bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards recovery: living in a home‐like setting after the move from a hospital ward
Authors: Pejlert Anita , Asplund Kenneth , Norberg Astrid 
Published: March 2003

• Six clients with a diagnosis of schizophrenia were interviewed about their experiences of their lives in a home‐like setting, their key care provider and the care received.• Their narratives of lived experiences in care were interpreted as living a process of health in the midst of severe mental illness, involving: ‘becoming more’, ‘being disabled’, ‘comforting/confirming relationship’, ‘discomforting/unconfirming relationship’ and ‘caring about the caring relationship’.• Fatigue and lack of strength influenced the lives of most clients considerably, and the stories were about problems and conflicts. Nevertheless, the clients seemed really to struggle to make communal life work, and there were experiences of increased competence and better self‐confidence in most of the stories.• On the whole care was described as good, and the process of health seemed to be supported by experiences of comfort and being confirmed in the client–care provider relationship.
Unwillingness to be violated: carers’ experiences of caring for a person acting in a disturbing manner. An interview study
Authors: Hellzen Ove , Asplund Kenneth , Sandman Per‐Olof , Norberg Astrid 
Published: March 2003

• Carers working in psychiatric care are sometimes exposed to insane, unpredictable and violent actions. In rare cases a patient appears to be resistant to all forms of pharmacological treatment.• Fifteen carers (four registered nurses, 11 enrolled nurses) on a psychiatric ward in Sweden were interviewed about their experiences when caring for a person who acted in a disturbing manner. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur.• Four themes were formulated which describe the carers’ uncertainty about the future, their inability to interpret the patient’s disturbing behaviour and their own overall feeling of meaninglessness.• The carers were of the opinion that the patient had the power and ruled the ward, which led to them feeling they were subjugated victims. The interviews also revealed the carers’ recognition of forbidden feelings and actions and unknown negative sides.• These results were interpreted and reflected on in the light of an ethical framework in order to achieve a deeper understanding of the text.• This paper shows that an ethical perspective is important when searching for the meaning of caring for patients acting in a disturbing manner. The study raises the question: ‘Is it possible to establish good when evil has dominion?’.
Waiting for a liver transplant: the experience of patients with familial amyloidotic polyneuropathy
Authors: Jonsén Elisabeth , Athlin Elsy , Suhr Ole B. 
Published: March 2003

• Liver transplant is a new treatment for familial amyloidotic polyneuropathy.• The purpose of this phenomenological study is to describe the experience of waiting for a liver transplant from the familial amyloidotic polyneuropathy patients’ perspective.• Unstructured and open‐ended interviews were conducted with 14 familial amyloidotic polyneuropathy patients and the analysis of data was inspired by Colaizzi’s method.• Waiting was found to involve two theme categories: waiting for a decision; and waiting for the operation. Seven themes were identified: bargaining with oneself; no influence/powerlessness; relief and joy; impatience; agony; time to prepare; and need for information and support.• Implications for nursing practice, such as informational and emotional support, are discussed.
Older people and laxative use: literature review and pilot study report
Authors: Koch Tina , Hudson Sally 
Published: March 2003

• This study explored older adults’ perceptions of constipation, and the measures taken if they believed themselves to be afflicted by this condition.• The paper provides an overview of the current literature surrounding laxative use, followed by a discussion of the pilot study and its findings.• The objectives of the pilot study were to establish older people’s definitions of the term ‘constipation’; identify prescribed laxatives, over‐the‐counter laxatives, and home remedies used by older people to manage constipation; produce a detailed account of when these products are used; identify the older person’s belief system underpinning their concepts of constipation, and their consequent use of laxative products; and produce information which will inform nursing practice, with a particular focus on nurses in community practice.• People who identified themselves as being constipated were interviewed on a one to one basis.• Participants shared their stories of loneliness, social isolation and anxiety related to constipation and the need to use laxatives on a daily basis, and described persistent unpleasant and often painful physical symptoms such as bloating, urges, excessive flatus, nausea and cramps, commonly associated with laxative ingestion.• Nurses are challenged to work with older people within a ‘wellness’ framework, helping clients to maintain their bowel function, rather than fall back on short‐term options, which provide only brief relief of symptoms, while ignoring the underlying causes.
Updating cardiopulmonary resuscitation skills: a study to examine the efficacy of self‐instruction on nurses’ competence
Authors: Davies Nigel , Gould Dinah 
Published: March 2003

