bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between organizational empowerment and job satisfaction perceived by nursing assistants at long‐term care facilities
Authors: Kuo Huai‐Ting , Yin Teresa Jeo‐Chen , Li I‐Chuan 
Published: February 2008

Aim.  The purpose of this study was to understand the relationships between organizational empowerment and job satisfaction among nursing assistants at long‐term care facilities in Taiwan.Background.  Nursing assistants are the major manpower at long‐term care facilities. The responsibilities of nursing assistants are complex and numerous and affect their job satisfaction. We assumed that a well‐organized and pleasant work environment is an important characteristic of organizational empowerment and ought to enhance the nursing assistants’ job satisfaction. However, little information exists that can be used by long‐term care facilities managers when they strive to increase the nursing assistants’ job satisfaction by modifying the regulations or interventions from an organizational perspective.Methods.  We used a cross‐sectional design with a descriptive correlation approach to understand the relationship between organizational empowerment and job satisfaction among nursing assistants at long‐term care facilities in Taiwan. A total of 28 long‐term care facilities and 114 nursing assistants participated in the study.Results.  The results indicated that, where there was a moderate level of organizational empowerment, a higher level of job satisfaction was found. Organizational empowerment was significantly associated with total job satisfaction (r = 0·366, p < 0·01). The variables of nationality (Vietnamese), resources, opportunity and informal power were significant predictors of job satisfaction (R2 = 0·318, F = 12·24, p < 0·001).Conclusion.  Organizational empowerment is significantly associated with job satisfaction among nursing assistants in this study.Relevance to clinical practice.  Nursing assistants need to receive more assistance and resources from their co‐workers to enhance their job satisfaction. The manager should initiate regular meetings and activities for staff who work in long‐term care facilities that will allow sharing, communication and support among the staff in terms of ideas, information and feelings.
Patients’ perceived care needs whilst waiting for a heart or lung transplant
Authors: Yorke Janelle , Cameron‐Traub Elizabeth 
Published: February 2008

Aim.  To explore the perceptions of caring and expectations of nursing care in patients on a heart and/or lung transplant waiting list.Background.  The waiting period for a heart or lung transplant can be very stressful and demanding for patients and their families. Care during the waiting period needs to be aimed at treating the symptoms and complications of patients’ underlying condition and also specific issues related to organ transplant candidacy.Method.  A qualitative research design, using semi‐structured interviews with 22 patients on a heart and/or lung transplant waiting list was used. Participants were interviewed on three separate occasions.Findings.  Qualitative analysis of the data revealed five major themes related to the nursing care needs of heart and lung transplant candidates. The themes were identified as information giving, maintenance of regular contact, familiarity, positive thinking and compassionate manner. These were five key aspects of communication within the nurse–patient relationship and formed the essence of caring as perceived by patients awaiting heart and/or lung transplantation.Conclusion.  Transplant candidates often experience prolonged waiting times for a transplant which is often laden with uncertainties and stress. This study provided an in‐depth description of patients’ perceptions of caring and their nursing care needs whilst on a heart and lung transplant waiting list.Relevance to clinical practice.  The findings provide useful advice to nurses about ways they can improve care and enhance caring for patients waiting for an organ transplant. Key elements of nursing care that foster the nurse–patient relationship that can be incorporated into nursing care pathways have been highlighted.
Quality of life in elders living alone in Taiwan
Authors: Lin Pao‐Chen , Yen Miaofen , Fetzer Susan Jane 
Published: February 2008

Aims and Objectives.  The aim of this study was to identify and describe predictors of QOL of elders who live alone in Taiwan.Background.  Despite a growing population of elders who live alone, research on their quality of life, important for policy decisions and health care provider interventions is virtually absent.Methods.  A descriptive correlational design surveyed 192 Taiwanese elders living alone, selected at random from urban and rural areas. During home visits elders completed the WHO‐QOL‐BREF, Social Support Scale and Center for Epidemiological Studies Depression Scale (CES‐D) in addition to providing demographic data.Results.  Multiple linear regressions showed that six variables predicted physical health and the psychological wellbeing QOL domains, accounting for 74·5 and 60·1% of the variance, respectively. Four variables predicted 46·7 and 34·3% of the environmental and the social relationship QOL domains, respectively.Conclusions.  Elders who live alone in rural areas and suffer from depression are at high risk for a low quality of life. However, elders living alone reported a better quality of life than their institutionalized counterparts. Interventional research and policy decisions focused on treatment for depression and providing social support networks, as these elders age, will be particularly important.Relevance to clinical practice.  By understanding variables associated with elders' quality of life, nurses can coordinate interventions to improve their quality of life. Poorly educated rural women who live alone are particularly vulnerable. Nursing assessment of quality of life indicators and implementation of strategies for increased social support are needed for high‐risk elders.
Living with a spinal cord injury: a grounded theory approach
Authors: Chen Hsiao‐Yu , Boore Jennifer RP 
Published: February 2008

