bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive health practices and temporal perspective in low‐income adults
Authors: Thompson Cheryl W , Fitzpatrick Joyce J 
Published: June 2008

Aims.  The purpose of this study was to describe health‐promoting behaviours and temporal perspective in low‐income adults.Background.  Positive health practices represent a broad range of health‐promoting behaviours. The ability to adopt positive health practices may be influenced by many factors, one of which is temporal perspective, the perceived relationship between past, present and future times.Methods.  This exploratory study was conducted in a south central Pennsylvania community with a convenience sample of individuals who were eligible for a subsidised low‐income housing programme. Positive health practices were measured using the Personal Lifestyle Questionnaire. Temporal perspective was measured with the Circles Test.Results.  The sample consisted of 75 subjects, 61 women (81%) and 14 men (19%). Positive health practices were relatively high (mean = 70 out of a possible score of 96). Forty three per cent of the subjects expressed future temporal dominance and 80% of the subjects in this study expressed non‐continuous temporal relatedness.Conclusions.  Health‐promoting behaviours in this low‐income sample were similar to those reported in other samples in middle‐class adult samples. The percentage of subjects who expressed future dominance was similar to findings in other samples. The percentage of subjects who expressed non‐continuous temporal relatedness was different from findings reported in other samples, suggesting that perception of the relationship of past, present and future times is different in this low‐income sample compared with other samples.Relevance to clinical practice.  The temporal relatedness findings suggest that low‐income individuals may not believe that adopting positive health practices will influence future health.
Community nursing services for postdischarge chronically ill patients
Authors: Chow Susan KY , Wong Frances KY , Chan Tony MF , Chung Loretta YF , Chang Katherine KP , Lee Rance PL 
Published: June 2008

Objective.  To examine community nursing services for patients with cardiovascular diseases, chronic respiratory diseases and other general medical conditions, making the transition from hospital to home.Design.  The original study design was a randomised controlled trial. This study is a secondary analysis of the hospital records documented by community nurses for the study‐group patients.Sample.  The sample consisted of 46 subjects, randomly drawn from the main study group of the study.Measurements.  The community nursing records were analysed using the Omaha System. Self‐reported health status and readmission data were retrieved from the data base of the original study.Results.  The three groups of patients experienced problems across the four domains in the Omaha System. Community nursing interventions did not differ greatly by disease groups. The primary purpose of home visits was observation, followed by treatment and procedures and health teaching. The community nurses in the study spent more effort providing health teaching to the respiratory group than to their counterparts. The outcome measures are self‐reported health status and hospital readmission rates. For self‐reported health status, significant differences were observed in the respiratory and cardiovascular group before and after community nursing services. For hospital readmission rate, no significant difference was found.Conclusions.  To improve the well being of chronically ill patients, a comprehensive home intervention programme, emphasising continuous needs of monitoring and case management, is fundamental to producing desired, measurable effects.Relevance to clinical practice.  This paper adds the understanding of home‐care services provided by community nurses to chronically ill patients. The scope of nursing services emphasises the significance of a positive, patient‐centred, caring and appropriate client–practitioner relationship to improve the self‐reported health of patients.
The pain experience and future expectations of chronic low back pain patients following spinal fusion
Authors: Bentsen Signe Berit , Rustøen Tone , Wahl Astrid Klopstad , Miaskowski Christine 
Published: June 2008

Aim.  In a sample of patients who underwent instrumented spinal fusions for chronic low back pain (CLBP), the purposes of this study were: to determine the amount of pain patients experienced and to determine the impact of length of time since surgery, use of pain medication and their outlook on the future on these pain intensity scores.Background.  An increasing number of people report CLBP and one of the treatments is instrumented fusion.Method.  The study used a cross‐sectional design. Visual analogue scales were used to measure pain intensity in different locations and a single item measured patients’ view of the future. Data were collected in November 2001.Results.  The sample consisted of 101 patients (71% women) aged 26–59 years treated with instrumented fusion 1–8 years ago. As many as 87% reported pain 1–8 years after the surgery. Most patients reported pain of low‐to‐moderate intensity in the neck and shoulders, back and hips, feet and legs and in total pain. As many as 45% of the patients did not take pain medication and patients using more analgesics reported more pain than those using fewer analgesics (p < 0·05). Patients with a more positive outlook on the future reported significantly less pain in all of the locations that were evaluated (p < 0·01).Conclusion.  A high percentage of patients with CLBP continue to experience pain 1–8 years after spinal fusion. A positive outlook towards the future seems to be associated with less pain in these patients.Relevance to clinical practice.  Patients who continue to experience pain and have a more negative outlook on the future may benefit from psychoeducational interventions that teach them how to better cope with their pain.
Exploring supportive care for individuals affected by Huntington disease and their family caregivers in a community setting
Authors: Soltysiak Beverley , Gardiner Penny , Skirton Heather 
Published: June 2008