• Nurses’ competence in cardiopulmonary resuscitation (CPR) has been shown to be consistently poor over the past decade. Studies have suggested that CPR teaching methods need to be evaluated and refined in order to improve practice. Self‐instruction has been suggested as one alternative to formal retraining programmes, but has not been evaluated with respect to nurses in the UK.• A quasi‐experimental design utilizing random allocation of matched subjects to one experimental and two control groups was adopted with a sample of 20 undergraduate nursing students. The subjects’ CPR ability was assessed concurrently using a resuscitation manikin and an observational checklist.• Subjects undertaking self‐instruction produced significantly (P < 0.05) higher ability scores than those who did not participate in retraining. The time spent in self‐instruction was evaluated positively by the students.• The results are discussed in the light of previous research and current recommendations for regular CPR updating by all clinical nurses.
Cancer nursing practice development: understanding breathlessness
Authors: Krishnasamy Meinir , Corner Jessica , Bredin Mary , Plant Hilary , Bailey Chris 
Published: March 2003

•  This paper considers methodological and philosophical issues that arose during a multi‐centre, randomized controlled trial of a new nursing intervention to manage breathlessness with patients with primary lung cancer.•  Despite including a diverse range of instruments to measure the effects of the intervention, the uniqueness of individuals’ experiences of breathlessness were often hidden by a requirement to frame the study within a reductionist research approach.•  Evidence from the study suggests that breathlessness is only partly defined when understood and explored within a bio‐medical framework, and that effective therapy can only be achieved once the nature and impact of breathlessness have been understood from the perspective of the individual experiencing it.•  We conclude that to work therapeutically we need to know how patients interpret their illness and its resultant problems and that this demands methodological creativity.
Staff activities and behaviour are the source of many feelings: relatives’ interactions and relationships with staff in nursing homes
Authors: Hertzberg Annika , Ekman Sirkka‐Liisa , Axelsson Karin 
Published: March 2003

• Family members do not give up their involvement in the life of their older relatives when they move to an institution.• Relatives feel that it is they who take the initiative to establish a working relationship with the staff at the nursing home.• Relatives want more spontaneous information from staff, particularly about residents’ daily lives, and there is a need for relatives to have opportunities to talk with staff under relaxed conditions.• Staff behaviour and activities towards residents and relatives are a source of many feelings for relatives.• Relatives’ understandings of the challenges faced by staff are not communicated to staff, nor are positive or negative experiences explicitly passed on to staff.
Is good ‘quality of life’ possible at the end of life? An explorative study of the experiences of a group of cancer patients in two different care cultures INFORMATION POINT: Factor analysis
Authors: Sahlberg‐Blom Eva , Ternestedt Britt‐Marie , Johansson Jan‐Erik 
Published: March 2003

• The purpose of this paper was to explore how a group of gravely ill patients, cared for in different care cultures, assessed their quality of life during their last month of life.• The study material comprised quality of life assessments from 47 cancer patients, completed during their last month of life. Two quality of life questionnaires, the EORTC QLQ‐C30 and a psychosocial well‐being questionnaire, were used. The data were treated in accordance with instructions for the respective questionnaires, and the results are presented primarily as means, mostly at the group level. Assessments from patients in two different care cultures, care‐orientated and cure‐orientated, were compared.• The results show that despite having an assessed lower quality of life in many dimensions than people in general, several patients experienced happiness and satisfaction during their last month of life.• ‘Cognitive functioning’ and ‘emotional functioning’ were the dimensions that differed least from those of the general population, and ‘physical functioning’, ‘role functioning’ and ‘global health status/quality of life’ differed the most. ‘Fatigue’ showed the highest mean for the symptom scales/items.• There was a tendency for those cared for in the cure‐orientated care culture to report more symptoms than those in the care‐orientated care culture. An exception to this was ‘pain’, which was reported more often by those in the care‐orientated care culture.• The implications of the results are discussed from different angles. The significance of knowledge concerning how patients experience their quality of life is also discussed with respect to the care and the planning of care for dying patients.
Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data INFORMATION POINT: Visual Analogue Scale
Authors: Gould Dinah , Kelly Daniel , Goldstone Len , Gammon John 
Published: March 2003

• Simulations are of particular advantage in research studies where large samples are necessary to achieve statistical power and the information must be collected under uniform conditions in order to aid interpretation.• In the study reported below, simulation was achieved through the use of medical photography accompanied by case studies of the same patients. All information was collected on the same day. The purpose of the study was to determine the validity of the three pressure ulcer risk assessment scales most commonly used in clinical nursing practice in the UK.• Each clinical nurse assessed the same four patients using three risk assessment scales and a visual analogue scale designed to capture their own clinical judgement. External validity was assessed by a panel of tissue viability experts who provided independent ratings.• Data were obtained from 236 clinical nurses, yielding 941 risk assessments.• Experience with this approach to data collection suggests that it requires careful planning. This should include measures to ensure that the simulated information is valid and that all data collectors have been adequately trained and are able to motivate the nurses participating in the study. Providing consideration is given to these issues, the use of simulation can help to collect data that would be difficult to obtain by more conventional means. It is also important to recognize that clinical decisions are de‐contextualized in simulations because they are reduced to verbal and visual summaries. The decision to use simulations should thus be taken only if this is acknowledged.
Families, nurses and intensive care patients: a review of the literature
Authors: HOLDEN JANET , HARRISON LYNNE , JOHNSON MARTIN 
Published: March 2003

