bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mothers’ coping in chronic childhood illness: the effect of presymptomatic diagnosis of vesicoureteric reflux
Authors: Swallow Veronica M. , Jacoby Ann 
Published: March 2003

Mothers’ coping in chronic childhood illness: the effect of presymptomatic diagnosis of vesicoureteric refluxAims of the study were to.Assess coping strategies of mothers who have a child with vesicoureteric reflex (VUR), determine mothers’ understanding of VUR before and after diagnosis, assess mothers’ perceived needs for support when coping with their child’s VUR and compare the above aims between two groups of mothers of children with VUR.Background.Vesicoureteric reflex (VUR) is a chronic, congenital, asymptomatic condition which when combined with urinary tract infection (UTI) can result in reflux nephorpathy (RN), contributing to 20% of kidney transplants. Unfortunately, VUR is not usually diagnosed until after proven UTI, by which time RN has often developed. However, recent research, the familial ureteric reflux study (FURS) identified for the first time VUR in a cohort of new‐borns investigated because of family history. Early detection and prompt treatment of UTI in the presence of VUR may significantly reduce the development of RN but this requires extreme vigilance by mothers, who are usually the primary carers.Design.As mothers’ experiences and perceptions were the focus, a qualitative design using semistructured, in‐depth interviews was used. After obtaining ethical approval, mothers of 15 children with VUR diagnosed presymptomatically (i.e. after particpation in the FUR study) and mothers of 14 children with VUR diagnosed post symptomatically were selected using a theoretical sampling matrix. All mothers gave informed consent and interviews were taped, transcribed and analysed using the ‘Framework’ technique.Findings.Findings for both groups fall into three discrete phases: the prediagnostic, diagnostic and postdiagnostic. Analysis showed that mothers in the post symptomatic diagnosis group experienced most problems in coping, particularly because of difficulty in engaging medical intervention in the prediagnostic phase. Generally, mothers in the presymptomatic group coped well apart from those who themselves had VUR and/or RN who expressed guilt about their child inheriting the condition and consequently difficulty in coping.Conclusion.Early diagnosis of VUR improved mothers’ coping. However, both groups identified a major need for improved information provision and support to assist coping with the sustained uncertainty of the condition.
Spirituality and psychosocial factors in persons living with HIV
Authors: Tuck Inez , McCain Nancy L. , Elswick Jr Ronald K. 
Published: March 2003

Spirituality and psychosocial factors in persons living with HIVAim of the study. This pilot study was designed to examine the relationships among spirituality and psychosocial factors in a sample of 52 adult males living with human immunodeficiency virus (HIV) disease and to determine the most reliable spirituality measure for a proposed longitudinal study.Background. HIV disease is among the most devastating of illnesses, having multiple and profound effects upon all aspects of the biopsychosocial and spiritual being. Although research has suggested relationships among various psychosocial and spiritual factors, symptomatology and physical health, much more research is needed to document their potential influences on immune function, as well as health status, disease progression, and quality of life among persons with HIV disease.Methods. This descriptive correlational study explored the relationships of spirituality and psychosocial measures. Spirituality was measured in terms of spiritual perspective, well‐being and health using three tools: the Spiritual Perspective Scale, the Spiritual Well‐Being Scale, and the Spiritual Health Inventory. Five psychosocial instruments were used to measure aspects of stress and coping: the Mishel Uncertainty in Illness Scale, Dealing with Illness Scale, Social Provisions Scale, Impact of Events Scale, and Functional Assessment of HIV Infection Scale. The sample was recruited as part of an ongoing funded study. The procedures from the larger study were well‐defined and followed in this pilot study. Correlational analyses were done to determine the relationship between spirituality and the psychosocial measures.Findings. The findings indicate that spirituality as measured by the existential well‐being (EWB) subscale of the Spiritual Well‐Being Scale was positively related to quality of life, social support, effective coping strategies and negatively related to perceived stress, uncertainty, psychological distress and emotional‐focused coping. The other spirituality measures had less significant or non significant relationships with the psychological measures.Conclusions. The study findings support the inclusion of spirituality as a variable for consideration when examining the psychosocial factors and the quality of life of persons living with HIV disease. The spiritual measure that best captures these relationships is the EWB subscale of the Spiritual Well‐Being Scale.
Being overwhelmed by the feeling of having a home and family. One aspect of the meaning of being dependent on care: a study of one patient and two of his nurses
Authors: Strandberg Gunilla , Norberg Astrid , Jansson Lilian 
Published: March 2003

