bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the duration of postnatal stay influence breast‐feeding rates at one month in women giving birth for the first time? A randomized control trial
Authors: Winterburn Susan , Fraser Robert 
Published: March 2003

Does the duration of postnatal stay influence breast‐feeding rates at one month in women giving birth for the first time? A randomized control trial The aim of the study reported in this paper was to examine the effect of postnatal stay on breast‐feeding rates at one month using a randomized control trial. Participants were recruited during parentcraft classes at a large teaching hospital in the north of England. Nulliparous women in the last trimester of pregnancy were randomly allocated to a short hospital postnatal stay (6–48 hours), or a longer stay (more than 48 hours). The mothers were contacted at one month following the birth to ask about the method of feeding. The study was approved by the hospital ethical committee, and participation was voluntary. The results demonstrated no significant effect of postnatal stay on breast‐feeding rates at one month. The main limitation of the study was the reluctance of the mothers in the long stay group to stay in hospital for longer than three days. This resulted in only a small difference between the lengths of hospital stay of the two interventions. The overall breast‐feeding rate for the study group had increased significantly when compared with local city wide rates. This increase may be as a result of a sampling bias or a Hawthorne effect.
The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand
Authors: Thassri Jeranoun , Kala Napaporn , Chusintong Ladda , Phongthanasarn Julianna , Boonsrirat Salee , Jirojwong Sansnee 
Published: March 2003

The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand The maternal mortality rate (MMR) in Thailand is higher than neighbouring developing countries including Malaysia and Singapore. The 1993 MMR of Thailand was 249 per 100 000 livebirths which was four times higher than the rates in Malaysia and Singapore (World Health Organization 1995). The major causes of these deaths were haemorrhage, toxaemia of pregnancy and sepsis which were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poor health. Between 1994 and 1995, a national study conducted by Thailand Ministry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another study conducted in the southern region also indicated that 13·8% of pregnant women were anaemic caused by iron deficiency (Phatthanapreechakulet al. 1997). Other behaviours which increased risks associated with child birth included non‐antenatal care (ANC) attendance, undertaking physically demanding tasks and failure to increase nutritional intake during their pregnancy period (N. Phiriyanuphong et al. 1992, unpublished report). These factors emphasize the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy which would reduce complications from their poor health status. This study was conducted in a regional hospital in Thailand where there was no systematic and well‐planned health education programme for pregnant women. The initial aim was to design a health education programme using input from the hospital health care professionals including obstetricians, nurses, nutritionists, health educators and health promoters. An active involvement of these personnel assisted to sustain the provision of the programme provided for pregnant women after the cessation of the study project. Another aim of the study was to evaluate the outcomes of the programme using a pre‐test–post‐test method among selected pregnant women who participated in the newly designed health education programme.
Advancing the science of symptom management
Authors: Dodd Marylin , Janson Susan , Facione Noreen , Faucett Julia , Froelicher Erika S. , Humphreys Janice , Lee Kathryn , Miaskowski Christine , Puntillo Kathleen , Rankin Sally , Taylor Diana 
Published: March 2003

Advancing the science of symptom management Abstract. Since the publication of the original Symptom Management Model (Larson et al. 1994), faculty and students at the University of California, San Francisco (UCSF) School of Nursing Centre for System Management have tested this model in research studies and expanded the model through collegial discussions and seminars. Aim. In this paper, we describe the evidence‐based revised conceptual model, the three dimensions of the model, and the areas where further research is needed. Background/Rationale. The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home‐care settings because few models of symptom management have been tested empirically.To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly‐based symptom management model allows the integration of science from other fields.
Continuous video recording: a new clinical research tool for studying the nursing care of cancer patients
Authors: Andersen Christina , Adamsen Lis 
Published: March 2003

