bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescent subjective well‐being and realized values
Authors: Rask Katja , Åstedt‐Kurki Päivi , Laippala Pekka 
Published: March 2003

Adolescent subjective well‐being and realized values Aims of the study. The purpose of this study was to describe adolescent subjective well‐being and realized values, and to examine the relationships between socio‐demographic variables, realized values and subjective well‐being from the adolescent perspective. Rationale. Adolescent subjective well‐being was conceptualized by means of four different dimensions: satisfaction, ill‐being, knowledge and activities related to well‐being. The values were operationalized by eight core ideas from which a principal components analysis identified 10 factors representing the realized values. Design. Data were gained by self‐report questionnaires from 245 adolescents from 7th and 9th grades, with a mean age of 14 years, in 13 secondary schools in southern Finland. The data were analysed statistically. Findings. According to the findings, most of the respondents were satisfied with life. However, one out of 10 did not experience the joy of life. There was no statistically significant difference in global satisfaction between girls and boys. Total ill‐being among the adolescents was rare, but one out of four participants had fairly often worried about money and 17% were frequently unusually tired. Girls and pupils from the 9th class experienced more ill‐being than boys and pupils from the 7th class. The findings suggest that certain values such as personal equilibrium, safe family relations, and family type are predictors of adolescent global subjective well‐being. Conclusions. While assessing and promoting adolescent well‐being it is important to pay special attention to the realization of values in life and not merely to appreciation of things. Implications for practice include the need to create opportunities for the realization of values when adolescents require health care services.
Unstructured interviews: challenges when participants have a major depressive illness
Authors: Moyle Wendy 
Published: March 2003

Background.  There is debate about undertaking sensitive research with vulnerable populations. Primarily, the literature has focused on informed consent, confidentiality and the principle of beneficence, with little discussion about data collection methods. Aim.  This paper discusses the challenges of conducting unstructured interviews when participants have a major depressive illness. Issues arose during a phenomenological study that explored the meaning of being nurtured with seven people who were hospitalized for depression. Findings.  The depressive illness and treatment were found to impact on participants' articulation and recalling of their experience, and raised ethical concerns about their informed consent. Personal engagement with participants raised the ethical issue of research vs. therapy. Furthermore, participants being in a hospital complicated the necessity for privacy. The methodological issue of bracketing of assumptions was deemed to be important to ‘see’ the phenomenological relevance of patients' experiences. Conclusion.  Knowledge and experience are required when conducting unstructured interviews. Debates about the challenges of unstructured interviewing needs to be highlighted in research texts to assist novice researchers. Support from an experienced research mentor would assist novice interviewers through the interview process and provide post‐interview debriefing.
Implementing audit in palliative care: an action research approach
Authors: Cooper Jan , Hewison Alistair 
Published: March 2003

Aim.  To investigate the factors that influence the successful implementation of audit in a palliative care setting. Background.  Quality assurance is a necessary component of contemporary health care. In the past, palliative care has not generally been subject to systems of audit and quality management. However in recent years the need for all health care organizations to have clear policies and procedures for maintaining quality has become more pressing. Method.  An action research project was conducted to investigate the implementation of audit in a palliative care setting, which involved the application and modification of the Support Team Assessment Scale (STAS). Findings.  A collaborative approach was adopted and this facilitated the identification of factors vital to successful introduction of the audit methodology into the unit. These included effective teamwork, the input of an external facilitator, good relationships with management and prompt and relevant feedback on progress. The use of STAS was fully integrated into the work of the unit and a robust programme of audit has been established. Conclusion.  Combining the cyclical nature of action research methodology and the audit process with Lewin's change theory provided a clear conceptual framework for the research. This approach would be applicable in a range of health care settings to bring about improvements in quality management.
The temporal landscape of night nursing
Authors: Brown Reva Berman , Brooks Ian 
Published: March 2003

Aims of the study.  The study arose secondarily from a study with a different primary purpose (to consider attitudes towards the implementation of changes to working practices). Its aim is to provide a ‘map’ of the temporal landscapes of night nurses. Background.  Our temporal landscapes are made up of recognizable domains, with permeable borders – private time and public time, home time and work time, past, present and future time, cyclical time. Just as a geography of space contains recognizable natural features – rivers, deserts, mountains – and features created by human beings – canals, roads, skyscrapers – so our temporal landscape contains natural features – day and night, the seasons – and features created by us – the ordering of social, economic, legal, and organizational time into, among others, the practices of family life, financial periods, and workloads. Methods.  Data were collected during longitudinal ethnographic research – observation, formal interviews, informal conversations – with the emphasis on areas such as shift work, workload, and the temporal aspects of caring. Conclusions.  The result is the production of a map, albeit a rough one, of the temporal landscape inhabited by night nurses as they go about their working lives.
Heart failure and its impact on older women's lives
Authors: Rhodes Diane L. , Bowles Cheryl L. 
Published: March 2003

