bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a new method for patient classification, the Oulu Patient Classification
Authors: Fagerström Lisbeth , Rainio Anna‐Kaisa , Rauhala Auvo , Nojonen Kaija 
Published: March 2003

Validation of a new method for patient classification, the Oulu Patient Classification At Vasa Central Hospital in Western Finland a further development of the Oulu Patient Classification (OPC) has been made by the development of weight coefficients and by estimating the nursing care intensity per nurse. The daily level of nursing care intensity of a ward is expressed by the number of nursing care intensity points per nurse. This article presents results from a validity test of the OPC at Vasa Central Hospital. The test was carried out by comparing the daily patient classifications by means of the OPC against measurements made by means of a new measuring instrument, the ‘Professional Assessment of Optimal Nursing Care Intensity Level’ (PAONCIL) developed at the Vasa Central Hospital. The study was implemented in eight wards during a period of 3 months. The data material consisted of two parts, the daily patient classifications based on the OPC (n = 19 324) and the measurements by means of the PAONCIL forms (n = 8458). Simple and multiple linear regression analyses were used as statistical methods in quantifying the linear relationship between the two interval‐scaled variables. In the test of concurrent validity the coefficient of determination was 0·366, i.e. the association between these two indicators is fairly strong (36·6%). The testing of construct validity showed that the construct validity of the indicator hardly deteriorates as a result of the patients being placed in separate nursing care intensity categories. There was a clear correlation between the scores allotted by the indicator to the six different sub‐areas of nursing care. When examining the construct validity of the OPC, no factors with independent explanatory power in predicting PAONCIL values were discovered other than those of the OPC. The OPC proved on the basis of this research material and these statistical methods to possess fairly adequate validity, and thus there is a good basis for further research and a development of nursing care.
Development of the Nursing Minimum Data Set for the Netherlands (NMDSN): identification of categories and items
Authors: Goossen  , Epping  , Van den Heuvel  , Feuth  , Frederiks  , Hasman  
Published: March 2003

Development of the Nursing Minimum Data Set for the Netherlands (NMDSN): identification of categories and items Rationale Currently, there is no systematic collection of nursing care data in the Netherlands, while pressure is growing from the profession, policy‐makers and society to justify the contribution of nursing and its costs. A nursing minimum data set can provide data to demonstrate nursing’s contribution to health care as it can be used to describe the diversity of different patient populations and the variability of nursing activities, and to calculate the associated nursing workload. Objective To identify categories and items for inclusion in the Nursing Minimum Data Set for the Netherlands. Design A multimethod, exploratory approach was used. This included interviews, document analysis, consensus rounds, seeking validation in the literature, and drawing up lists of most frequently occurring patient problems, interventions and outcomes of care. Eight hospitals, with a total of 16 wards, participated in the study. Results Relevant categories and items emerged after analysis and grouping of the material and included: five hospital‐related items, six patient demographics items, seven medical condition items, 10 nursing process items, 24 patient problems, 32 nursing interventions, four outcomes of nursing care, and three complexity of care items. Almost every item could be located in the existing documentation systems, the lists of patient problems, outcomes and interventions, or in the literature. Conclusion A set of categories and items of nursing data has been identified. The content validity of this set is partly supported by its consistency with the literature, findings from practice and the judgement of potential users. Nursing outcomes need further development. The data set will be tested in practice to find out whether the categories and items are useful, and whether they can be minimized.
Evaluating clinical supervision in community homes and teams serving adults with learning disabilities
Authors: Malin Nigel A. 
Published: March 2003

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities This paper provides a discussion of some of the professional and policy outcomes associated with implementing clinical supervision within a community service for adults with learning disabilities. It is based upon a small qualitative study whose aim was to examine how clinical supervision was operating, its strengths, its weaknesses and where improvements might be made. The study followed the introduction of clinical supervision 9 months earlier for nurses and carers employed in three community homes and one community multiprofessional team. The method consisted of direct observation of individual and group supervision and staff completing critical incident questionnaires, followed by semi‐structured, audio‐taped interviews with seven registered nurses and four community team members, including a social worker, psychologist and physiotherapist. Outcomes were expressed in two ways: in terms of the benefits of clinical supervision or of its ambivalence. The range of matters brought for discussion, or resolution, in supervision reflected some of the difficulties or dilemmas staff faced working in this area, for example promoting empowerment and assisting clients to make choices, and dealing with clients’ challenging and inappropriate behaviours. As for the role of supervisor there was some evidence of nurses expressing apprehension or unpreparedness, also a perceived general concern over the relatively low status of clinical supervision, thought to be due to absence of visible management approval or failure to articulate properly the objective of supervision. A limitation of the study was its small subject sample although considerable data were gathered in each of the units through relatively long‐term contact.
Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers
Authors: Arnetz Judith E. , Arnetz Bengt B. 
Published: March 2003

Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers The aim of this study was to implement and evaluate a practical intervention programme designed to help staff in health care work‐places to deal with patient violence towards staff. The programme was part of a controlled, prospective study that ran for 1 year. The study population was comprised of staff at 47 health care work‐places, randomly assigned to either the intervention or control group. The Violent Incident Form (VIF), a checklist designed to simplify the registration of violent events, was introduced at all 47 work sites, where staff were instructed to register all types of violent and threatening incidents directed towards them during the 1‐year study period. The intervention work‐places also followed a structured feedback programme, where the circumstances concerning registered incidents were discussed on a regular basis with work‐place staff. Baseline examination of the study groups revealed no statistically significant difference with regard to self‐reported violence in the past year. At the conclusion of the 1‐year period, the difference between groups was statistically significant (P < 0·05). Staff at the intervention work sites reported 50% more violent incidents than the control work sites during the year. Compared to the control group, intervention group staff reported better awareness: of risk situations for violence (P < 0·05); of how potentially dangerous situations could be avoided (P < 0·05); and of how to deal with aggressive patients (P < 0·05). Logistic regression analysis confirmed an increased risk for self‐reported violence in the intervention group post‐intervention (odds ratio 1·49; 95% confidence interval 1·07–2·06; P < 0·05). The structured feedback programme seems to have improved staff knowledge of risks for violence in the intervention group.
Illness narratives of persons with post‐polio syndrome
Authors: Wenneberg Stig , Ahlström Gerd 
Published: March 2003

Illness narratives of persons with post‐polio syndrome This qualitative study investigated the lifetime illness experience of individuals with the ‘late effects’ of polio or post‐polio syndrome. Fifteen individuals were interviewed twice about their illness experience and the interviews were transcribed verbatim. The empirical material first underwent a categorization process. The preliminary categories generated through this analysis were then condensed into broader categories which in the final analysis gave rise to the following temporal pattern or stages of the illness experience: (1) the acute phase of polio and subsequent treatment and care; (2) rehabilitation and care at institutions for the disabled; (3) adaptation to a new life; (4) living with the post‐polio syndrome today, and finally, (5) memories of the past and apprehensions concerning the future. In spite of the difficult experiences of falling ill and slowly recovering from a life‐threatening disease, these individuals have had a good life and accomplished most of their ambitions in the areas of work and family life. Their present psychosocial situation is complicated by the symptoms of the post‐polio syndrome which make them more vulnerable to stress, but they are able to handle this burden except when any added strain makes it overwhelming. This potential vulnerability may sometimes express itself as a sudden flashback to traumatic polio experiences and it is therefore important that nurses are aware of the illness history of this patient group.
Barriers to learning from reflection: a study of the use of groupwork with post‐registration nurses
Authors: Platzer Hazel , Blake David , Ashford Dorothy 
Published: March 2003

Barriers to learning from reflection: a study of the use of groupwork with post‐registration nurses There are few studies which describe the use of groups to facilitate reflection and even fewer which evaluate the effectiveness of such groups. Much of the literature discussing the techniques used to facilitate reflection suggests that learners willingly engage in such processes and find them enjoyable. This paper reports on a qualitative study of the use of groups to develop learning through reflection on a part‐time post‐registration diploma programme for nurses. The findings suggest that there are many barriers to learning which must be overcome before practitioners can use the opportunities to reflect on and learn from their experience. It is also contended that such learning may not necessarily be an enjoyable experience. The findings suggest that previous educational experience and the current culture in which nurses and midwives work, impose tremendous barriers to reflecting on, and learning from, experience. In particular these affect the willingness of learners to expose themselves to the judgement of others and their ability to be open to taking responsibility for their own learning. Other barriers to learning in groups are the effects of other group members, their commitment or resistance to shared learning, the ways in which group members interact with each other and facilitation styles.
An action research inquiry into a health visitor parenting programme for parents of pre‐school children with behaviour problems
Authors: Kilgour Christina , Fleming Valerie 
Published: March 2003