Being overwhelmed by the feeling of having a home and family. One aspect of the meaning of being dependent on care: a study of one patient and two of his nursesRationale. This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger body of data, interviews with one patient and two of his nurses were selected to study.Aim. The aim was to deepen understanding of the meaning of being dependent on care when this appears desirable for the patient.Methods. A phenomenological–hermeneutic approach was used to interpret the material. Interviews were recorded and transcribed verbatim.Findings/discussion. The interpretation discloses the meaning of being dependent on care as an overwhelming, unfamiliar feeling of having a home and family. The patient is beguiled into believing he is the ruler in an established relationship and his dependency on care gives him an opportunity to be surrounded by loving, altruistic, helpful people. Being dependent on care is overwhelming and irresistible, i.e. coveted, but simultaneously it is like walking on thin ice, i.e. treacherous. The irresistible desire concerns being unconditionally cared about. The danger is that this ‘family membership’ will not last. It is brought to the patient because of his dependency on care and it is based on his terms. There is reflection about the patient being unprepared for dealing with his own world of loneliness.
Characteristics of an Accident and Emergency liaison mental health service in East London
Authors: Callaghan Patrick , Eales Sarah , Leigh Laurie , Smith Angie , Nichols Joe 
Published: March 2003

Characteristics of an Accident and Emergency liaison mental health service in East London Aim of the study. To analyse the work of a liaison mental health service at the Accident and Emergency (A & E) department of a hospital in East London. Background. The English National Service Frameworks (NSF) for Mental Health recommend that A & E departments provide liaison mental health services and this study reports how a service in East London is responding to this challenge. Research methods. Data were collected during a 14‐month period using a specially designed audit form. Results. The typical referral was aged 36, of either sex, United Kingdom (UK) non‐White with a diagnosis of depression. The majority of referrals were in the afternoon and seen immediately. A slight majority were known to mental health services; many were new referrals. Older and male clients were more likely, and Bengali and other Asian clients were less likely, to be registered with a psychiatrist. There were seasonal variations in referral type. Emergency referrals tended to have a diagnosis of schizophrenia; urgent and non‐urgent referrals were more likely to be depressed. The outcome for the majority of referrals was referral to appropriate community services. The majority of non‐clinical referrals were for advice, information and support. Discussion and conclusions. The service seems a useful resource for A & E staff, and clients with mental health problems. The service is a channel through which people access mental health services and appears to address the NSF for Mental Health.
Nurse‐environment misfit and nursing practice
Authors: Takase Miyuki , Kershaw Esme , Burt Lorraine 
Published: March 2003

Nurse‐environment misfit and nursing practice Aim of the study. The purpose of the following descriptive correlational study was to investigate nurses’ responses to the image discrepancy between the public and nurses, and its relationships with their self‐concept, job satisfaction and performance. Background. It has been long said that nurses live in a dual structure wherein the nurse’s journey toward professionalization is constrained by nursing stereotypes in a society. This duality of the nursing universe is assumed to have created a person‐environment misfit which could lead to nurses’ job dissatisfaction and low job performance. Nonetheless, little study has been done in this area. Design/Methods. The study was conducted in 1999 with ethical approval from an Australian University. A sample of 80 Australian registered nurses participated by completing the Porter Nursing Image Scale, Index of Work Satisfaction (IWS) and Six‐Dimension Scale of Nursing Performance. Data were analysed using descriptive statistics and Pearson correlation. Results. The results suggested that there is a discrepancy in the images of the nursing profession between nurses and the public, which can contribute to the nurse‐environment misfit. The results also supported a negative correlation of the misfit with nurses’ job satisfaction and performance. Conclusion. Despite the limited sample size and characteristics, this study provides evidence to encourage nurses to improve the public image of nurses, which will enhance the professionalization of nursing.
Practice nurse and health visitor management of acute minor illness in a general practice
Authors: Pritchard Alison , Kendrick Denise 
Published: March 2003

Practice nurse and health visitor management of acute minor illness in a general practice Objective. To evaluate practice nurse (PN) and health visitor (HV) management of patients with acute minor illnesses, monitor the effect on general practitioner (GP) workload, and describe the range of conditions seen by nurses. Design. Patients requesting ‘urgent’ appointments (within 24 hours) were offered consultations with a PN or HV trained in the management of acute minor illness. Comparative data were collected before and after the establishment of the acute minor illness service. Setting. A general practice in Nottingham, England. Main outcome measures. Patient satisfaction, consultation rate, prescriptions, investigations, referrals and urgent re‐consultations for the same condition within 2 weeks. Results. About 2056 urgent consultations were recorded in the study period, of which 332 (16·1%) were seen by PNs and 46 (2·2%) by a HV. High levels of patient satisfaction were reported for all health professionals. Patients seeing the HV reported higher levels of satisfaction than those consulting GPs (P=0·033) and PNs (P=0·010). There was no difference by health professional for prescription rates (P=0·76), re‐consultations (P=0·14), or referrals to secondary care (P=0·07). General practitioners were more likely to initiate further investigations than the PNs or HV (P < 0·001). Conclusion. With suitable training, PNs and HVs can successfully manage patients with a range of conditions. General practitioner workload can be reduced while maintaining high patient satisfaction levels.
A stepwise multivariate analysis of factors that contribute to stress for mental health nurses working in the community
Authors: Edwards D. , Burnard P. , Coyle D. , Fothergill A. , Hannigan B. 
Published: March 2003