Aim of the study.  This phenomenological study sought to examine and describe the experience of living with heart failure (HF) from the perspective of five women who live with Stage II HF. Background.  Research has shown that women are affected by HF differently than men, having different risk factors, a higher increase in mortality per decade, and longer survival after diagnosis. Women have also been greatly under‐represented in studies of HF. A search of the literature revealed only one Swedish study examining the overall impact of HF on women's conceptions of their own lives. Research methods.  Four 1‐hour semi‐structured interviews were held with each participant. Colaizzi's steps were used to analyse the verbatim transcripts of the interviews, drawing meanings from the participants' words. Findings.  Four main themes emerged from the data: ‘Acknowledging Losses in Their Lives’, ‘Accepting the Losses’, ‘Changing Their Lives’ and ‘Deepening Relationships’. Additionally, each theme contained several subthemes. Conclusion.  Findings from this study indicate that no aspect of women's lives escapes the impact of HF. It causes immense losses in many areas of life, and requires tremendous changes in many aspects of daily living. Yet, drawing on inner resources of great strength and courage, these women learn to find contentment in their lives. They discover ways to create productive lives and deeply meaningful relationships, within the boundaries imposed by HF.
Dis/integrated care: family caregivers and in‐hospital respite care
Authors: Gilmour Jean A. 
Published: March 2003

Aim.  The aim of this study was to explore family caregivers' experiences of in‐hospital respite care for people with dementia and the factors that influenced their perceptions of the service. Background.  The provision of respite care is based on the assumption that temporary relief from caregiving will relieve caregiver stress and may possibly extend the duration of home care. Research evidence suggests that this is a simplistic perspective which fails to account for families' concerns about the quality of institutional care and the impact of relocation on the person being cared for. Design.  Nine family caregivers, using four different hospitals sites were interviewed during a period of 3 years from 1994 to 1997. The research texts were analysed using a critical discourse analysis approach drawing on the work of Foucault. Findings.  Family caregiver texts were distinguished by difference rather than by homogeneity. Caregivers occupied a range of positions in terms of their ability to take advantage of the respite time intermittent care offered. My reading of these texts has highlighted the aspects of nurse–family relationships that ameliorated, or alternately exacerbated, the tensions felt by caregivers, as they were torn between the necessity to have a break and their anxieties about the impact of in‐hospital respite care on the person with dementia. Conclusion.  Nurses' practices in this study were a critical element in facilitating, or alternately constraining, family caregivers' ability to relinquish care and to take full advantage of the respite time. The research findings highlight the need for nurses and other formal caregivers to locate themselves in a secondary and supporting caregiving role, to acknowledge the family caregivers as the primary caregiver, and use family caregivers in‐depth and intimate knowledge of the needs of their relative to inform care within the institutional setting.
Titmuss and the gift relationship: altruism revisited
Authors: Rapport F.L. , Maggs C.J. 
Published: March 2003

Rationale.  This paper revisits Richard Titmuss' 1970s blood donation model in the light of its 1997 reprint in order to consider whether we are justified in continuing to accept that the main reason for blood donation (and other donation types) is an altruistic desire to help others. Aim.  This paper explores how others have examined the notion of altruism, before concentrating on two major elements of Titmuss' work: blood donors' motives to donate and the social implications of gift‐giving in relation to the uniqueness of blood donation. Design.  Donor motivation is discussed in detail with particular reference to questions 4 and 5 of Titmuss' blood donor survey and through a critical appraisal approach to his work. Findings.  Methodological inconsistencies are revealed in the design and implementation of the survey, as well as in Titmuss' list of blood donation's unique attributes, bringing into question the rigour of his findings. It may be that blood donors are altruistically motivated, but such conclusions cannot be drawn from this work. It is also unclear if ‘altruism’ can be shown in the example of blood donation or other donation types. Recommendations.  We should reconsider the motivation behind gifting in health care in the light of these findings and ensure that evidence‐based practice is consistent with methodological rigour. Nurses and other health professionals need to have a clearer understanding of concepts such as altruism in order to appreciate why people seek to donate.
A review of physical restraint minimization in the acute and residential care settings
Authors: Evans David , Wood Jacquelin , Lambert Leonnie 
Published: March 2003

