bluuebunny/crossref_metadata_2025_split huggingface dataset:
An insight into the experiences of parents with inflammatory bowel disease
Authors: Mukherjee Suzanne , Sloper Patricia , Turnbull Alastair 
Published: March 2003

An insight into the experiences of parents with inflammatory bowel disease Aims and objectives. To identify parents' views, both positive and negative on: how inflammatory bowel disease (IBD) affects people in their parenting role; effects parents with IBD have noticed in their children; ways of dealing with any difficulties in parenting; and support needed by parents with IBD. Design. This was a small‐scale exploratory study, adopting a qualitative research design. A purposive sample of 19 mothers and five fathers with IBD was recruited through two hospitals and a voluntary group in the north of England. Research methods. Data were collected through a combination of focus groups and interviews, and analysed using the `framework approach'. Findings. The main positive effect for parents was developing a closer relationship with their children. When parents were experiencing symptoms there were difficulties in caring for young children; problems taking children to and from school, and attending school events; restrictions in social life; irritability and reduced tolerance of children. When in hospital, it was sometimes difficult to arrange for care of young children. These difficulties caused worry and guilt for parents, and a few spoke of periods of depression. Parents noticed that their children seemed caring and understanding of illness, but were also anxious when the parent was ill or in hospital, and reacted with anger or frustration to restrictions in social activities. Strategies commonly used to deal with difficulties were turning to family for support and trying to control symptoms. Support from health professionals was variable. Parents wanted more practical assistance, information for families on the effects of IBD, and support in coping with the condition. Awareness‐raising about IBD was considered important within health, social services, education and housing departments. Conclusions. As a group in regular contact with parents with IBD, health professionals have an important role to play in providing support. Staff should be particularly vigilant towards parents with severe symptoms, mothers of younger children, and those receiving limited help from their families.
Rituals and nursing: a critical commentary
Authors: Philpin Susan M. 
Published: March 2003

Rituals and nursing: a critical commentary Aim of the paper. This critical commentary explores the concept of ritual in the nursing and social science literature in terms of investigating different understandings of its meaning and purpose. Rationale. The term `ritual' is often used in a pejorative sense in nursing literature to refer to unthinking, routinized action by nurses, which lacks any empirical foundation. The purpose of this paper is to explore alternative understandings of the meaning of ritual, suggesting that the negative usage described above misses out on the wider symbolic meaning of the word. Method. The literature search used a combination of electronic databases (CINAHL, ASSIA, MEDLINE and RCN) from 1960 to 2000 and serendipitous references in texts. Findings. The commentary is presented under the following two broad emerging themes: first, the complex issues surrounding the definition of ritual, including the relationship between rational and rational action and second, the purposes served by ritual. Conclusions. The paper concludes with the recommendation that the rituals nurses use in the performance of their care are worthy of research as a rich source of insight into the meaning and purpose of nursing actions.
Patient and carer needs following a cancer‐related hospital admission: the importance of referral to the district nursing service
Authors: Wilson Kate , Pateman Brian , Beaver Kinta , Luker Karen A. 
Published: March 2003

Patient and carer needs following a cancer‐related hospital admission: the importance of referral to the district nursing service Background. Despite 30 years of research attention, discharge planning and district nurse (DN) referral remain problematic and few cancer‐related publications exist. With shorter hospitalizations, discharged cancer patients and their carers may experience unmet needs for assessment, information and support. Although DN referral might enable patient/carer needs to be met, the DN role lacks clarity. Aim. To investigate the needs of people with cancer, and their lay carers during discharge from hospital to home, and identify the role of DNs in meeting these needs. Method. In this qualitative study, 71 pre‐ and postdischarge interviews were performed with cancer patients and (where possible) their carers. Predischarge interviews focused on expectations and postdischarge interviews on experiences of discharge and aftercare. Interview tapes were transcribed and analysed thematically. Results. Interviewees anticipated few aftercare needs during predischarge interviews but described met and unmet needs during postdischarge interviews. Unmet needs of those referred and not referred to the district nursing service were similar. Patients and carers had unmet needs for psychological support related to nutrition. Carers, especially those not resident with and not related to patients, had informational needs. Even very elderly, ill and isolated patients felt that other people had greater needs than their own and many thought that DNs only performed physical tasks. Conclusion. All cancer patients discharged from hospital might be referred to a DN for ongoing assessment of needs. However, to ensure optimal results, the DN role needs to be clarified and public perceptions altered. Further research on psychological aspects of nutrition and the needs of carers not resident with/not related to patients is necessary.
Nursing the spirit: the Framework of Systemic Organization
Authors: Friedemann Marie‐Luise , Mouch Judith , Racey Teri 
Published: March 2003

