventions for individual patients.
A Model of Chronic Dyspnea
Authors: McCarley Cynthia 
Published: June 2007

Purpose:To present an overview of dyspnea, differentiate chronic dyspnea from acute dyspnea, critique models of dyspnea found in the nursing literature, and propose a new model of chronic dyspnea to guide the care and evaluation of chronic dyspnea in patients living with chronic obstructive pulmonary disease (COPD). Dyspnea is the major symptom that impairs quality of life for nearly 16 million Americans who have COPD.Methods and Sources:Review of scholarly literature on dyspnea by searching CINAHL and MEDLINE (1980‐1998) using dyspnea and chronic obstructive lung disease as key words. The search produced studies conducted by a variety of health care professions including those in nursing, medicine, exercise physiology, and respiratory therapy.Findings:The existing models fail to differentiate between acute and chronic dyspnea. These models were found to be inadequate for guiding interventions to decrease the long‐term adverse consequences of chronic dyspnea.Conclusions:A useful model of chronic dyspnea defines chronic dyspnea as distress with varying levels of intensity and long‐term physical, psychologic, and sociocultural consequences. The proposed model has implications for both research and clinical practice by identifying the consequences of chronic dyspnea as outcome measures of the effectiveness of treatment.
Testing a Model of Avoiding Environmental Tobacco Smoke in Young Adults
Authors: Martinelli Angela Maria 
Published: June 2007

Purpose:To test an explanatory model of gender, self‐efficacy, situational influences, and other health‐promoting behaviors on the avoidance of environmental tobacco smoke (ETS) in young adults. ETS is a cause of lung cancer, pulmonary disease, and cardiovascular disease. Although young adults are at increased risk for ETS exposure, there are few behavioral studies of ETS exposure and no reported studies of ETS exposure in young adults. Although college students are often exposed to ETS, the college environment offers a setting in which the opportunities for change are substantial.Design:Model‐testing. Data are reported on a convenience sample of 136 nonsmoking 18‐ to 25‐year old students in one mid‐atlantic U.S. university. This sample of nonsmokers was drawn from a larger sample of 241 smokers and nonsmokers in 1995. Model constructs were based on Pender's health promotion model (HPM).Methods:The General Self‐efficacy Scale, Health Promotion Lifestyle Profile, and ETS Avoidance Scale were used along with items measuring ETS‐avoidance efficacy and Living with Smoke. Path analysis was used to test the model.Findings:The trimmed explanatory model showed that 26% of the variance in avoiding ETS was accounted for by gender, having self‐efficacy, and ETS‐avoidance efficacy, not living with people who smoke, and performing other healthy behaviors. Being female and general self‐efficacy indirectly influenced ETS avoidance through their effects on related health promoting behaviors.Conclusions:The explanatory model of ETS avoidance can provide useful information for the development of interventions to prevent exposure to passive smoke. Given the occurrence of ETS exposure in young adults, longitudinal research using this explanatory model is yielding promising results. Enhancing the self‐efficacy of young adults and encouraging healthy lifestyle behaviors may be an important factor in their avoidance of ETS.
Adolescent Resilience
Authors: Hunter Anita J. , Chandler Genevieve E. 
Published: June 2007

Purpose:To explore what resilience means to adolescents and whether the Resiliency Scale can accurately measure resilience. Researchers have identified that resilience in children and adolescents may lead to psychosocial maladaption and psychopathology in adulthood. Further research is necessary in order to understand what resilience is in adolescence and to identify those at risk for psychosocial problems.Design:A triangulated research design was used to explore the concept of resilience in adolescents. This small pilot study, conducted in 1997, had a purposive sample of 51 10th‐grade and 11th‐grade volunteers from one inner‐city, vocational high school in New England.Methods:A researcher‐developed demographic tool was used to explore the environment of adversities to which students were exposed. Wagnild and Young's Resiliency Scale was used to measure adolescents' perceptions of their resilience. Focus groups, structured and unstructured interviews, and written stories were used to gather phenomenologic data.Findings:Despite the traumatic and violent world in which participants lived, the adolescents ranked themselves as “resilient.” These adolescents believed that being resilient was to be (a) disconnected from others because they could not trust, (b) isolated because they had inadequate or no support systems, and (c) insulated because the emotional pain was too much to bear.Conclusions:This study of resilience in adolescence shows the need for further research; the investigators question whether resilience is really a healthy state, and wonder if similar interventions are necessary for both “resilient” and “vulnerable” adolescents.
Physicians' Neonatal Resuscitation of Extremely Low‐Birth‐Weight Preterm Infants
Authors: Catlin Anita Joy 
Published: June 2007

Purpose:To examine the perceptions of physicians who make delivery room decisions to resuscitate extremely low‐birth‐weight (ELBW) neonates at marginal viability. Nurses, parents, economists, and ethicists have questioned resuscitation of ELBW neonates, many of whom experience high levels of morbidity and mortality. Yet no systematic studies were found that addressed physicians' perceptions and delivery room decisions.Design:Descriptive, using naturalistic inquiry. A national U.S. convenience sample was obtained in 1996‐1997 of 54 physicians in five perinatal subspecialties who resuscitated ELBW neonates.Methods:Tape‐recorded and transcribed interviews were analyzed using NUD* IST software and line‐by‐line constant comparison.Findings:Despite awareness of the high morbidity and mortality, 96% of the physicians offered resuscitation to all ELBW neonates in the delivery room. The main factors affecting their decisions were “the role of physician;” having been “trained to save lives;” the belief that “if called, I resuscitate;” the inability to determine gestational age; requests from parents to “do everything;” and the need to move from a “chaotic” delivery room to a controlled neonatal intensive care unit. Six major themes were: role expectation, uncertainty, awareness, internal and external forces, burden, and continuing quandaries. Physicians were burdened by the devastated and dying babies, by their inability to predict which neonates had a chance for intact survival, and by conflicts with colleagues about viability. Statistical probability of survival, legal constraints, and cost of care did not appear to affect greatly their decisions. Physicians asked that society and national policy makers set parameters for resuscitation.Conclusions:The American Academy of Pediatrics' Neonatal Resuscitation Protocol needs revision to delineate the ethical criteria for resuscitation. Early prenatal education for families which clearly teaches the margins of viability and outcomes of early deliveries is also recommended. Physicians must be supported in changing the recessitation paradigm.
Language Plus for International Graduate Students in Nursing
Authors: Julian Mary Ann , Keane Anne , Davidson Kristin 
Published: June 2007