Aims.  This paper reports a study which examined patients’ experiences of suffering a spinal cord injury.Background.  Spinal cord injury has major bio‐psycho‐social and spiritual implications for patients. However, very limited research exists regarding the experience of patients with spinal cord injury in Taiwan or other countries worldwide.Method.  Grounded theory was used to explore the psychosocial implications for patients of spinal cord injury.Data collection and analysis.  Data were collected from October 2002 – March 2003 through tape‐recorded, semi‐structured interviews and complete observation of a group discussion focusing on patients with tetraplegia, in a rehabilitation hospital in Taiwan. The number of patients with spinal cord injury interviewed for this study was 15, involving 18 interviews. Data collection and analysis occurred concurrently.Results.  The findings resulted in the core category ‘living with a spinal cord injury’ and identify the experiences of suffering a spinal cord injury. Three stages were identified as the individual experience, including four categories: stage 1 A catastrophic life event, stage 2 Confront challenges and stage 3 Moving forward or Withdraw from society.Conclusions.  This study shows that patients suffering a spinal cord injury have to find their own way and learn to live with their disability. Patients who did better in living with spinal cord injury point could move forward, otherwise, they may withdraw from society.Relevance to clinical practice.  Health professionals need to recognize patients’ experiences, perceptions and needs, to provide better nursing care.
A Health Need Satisfaction Instrument for Taiwan's single‐living older people with chronic disease in the community
Authors: Shih Shaw‐Nin , Gau Meei‐Ling , Tsai Jen‐Chen , Li I‐Chuan , Liou Ying‐Mei , Shih Fu‐Jin 
Published: February 2008

Aims.  The aims of this study were to explore health needs and need satisfaction of Taiwan's single‐living older people with chronic disease in the community, develop a culturally sensitive Health Need Satisfaction Instrument and examine the relationships between health needs and need satisfaction.Background.  Until now, there has been no reliable instrument for health professionals to assess, comprehensively, health needs and needs satisfaction for Chinese single‐living older people with chronic disease in the community.Design.  Between‐method triangulation design was used. The first phase explored the contextual content of health needs from the perspectives of a purposive sampling (n = 44) using the explorative qualitative method. The second phase developed the Health Need Satisfaction Instrument and established its reliability and validity. The final phase implemented the instrument in a cohort study (n = 110) and examined the relationship between the respective/overall health needs and need satisfaction.Results.  A Health Need Satisfaction Instrument with good validity and reliability encompassing tangible, psychospiritual and informational needs was developed. A significant correlation between tangible and psychospiritual needs (r = 0·238, p < 0·05) and between tangible and informational needs (r = 0·306, p < 0·01) was found. Three types of need satisfaction were inter‐related (p < 0·01). A negative correlation between global health needs and need satisfaction (r = −0·223, p < 0·05) was found. Each domain of need satisfaction was negatively correlated with that particular type of health needs (p < 0·01), except for psychospiritual need (r = 0·339, p < 0·01). A measurement model between health needs and need satisfaction was established.Conclusion.  This study set a successful example of a rigorous, cross‐cultural instrument development process for community‐based Taiwan's single‐living older people.Relevance to clinical practice.  Using Health Need Satisfaction Instrument, the less satisfied multidimensional health needs of community‐based Taiwan's single‐living older people with chronic disease can be more accurately assessed and met.
Patients’ illness perception four months after a myocardial infarction
Authors: Alsén Pia , Brink Eva , Persson Lars‐Olof 
Published: February 2008