• Nurses striving to give holistic care to provide quality care for their patients, need to recognize the importance of caring for patients' families.• A detailed review of the literature examining the relationships between nurses and intensive care patients' families was undertaken to examine its strengths and weaknesses as a basis for further study.• Studies show that although nurses are often in the best position to meet families' needs, their needs are not always met.• The building of good relationships with families is essential for nurses, and yet evidence shows that some nurses have difficulties in this area.• Good practice is identified and obstacles nurses face in forming relationships with families are explored.• Strategies for improving the interaction process between intensive care nurses and patients' families are systematically evaluated.
Investigating the effect of erectile dysfunction on the lives of men: a qualitative research study
Authors: PONTIN DAVID , PORTER TIM , Mc DONAGH RURAIDH 
Published: March 2003

• The aim of this project was to identify and explore the issues facing men who live with erectile dysfunction (ED), in particular men's' relationships with women partners and men's interactions with the wider world.• In order to gain an understanding of their everyday lives, a qualitative research design was used. This is an account of the interpretation and analysis of nine interviews with men living with ED that were carried out during the autumn of 1997.• The analysis identified two main themes, `loss' and `being alone with it'; with meta‐categories `making sense of it' and `telling other people', and `place of sex'. The latter acts as a bridge between the two themes.• The implications for nursing practice are considered and recommendations are made for practice, education and research.
The effect of visual stimuli on pain threshold and tolerance
Authors: TSE MIMI M. Y. , NG JACOBUS K. F. , CHUNG JOANNE W. Y. , WONG THOMAS K. S. 
Published: March 2003

• For many hospital patients, the experience brings pain and anxiety. Unfamiliar surroundings, various diagnostic and therapeutic procedures, and the sight and sounds of medical procedures exacerbate pain and anxiety.• To block off the anxiety‐inducing sights and sounds of hospital surroundings and create a pleasing environment, the therapeutic potential of visual stimulation as a nursing intervention was investigated.• In a randomized, controlled, cross‐over study, pain was produced by a modified tourniquet technique in 46 healthy volunteers. Subjects were randomly allocated to two groups (Group V and Group B) with subsequent cross‐over. Those in Group V watched a soundless video display of natural scenery during tourniquet inflation, whereas in Group B subjects watched a static blank screen.• Pain threshold was defined as the time when subjects reported the first detectable pain, whereas pain tolerance was the time the pain was reported to be intolerable and deflation of the tourniquet was requested.• With the use of visual stimuli, there was a significant increase in pain threshold (P < 0.05) and pain tolerance (P < 0.01). Gender and the sequence of visual stimuli did not have any significant effect on pain threshold and pain tolerance.• Further studies specifically addressing level of anxiety and physiological data correlated with pain scores and visual stimuli are needed.• The findings have implications for nurses and other healthcare professionals to use various visual stimuli as positive adjuncts to other methods of pain relief and for different pain conditions in clinical areas.
Improving glycaemic control of insulin‐treated diabetic patients – a structured audit of specialist nurse intervention
Authors: Yong Alice , Power Eileen , Gill Geoffrey 
Published: March 2003

Summary•  Insulin‐treated diabetic patients with poor glycaemic control are frequently referred to diabetes specialist nurses, but little data exist as to the effectiveness of this practice.•  We therefore analysed the progress of 43 prospectively referred insulin‐treated patients with glycosylated haemoglobin (HbA1c) levels > 7.5%.•  Diabetes nurse intervention involved re‐education, dietary advice and insulin dose adjustment. Improvement in control was defined as a final HbA1c < 7.0% or a fall of HbA1c of > 1.0% at 6 months post‐intervention.•  Almost two‐thirds (63%) of patients achieved improvement status, with no increase in body weight or hypoglycaemic episodes. Disappointingly, however, the ‘non‐improver’ group (37%) showed a mean deterioration in HbA1c.•  In conclusion, diabetes nurse intervention for poorly controlled insulin‐treated diabetic patients is generally effective, but intervention may be best targeted to responsive patients.•  The factors which influence diabetic patients' ‘responsiveness to change’ require further investigation.
Microhabitat specialization in a species‐rich palm community in Amazonian Ecuador
Authors: Svenning Jens‐Christian 
Published: March 2003

