bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chinese female nurses’ perceptions of male genitalia‐related care – Part 2
Authors: Zang Yu‐Li , Chung Loretta Y F , Wong Thomas K S , Chan Moon Fai 
Published: November 2008

Aims.  This study was designed to investigate Chinese female nurses’ perceptions of certain male genitalia‐related care and the influence of their demography and experiences on their perceptions.Background.  Several physical conditions, in which male genitalia‐related care is required, have been found to have considerable negative impact on male patients, leading to decreased quality of life and psychosocial and sexual dysfunctions. Available studies suggest that Chinese female nurses’ conduct during the provision of male genitalia‐related care is negative. However, the evidence is weak with respect of the degree of Chinese nurses’ negativity and what the contributory factors may be.Design.  Survey.Methods.  Chinese female nurses in nine units in five hospitals were surveyed. Of 378 returned questionnaires, 312 were usable, and 138 contained textual comments. Numerical data were analysed using spss14.0, and textual data were analysed using thematic analysis.Results.  The majority of participants had never performed genital wound care, perineal area shaving, perineal hygiene, suprapubic and urinary catheterisation. More than half preferred only bladder irrigation and washout to be performed by nurses and preferred the other male genitalia‐related care to be performed by a male. Participants tended to agree meatal cleansing, perineal area shaving, perineal hygiene and urinary catheterisation were embarrassing, awkward and intrusive, but to disagree that they were sexual, dirty, stigmatising or having an impact on the male patient’s sexual health.Conclusion.  This study suggests that Chinese female nurses play limited roles in the practice of male genitalia‐related care, but their perceptions of such care are not negative.Relevance to clinical practice.  Given the increasing move of Chinese female nurses to other countries, sexuality, sexual harassment, privacy and the constraints of traditional Chinese beliefs on sexuality over professional nursing conduct should be emphasised in clinical training programmes.
‘Visible‐ness’: the nature of communication for children admitted to a specialist children's hospital in the Republic of Ireland
Authors: Lambert Veronica , Glacken Michele , McCarron Mary 
Published: November 2008

Aim. This article presents the core concept of ‘visible‐ness’ that emerged from an ethnographic study, which explored the nature of communication, for children (for ease of reading children refers to children and young people), admitted to a children’s hospital in the Republic of Ireland.Background. The importance of engaging with both child and family has been espoused as fundamental in promoting ‘family’‐centred care. To date, studies have almost exclusively explored parents’ and nurses’ perspectives of the nature of parent participation and nurse–parent interactions and relationships. Although there is evidence of an emerging body of knowledge, which explores children’s perspectives of their information, and communication needs, little is known empirically about the communication process between children and members of the health care team in inpatient hospital settings.Design. The principles of ethnography underpinned the study design.Method. Fieldwork took place over four months in one 35‐bedded children’s ward. Forty‐nine children, ranging in ages from 6 to 16 years with a variety of medical and surgical conditions, participated. Various modes of data collection were employed, namely semi‐participant observations, unstructured interviews, draw and write technique and a child‐friendly ‘stick a star’ quiz.Results. The core concept to emerge was that of ‘visible‐ness’. ‘Visible‐ness’ existed along a continuum consisting of two polar ends, ‘being overshadowed’ and ‘being at the forefront’. These polar ends illuminated the degree to which children were, or wanted to be, included in the communication process and the extent to which children’s agenda was addressed.Conclusion. This study provides empirical insight into children’s experiences of communication in an inpatient hospital setting. A key recommendation calls for the development of communication assessment strategies to determine the ‘ideal’ position children would like to occupy, at any given point in time, along the ‘visible‐ness’ continuum.Relevance to practice. This study emphasises the need for all health professionals to embrace the individualism of each child patient with regard to their specific communication needs.
Does the perceived importance of a pain management task affect the quality of children’s nurses’ post‐operative pain management practices?
Authors: Twycross Alison 
Published: November 2008

