bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group Preparation of Pediatric Surgical Patients
Authors: McGrath Margaret M. 
Published: October 2007

AbstractThe purpose of this study was to validate the effect of group preparation, designed to increase pediatric surgical children's (and their parents) adaptation to hospitalization. Forty‐four children, aged 3–12, admitted for tonsillectomies were randomly assigned to either group condition or control. These were compared to forty children receiving individual Stress Point Preparation from a study done in the same institution three months earlier. Both the group and the individual intervention were based on a combination of systematic preparation, rehearsal, and supportive care conducted prior to each stressful procedure. Group preparation also included: (a) peer exposure, support and identification, (b) group process, and (c) group teaching.The children's hospital adjustment was measured by blind ratings of behavioral upset and cooperation during the blood test, medication injection, induction, and post operative fluid intake and by recovery room medication and pulse rates and time to first voiding. Post hospital adjustment was assessed with the Vernon et. al., Post Hospital Behavior Inventory. Parent outcome measures included self ratings for anxiety and satisfaction with information and care. As hypothesized, children prepared in a group showed significantly less upset and more cooperation, and their parents were better informed and more satisfied than did children receiving individual preparation or those in the control.
Role Considerations in Care of the Dying Patient
Authors: Williams Carol A. 
Published: October 2007

AbstractTwentieth century Americans are ill‐prepared for death, either their own or that of another. Death has become a less visible part of daily life. Health professionals in general and nurses in particular often deny their legitimate role in relation to the dying patient, and instead regard death as a treatment failure. This paper contrasts the dying role and the sick role of the patient, and the therapeutic role and the supportive role of the nurse. It applies the concepts of role insufficiency and role supplementation to the care of the dying and suggests implications for research.
Cure: The Potential Outcome of Nursing Care
Authors: Loomis Maxine E. , Wood Delores jean 
Published: October 2007

AbstractThe recent Social Policy Statement of the American Nurses Association (1980) has advanced a definition of nursing as “the diagnosis and treatment of human responses to actual or potential health problems.” This definition has legitimized efforts of the last decade to develop a system of nursing diagnosis and should provide the impetus for subsequent development of nursing treatment interventions. Barnard (1982) has proposed a model for linking the phenomenon of concern to nursing with the human responses present in the maternal‐child nursing situation. Other specialty models are likely to follow.In this article we present the possibility that in the diagnosis and treatment of human responses, nurses are capable of curing the actual or potential health problem. The most recent definition of nursing has opened up exploration of the interactions among human response systems and actual or potential health problems. Clinicians, researchers, and theoreticians are now in a position to reconceptualize nursing's impact on health and health problems.
ALS& Aging: A Case Study in Autonomy and control
Authors: Power Deborah J. , Craven Ruth F. 
Published: October 2007

AbstractQuality of life is often seen as an ideal that is impossible to achieve in long‐term care. This paper suggests that the maintenance of automony and control is basic to attaining the highest potential quality of life.Quality of care has become a particular concern in nursing. In the long‐term care setting, the quality of care has come to the attention of the public, resulting in a loud outcry against the nursing home industry as a whole. Even those facilities that already provide high‐quality nursing care must strive for even higher standards if they are to move health care delivery towards the ever elusive ideal–the greatest possible quality of life.Individualization of patient care has become a watchword in nursing. Yet it may be undermined by the health care system and by nursing staffing patterns in general and nursing philosophy and allocation of time in particular. Upon entering a long‐term care facility the geriatric patient loses much autonomy. Activities of daily living become regulated by the system and are determined by the time available for staff members to assist the patient. As the elderly become more physically disabled they become increasingly dependent on the staff, losing more and more control over their life‐style– when they rise, what they wear, even how they dress.Quality of life must be considered from a person's point of view and in relation to the capabilities of that person (Cassel, 1980). The maintenance of autonomy and control can be crucial in maintaining self‐esteem and achieving quality of life. Loss of control over the outcome of one's own behavior leads to helplessness. Helplessness is based on the perceptions and beliefs of the individual, whether they be founded on fact or fallacy (Seligman, 1975). The helpless individual too frequently lacks quality of life.This paper presents a plan for individualized care, which focuses on the issue of patient autonomy versus “adequate” nursing care. It was developed collaboratively between a patient and the authors–nurses who assume the role of consultant and patient advocate.
Psychotherapeutic Treatment of Idiopathic Cardiomyopathy: A Case Study
Authors: Martin Elizabeth Jane 
Published: October 2007