Purpose:To provide information about an English‐language support program that focuses on the needs of international graduate nursing students. The growing presence of these students coincides with the increasing numbers of universities committed to world health. Crucial social and language competence affect the success and progress of international students in graduate nursing programs.Design:Reviewed literature was 1980 to 1998, in nursing and applied linguistic research including second‐language acquisition, phonology, discourse analysis, and language pragmatics to identify social and language phenomena.Findings:Investigators suggest essential elements such as conventions of academic writing, reading comprehension, vocabulary, and pronunciation skills be included in the supportive Language Plus program.Conclusions:Ongoing development of the Language Plus program can promote collaboration between nurses and linguists and increase the success of international graduate nursing students.
Research‐based Practice with Women Who Have Had Miscarriages
Authors: Swanson Kristen M. 
Published: June 2007

Purpose:To summarize a research‐based description of what it is like to miscarry and to recommend an empirically tested theory of caring for women who have experienced miscarriage.Design:The research program included three phases: interpretive theory generation, descriptive survey and instrument development, and experimental testing of a theory‐based intervention.Methods:Research methods included interpretive phenomenology, factor analysis, and ANCOVA.Findings:A theory of caring and a model of what it is like to miscarry were generated, refined, and tested. A case study shows one woman's response to miscarrying and illustrates clinical application of the caring theory.Conclusions:The Miscarriage Model is a useful framework for anticipating the variety of responses women have to miscarrying. The caring theory is an effective and sensitive guide to clinical practice with women who miscarry.
From Randomized Trial to Community‐focused Practice
Authors: Moore Mary Lou 
Published: June 2007

Purpose:To describe the use of findings from a randomized trial—a nursing intervention using telephone contacts to reduce the incidence of low‐birth‐weight and preterm births—in four community settings in North Carolina, to show that implementing research into practice is important. Low‐birth‐weight and preterm births are the major cause of high infant mortality in the United States. Rates are highest among African‐American women. Telephone intervention as a strategy for preventive health care can be cost effective, reduce low‐birth‐weight and preterm births in African‐American women, and provide a means of health consultation for parents of children age five and under.Organizing Framework:Four community programs are discussed in relation to five phases of implementing and sustaining research in communities: research, transfer, transition, regeneration, and empowerment. Modification from the original research, bonuses, and barriers are described for each program.Methods:The randomized trial was conducted from 1990‐1995. Randomized trial data and data for subsequent projects were collected from telephone interviews and health care records from 1994‐1998. A successful adaptation was made from the original randomized trial to the four programs by (a) educating the staff for each program about the methods and findings in the original research, and (b) working with program staff to make appropriate modifications for each site.Conclusions:Findings from a randomized trial can be used in a variety of settings. By working together, researchers and community‐health nurses can integrate research findings into community‐health nursing practice.
Ethical and Methodologic Benefits of Using a Reflexive Journal in Hermeneutic‐Phenomenologic Research
Authors: Smith Brian A. 
Published: June 2007

Purpose:To illustrate the importance of considering the researcher's written reflections on the qualitative research process as a valuable source of data and as a means of enhancing ethical and methodologic rigour.Organizing Construct:Excerpts from the researcher's reflexive journal are presented as evidence of an audit trail. Ethical and methodologic concerns arising during the research process are outlined and the value of reflecting on these issues is addressed.Methods:A hermeneutic‐phenomenologic study, conducted in Scotland, included in‐depth interviews with six problem drinkers to explore the lived experience of their suffering. The researcher was considered to be a primary data‐collection tool, whose reflections on the research process added to the contextual richness of the study. For an interpretative approach to data analysis, the researcher found metaphors to convey the participants' stories to a new audience. This intuitive, creative process was analysed and reported in the reflexive journal.Conclusions:The researcher's self‐awareness, fostered by the use of a reflexive journal, is mirrored by the participants' ability to reflect on the final interpretation of their stories and on the therapeutic benefits of the research process. The researcher's reflexive journal reveals previously hidden contextual information which enhances the prime ethical and methodologic aim of the study—to understand the lived experience of suffering by problem drinkers.
Assisted Dying and Nursing Practice
Authors: Schwarz Judith Kennedy 
Published: June 2007

Purpose:Nurses' views are often solicited about physician‐assisted dying, a concept that incorporates both assisted suicide and active euthanasia. Yet nurses are rarely asked about their own clinical experience of assisted dying. The literature indicates that many nurses experience difficulty distinguishing professionally sanctioned end‐of‐life interventions from those that are not. In this article the investigator explores the social, legal, and political roots of assistance in dying, and critically examines the profession's position on nurse participation in assisted dying and the research regarding nurse‐assisted dying.Scope:The bioethics and nursing literature was reviewed from 1990 to 1999. The databases used were the Cumulative Index to Nursing and Allied Health Literature and Medline.Conclusions:The complex nature of caring for highly symptomatic dying patients, and the difficulty some nurses experience in distinguishing a moral difference between hastening and assisting death, strongly indicate a need for additional nursing research that does not use a forced answer.