Aim.  To ascertain whether there is a relationship between the perceived importance of pain management tasks and the quality of an individual nurse’s practice.Background.  The evidence to guide nurses’ pain management practices is readily available. However, children’s nurses’ pain management practices often fall short of the ideal. The (lack of) priority attributed to pain management has been suggested as one reason for this. However, this supposition has not previously been explored.Design.  Participant observation.Method.  Data were collected about children’s nurses’ (n = 13) post‐operative pain management practices on one children’s surgical ward in the English Midlands. Nurses (n = 12) also completed a questionnaire to provide a measure of the importance attributed to pain management tasks.Results.  The questionnaire responses of individual participants (n = 12) were compared to the observational data. The perceived importance of a pain management task did not affect the likelihood of it being undertaken.Conclusion.  Several explanations for these results have been put forward. It is apparent that the hypothesis, put forward in other studies that increasing the priority attributed to pain management will improve pain management practices may be overly simplistic.Relevance to clinical practice.  The evidence to guide nurses’ pain management practices is readily available. However, children’s nurses’ pain management practices seem to fall short of the ideal. Possible reasons for this need to be explored so that practice can be improved.
Nursing work and the use of nursing time
Authors: Duffield Christine , Gardner Glenn , Catling‐Paull Christine 
Published: November 2008

Aim. To find that changes in models of service delivery together with the dynamic nature of the contemporary health care context have changed the direction and focus of nurses’ work. The aim of this paper is to explore some of the drivers for change and their impact and recommend a way forward to optimising nurses’ work in the hospital environment.Background. The healthcare workplace has been transformed over the past 20 years in response to economic and service pressures. However, some of these reforms have had undesirable consequences for nurses’ work in hospitals and the use of their time and skills.Results. As the pace and complexity of hospital care increases, nursing work is expanding at both ends of the complexity continuum. Nurses often undertake tasks which less qualified staff could do while at the other end of the continuum, are unable to use their high level skills and expertise. This inefficiency in the use of nursing time may also impact negatively on patient outcomes.Conclusions. Nurses’ work that does not directly contribute to patient care, engage higher order cognitive skills or provide opportunity for role expansion may decrease retention of well‐qualified and highly skilled nurses in the health workforce.Relevance to clinical practice. In this climate of nursing shortages, we need to use nurses in a cost‐effective but also, intellectually satisfying manner, to achieve a sustainable nursing workforce.
An international hospital outcomes research agenda focused on nursing: lessons from a decade of collaboration
Authors: Clarke Sean P , Aiken Linda H 
Published: November 2008

Aims.  To describe the origins, design and outcomes of an international hospital outcomes collaboration focused on nursing issues.Background.  Across countries with different cultures and histories, nursing and healthcare leaders face similar issues with respect to workforce supply, quality and safety of care and financial constraints. Until researchers began using common research protocols to investigate structure, and outcomes variables in hospital nursing across countries, studying the aspects of work environments most important to patients and nurses in large numbers of hospitals was very difficult, if not impossible.Method.  Review/essay.Conclusions.  The international collaborations discussed in this article led by the University of Pennsylvania have found remarkable similarities in the experiences of hospital nurses across countries in terms of positive and negative aspects of their work, sizeable differences across hospitals within countries in working conditions and investments in high‐quality practice environments, and consistent evidence of connections between modifiable features of nurses’ work environments and both patient well‐being and factors influencing workforce stability.Relevance to clinical practice.  International research collaborations allow benchmarking of countries and facilities within countries on work environment factors that are important to the provision of high quality nursing care. Results of this ongoing research initiative have helped strengthen the case that optimal management of practice environments for nurses in hospitals and other settings are a key strategy for optimising patient outcomes.
Transformative impact of Magnet designation: England case study
Authors: Aiken Linda H , Buchan James , Ball Jane , Rafferty Anne Marie 
Published: November 2008

Aims. To test the impact of the implementation of Magnet principles of improving nurses’ work environments.Background. Magnet hospital designation developed in the USA in the 1980s to recognise hospitals that had created excellent patient care environments and supported the professional practice of nursing. A pilot initiative in England was the first test of the applicability of Magnet standards outside the USA.Methods. Research methods included surveys of nurses in the demonstration hospital in a predesign and postdesign and comparisons to survey results of nurses practicing in a national sample of 30 National Health Service Trusts.Results. Prior to beginning the Magnet journey, the demonstration hospital had a nurse work environment that was somewhat less positive than the national sample NHS hospitals. Nurses practicing in the demonstration hospital were somewhat less satisfied with their jobs than nurses in other NHS hospitals. Following a two‐year period during which the evidence‐based Magnet standards were implemented and Magnet Designation was awarded, the quality of the nurse practice environment had improved significantly, as had job satisfaction of nurses and their appraisals of the quality of patient care. The quality of the nurse practice environment after Magnet designation was better than that of a national sample of NHS trusts. Improved nurse outcomes were because of the improved practice environment rather than staffing enhancements.Conclusions. Implementation of the Magnet hospital intervention was associated with a significantly improved nursing work environment as well as improved job‐related outcomes for nurses and markers for quality of patient care.Relevance to clinical practice. Nurses can use Magnet principles to improve the quality of their work environments.
Work–family conflict of nurses in Japan
Authors: Fujimoto Tetsushi , Kotani Sachi , Suzuki Rie 
Published: November 2008