Continuous video recording: a new clinical research tool for studying the nursing care of cancer patients Aim. The aim of this study was to clarify issues around the patient–nurse interaction during pulsed dose rate (PDR) brachytherapy. Background. Cancer diagnosis, response and survival rates as well as the side‐effects of radiation therapy are well described in international literature. However, no scientific data apparently exist on the reactions and behaviour of cancer patients during stressful irradiation treatments nor on nursing performance in these situations. The study involved gynaecological and anal cancer patients. Treatment needles (10–20 cm) were implanted in the tumours of these patients during the PDR brachytherapy. This treatment was administered during a 15–30‐minute period each hour, for a duration of 30–60 hours. Patients were partially isolated and immobilized, and typically positioned on the back or side. In preparation for the therapy, patients had to fast and drink sparingly. Observation and nursing care could only be performed during pauses in the treatment. Method. This paper is based on 142 hours of continuous video recording of patients undergoing PDR brachytherapy. Data were collected on five patients and 17 nurses. Findings. The study shows that nurses were with patients for approximately 1/4 of the available time. The majority (75%) of any communication with patients centred around physical care. Although patients were in a stressful situation, they did not anticipate receiving any psychological support from nursing staff. Patients showed individual patterns of behaviour and coping. Conclusions. Continuous video recording, as a research tool can document accurately interaction and behaviour between cancer patients and nursing staff. Video recording discloses examples of both eminent and negligent nursing care and as such can be a useful tool for instruction and for future research. The credibility, validity and limitations of using video recording are discussed.
The nurse – a resource in hypertension care
Authors: Aminoff Ulla Britt , Kjellgren Karin I. 
Published: March 2003

The nurse – a resource in hypertension care Aim of the study. To explore the content and structure of communication between patient and nurse at follow‐up appointments concerning hypertension. Background. Hypertension is a chronic condition and calls for co‐operation between health care providers and patients over a long period of time. One important purpose of the follow‐up consultations is to transfer knowledge between patients and health care providers in order to empower patients. This is an important determinant of the quality of care. Design/methods. The study was based on 20 audio‐recordings of actual follow‐up appointments and was approved by ethics committees. The consultations took place at four different health care units for hypertensive patients. Findings. The average length of consultations was 18 minutes. In the consultations, patients initiated an average of eight new topics and nurses an average of 20. All nurses talked with patients about life style. Compared with previous studies of follow‐ups with physicians, consultations with nurses addressed lifestyle factors and adherence to treatment to a higher degree. It was also observed that patients were more actively involved in interaction with nurses compared with the follow‐ups with physicians. Conclusions. Active patient participation in care is a critical factor in improving adherence to treatment. It would be of value to develop and assess a more patient‐centred organization of hypertension care and thereby more individualized hypertension treatment. Nurses may have a pivot role in such care.
Cohesion among nurses: a comparison of bedside vs. charge nurses’ perceptions in Australian hospitals
Authors: Chaboyer Wendy , Najman Jake , Dunn Sandra 
Published: March 2003

Cohesion among nurses: a comparison of bedside vs. charge nurses’ perceptions in Australian hospitals Aim. This study examines the extent to which hospital nurses view their working environment in a positive sense, working as a cohesive group. Background. Despite the fact that nursing in Australia is now considered a profession, it has been claimed that nurses are an oppressed group who use horizontal violence, bullying and aggression in their interactions with one and other. Methods. After ethical approval, a random sample of 666 nurses working directly with patients and all 333 critical care nurses employed in three large tertiary Australian hospitals were invited to participate in the study in the late 1990s. A mailed survey examined the perceptions of interaction nurses had with each other. The hypothesis, that level of employment (either Level I bedside nurses or Level II/III clinical leaders) and area of work (either critical care or noncritical care) would influence perceptions of cohesion, as measured by the cohesion amongst nurses scale (CANS) was tested. Results. In total 555 (56%) surveys were returned. Of these, 413 were returned by Level I and 142 by Level II/III nurses. Of this sample, 189 were critical care and 355 noncritical care nurses. There was no difference between Level I and II/III nurses in mean CANS scores. It is interesting to note that the item rated most positively was ‘nurses on the units worked well together’, however, the item rated least positive was ‘staff can be really bitchy towards each other’ for both Level I and II/III nurses. There was no difference in CANS scores between critical care and noncritical care nurses. Conclusions. Nurses working in Australian hospitals perceived themselves to be moderately cohesive but, as would be expected in other work settings, some negative perceptions existed.
Re‐thinking representations, re‐writing nursing texts: possibilities through feminist and Foucauldian thought
Authors: Huntington Annette D. , Gilmour Jean A. 
Published: March 2003