AbstractThe referral of an extremely anxious young. Black mother suffering from idiopathic cardiomyopathy to a local psychotherapy clinic by her internist for evaluation and treatment caused consternation among the professional staff (psychologists and psychiatric social workers). Although all felt competent to assess and manage the patient's anxiety, none felt comfortable with the serious physical manifestations of the cardiopathy. When a nursing faculty member who was supervising graduate nursing students in the agency volunteered to take the case, the assignment was readily made. This paper is a description of the course of treatment of that client. Following a brief review of the literature on psychosomatic illness and idiopathic cardiomyopathy, the client is described and the course of treatment detailed. Then the theories that served as the basis for the clinical interventions are identified, and the shift from the psychodynamic to the Bowen Family Systems approach is discussed.
In Opposition to Nursing Diagnosis: A Minority Opinion
Authors: Shamansky Sherry L. , Yanni Celeste R. 
Published: October 2007

AbstractDoes nursing diagnosis further nursing practice? This article examines the premises underlying nurses diagnoses and their impact on clinicians and the health care delivery system. The authors argue that nursing diagnoses in their current form limit nursing practice, create obstacles to clear communication, and constrain inference and intuition.Once upon a hot summer day, a community health nursing student returned from a home visit to do her charting. Unbeknown to her instructor, this student was an aficionado of nursing diagnosis. She completed her note and gave it to the instructor to read:S: “My feet hurt.”‘7 waked three miles today.(in 97o weather.)O: Ankles edematous bilaterally; dorsum of feet warm to touch; 1 cm. vesicle on plantar aspect, right foot.A. Alternation in comfort as a result of restless legs.P. Bathe feet in tepid water; dry well; do not rupture vesicle; elevate legs.
Discovery of Nursing Gestalt in Critical Care Nursing: The Importance of the Gray Gorilla Syndrome
Authors: R. N. Sue Holland Pyles , Stern Phyllis Noerager 
Published: October 2007

AbstractHow do critical care nurses determine if a patient is developing cardiogenic shock? What assessment and decision‐making processes do they use, and how do they learn them? To find out, in‐depth interviews were conducted with 28 critical care nurses during a study that investigated the practice of critical care nurses in the early detection and prevention of cardiogenic shock in patients with acute myocardial infarction (AMI). Through the analysis and comparison of these interviews, we developed a theory of> Nursing Gestalt to explain the cognitive process used by experienced critical care nurses in making assessments and judgments. Moreover, we discovered that critical care neophytes learn to make assessments, diagnoses, and sound judgments about care from a more experienced nurse who supports and teaches the neophyte the Nursing Gestalt during a mentoring relationship. We call this mentoring relationship The Cray Gorilla Syndrome, for reasons we will explain later.This paper presents selected findings from the study. The origin and properties of Nursing Gestalt are discussed, as well as factors that enhance its development and use–namely, The Gray Gorilla Syndrome.
Locus of Control: Implications for Clinical Nursing Practice
Authors: Shillinger Freda L. 
Published: October 2007

AbstractCompliance, adherence, and a therapeutic alliance are terms that, when used in a health care context, refer to the process whereby a patient assumes the various tasks that comprise a therapeutic regimen. When a patient is said to be compliant there is the suggestion that he has been coerced; when he is said to be adherent it appears that he is conforming to some norm or standard set for him; when he forms an alliance it seems he has negotiated what it is he will do to care for himself. Coercion, conformity, and negotiation make up a continuum that varies in the degree to which a patient is active in the decisions being made about himself, or inversely, the degree to which others determine the patient's behavior (Barofsky 1978). All too often a person's experience with the health care system is coercive, thereby restricting the individual's need to freely direct and control his life affairs freely, which in turn leads potentially to noncompliance behaviors.Individuals perceptions of their control over the environment and its relationship to other areas of cognitive functioning and to behavior have aroused considerable interest. Health beliefs and behaviors, however, have received little attention as a specific area in which to investigate perceptions of control. Since many health actions depend on voluntary behaviors and many health programs are predicated on an assumption of controllability, patients'expectancies concerning control seem to be a worthwhile area for examination.Locus of control, an individual difference construct from social learning theory, has shown some promise in predicting and explaining specific health‐related behaviors. Yet compliance problems, being highly complex, are not easily reducible to a single simple explanation. This paper will review research demonstrating the utility of locus of control in understanding health behaviors. A method for incorporating the construct into the nursing process will be described. Using this framework as a basis, the author will explore methods of increasing client participation in treatment programs while maintaining a therapeutic alliance.
Effectiveness of Policy Related Research: Nurse‐Midwifery as Case Study
Authors: Diers Donna , Burst Helen Varney 
Published: October 2007