Aims.  To elucidate the concept of spirituality as an essential and integrated dimension of the functioning of individuals and families through the Framework of Systemic Organization (Friedemann 1995) and to demonstrate with a case example, how a nurse can integrate spirituality in the care of a terminally ill patient. Background.  Spirituality is the focus of discussion in nursing and other health professions in the United States of America, but whether or not it should be generally included in patient care is heavily debated. Also unanswered is the question about how spirituality should be addressed. The Framework of Systemic Organization (Friedemann 1995) is introduced here as an organizing structure to guide nurses in caring for the spiritual needs of patients. Implementation of the theoretical framework.  Spirituality is defined as connecting to systems such as God, nature or other people, and thus finding meaning through relationships. Key to spiritual care is the establishment of a balance between control and spirituality that is tailored to an individual patient's history, values and needs. A case example is used to show how a nurse intervenes with a patient who faces death. Findings.  The example shows that control remains important in a patient's life process until death arrives. Nevertheless, a dying patient benefits from an increasing focus on spirituality to gain self‐acceptance, reconciliation with the family and restoration of emotional health. Nurses are instrumental in finding the balance between control and spirituality that a patient desires. Conclusion.  Nurses who have explored and reconciled their own spiritual beliefs can learn to address their patients' unique needs within the broad context of family and environment. Nursing the spirit by using the Framework of Systemic Organization is a client‐directed and intimate process that leads to growth of both patient and nurse.
Nurses' perceptions of discharge planning in acute health care: a case study in one British teaching hospital
Authors: Atwal Anita 
Published: March 2003

Aim of the study.  To provide an in‐depth understanding of nurses' perceptions of the hospital discharge process in a London teaching hospital. Background.  Discharging patients from hospital is a key component of the nurse's role in acute health care settings. It is remarkable that despite government legislationand research, which stretches back over 20 years in both Europe and North America, discharge planning remains problematic. Furthermore, it is an activity that requires collaboration between health and social care agencies. In the United Kingdom there is a new emphasis and incentive on managing acute hospital beds, which in turn results in shorter stays in hospital. In London, discharge planners face additional problems because of social, economic and environmental factors. Method.  Using a case study design, 19 nurses were interviewed using the critical incident approach to obtain their perceptions of the discharge process. Direct observation was conducted to record interactions between nurses and health care professionals in multidisciplinary teams. In total 14 meetings were attended in elder care and orthopaedics and 7 in acute medicine. Findings.  Aspects of the discharge process were often ignored or neglected and assessments were rarely co‐ordinated. The nursing ward handover was regarded as a process that hindered communication. Lack of time was reported to be the biggest barrier that affected interprofessional working and hence the co‐ordination of assessments. Conclusion.  The findings have important implications for nurses, managers and educational establishments. It is essential that social and medical diagnoses run parallel and that accurate information is collated and communicated within the multidisciplinary team. Further research into the impact of time pressures on communication, interprofessional working and the discharge process is needed.
Predictors of job satisfaction and absenteeism in two samples of Hong Kong nurses*
Authors: Siu Oi‐ling 
Published: March 2003

Background.  Stress‐related outcomes of job satisfaction and absenteeism among nurses should receive more attention in Hong Kong because absenteeism is costly. Many nurses' complaints are due to organizational change in privatization since the establishment of the Hong Kong Hospital Authority in 1991. Organizational climate is found to be an antecedent of job dissatisfaction and absenteeism in many studies in western societies. Aim.   To investigate the role of organizational climate and psychological distress on job satisfaction; and the role of climate, distress and job satisfaction on absenteeism in Hong Kong nurses, while controlling for demographic variables. Methods.  A self‐administered questionnaire survey method was used to collect data from two samples of nurses within a 8‐month period. They are, respectively, 144 (74 general nurses, 70 psychiatric nurses; 47 males, 97 females) and 114 (85 general nurses, 29 psychiatric nurses; 17 males, 97 females) nurses. Results.  Multiple regression analyses revealed that occupational type (psychiatric/general), environment (the physical conditions in the work area) and psychological distress were significant predictors of job satisfaction for sample 1; and well‐being (social relations, welfare and health issues) was the only significant predictor of job satisfaction for sample 2. However, age, involvement (the degree of commitment displayed towards employees by the organization), psychological distress and job satisfaction were significant predictors of absenteeism for sample 1; and occupational type, organization (the interaction between the worker and the organization), and involvement were significant predictors of absenteeism for sample 2. Conclusions.  The empirical findings provide support for the climate–job satisfaction and climate–absenteeism relationships. Psychological distress could be an antecedent of job satisfaction; and job satisfaction could be an antecedent of absenteeism. Certain climate dimensions should be improved to enhance job satisfaction and reduce distress, which in turn will reduce absenteeism.
Cadets and nursing students: same destination – different route
Authors: Draper Jan , Watson Roger 
Published: March 2003