Re‐thinking representations, re‐writing nursing texts: possibilities through feminist and Foucauldian thought Focus. Critical approaches are increasingly being used to inform theory and research within the discipline of nursing. In this paper we discuss the work of feminist writers, particularly those located within the postmodern, and Michel Foucault. Their work, although having significant points of difference, can be viewed as complementary and our engagement with these ideas has led us to re‐think nursing knowledge. Rationale. Using ideas from Foucault and postmodern feminism foregrounds critical questions such as whose knowledge is visible in nursing literature, whose is suppressed, and the power relationships reflected in representations of knowledge. Our exploration of representations of knowledge has led us to review fundamental nursing texts that we consider to be important political and ideological artefacts in the enculturation of student nurses. The dominant position of medical knowledge in the texts reviewed continues to position this ‘voice’ as primary in nursing literature. Discussion. Drawing on our current research on endometriosis to illustrate the potential inherent in rewriting such texts, we argue for a repositioning of knowledge related to the illness experience. Privileging the voices of people who are the focus of our clinical care reflects the reality of nurses’ work; the embodied experience of the person is made visible rather than marginalized in the illness discourse.
Nursing research in Spain: bibliometrics of references of research papers in the decade 1985–1994
Authors: Pardo Carmen , Reolid María , Delicado María‐Victoria , Mallebrera Elena , García‐Meseguer María‐José 
Published: March 2003

Nursing research in Spain: bibliometrics of references of research papers in the decade 1985–1994 Background. Spain is one of the few European countries to have recently totally incorporated the study of nursing into the university sector. Bibliometric studies may be of a great help for the consolidation of nursing research. Aim of the study. The aim of this paper is to describe bibliographic references in Spanish nursing research papers and their evolution over a decade. Method. The method consists of a retrospective bibliometric study of a sample (cluster sampling) of 622 research papers (original papers and review papers), which were contained in the Spanish nursing journals Enfermería Científica, Revista ROL de Enfermería, Enfermería Clínica and Enfermería Integral, and published from 1985 to 1994. The journal Nursing Research was selected for qualitative comparative purposes. A series of classic bibliometric indexes were used. Results. The mean of references per paper is 10·64 ± 10·42; this increased over time (P < 0·001). Review papers have more references (P < 0·001). Price index (percentage of references published during the last 5 years) is 44% and the Insularity (percentage of references published in same country as the article) is 55%. References to journals predominate (58·6%), with a growing tendency for references to Spanish nursing journals, although they are still scarce (18·1% of the references to journals). Spanish is the language of most of the references (60·3%), the second language being English (36·1%). Conclusions. Bibliographic references in Spanish nursing research papers are scarce and not very specific: this happens both in regard to Nursing Research and to publications in other national and international science areas. However, there is an increasing tendency of references (including references to nursing journals) in the period analysed. The age of the references places Spanish nursing in an intermediate position between the ‘hard’ sciences and the humanities; and, according to the type of documentation used, we find it halfway between experimental and natural sciences, and technologies and social sciences. There has been a slight increase in references in English in recent years.
Traditional healing in Likorrahi in the early 20th century
Authors: Tsiou Chryssoula 
Published: March 2003

Traditional healing in Likorrahi in the early 20th century Aim. The aim of this study is to record empirical data and views regarding health, illness, healing, hygiene, prevention and birth in a rural society at the beginning of the 20th century. Background. Likorrahi was a small Greek village in the region of Epirus that was abandoned during the 1970s. Epirus is a rural and mountainous area. Design. The research was conducted 10 years ago among former inhabitants of the community of Likorrahi. The informants were 33 Likorrahites over the age of 60. The research method which was used was that of ethnographic interviews focusing on general health issues. Findings. The findings show that in the early 20th century different doctors, nurses and midwives offered their health care services free to the Likorrahites. There were few doctors, there was no medicine and science knew little of disease. Conclusions. This study has historical value for nurses and other health professionals. It will also be of interest to anthropologists, ethnographers and students of rural history.
The impact of assessing the prevalence of pressure ulcers on the willingness of health care institutions to plan and implement activities to reduce the prevalence
Authors: Halfens Ruud J.G. , Bours Gerrie J.J.W. , Bronner Claudia M. 
Published: March 2003