Aim.  The aim of this research was to identify the needs and coping strategies of individuals with Huntington disease and their family members/carers and to ascertain the extent to which they were supported by the type of specialised service provided in this unit.Background.  The duration of the illness may be up to 30 years and there are far reaching implications for the affected person, family members and carers. Services for families need to provide expert psychological and practical support, whilst remaining planned and flexible. The aim of this research was to identify needs and coping strategies of individuals with Huntington disease and their carers and ascertain the extent to which they were supported by a specialised community service.Methods.  Five focus groups and three individual interviews were used to gather data from affected individuals, family, carers and staff of the unit (n = 33). A semi‐structured discussion guide was used in every case. Data were analysed using an inductive coding technique.Results.  Three main themes emerged; (i) Transitions and the journey, (ii) Challenges in finding and providing support and (iii) The role of the unit in providing supportive care. While the service was seen as supportive, the need for flexibility was emphasised to facilitate the transition from unaffected to affected status. Affected individuals felt it was important to be known as the person they had been, despite the changes due to the disease.Conclusions.  Provision of service in a dedicated unit is an appropriate way to support affected patients and their carers. Enhancing understanding of the disease and allowing the individual to make choices can assist coping with this challenging disease.Relevance to clinical practice.  It is helpful to allow patients control over timing and frequency of contact with professionals. Improving understanding of the condition in the public and health professionals may enable patients to access a greater range of social activities.
The impact of type 1 diabetes and eating disorders: the perspective of individuals
Authors: Hillege Sharon , Beale Barbara , McMaster Rose 
Published: June 2008

Aim. To describe the perspective of individuals living with the chronic conditions of both type 1 diabetes (T1D) and eating disorders.Background. The TID and eating disorders are major concerns in Western society with the consequence of more prevalent and severe health complications. This paper arose from research on the impact of T1D on the self of adolescents and young adults.Design. In a larger longitudinal study (doctoral) of 27 participants (both male and females), data were collected from 1994 from 2001 using in‐depth semi‐structured interviews and a grounded theory approach; four female participants reported that they were experiencing T1D and an eating disorder. This subset of four participants from the original study was case analysed and the issues that arose for the participants are described using secondary analysis.Conclusions. Issues uncovered included the complexity of managing the interactions of the physical, emotional and social dimensions as well as personal relationships for the participants. These interrelated issues interfere with all‐round management of T1D and eating disorders. Recognition and management of the comorbidity that exits in substantial numbers are of paramount importance in clinical practice. It is also necessary to incorporate the support of significant others in the health care partnership.Relevance to clinical practice. Health professionals who treat individuals with T1D need to be aware of the incidence of eating disorders among people with TID. Unhealthy weight control practices are of particular concern because they lead to poorer metabolic control which has a flow on effect causing micro vascular complications.
Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form)
Authors: Li Ho Cheung William , Wong Mi Ling Eliza , Lopez Violeta 
Published: June 2008

Aim. The present study aimed at examining the factorial structure of the Chinese version of the State Anxiety Scale (Short form), using exploratory and confirmatory analyses.Background. The factorial structure of the short form of the Chinese version of the State Anxiety Scale for Children has neither been examined by using exploratory factor analysis nor been examined by confirmatory factor analysis. Consequently, whether the factor structure of the short form is congruent with the hypothesised configuration of the factor structure of the full form cannot be confirmed.Design. Survey.Method. A test–retest, within‐subjects design was employed. Two hundred children (7–12 years of age) admitted for surgery in a day surgery unit was invited to participate in the study. They were asked to respond to the Chinese version of the State Anxiety Scale (short form) before surgery and upon discharge home.Results. The results of exploratory factor analysis showed that there are two factors underlying the short form, which is congruent with hypothesised configuration of the factor structure of the full form. Confirmatory factor analysis confirmed the construct validity, with a good fit between the factor structure of the short form and the observed data.Conclusion. This study addressed a gap in the literature by examining the factorial structure of the short form. The results confirmed the factor structure of the short form is congruent with the hypothesised configuration of the factor structure of the full form.Relevance to clinical practice. The availability of a valid, reliable and convenient instrument is crucial in evaluating the effectiveness of nursing interventions. The findings also suggest that the short form is an objective assessment tool and can be used by clinical nurses as objective assessment tool in measuring anxiety level of Chinese children in busy clinical settings, where time constraints make the use of the full form unfeasible.
Risk factors and prevention among patients with hospital‐acquired and pre‐existing pressure ulcers in an acute care hospital
Authors: Wann‐Hansson C , Hagell P , Willman A 
Published: June 2008