An action research inquiry into a health visitor parenting programme for parents of pre‐school children with behaviour problems Parent education programmes have recently been given a high profile in this country, such provision deemed necessary because of the commonality of children's behaviour problems and because of their potentially far‐reaching effects on the child, the family and society. This action research study, undertaken in Scotland, aims to explore a health visitor parenting programme for parents of pre‐school children with behaviour problems. Within this study, children with behaviour problems were identified as those whose parents perceived them to have such problems, the children eliciting a wide range of behaviours and to varying degrees. Critical social science is the chosen methodology, since it allows exploration of how people comprehend their social reality. Group interactions were recorded on audio‐tape and themes associated with the methodology of enlightenment, empowerment and emancipation were identified. The results of the study demonstrate how a liberating, collaborative approach to parental education can empower mothers, by increasing understanding and raising self‐esteem.
Moving on from interpretivism: an argument for constructivist evaluation
Authors: Walker Esther , Dewar Belinda Jane 
Published: March 2003

Moving on from interpretivism: an argument for constructivist evaluation This paper examines the research process in the context of an evaluation of work‐based learning. The findings of the evaluation are used to illustrate issues around roles and relationships within interpretivist research where a separation is maintained between the researcher, as investigator, and the participants, as the subject of their investigation. The discussion focuses on: the threatening nature of evaluation and the way in which that affects the process of inquiry and learning; the ways in which people's perceptions of research can act as barriers to the implementation of change; and the consequences of this role separation for practice development. In exploring these issues the paper argues for an approach to evaluation research which (a) emphasizes collaboration, (b) is orientated to change and (c) treats the evaluation process as a learning opportunity through which professionals acquire the skills and knowledge to investigate and advance their own practice.
How we live: participatory research with six people with learning difficulties
Authors: Richardson Malcolm 
Published: March 2003

How we live: participatory research with six people with learning difficulties Drawing from the Social Model of disability, six people with learning difficulties participated over 18 months in researching their own lived experiences. The method involved weekly group discussions supplemented by participant observation. The study’s value stems from in‐depth inquiry, which included the participants in the data collection, analysis, dissemination and consequences that they found meaningful. The participants lived in nurse managed community homes. They described how they had faced social and economic exclusion, for example, concerning marriage, child rearing and decently paid employment. With the assistance of nursing staff, the participants had overcome many other social barriers and were enjoying a wide range of activities and choices. Consequently, the participants lived varied lives which they described as interesting and worthwhile. Contemporary models of nursing had successfully directed nursing staff to support ‘ordinary living’. However, some disabling assumptions were evident within contemporary nursing. Hence, models of nursing and service delivery were helping both to create lifestyles that the participants valued, whilst simultaneously contributing to their disempowerment.
Critical care cardiovascular nurse expert and novice diagnostic cue utilization
Authors: Reischman Rosalyn R. , Yarandi Hossein N. 
Published: March 2003

Aim.  Critical care cardiovascular (CCCV) nursing diagnostic expertise was the focus of this research. The purpose of the study was to compare diagnostic cue utilization between expert and novice CCCV nurses. Background.  Knowledge related to objective measures of clinical nursing diagnostic expertise would enhance effective and efficient recognition, utilization, and reward of clinical expertise. Methods.  Five CCCV written simulations served as instruments in the study. Diagnostic content areas included left ventricular dysfunction, cardiac tamponade, sepsis, right ventricular failure, and hypovolemia related to internal abdominal haemorrhage. The sample was composed of 23 expert and 23 novice nurses. After reading each simulation, subjects were asked to verbally recall the simulation, give an impression of the predominant problem or diagnosis, and give a diagnostic explanation. Verbal recalls were audio‐taped for protocol analysis. Diagnostic accuracy and cue utilization were determined through comparisons of subjects' recalled diagnoses and cues with results from an expert panel review consensus. The major variable was the mean recalled proportion of highly relevant cues to total cues (HRC/TC) on accurately diagnosed simulations. Chi‐square analysis revealed that diagnostic accuracy was greater with experts than with novices. Differences between and among simulations, expertise, accuracy and the mean proportion of highly relevant cues to total cues were examined with a 4 × 2 × 2 factorial analysis of variance. Results.  When considering all accurately diagnosed simulations, experts had a higher HRC/TC than novices. The major limitations were the use of low fidelity written simulations and virgin verbal protocol methods. Conclusion.  The findings generally support the idea that the development of diagnostic expertise is associated with the ability to focus on highly relevant cues.
Impact of urinary and climacteric symptoms on social and sexual life after surgical treatment of stress urinary incontinence in women: a long‐term outcome
Authors: Lalos Othon , Berglund Anna‐Lena , Lalos Ann 
Published: March 2003