A stepwise multivariate analysis of factors that contribute to stress for mental health nurses working in the community Aims. The aim of the study was to examine the variety, frequency and severity of stressors experienced by community mental health nurses (CMHNs) in Wales. Background. Numerous studies undertaken throughout the United Kingdom (UK) have indicated that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout. Sample sizes have tended to be small and participants have been drawn mainly from sites in England. Methods. A questionnaire booklet, which included a number of validated measures, was distributed to 614 CMHNs. These included Maslach Human Services Survey, Community Psychiatric Nursing (CPN) Stress Questionnaire, PsychNurse Coping Questionnaire, Rosenberg Self‐Esteem Scale and General Health Questionnaire GHQ‐12. The study was the largest of its kind conducted in the UK. Results. Data were collected from 301 CMHNs, representing a response rate of 49%. Community mental health nurses identified the most stressful issues as trying to maintain a good quality service in the midst of long waiting lists and poor resources and having too many interruptions while trying to work in the office. The best demographic predictors of high stress scores were having an unsupportive line manager, working with a specific client group and not having job security. These factors accounted for 20% of the variance in the total stress score. When the results from the psychometric instruments were included, 46% of the variance in the total stress score was accounted for. The predictive variables were emotional exhaustion, working with a specific client group, job security and alcohol consumption. Conclusions. These findings indicate that there is a need to create more supportive environments both in terms of job security and management support, especially for those working in the fields of severe mental illness and rehabilitation.
Psychosocial rehabilitation after disfiguring injury or disease: investigating the training needs of specialist nurses
Authors: Clarke Alex , Cooper Clare 
Published: March 2003

Psychosocial rehabilitation after disfiguring injury or disease: investigating the training needs of specialist nurses Aim of this study. To investigate the training needs of specialist nurses working with patients who have disfiguring conditions. Background. As the psychosocial impact of disfiguring illness and disease becomes more widely recognized and understood, there are increasing issues about who can provide this kind of input. Whilst nurses have been identified as the health professionals who are often the most appropriate to fulfil this role, there is less evidence that they feel confident in their skills to provide it. The volume of requests from health professionals, particularly nurses, to a lay‐led organization specializing in facial disfigurement suggested both an acknowledgement of the importance of providing psychosocial support to this population, together with a perceived lack of skill in this area. Design/Method, Study 1. This study used a cross‐section design. Two groups of nurses working either in burns or in head and neck cancer were surveyed by questionnaire. Results, Study 1. Both the burns group and head and neck group rated their skills in the social rehabilitation of their patient group as significantly lower than their skills in physical rehabilitation. Design/Method, Study 2. Using a multiple baseline design, a pilot intervention consisting of a specifically focused resource pack and 1‐day training course was delivered to eight head and neck cancer nurses. Results, Study 2. Postintervention, only the targeted skills (those concerned with social rehabilitation) were rated as significantly improved. Research continues to establish the extent to which these skills are implemented by nurses in the clinical setting and passed on to patients. Conclusions. These findings suggest that although nurses do not feel as skilled in delivering psychosocial support to patients as they do in delivering more traditional aspects of physical nursing care, they can very easily take on this role when given simple training and access to appropriate resources. This training can be provided by a lay‐led organization.
Insufficient sleep, cognitive anxiety and health transition in men with coronary artery disease: a self‐report and polysomnographic study
Authors: Edéll‐Gustaffson Ulla M. 
Published: March 2003