Aims and objectives. This study aimed to describe and identify risk factors associated with hospital‐acquired pressure ulcers among adults in an acute care hospital compared with patients with pre‐existing pressure ulcers present on admission. A further aim was to identify the preventive measures performed with both groups respectively.Background. Pressure ulcers occur most often in older and immobile persons with severe acute illness and neurological deficits. However, few studies have addressed risk factors that are associated with hospital‐acquired pressure ulcers compared with patients with pre‐existing pressure ulcers.Design. A point prevalence study with a cross‐sectional survey design was conducted at a Swedish university hospital.Method. Data on 535 patients were recorded using a modified version of the protocol developed and tested by the European Pressure Ulcer Advisory Panel, including the Braden scale for risk assessment.Results. The prevalence of pressure ulcers was 27% (95% confidence interval, 23–31%). Higher age and a total Braden score below 17 were significantly associated with the presence of pressure ulcers. Among individual risk factors higher age, limited activity level and friction and shear while seated or lying down were associated with hospital‐acquired pressure ulcers, whereas only higher age and friction and shear were associated with the presence of pressure ulcers in the overall sample. There was an overall sparse use of preventive measures to relieve pressure.Conclusion. The findings of the present study revealed that pressure ulcers and the insufficient use of preventive measure to relieve pressure is still a problem in acute care settings. A continued focus must be placed on staff training in identifying patients at risk for pressure ulcers development.Relevance to clinical practice. Increasing the ability to identify patients who are at risk for pressure ulcer development can assist in preventing unnecessary complications and suffering as well as reduce costs.
Nutritional status and patient characteristics for hospitalised older patients with chronic obstructive pulmonary disease
Authors: Odencrants Sigrid , Ehnfors Margareta , Ehrenberg Anna 
Published: June 2008

Aim. The aim of the study was to describe and compare nutritional status and social and medical characteristics among older patients with chronic obstructive pulmonary disease admitted to an acute care hospital ward for respiratory medicine.Background. Chronic obstructive pulmonary disease is a condition associated with risk of developing malnutrition. A body mass index <20 is predictive of hospitalisation for acute exacerbations of chronic obstructive pulmonary disease. Knowledge about patient characteristics is crucial for the identification of malnourished patients and the development of nursing care for these patients.Design. Quantitative descriptive study.Methods. Thirty‐three hospitalised women and 17 men with a mean age of 75·7 years (SD 6·9) were consecutively included. A very severe case of chronic obstructive pulmonary disease was indicated in 28 out of 39 patients who underwent a lung function test. Data were collected with measurement of nutritional status using Mini Nutritional Assessment, anthropometry and lung function.Results. Nearly half of the patients (48%) were identified as malnourished, an equal part as at risk for malnutrition and two patients as well nourished. The mean Mini Nutritional Assessment score of 17·2 (SD 3·99) for all patients was near the Mini Nutritional Assessment cut‐off score (i.e. 17) for malnutrition. Patients identified as malnourished had a mean body mass index of 18·9 and those at risk for malnutrition had a mean of 23·4. It was more common for those identified as malnourished to live singly, to not live in own property and to be dependent on daily community service. Seven patients identified as malnourished died during the data collection period.Conclusions. This study provides important knowledge about further risks of impaired nutritional status among older patients with chronic obstructive pulmonary disease.Relevance to clinical practice. This knowledge can provide registered nurses with the necessary knowledge to make them aware of certain patients needing particular kinds of attention.
Evaluation of negative emotional care experiences in burn care
Authors: Wikehult Björn , Hedlund Mathilde , Marsenic Milica , Nyman Sofi , Willebrand Mimmie 
Published: June 2008