1Relationships between microhabitat variables (altitude, inclination, topographic position, drainage, canopy height) and the distribution and abundance of palms and palm‐like plants in 50 ha of old‐growth terra firme rain forest in the Yasuní National Park, lowland Amazonian Ecuador, were examined using 118 20 × 20 m plots laid out in a stratified random design.2If microhabitat niche differentiation is important for maintaining the species richness of the community, then (i) the distribution of the palms will be strongly influenced by microhabitat heterogeneity and (ii) palms of similar growth form will show antagonistic microhabitat relationships.3Mantel and cluster analyses showed that palm species distributions were strongly structured by topography. The main difference in species composition was between plots in the bottomland and plots on the upper slopes and hill tops.4Logistic and logit analyses showed that 20 of the 31 palm and palm‐like taxa analysed had distributions that were significantly related to the microhabitat variables measured, mainly to topography but also to drainage and canopy height.5Spatial autocorrelation in the overall community structure was not explained by the microhabitat variables. Analyses of distributions or abundances of single species showed neighbourhood effects for seven taxa.6Antagonistic patterns of microhabitat preferences were recognizable among some species pairs of small palms, medium‐sized palms and palm‐like plants, but not among canopy palms.7It is concluded that microhabitat specialization is an important factor in maintaining the diversity of this palm community, while mass effects might also be important.
Herbivores, seed banks and seedling recruitment in mesic grassland
Authors: Edwards G. R. , Crawley M. J. 
Published: March 2003

1 An experiment was carried out in a species‐poor acid grassland to determine the effect of insect, mollusc and rabbit herbivory on the size and composition of the seed bank and on seedling recruitment from the seed bank and seed rain. From 1991 to 1997, insects and molluscs were excluded with pesticides, and rabbits with fences. Seedling recruitment was monitored over 22 months in gaps established in the vegetation in summer 1995. 2 The most common species recorded from the seed bank in early summer 1995 were dicots (17 species), but perennial grasses (five species) were numerically the most abundant (65% of total). There was no relationship between the species composition of the seed bank and the established vegetation. 3 The size of the seed bank of eight species was greater on fenced plots, a result that reflected increased seed rain where rabbits were excluded. Insects and molluscs had no effect on the size of the seed bank of any species. The number of species in the seed bank was not affected by any of the herbivore exclusions. 4 A comparison of seedling emergence in gaps formed over the original soil with gaps where the soil had been sterilized indicated that only Galium saxatile and Cytisus scoparius recruited from the seed bank. Seedling recruitment was almost entirely derived from the recent seed rain, was dominated by the most abundant perennial grasses in the vegetation (Festuca rubra and Holcus lanatus), and had a species composition that resembled the established vegetation. Results highlight that the potential for seedling establishment in gaps to bring about vegetation change in this grassland is low. 5 Six species had higher seedling densities on rabbit‐fenced plots, but the significant effect of fencing disappeared by plant maturity for most species. Survival of seedlings was lower on fenced plots where non‐grazed biomass accumulated, so that after 22 months Agrostis capillaris was the only species with more plants present where rabbits were excluded. Rumex acetosa and Stellaria graminea showed higher seedling emergence where molluscs were excluded. More seedlings of Rumex acetosa were also found where insects were excluded. These invertebrate effects were still evident at plant maturity.
Migration of herbaceous plant species across ancient–recent forest ecotones in central Belgium
Authors: Bossuyt Beatrijs , Hermy Martin , Deckers Jozef 
Published: March 2003

1 We studied the migration of forest plant species using their percentage cover and frequency in 197 plots distributed over 26 transects across ecotones between ancient and recent deciduous forests in the Meerdaal forest complex in central Belgium. The recent forest stands varied in age between 36 and 132 years, and all occurred on silty, well‐drained soils. 2 The total cover, number and diversity of field layer species did not differ significantly between ancient and recent forest stands. 3 The number and cover of the ancient forest plant species and of ant‐dispersed species correlated positively with the age of the recent forest and negatively with both the duration of its former agricultural land use and the distance to the ancient forest. This implies a slow colonization of the recent forest stands by these species; all species were, however, able to migrate across the ecotones. 4 The cover of four species (Anemone nemorosa, Lamium galeobdolon, Convallaria majalis and Polygonatum multiflorum) declined along the transect, suggesting that they are limited by seed dispersal. Their colonization rates, calculated from the occurrence of the farthest individual, ranged from < 0.05 to 1.15 m year−1 and for other measures from < 0.05 to 0.65 m year−1. Anemone and Lamium appeared to colonize the recent forest by establishment of isolated individuals, while Polygonatum and Convallaria expanded populations from existing patches on the border between ancient and recent forest. 5 Several forest species were able to colonize the recent forest rapidly, where some of them even reached a higher abundance, due to the increased availability of colonization sites with a higher nutrient content and a thinner organic layer.