Objectives.  The objective of this review was to investigate physical restraint minimization in acute and residential care settings. The first aim was to determine the effectiveness of attempts to minimize the use of physical restraint, and the second was to generate a description of the characteristics of restraint minimization programmes. Method.  A comprehensive search was undertaken involving all major databases and the reference lists of all relevant papers. To be included in the review studies had to be an evaluation of restraint minimization in an acute or residential care setting. As only a single randomized controlled trial (RCT) was identified, it was not possible statistically to pool the findings of different studies on the effectiveness of restraint minimization. To generate a description of the characteristics of restraint minimization programmes, the reported components of these programmes were identified and categorized. Results.  A total of 16 studies evaluating restraint minimization were identified: three in acute care and 13 in residential care. Of these, only one was an RCT, with the most common approach being the before and after study design. Based on the findings of the single RCT, education supported by expert consultation effectively reduced the use of restraint in residential care. There has been little evaluation of restraint minimization in acute care settings. The common approach to restraint minimization has involved a programme of multiple activities, with restraint education being the characteristic common to most programmes. Discussion.  Evidence suggests that physical restraint can be safely reduced in residential care settings through a combination of education and expert clinical consultation. There is little information on restraint minimization in acute care settings. The major finding of this review is the need for further investigation into all aspects of restraint minimization.
Development and testing of the theory of collaborative decision‐making in nursing practice for triads
Authors: Dalton Joanne M. 
Published: March 2003

Background.  Although nurses depend heavily on informal family caregivers to provide care to clients and to be involved in care planning and decision‐making, no nursing theories that include the client, the caregiver, and the nurse were available to guide collaborative care planning and decision‐making. Aim.  The purpose of this paper is to describe the construction and initial testing of the theory of collaborative decision‐making in nursing practice for a triad. The theory represents an extension of Kim's theory of collaborative decision‐making in nursing practice. Kim's theory was developed to describe and explain collaborative decision‐making in a dyad (client and nurse). The inclusion of a third person (family caregiver) in the theory required the addition of concepts about the caregiver, coalition formation, and nurse and caregiver outcomes. The expansion of Kim's dyadic theory to a triadic theory was achieved by means of a modified version of the theory derivation process described by Walker and Avant. Conclusions.  The theory of collaborative decision‐making in nursing practice for a triad can be used to guide further research and clinical practice. The theory provides a framework for researchers who are interested in studying the effects of collaboration regarding decision‐making among nurses, family caregivers, and clients. The initial testing of the new theory in home health care nursing revealed variety in the nature of the client–caregiver–nurse relationships, the many processes used by the nurses in proceeding with the home visits, a multitude of decisions considered and different collaborative, noncollaborative, and coalition–forming interactions. The limited evidence of the empirical adequacy of the theory precludes development of definitive guidelines for clinical practice at this time. More studies are required before clinical practice guidelines can be developed.
Who owns the child in hospital? A preliminary discussion
Authors: Shields Linda , Kristensson‐Hallström Inger , Kristjánsdóttir Gudrun , Hunter Judith 
Published: March 2003

Aim.  To ‘own’ a person is considered an infringement of human rights, but we suggest that concepts of ownership influence interactions between parents and staff when a child is admitted to hospital. This paper aims to stimulate debate and contains an explanation of the exploration of the literature for research and discussion of ownership of the child. Method.  A wide variety of library indexes, databases and populist media were examined although it was impossible to examine all literature which may have contained references to this topic, and, apart from databases which contained abstracts in English, we could not include literature written in any language other than English, Swedish, and Icelandic. Findings.  We found no research that examines how concepts of ownership of a child affects communication between health professionals and parents and, ultimately, the delivery of health care. This paper begins discussion on the issues. Discussion.  Historical literature shows that ownership of humans has been a part of many cultures, and parents were once considered to own their children. Ownership of another has legal connotations, for instance in guardianship struggles of children during marriage breakup and in ethical debates over surrogacy and products of assisted conception. Within health care, it becomes a contentious issue in transplantation of body parts, in discourse on autonomy and informed consent, and for religious groups who refuse blood transfusions. In health care, models such as family centred care and partnership in care depend on positive communication between parents and staff. If a hospital staff member feels that he/she owns a child for whom he/she is caring, then conflict between the staff member and the parents over who has the ‘best interests of the child’ at heart is possible. Conclusion.  We encourage debate about concepts of who owns the hospitalized child – the parents or the staff? Should it be argued at all? Is the whole concept of ownership of another, be it adult or child, the ethical antithesis to modern beliefs about human rights? Comment on this issue is invited.
Strategies for resolving aboriginal adolescent pregnancy in eastern Taiwan
Authors: Tsai Yun‐Fang , Wong Thomas K.S. 
Published: March 2003