Aims and objectives.  The purpose of this paper is to explore the determinants of work–family conflict among Japanese nurses by using microdata describing nurses’ characteristics working at health facilities in Japan. We focus in particular on the impacts of shift work and workplace child care support on the conflict between work and child care with preschool children.Background.  With a declining fertility trend, it is not easy to recruit sufficient number of nurses from the pool of graduate nurses. Therefore, support for reemployment of inactive nurses and prevention of turnover and enhancement of retention for active nurses have become the important strategies, along with the recruitment of new graduates.Design and method.  We focus on the impacts of (i) flexibility in shift work and (ii) child care support at work, on the conflict between work and child care through performing multivariate regression analysis. The data used in this study come from a survey conducted on members of the Japanese Nursing Association as of the end of July 2001. Concerning shift work and child care support, we limited the sample to the full‐time female employees. The sample is limited to 378 respondents who were mothers of preschool children.Result.  The results can be summarised as follows: (i) working night shifts does not have a significant effect on the conflict in balancing work and child care. Also findings show that three‐shift duty is more likely to increase the conflict. (ii) When supportiveness about child care responsibilities with small children is absent at work, the conflict is likely to increase. (iii) For mothers working night shifts, the reduction of the duties are likely to reduce the conflict.Conclusion.  These results highlight the importance of establishing a system in which nurses can select the work hours flexibly and to promote awareness at work regarding the importance of child care support to strike balance between the nursing work and child‐raising.Relevance to clinical practice.  The difficulty in balancing work and child care is one of the main factors that prevent inactive nurses from returning to work. Also, enrichment of child care support is important to reemploying inactive nurses. Therefore, revealing the difficulty that nurses experience in balancing work and child care, and the effectiveness of child care support for securing nursing labour, is highly relevant to clinical practice.
Career redevelopment programmes for inactive nurses in Japan
Authors: Tanaka Sachiko , Serizawa Takako , Sakaguchi Chizuru 
Published: November 2008

Aims and objectives.  The purpose of this paper is to examine the challenges and problems in using career redevelopment programmes and individual hospital programmes to prepare inactive nurses to re‐enter into the workforce in Japan.Background.  It is critical to supply sufficient skilled health human resources for medical care. Although, Japan has a mandatory retraining programme for supporting nurses to return to the workplace after a career break, it is unclear to what extent there are benefits to nurses from these programmes.Design.  The research of career redevelopment programme was undertaken in three administrative divisions’ nurse centres in local prefecture A, B and C. A survey of nurses participating in the programme running in T Hospital was also conducted. The issues examined were the background and motivations of participants, the length of career break, the percentages returning to work and the effectiveness of each programme.Result.  The average age of participants was 40 years, ranging widely from the 20–60 years. Local prefecture A tended to have narrower age range than others, namely from the 30–50 years. The average period of career break was around eight years at two of three. Length of experience was quite varied from entry level to 20 or 30 years in nursing. Feedback from nurses in the case study T Hospital suggests that the most effective ways of providing support through the programme was to meet the need for continuing support, including working styles after return to work and using the resources programme in their own area of domicile.Relevance to clinical practice.  In the potential return of the nurse, the following are important: (i) job support system by using social resources effectively in the community level; and (ii) introduction of diverse working styles that take account of varying work‐life balance, as well as childcare support, by using existing facilities or human resources.
Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water
Authors: Oswald William E. , Hunter Gabrielle C. , Lescano Andres G. , Cabrera Lilia , Leontsini Elli , Pan William K. , Soldan Valerie Paz , Gilman Robert H. 
Published: November 2008