Summary“Policy” is inevitably “politics”– the use of power. What is so striking and instructive about the nurse‐midwifery studies is that so much has been accomplished by their use when the studies themselves are so few; the nurse‐midwives who benefit from the changes in policy are few as well; however, the changes in health care access are great. Granted, other forces are at work here, including the wisdom of the professional organization of nurse‐midwives in concentrating its agendas, the marriage of consumer and provider interests in humane experience in childbirth, the rise of feminism, the wish of patients and providers (nurse‐midwives) alike to control their own existence, the disenchantment of childbearing families with traditional patronizing obstetrical care, and so on. Many of these variables are not rational contributions to policy formulation. What is rational is the argument from data, and that is where the studies come in.Yet what becomes clear in this review is that no amount of research will ever be enough. The intricate relationship of policy to politics shows through very clearly in the studies reviewed, and as the politics change (from “safety” as agenda to “cost effectiveness” or competition) more data will continue to be needed. Indeed public policy making is an eternal process.Important as effectiveness studies are and have been, alone they could not possibly make or break the policy considerations nursing faces. Without studies of effect, however, nursing is left to argue on moral principle, right to practice, or naked power. With them, nursing may argue, as Fagin (1982b) has, that its services are “substitutive, not additive”, (p. 1849)
Issues for Research on Alternative Patterns of Care for Low Birth weight Infants
Authors: Brooten Dorothy 
Published: October 2007

SummaryIt is unlikely that the rate of very low birthweight infants born annually will change in the near future. However, efforts to improve their outcomes and to control the cost of their care will continue. Professional opinion, special interests, politics, and values all will play some role in public policy decisions about the provision of care to this group, especially during periods of economic restraint. In this context it is even more important for nursing to examine alternative models of care that are efficacious, that justify their costs, and that promote the image and self‐determination of the profession in advancing its practice.
The Financial Distress of Higher Education: Impact on Nursing
Authors: Morton Paula C. 
Published: October 2007

SummaryUntil recently, serious financial problems were of limited concern to nursing education. With generous program and student aid from government sources, nursing education has not felt the same kind of severe financial distress that has afflicted the rest of higher education (Gonyea,1978). Unfortunately this state of affairs is changing. Funding of such programs is an expensive proposition for colleges and universities, and some institutions of higher education have begun to question the feasibility of continuing to fund their nursing programs (Allen & Gray,1975). Additionally, as supply and demand gaps in nursing manpower have narrowed, there is less incentive for the government to underwrite the costs of nursing education.It is expected that tuition costs to nursing students will continue to escalate. Job opportunities for graduates will be less attractive and fewer in number than previously. Fewer women in the future are likely to select nursing as their career field. Small nursing education programs will be unable to sustain the very high costs of educating students and will likely cease to exist. Nursing education programs within colleges and universities will very likely compete less successfully with other institutional programs than they have in the past for the limited dollars.As in all of higher education, nursing education will increasingly be held accountable for its costs, costs that will only increase in the coming decade. It will be asked to do more with far fewer resources, in terms of dollars, numbers of students, and numbers of programs. Should this trend continue, the profession may well be confronted in 20 to 30 years with another critical shortage of nurses across the nation.
Priorities for Nurse Training Act Legislation: A National Survey of Nursing Deans
Authors: Crosby Leanna J. , Facteau Lorna M. , Donley Sister Rosemary 
Published: October 2007