Aim and objective.  To assess recollection of negative emotional experiences during burn care.Background.  Patients in intensive care frequently report negative emotional experiences. Patients with severe burns who are treated in intensive care units undergo painful care procedures, but there have been no recent evaluations of their care experiences.Design.  Former burn patients (n = 42) were randomly assigned to three groups: postal questionnaire, telephone interview and face‐to‐face interview.Methods.  Assessments included negative care experiences (feelings of uncertainty, powerlessness, being afraid, insecure, being a nuisance, or neglected), severity of injury, patient satisfaction, personality traits and psychological symptoms.Results.  Overall, the degree of recalled negative experiences was low and associated with greater severity of injury, more symptoms of post‐traumatic stress disorder and lower satisfaction with care. The feeling of powerlessness was the most common, as 67% of participants had such feelings to some extent.Conclusions.  Overall, negative care experiences were uncommon and most prevalent among the severely injured. Such experiences were also associated with psychological symptoms and lower patient satisfaction.Relevance to clinical practice.  Although relatively uncommon, negative emotional care experiences should be monitored more closely during care.
Isolation, motivation and balance: living with type 1 or cystic fibrosis‐related diabetes
Authors: Tierney Stephanie , Deaton Christi , Webb Kevin , Jones Andrew , Dodd Mary , McKenna Diane , Rowe Rachel 
Published: June 2008

Aims and objectives.  To explore patients’ responses to developing and managing cystic fibrosis‐related diabetes and to contrast their views with those of individuals with type 1 diabetes mellitus.Background.  The incidence of diabetes among people with cystic fibrosis has increased with improvement in life expectancy. However, little is known about how patients respond to and manage cystic fibrosis‐related diabetes, and how this compares with people living with type 1 diabetes mellitus.Design.  Qualitative research was undertaken in order to fully explore meanings and views.Methods.  Semi‐structured telephone or face‐to‐face interviews were conducted with patients who had cystic fibrosis‐related diabetes or type 1 diabetes mellitus, during which, they discussed diagnosis and management of diabetes. Framework analysis was employed to identify themes and to consider similarities and differences between the two groups.Results.  Eleven cystic fibrosis‐related diabetes and 12 type 1 diabetes mellitus patients were interviewed in 2006. Patients with cystic fibrosis‐related diabetes described their diabetes diagnosis as a progression of their primary illness, management of which was important owing to the benefits it brought to their cystic fibrosis. Those with type 1 diabetes mellitus were more likely to report feeling psychologically low because of diabetes and to list long‐term complications as a key factor motivating self‐management. Both groups struggled to balance the demands of diabetes with other life and health obligations, and experienced isolation because of diabetes.Conclusions.  Variation in perceptions recalled during interviews stemmed from diabetes being part of an existing life‐threatening chronic illness in people with cystic fibrosis‐related diabetes. Similarities and differences in attitudes and management practices were found, with less urgency regarding glucose monitoring and fewer information resources available for those with cystic fibrosis‐related diabetes.Relevance to clinical practice.  Both groups need support for optimal diabetes management and access to appropriate resources outside specialist clinics. Web‐based technologies could prove useful for those with cystic fibrosis‐related diabetes as face‐to‐face interaction may be prevented owing to the risk of cross‐infection.
People with heart failure and home health care resource use and outcomes
Authors: Madigan Elizabeth A 
Published: June 2008

Aims and objectives.  Patients with heart failure represent a common patient population in home health care, yet little is known about their outcomes.Background.  Patients with heart failure, regardless of site of care, experience substantial numbers of rehospitalisations in the United States. Home health care is a common postacute care service for patients with heart failure.Design.  Retrospective analysis.Methods.  The study employed a large administrative data base from 2003 – the Outcomes and Assessment Information Set, which is required for all US Medicare and Medicaid patients receiving home health care.Participants.  There were 145 191 patients with a primary diagnosis of heart failure represented in the data set. The outcomes of interest were the trajectory of care (point of entry and discharge from home health care), hospitalisation, length of stay and change in functional status.Results.  Almost three‐quarters (73·9%) of patients entered home health care following a hospital stay. Nearly two‐thirds (64%) remained at home at discharge from home health care. Approximately 15% of patients are hospitalised during the home health care episode, most often for symptoms consistent with exacerbation of the heart failure, if a reason could be identified. The average length of stay in home health care was 44 days. There was only a small improvement in functional status: 0·50 points for activities of daily living and 0·57 points for instrumental activities of daily living. Similar small improvement occurred in depressive symptoms, 0·68.Relevance to clinical practice.  There may be room for improvement in these outcomes with more recent evidence that suggests strategies for reducing hospitalisation and improving patient functional status abilities. Yet, the chronic progressive nature of heart failure may also provide a limiting factor in the outcomes that can be attained.