SummaryObjective  To document frequency of hygiene practices of mothers and children in a shantytown in Lima, Peru.Methods  Continuous monitoring over three 12‐h sessions in households without in‐house water connections to measure: (i) water and soap use of 32 mothers; (ii) frequency of interrupting faecal‐hand contamination by washing; and (iii) the time until faecal‐hand contamination became a possible transmission event.Results  During 1008 h of observation, 55% (65/119) of mothers’ and 69% (37/54) of children’s faecal‐hand contamination events were not followed within 15 min by handwashing or bathing. Nearly 40% (67/173) of faecal‐hand contamination events became possible faecal‐oral transmission events. There was no difference in the time‐until‐transmission between mothers and children (P = 0.43). Potential transmission of faecal material to food or mouth occurred in 64% of cases within 1 h of hand contamination. Mean water usage (6.5 l) was low compared to international disaster relief standards.Conclusions  We observed low volumes of water usage, inadequate handwashing, and frequent opportunities for faecal contamination and possible transmission in this water‐scarce community.
Cost‐effectiveness of specific immunotherapy with Grazax in allergic rhinitis co‐existing with asthma
Authors: Nasser S. , Vestenbæk U. , Beriot‐Mathiot A. , Poulsen P. B. 
Published: November 2008

Background: In the United Kingdom, approximately 10.8 million people suffer from asthma, placing an economic burden on the society of more than £2 billion per year. For allergic asthma, treatment options consist of allergen avoidance, symptomatic treatment and allergen‐specific immunotherapy (SIT). Only SIT addresses the underlying cause of the disease, reducing symptoms and offering the potential for long‐term improvement. Grazax – the first tablet‐based SIT – is indicated for the treatment of patients with grass pollen‐induced rhinoconjunctivitis, including those with co‐existing asthma.Objective: To assess the cost‐effectiveness of Grazax in patients with rhinoconjunctivitis and co‐existing asthma.Methods: A prospective pharmacoeconomic analysis was carried out as part of a multinational clinical trial assessing the efficacy of Grazax (n = 79) compared with placebo (n = 72). Both groups had access to symptomatic medication; thus the placebo group represented current standard care. Pooled data on health resource use, productivity loss because of absence from work and quality of life (Quality Adjusted Life Years, QALYs) were collected in the trial. Reduced productivity at work was estimated from the literature. A societal perspective was adopted with a 9‐year time horizon. The NHS price of Grazax of £2.25 per tablet was used.Results: The QALY gain was significantly higher for patients treated with Grazax than the placebo group receiving symptomatic medication alone (0.197 discounted QALYs gained 9 years into the future – equal to an extra 72 days of perfect health over 9 years). The levels of resource use and productivity loss were higher for the placebo group. As a result, the cost per QALY gained with Grazax was £4319, which is highly cost‐effective. Price sensitivity analyses demonstrated that Grazax remained cost‐effective up to a tablet price of £5.07.Conclusion: SIT with Grazax is a cost‐effective strategy compared with standard management of patients with rhinoconjunctivitis and co‐existing asthma.
Gene expression measurements in the context of epidemiological studies
Authors: Bieli C. , Frei R. , Schickinger V. , Steinle J. , Bommer C. , Loeliger S. , Braun‐Fahrländer C. , Von Mutius E. , Pershagen G. , Lauener R. 
Published: November 2008

Background:  Gene expression measurements became an attractive tool to assess biological responses in epidemiological studies. However, collection of blood samples poses various technical problems.We used gene expression data from two epidemiological studies to evaluate differences between sampling methods, comparability of two methods for measuring RNA levels and stability of RNA samples over time.Methods:  For the PARSIFAL study, PBLC of 1155 children were collected using EDTA tubes in two countries. In the PASTURE study, tubes containing RNA‐stabilizing solutions (PAXgene® Blood RNA Tubes; PreAnalytiX) were used to collect cord blood leucocytes of 982 children in five countries. Real‐time PCR (conventional single tube assay and high‐throughput low density arrays) was used to quantify expression of various innate immunity genes. In 77 PARSIFAL samples, gene expression was measured repeatedly during prolonged storage.Results:  In PARSIFAL (EDTA tubes) the median RNA yield after extraction significantly differed between the two centres (70 and 34 ng/μl). Collecting blood into an RNA‐stabilizing solution markedly reduced differences in RNA yield in PASTURE (range of medians 91–107 ng/μl). The agreement [Spearman rank correlation (r)] between repeated measurements of gene expression decreased with increasing storage time [e.g., for CD14: r (first/second measurement) = 0.35; r (first/third measurement) = 0.03]. RNA levels measured with either the conventional method or low‐density arrays were comparable (r > 0.9).Conclusion:  Collecting blood samples into tubes containing an RNA‐stabilizing solution increases RNA yield and reduces its variability. Long‐term storage of samples may lead to RNA degradation, requiring special attention in longitudinal studies.