Background. Adolescent pregnancy has become a main issue in the health care system for aborigines in eastern Taiwan. Using aboriginal nurses to provide information on sexual behaviour may have potential as a means of promoting healthy sexual practices among aborigines. Aim. To explore aboriginal nurses' perspectives on strategies for resolving the high prevalence rate of Aboriginal adolescent motherhood in eastern Taiwan. Design and methods. A qualitative research design was employed and intensive individual interviews and focus groups were conducted among a convenience sample of aboriginal nursing staff in eastern Taiwan. Content analysis was used to analyse the data. Results. Nine strategies were identified. They can be divided into family, school and society aspects. The family aspect included ‘enhancing parents’ sex education' and ‘enhancing the understanding of older people about sex education in villages’. The school aspect included ‘enhancing sex education in school’, ‘offering interrelationship courses for adolescents’, ‘offering gender issue courses for adolescents’ and ‘enhancing school teachers’ sex education training'. The social aspect included ‘advocating the sense of family in church’, ‘advocating social norms in church’ and ‘discussing appropriate sexual behaviour in adolescent church fellowships’. Conclusions. Health care providers can design intervention programmes to reinforce the ability of family, school and society to deliver sex education. In addition, training and cooperating with Aboriginal nurses to execute these programmes may also decrease teenage pregnancy rates in the future.
Multi‐species territoriality and dynamic of neotropical forest understorey bird flocks
Authors: Jullien Mathilde , Thiollay Jean‐Marc 
Published: March 2003

1.  Eleven contiguous mixed‐species bird flocks, with colour‐banded individuals, were monitored continuously during 3  years in a 132‐ha study area of primary rainforest in French Guiana. 2.  Flock members were divided into six categories according to their flocking propensity and occurrence: 10 core or permanent species and 56 regular, occasional or incidental species. Each core species was represented by a single breeding pair with their fledglings and extra ‘floaters’ (unmated subadults and adults). 3.  Flock home ranges overlapped slightly, but were communally defended by all core species in areas of overlap. Their size varied from 3·2 to 14·3  ha and was inversely correlated with vegetation density, but not flock size or species composition. 4.  Flock number, size and composition, as well as boundaries were highly stable between seasons and years. Each flock had a single permanent gathering site and bathing site in late afternoon, the latter sometimes shared by 2–3 flocks. 5.  Core species produced 0·18–0·73 fledglings per pair per year, which stayed in their natal flock for 200 to over 421 days. Then, these individuals usually moved between two and six different flocks, sometimes for up to 3  years, before finding a mate and a flock where they could settle and breed. Once breeding, they probably remained for life in the same flock. The mean annual survival rate was at least 0·75. 6.  This highly evolved and stable organization, associated with a low breeding success and high survival rate was a critical factor maintaining low species density, delayed reproduction and a proportion of floating individuals buffering population fluctuations. 7.  These social groups with their multi‐species territoriality and co‐evolved roles of flock members were similar to those described elsewhere in South America. They seem to be a general phenomenon in neotropical lowland rainforests.
Persistence thresholds for phocine distemper virus infection in harbour seal Phoca vitulina metapopulations
Authors: Swinton  , Harwood  , Grenfell  , Gilligan  
Published: March 2003

1.  This paper explores the concept of the critical community size for persistence of infection in wildlife populations. We use as a case study the 1988 epidemic of phocine distemper virus in the North Sea population of harbour seals, Phoca vitulina. 2.  We summarize the available data on this epidemic and use it to parameterize a stochastic compartmental model for an infection spreading through a spatial array of patches coupled by nearest‐neighbour mixing, with replacement of susceptibles occurring as a discrete annual event. 3.  A combination of analytical and simulation techniques is used to show that the high levels of transmission between different seal subpopulations, combined with the small annual birth cohort, act to make persistence of infection impossible in this harbour seal population at realistic population levels. The well known mechanisms by which metapopulation structures may act to promote persistence can be seen to have an effect only at weaker levels of spatial coupling, and higher levels of host recruitment, than those empirically observed.