Aims and objectives.  The aim of this study was to explore patients’ illness perception of myocardial infarction four months after a myocardial infarction.Background.  An important task for research on recovery from myocardial infarction is to understand the factors that influence an individual's adherence to secondary preventive strategies. Perceptual, cognitive and motivational factors have been found to influence adherence to a secondary preventive regimen.Method.  Twenty‐five patients were interviewed four months after a myocardial infarction. In accordance with grounded theory methodology, data collection and analysis were carried out simultaneously.Results.  The findings can be understood in light of two core categories: ‘trust in oneself ’ vs. ‘trust in others’; belief in one's own efforts to control the illness; and ‘illness reasoning’, lines of thought about illness identity. In searching for relationships, six categories describing variation in illness perceptions of a myocardial infarction emerged: (i) ‘sign of a chronic condition – feasible to influence’; (ii) ‘sign of a chronic condition – uncontrollable’; (iii) ‘acute event that can recur – feasible to influence’; (iv) ‘acute event that can recur – uncontrollable’; (v) ‘unthinkable acute event’; and (vi) ‘non‐recurring acute event’.Conclusion.  The more reflective patients perceived the heart attack as a sign of a chronic condition; they also devoted time for reasoning about the possible causes of their illness. This is in contrast to patients who were less reflective and viewed their myocardial infarction as an acute event, which they avoided thinking about. The findings contribute to our understanding of variation in illness perceptions.Relevance to clinical practice.  The examination of how individuals perceive myocardial infarction may help health‐care professionals individualize secondary preventive strategies, thereby improving adherence to health‐care regimens. Nurse–patient discussions could begin with identification of the patient's variations of reflectiveness concerning his/her illness.
How do older people experience their management of medicines?
Authors: Westerbotn Margareta , Fahlström Elin , Fastbom Johan , Agüero‐Torres Hedda , Hillerås Pernilla 
Published: February 2008

Aim.  The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective.Background.  Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes.Methods.  This qualitative study involved audiotaped interviews with 25 very old persons. Inclusion criteria: aged ≥85 years, mini‐mental state examination ≥24, living at home, taking medicines regularly. Data collected May–June 2005, analysed using content analysis.Design.  Descriptive study.Results.  Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up.Conclusion.  Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes.Relevance to clinical practice.  Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health‐care resource use.
The influence of culture on diabetes self‐management: perspectives of Gujarati Muslim men who reside in northwest England
Authors: Fleming Elizabeth , Carter Bernie , Pettigrew Judith 
Published: February 2008

Aim. To present the findings of a study which explored the influence of culture on (type 2) diabetes self‐management in Gujarati Muslim men who reside in northwest England.Background. This study was informed by an embodied perspective of culture, in which culture is grounded in the body and self. This contrasts with some contemporary health research and policy which adopts an oversimplified perspective, portraying culture as static and deterministic and being responsible for non‐adherent self‐management behaviours.Method. A case‐study approach was used, which combined interview and participant observation methods. Data were collected from Gujarati Muslim men about their lived experiences of diabetes self‐management. These accounts, along with further narrative data from ‘significant other’ participants, were analysed over several cycles.Results. Two central concepts guide the results: embodied culture and dynamic culture. These concepts reflect the subjective and contextual nature of culture and are illustrated in the themes ‘past experiences and socio‐economic factors’, ‘social and gendered roles’ and ‘personal choice and contextual factors’. The findings highlight that the complexity of life means that culture never exists in isolation, but is one of the many factors that a man negotiates to inform his diabetes self‐management.Conclusion. We draw attention to the dissonance between the way culture is presented in some government policy and research, and the way it is understood in an embodied approach. TheNational Service Framework for Diabetesadvocates the provision of individualized culturally appropriate care, and in this paper, we make suggestions as to how an embodied approach can be incorporated within the framework.Relevance to clinical practice. Nurses have an integral role in implementing the National Service Framework for Diabetes. This paper contributes to the debate about how nurses can best deliver this framework to a diverse patient population.
Toward a trajectory of adjustment in women with end‐stage renal disease on haemodialysis
Authors: Tanyi Ruth A , Werner Joan Stehle 
Published: February 2008

Aims.  To examine the lived experiences of community‐dwelling women with end‐stage renal disease undergoing haemodialysis treatment.Background.  End‐stage renal disease is a chronic progressive disease with renal transplantation as a major treatment option. However, the majority of patients choose haemodialysis as their primary treatment. In this disease, many changes occur in the body that demand adjustment in every aspect of these patients’ lives. The turbulent trajectory of adjusting to this disease and treatment has been under‐researched. Given the increased number of patients requiring haemodialysis, a fuller understanding of the experienced disease course is essential in guiding clinical efforts.Method.  Descriptive phenomenology was used as it suited the purpose of this study.Design.  Sixteen adult women from two large haemodialysis centres in a large Midwestern city in the USA were interviewed. All data were analysed using Colaizzi's methodological interpretation.Findings.  Three major themes emerged supporting a possible adjustment trajectory: initiation‐the initial phase of adjustment; appreciation‐the middle phase of appreciating haemodialysis treatment; and grappling‐the later phase of dealing with adverse effects from haemodialysis. The findings, however, suggest that experiences in the adjustment trajectory are interwoven, circular and ongoing, rather than linear.Conclusion.  More research is needed in this under‐researched area to guide practice for meeting the demands of this growing patient population.Relevance to clinical practice.  These results provide knowledge that can assist nurses to implement care that is tailored to support adjustment, thus minimizing setbacks and improving patients’ well‐being.
Determining caseloads in the community care of frail older people with chronic illnesses
Authors: Williams Allison , Cooper Brad 
Published: February 2008