Abstract1984 represents a pivotal year for nursing and nursing education in part as a result of future legislation of the Nurse Training Act (NTA). In the face of lost federal funds secondary to the recession, and/or the current administration's attitude toward funding for higher education as well as a decreasing number of college‐age students, nursing must be prepared to launch a united effort to recapture lost funds and/or prevent future losses. This must be a deliberate, pragmatic, and well‐organized effort. It must be goal‐oriented, not merely reactive. To assess how nursing deans and/or chairpersons are planning to confront the financial and demographic realities of the1980s and 1990s a national survey was conducted among 227 nursing education administrators. These administrators responded to a four‐page questionnaire providing quantitative and qualitative data. Areas covered in the questionnaire included previous use of NTA funds, priorities for future nurse training legislation and funding, enrollment trends of undergraduate and graduate nursing students and lastly, master plans and future goals designed to cope with reduced federal funding. Categories that were most important in the establishment, maintenance, or expansion of their programs were capitation, graduate and undergraduate student assistance, and special projects. The respondents indicated that future priorities for nurse training funding would include direct student assistance, piogram and institutional support, and individual needs of specific schools and/or regions. The respondents claimed that over the last five years 30% of schools had experienced a decline in enrollment of undergraduates, and 27% had experienced a decline in graduate enrollment. Lost federal funds contributed to 74 % of the undergraduate decline and 74% of the graduate decline. Future goals and master plans designed to cope with reduced federal funding have been characterized as developmental programatic approaches and/or a combined developmental/programatic approach. However, a startling 16% of the total respondents did not indicate future plans or goals. This survey further indicated that the priorities of those surveyed have changed from program concerns to student concerns and that their assessed needs are dramatically different from those of the Reagan administration. Of the deans and/ or chairpersons surveyed, 74% indicated that they were generating creative plans to cope with lost federal funds.
Selecting a Clinical Nursing Problem for Research
Authors: Fleming Juanita W. 
Published: October 2007

SummaryClinical nursing problems selected for inquiry are generally those encountered in nursing practice and those that deal with modalities of patient care such as support, comfort, prevention of trauma, promotion of recovery, health screening, appraisal and/or assessment, health education, and coordination of health care. The psychosocial dimensions of health care are an essential aspect of clinical nursing research. Factors considered in selecting a clinical nursing problem for research fall into three general categories: personal, social, and scientific. The personal factors include interest in the problem, competence to conduct the study, time, energy, and money to conduct the study as well as the essential instruments, space, personnel, and equipment to carry out the study. Social factors are concerned with the advancement of science and the ethical value of the study as well as its practicability and applicability. The scientific factors are those that relate to the logic, empirical, rep‐licable, reductive, and transmittable aspects of selection of the problem for study.
The Metaparadigm of Nursing: Present Status and Future Refinements
Authors: Fawcett Jacqueline 
Published: October 2007

AbstractThe central concepts and themes of the discipline of nursing are identified and formalized as nursing's metaparadigm. Examples illustrate the direction provided by the metaparadigm for theory development. Refinements of the metaparadigm through conceptual models and programs of nursing research are proposed.
Explaining Primary Care Visits
Authors: Molde Susan , Baker Dorothy 
Published: October 2007

AbstractPatients visit health professionals for a variety of medical and nonmedical reasons, many of which are not obvious. This study examined the reasons motivating people to initiate visits to a clinic staffed by nurse practitioners. 128 patients responded to a special question concerning expectations of the visit. Approximately 30% of the sample had “hidden agendas” that could not have been predicted during their regular interview on arrival at the clinic. At that time virtually all sampled patients said that they had initiated a visit because of a physical symptom, but their later responses to the special question consistently revealed their needs for nursing care. Implications for nurse practitioner practice and research are presented.
The rhetoric of nursing theory
Authors: Levine Myra Estrin 
Published: October 2007

Summary.Skeptics who question the validity and relevance of nursing theory in the nursing curriculum demonstrate the failure to persuade nurses of the importance of theory. Attempts to justify theory by forcing its use in contexts where it barely fits have contributed to the increasing disenchantment. But however misused and misunderstood, theory is nevertheless a lasting and essential part of nursing knowledge. Theory is the intellectual life of nursing. To further research, experiment, and insight in nursing as a discipline, theorizing must be encouraged–subject as all intellectual efforts must be–to honest critique and a healthy willingness to acknowledge success or failure.
Functional performance in people with chronic obstructive pulmonary disease
Authors: Leidy Nancy Kline 
Published: October 2007

Summary.The extent to which individuals with a chronic physical illness perform their day‐to‐day activities and maintain the independence and autonomy they desire is both an indicator of adaptation and an important clinical outcome criterion. Yet the concept of functional performance is not well understood. Studies of people with chronic obstructive pulmonary disease (COPD) have attempted to identify physiologic and psychosocial factors that contribute to functioning in this population. These studies have used a melange of terms, including functional status, functional ability, quality of life, and health status interchangeably. They have also employed a variety of instruments to operationalize functional performance and an assortment of predictors to understand the phenomena. Perhaps as a result of this disarray, no attempt has been made to synthesize the literature for nursing research and practice. The purpose of this paper is to summarize the research on functional performance in people with COPD, indicate areas of understanding and quandary, suggest possible flaws, and propose several new directions for practice and research.