The impact of assessing the prevalence of pressure ulcers on the willingness of health care institutions to plan and implement activities to reduce the prevalence Background. In 1998, 89 health care institutions (hospitals, nursing homes, residential homes, and community care institutions) participated in the first Dutch National Pressure Ulcer Prevalence Study. Aim. Based on the innovation–decision process for individuals (Rogers 1995), the effect of their participation was investigated at different levels in the institutions [prevalence assessment coordinator, director, ward management (enrolled) nurses, and the pressure ulcer committee]. Method. A mail questionnaire was developed and filled out by 54 coordinators of the participating health care institutions. Results. Results showed that according to the coordinators most levels of the institutions were familiar with the results of the prevalence assessment, understood them, and were persuaded that their prevalence rate had to be changed. As a result, almost all of the coordinators of the institutions were planning activities to change pressure ulcer management, while half of the coordinators had already implemented some actions. The main activities planned or implemented were developing or updating the prevention and treatment protocol and educating the (enrolled) nurses. Some institutions were planning or had already implemented the appointment of a nurse specialist or a nurse paying special attention to pressure ulcers. Results showed that the different levels of the institutions took initiatives on different categories of activities. Conclusion. It is concluded that participating in the first national prevalence study was a positive experience for the institutions, because agenda‐setting took place and most started to plan or implement activities to improve the prevention and treatment of pressure ulcers.
Infant feeding responsiveness: a conceptual analysis
Authors: Mentro Anne M. , Steward Deborah K. , Garvin Bonnie J. 
Published: March 2003

Infant feeding responsiveness: a conceptual analysis Background. The phenomenon of infant responsiveness to the caregiver during feeding interactions has been of interest to researchers for many years, because of its associated implications for child growth and development. Although many studies have examined feeding responsiveness in caregiver–infant dyads, it is infrequently and inconsistently defined in the literature. Specific Aims. The purpose of this paper is to clarify the concept of infant feeding responsiveness through the provision of a working definition of the concept for further study and usage. Methods. Medline, CINAHL, and PschInfo databases from the year 1970 to the present were searched for English articles containing the keywords ‘infant’, ‘feeding’, ‘responsiveness’, ‘synchrony’, and/or ‘interaction’. Articles were selected for inclusion according to whether or not the phenomenon of infant feeding responsiveness was defined or assessed. Walker and Avant’s (1995) method for concept analysis was employed for the development of defining attributes, case examples, antecedents, and consequences for further clarification of the concept of infant feeding responsiveness. Findings. Infant feeding responsiveness was defined as the manifestation of physiologically influenced visual, expressive, vocal and motor reactive behaviours expressed by an infant in reaction to a caregiver’s feeding attempts, indicating a readiness to feed. Conclusions. Implications for nursing are explored as well as the need for refinement of measures of this concept.
`Great fleas have little fleas': Irish student midwives' views of the hierarchy in midwifery
Authors: Begley Cecily M. 
Published: March 2003

`Great fleas have little fleas': Irish student midwives' views of the hierarchy in midwifery Background. Many studies have investigated the world of the student nurse, but there is little work into the lives and experiences of student midwives. Studies of Irish midwives' provision of care have demonstrated that they are not fulfilling their complete role, and research into their education was deemed to be necessary. Aim. To explore the opinions, feelings and views of student midwives as they progressed through their 2‐year education programme in Ireland. Methods. Both quantitative and qualitative methods were used and the qualitative sections of the study were guided by the phenomenological approach. Ethical approval was granted. All students in the first intake of 1995 in all seven midwifery schools in Southern Ireland agreed to take part (n=125). Individual and group interviews, diary‐keeping and questionnaires collected data. Results. The findings presented in this paper describe the students' views of the hierarchical structures in midwifery, and the role and behaviours of the `Matron'. The data describes a subculture of nursing/midwifery subordination. Discussion. One reason for the hierarchical nature of the midwifery profession may be because it is an almost totally female‐dominated profession, with the female hierarchy exercising control over other women within a male‐based power structure. Many hospitals preferred to employ their own students as staff, ensuring a continuation of the hierarchical regime. Conclusion. The recurring nature of this problem may be because midwives now fear change more than they desire it. Further research is required to ascertain whether the reason for the strong hierarchy is because of the continuation of midwifery from the male‐dominated profession of nursing, to the existence of the industrial/economic model of maternity care or to the impact of the medicalization of childbirth.