Aims and objectives.  The purpose of this paper is to discuss and critique the literature related to the measurement of caseloads by sociomedical case managers in the context of community care for frail older people.Background.  As a result of reduced mortality rates, there is an ageing, chronically ill population in need of long‐term continuity of care. Case management is a model of care designed to maintain the quality of life of frail older people living in the community whilst constraining the associated costs of care.Method.  A review of the literature was undertaken to examine methods of determining caseloads for frail older people in the community setting to identify where investigations are absent or not robust.Conclusions.  An absence of empirically tested approaches to determining caseloads and the wide variability in caseloads in caring for frail older people was evident. Predictors of variations in case management resources have been described at both the programme and client level, although controversy about the validity of these predictors, such as age and functional status, has been reported.Relevance to clinical practice.  The ageing population is a vulnerable group, and is entitled to live out their lives in the comfort and familiarity of their own homes where possible. Coordinated and supportive healthcare organizations and health system policies are critical to support empirically tested caseload indexes. These findings have implications for quality of care, planning and workforce policy development for our increasingly aged society. Recommendations for further research conclude this paper.
The small GTPase Rac and the p21‐activated kinase Cla4 in Claviceps purpurea: interaction and impact on polarity, development and pathogenicity
Authors: Rolke Yvonne , Tudzynski Paul 
Published: February 2008

Summary Claviceps purpurea, the ergot fungus, is a highly specialized pathogen of grasses; its colonization of host ovarian tissue requires an extended period of strictly polarized, oriented growth towards the vascular tissue. To understand this process, we study the role of signalling factors affecting polarity and differentiation. We showed that the small GTPase Cdc42 is involved in polarity, sporulation and in planta growth in C. purpurea. Here we present evidence that the GTPase Rac has an even stronger and, in some aspects, inverse impact on growth and development: Δrac mutants form coralline‐like colonies, show hyper‐branching, loss of polarity, sporulation and ability to penetrate. Functional analyses and yeast two‐hybrid studies prove that the p21‐activated kinase Cla4 is a major downstream partner of Rac. Phosphorylation assays of MAP kinases and expression studies of genes encoding reactive oxygen species (ROS)‐scavenging and ‐generating enzymes indicate a function of Rac and Cla4 in fungal ROS homoeostasis which could contribute to their drastic impact on differentiation.
A temperature‐regulated Campylobacter jejuni gluconate dehydrogenase is involved in respiration‐dependent energy conservation and chicken colonization
Authors: Pajaniappan Mohanasundari , Hall Johanna E. , Cawthraw Shaun A. , Newell Diane G. , Gaynor Erin C. , Fields Joshua A. , Rathbun Kimberly M. , Agee Willie A. , Burns Christopher M. , Hall Stephen J. , Kelly David J. , Thompson Stuart A. 
Published: February 2008

Summary Campylobacter jejuni is a gastrointestinal pathogen of humans but can asymptomatically colonize the avian gut. C. jejuni therefore grows at both 37°C and 42°C, the internal temperatures of humans and birds respectively. Microarray and proteomic studies on temperature regulation in C. jejuni strain 81–176 revealed the upregulation at 42°C of two proteins, Cj0414 and Cj0415, orthologous to gluconate dehydrogenase (GADH) from Pectobacterium cypripedii. 81–176 demonstrated GADH activity, converting d‐gluconate to 2‐keto‐d‐gluconate, that was higher at 42°C than at 37°C. In contrast, cj0414 and cj0415 mutants lacked GADH activity. Wild‐type but not cj0415 mutant bacteria exhibited gluconate‐dependent respiration. Neither strain grew in defined media with d‐gluconate or 2‐keto‐d‐gluconate as a sole carbon source, revealing that gluconate was used as an electron donor rather than as a carbon source. When administered to chicks individually or in competition with wild‐type, the cj0415 mutant was impaired in establishing colonization. In contrast, there were few significant differences in colonization of BALB/c‐ByJ mice in single or mixed infections. These results suggest that the ability of C. jejuni to use gluconate as an electron donor via GADH activity is an important metabolic characteristic that is required for full colonization of avian but not mammalian hosts.