Background.  In response to the policy initiatives in England to secure recruitment and retention in the nursing and midwifery professions, strategies to improve and extend access to preregistration education and training in England have been developed. The relatively recent development of modern cadet schemes is an example of such a strategy. Despite the increasing interest in and proliferation of cadet schemes, there is as yet little evidence for their effectiveness. Reporting on an evaluation of a scheme in England, this paper makes some contribution to this evidence. Aims and objectives.  The project explored former nurse cadets' experiences of the cadet scheme 9 months after their transition to nurse education. The aims of the project were to evaluate the extent to which former cadets and university staff considered the scheme to prepare students effectively for access to university nurse education. Methods.  The first cohort of former cadets entered nurse education in September 2000. After 9 months they were invited to contribute to an evaluation of the cadet scheme and their present experience. The evaluation consisted of a structured questionnaire sent to all the former cadets, a focus group interview with the former cadets, informal discussions with university staff and brief documentary analysis. Conclusion.  Tensions were apparent between the worlds of education and clinical practice: the cadets felt better prepared clinically than academically and found an element of repetition in the nursing programme. They valued their preparation, which they felt put them at an advantage over other nursing students. However, some of them experienced difficulties in the transition to higher education and further review is therefore required to establish the success of cadet schemes.
In the field: notes on observation in qualitative research
Authors: Mulhall Anne 
Published: March 2003

Background.  Observation is used in research in two ways – structured and unstructured. Which of these methods to choose depends on the research question but will be defined predominantly by the paradigm underlying each study. Positivistic research generally uses structured observation and interpretist/naturalistic paradigms use unstructured observation. This paper is concerned with unstructured observation. Aim.  To discuss the importance of unstructured observation as a research method and to examine critically the problems associated with both access and field notes. Application to nursing.  Although unstructured observation has been used in nursing research, it is less favoured than the interview. Furthermore, although some of the dilemmas concerned with observation such as the role of the researcher, covert research and informed consent have received attention in the nursing literature, other aspects remain relatively unexplored. In particular little has been written concerning access to the field and field notes. Both of these aspects have practical and theoretical considerations that require the attention of the researcher. This omission may partly explain nurses' apparent reluctance to use unstructured observation in their studies. This paper seeks to redress this situation.
Supporting carers of people diagnosed with schizophrenia: evaluating change in nursing practice following training
Authors: Gall Sheena H. , Atkinson Jacqueline , Elliott Lawrence , Johansen Ron 
Published: March 2003

Background.  United Kingdom legislation and clinical standards for schizophrenia challenge nurses to re‐examine the support that they provide to carers. Nurses are in a key position to provide this support but may lack the necessary skills to do so. The training programme evaluated in the present study aimed to address this problem. Study aim.  To evaluate change in clinical practice brought about by post‐registration training for mental health nurses in supporting carers of people diagnosed with schizophrenia. Design/methods.  The study was undertaken in collaboration between the Universities of Dundee and Glasgow, and Tayside National Health Service (NHS) Trust (Scotland). Respondents were nine nurses who completed training and then delivered a planned programme of support to carers. Data on nursing practice were gathered through semi‐structured interviews with nurses before training and after providing support. Following the support intervention, carers also commented on the nurses' practice. Findings.  Eight of the nine nurses reported changes in practice in five key areas: They built collaborative relationships with carers, developed a carer focused approach to their practice, acknowledged and supported the carer role, and made progress in identifying carer needs and accessing resources to meet these needs. Nurses experienced difficulties supporting carers who had mental health problems or previous negative experiences of services. Those who lacked community experience also found it difficult to adjust to working in a community setting. Although clinical supervision helped them to work through these difficulties, they remain largely unresolved. Conclusions.  Findings from this study indicate that appropriate training may enable nurses to improve the support provided to carers of people diagnosed with schizophrenia. This study represents an important stage in determining the nature of support offered to carers by nurses. While developed to help nurses to meet clinical standards set for schizophrenia in the UK, findings may have clinical significance for nurses in other countries.
A positive relationship between local abundance and regional occupancy is almost inevitable (but not all positive relationships are the same)
Authors: HARTLEY STEPHEN 
Published: March 2003