Insufficient sleep, cognitive anxiety and health transition in men with coronary artery disease: a self‐report and polysomnographic study Aims. To explore possible links between sleep quality, cognitive anxiety and the effects of sleep disturbances on health, daytime functioning and quality of life, for assessment in a larger study. Hypotheses were: (a) patients with coronary artery disease have insufficient sleep as measured by self‐reported sleep and by polysomnography, (b) self‐reported sleep is associated with polysomnographically measured sleep, (c) reduced sleep quality is associated with physical and mental health, and interferes with quality of life as measured by means of interviews and polysomnography, (d) reduced sleep quality is associated with reduced resilience to stress. Background. It has become increasingly evident that poor sleep with sleep initiation difficulties is an independent risk factor for cardiac events among men, and requires more attention in clinical nursing practice. Design. Descriptive, correlative and explorative study. Sample. Forty‐four men, aged 45–70, about to undergo coronary artery bypass surgery at a Swedish University Hospital. Research methods. Interviews and 24‐hour continuous ambulatory polysomnography were performed. For the interviews, the Uppsala Sleep Inventory, Spielberger State Anxiety Scale and the Nottingham Health Profile instruments were used. Results. Seventeen patients (38·6%) had insufficient sleep and 12 had sleep initiation difficulties. Logistic regressions revealed that reduced stage 3–4 sleep predicted poorer overall health, initiation of sleep difficulties, predicted insufficient sleep and involuntary thoughts predicted fragmented sleep. Poorer quality of life was predicted by reduced deep sleep. Independent predictors for emotional distress were sleep efficiency below 85%, fragmented sleep and a daytime nap longer than 15 minutes. Conclusions. Objective sleep was associated with several subjective sleep variables. The results provide empirical support for significant variables included in a theoretical framework relating to sleep quality, cognitive anxiety, health and quality of life. A larger study is recommended that includes both men and women.
Challenging contemporary mental health policy: time to assuage the coercion?
Authors: Hannigan Ben , Cutcliffe John 
Published: March 2003

Challenging contemporary mental health policy: time to assuage the coercion? Background. In the United Kingdom (UK) and elsewhere throughout the world, the policy and legal frameworks that surround the provision of mental health care are becoming increasingly coercive. For example, emerging mental health policy in the UK includes a commitment to the introduction of compulsory treatment in the community. Aims. In this paper, our aims are: to explore the context in which this more coercive mental health policy has arisen in the UK; to challenge the assumptions and the evidence that lie behind the introduction of proposed new mental health policies; and to consider the impact that a more coercive policy is likely to have on the practice of mental health nursing. Discussion. In the UK, representatives of central government have declared that `care in the community has failed'. This view has been reinforced by media representations of mental health issues. Policy documents have drawn attention to the risks posed by people with mental illnesses. Correspondingly, proposed initiatives emphasize the need to more closely `manage' people with mental health problems, and set out a new legislative and policy framework to achieve this. We question the assumptions and evidence that underlie these planned new developments. We argue that, contrary to government assertions, there is no unequivocal evidence that `community care' has failed. We observe, too, that people with mental health difficulties are often amongst the most vulnerable members of society. Finally, we consider the impact that a more coercive policy framework will have on the work of mental health nurses, and argue that the shift towards a more `controlling' role is likely to run counter to what many nurses see as the `core' of their work.
Cuff width influence on blood pressure measurement during the pregnant‐puerperal cycle
Authors: Oliveira Sonia M. Junqueira V. , Arcuri Edna A.M. , Santos Jair Licio F. 
Published: March 2003

Cuff width influence on blood pressure measurement during the pregnant‐puerperal cycle Background. The correct evaluation of blood pressure (BP) during pregnancy is a crucial factor in the prevention of eclampsia. Following American Heart Association (AHA) guidelines to employ a correct cuff width (CCW), 20% larger than arm diameter, we demonstrate that the standard cuff width (SCW), 12 cm wide, is too large for lean women causing underestimation of BP. Aims. To identify the arm circumference (AC) in pregnant women and the corresponding cuff width; to compare BP records from CCW vs. SCW; and to identify under‐ and overestimation of BP in SCW reading. Design. A follow up study of BP was performed in 104 pregnant women using two cuffs widths (CCW vs. standard one). The investigation was carried out during all antenatal appointments and postpartum stage in two maternity hospitals. In every appointment BP was registered three times with each type of cuff; and the means of those three readings were compared. Methods. The CCW for each woman was selected according to AHA recommendation for cuff width size (20% larger than arm diameter), which was based on the classical European and North‐American studies. Results. Arm circumference varied from 20 to 38 cm requiring a cuff width from 8 to 14 cm. The CCW most employed was 10 cm wide. The SCW (12 cm) was employed as CCW in only 13·4% of the subjects. Statistical difference was found on BP means when comparing both cuffs (P < 0·05), reaching 23 mmHg in systolic values and 20 in diastolic ones. Such differences showed a serious underestimation when SCW was employed in 80·8% of the subjects and overestimation in 5·8% of obese subjects. Conclusion. Our findings showed that the SCW underestimates BP of pregnant women. Our hypothesis is that such underestimation may lead to the misdiagnosis of pre‐eclampsia, particularly in lean pregnant women.