Summary

Recent attempts to examine the role of different mechanisms in generating a positive abundance‐occupancy relationship failed to properly distinguish between Brown's (1984) sampling artefact, and the form of relationship to be expected from a random distribution of individuals.
Because random distributions generate a positive relationship, one can never predict that removing the influence of some or all of the mechanisms will lead to ‘no relationship’.
In considering how the spatial aggregation of individuals might influence the form of the abundance‐occupancy relationship it is demonstrated that curvilinear and triangular relationships are expected, and that correlation coefficients and linear regression statistics are unlikely to be sensitive to the addition and removal of mechanisms.
Examining distributional data with alternative indices of spatial structure may lead to a more intuitive understanding of how different mechanisms influence the form of abundance‐occupancy relationships.
The adjustment of reproductive threshold to prey abundance in a capital breeder
Authors: Madsen Thomas , Shine Richard 
Published: March 2003

1. Many organisms rely upon stored energy reserves to support reproduction and do not initiate breeding until their reserves exceed some ‘reproductive threshold’. However, the determinants of such thresholds are poorly understood; for example, we do not know if they are fixed (invariant) or respond dynamically to fluctuations in resource availability. 2. An 8‐year field study on water pythons (Liasis fuscus Peters 1873) in tropical Australia shows that individual female pythons adjust their reproductive thresholds in response to annual variation in prey abundance. 3. In every year of the study, female pythons that reproduced were in better condition (mass relative to body length) than non‐reproductive females. However, in years with low abundance of rats, female pythons reproduced despite being in relatively poor condition. Indeed, the mean condition of reproductive pythons in one particularly ‘bad’ year was as low as the mean condition of non‐reproductive females in a ‘good’ year. 4. Clutch sizes were slightly reduced in a ‘bad’ year, but the main effect of the lowered threshold was greater emaciation of the females after laying. 5. Recapture records of marked snakes show that the annual variation in thresholds is due to flexibility of individual females, not to differential representation of cohorts with different reproductive thresholds. 6. The dynamic adjustment of threshold levels fits well with predictions from life‐history models and is likely to be a widespread phenomenon.
The foraging performance of great and blue tits (Parus major and P. caeruleus) in relation to caterpillar development, and its consequences for nestling growth and fledging weight
Authors: Naef‐Daenzer Beat , Keller Lukas F. 
Published: March 2003

1. We analysed the effect of prey density and size on the foraging performance of great and blue tit (Parus major L., P. caeruleus L.) parents, and its consequences for the growth and fledging weight of nestlings. Because fledging weight is a determinant of subsequent survival and therefore fitness, foraging decisions of the parents play a key role in the reproductive system of tits. The analysis quantifies (i) the rate at which energy is delivered to the nestlings in relation to prey size and abundance, and (ii) the growth rates of nestlings and the resulting fledging weight in relation to the rate of food delivery by the parents. 2. The searching time per prey item increased exponentially with decreasing prey biomass. During the peak abundance of caterpillars, the average searching time per item was 2·5–3 min instead of 5–6 min before and after the peak. Searching time was significantly reduced when the birds returned to the foraging site where the preceding prey was found. This accords with the clumped distribution of caterpillars within the canopy. 3. The foraging performance (in mg caterpillars per min) was maximal when caterpillars were both abundant and large, i.e. shortly before they left the trees for pupation. The high feeding frequency and the large prey then caused a peak energy flow rate to the nestlings of 4–5 times the rate before or after the caterpillar peak. This suggests that the foraging success and rate of food delivery by tit parents was primarily determined by the abundance and size of prey. 4. The growth rate of nestlings, as well as their fledging weight was correlated with the rate of food delivery. Low feeding performance of the parents resulted therefore in poor relative growth rates of only 0·3–0·6 of the rate achieved under optimal conditions and, as a consequence, in a low fledging weight. This indicates that tit parents have restricted options to adjust prey delivery rates according to the requirements of the brood. 5. The results give insight into the chain of causal mechanisms through which an environmental factor (availability of food) has a strong and immediate effect on fitness (growth, fledging weight and, thus, survival of the nestlings). The importance of caterpillar size for foraging success and prey delivery rates of parent tits makes clear, why the phase of best foraging conditions is shorter than the period during which caterpillars are available. The relationships we quantified give a proximate explanation for the great effects that temperature and caterpillar growth have on the between‐year variation in selection intensity for laying date observed in other studies.