Impact of urinary and climacteric symptoms on social and sexual life after surgical treatment of stress urinary incontinence in women: a long‐term outcome Aim.  The aim of the present study was to evaluate the long‐term results of surgical treatment of stress urinary incontinence (SUI) using both subjective and objective methods. Background.  Few studies have focused on the influence of biological and social changes in a woman’s life on the long‐term outcome of surgical treatment of stress urinary incontinence. Methods.
The study included 45 women with genuine SUI treated with either retropubic urethrocystopexy (n=30) or puboccocygeal repair (n=15). The assessment included interviews, questionnaires, urinary diary, pad test, continence test and urodynamic investigation. Results.
The results were evaluated at intervals of 3 months, 1 year and 5–7 years after the treatment. One year after the surgical treatment 71% of the women in the urethrocystopexy group and 80% in the pubococcygeal repair group were subjectively cured, while 5–7 years after surgery the corresponding values were 43% vs. 60%. However, according to pad test a 67% of the women in the urethrocystopexy group and 47% in the pubococcygeal repair group had ceased to leak urine 1 year after the operation whereas at the long‐term follow‐up the corresponding values were 64% vs. 71%. According to the questionnaire at the long‐term follow‐up only 35% of the women in the whole group had genuine SUI whereas 21% had urge‐incontinence. Moreover, 37% experienced sweating, 23% flushing and 44% vaginal dryness. The number of women with adiposity had increased significantly (P < 0·001) at the long‐term follow‐up. Twenty‐eight per cent of the women decreased their activities whereas the majority experienced no impediment. Seventy‐nine per cent reported that they were sexually active and the majority reported satisfaction with their sexual lives. Conclusions.  Accurate assessment of postoperative results of SUI demands rigorous recording of subjective and objective data taking into consideration psychological and social factors, otherwise there is a high risk of bias in the interpretation of the results of the treatment for SUI. This study indicates that, in order to give women with SUI adequate treatment the nursing care should comprehend the women’s divergent experiences of urinary incontinence and its impact on social and sexual life.
Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability
Authors: Richardson Anette , Adner Nils , Nordström Gun 
Published: March 2003

Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability Aims. The purposes of this study were to describe how persons with insulin‐dependent diabetes mellitus (IDDM) accept their disease and what sense of coherence they have, in order to determine whether a person’s acceptance of the disease is related to his or her sense of coherence. Whether acceptance of the disease and sense of coherence are related to the disease duration, complications of the disease, metabolic control and demographic data would also be determined. Design. One hundred and seven, randomly selected, insulin‐dependent, diabetic subjects (47 men and 60 women) participated in the study. The Acceptance of Disability Scale Modified (ADM scale), the Sense of Coherence Scale (SOC scale), a study‐specific questionnaire and the patients records were used to collect the data. Background. IDDM implies a major change in way of life. Ingrained procedures and patterns of behaviour must be adapted to the disease and its treatment. Results. The results of the present study show that educational level seems to be an important factor for how well a person accepts the disease and the sense of coherence. Persons with higher scores on the ADM and the SOC scales had higher levels of education. Moreover, they also had a better metabolic control. Individuals with a poor metabolic control had more disease‐related complications. A significant correlation between the ADM and the SOC scores was found, indicating that persons with a high degree of acceptance of the IDDM also had a high coping capability. Conclusions. It is important to individualize the care of subjects with IDDM and to identify the persons with low acceptance of their disease and a low sense of coherence.
Examining the process of community development
Authors: Lindsey Elizabeth , Stajduhar Kelli , McGuinness Lisa 
Published: March 2003

Aim of the study. To present the results of evaluation research investigating a successful community development project. Rationale. Many governments, health care agencies, and organizations require community participation in health care. As a result, nurses and other health professionals are often required to practice using a philosophy of community development. Although the theoretical, philosophical, and practical components of community development are well articulated, there is little evidence that exemplifies the experience of initiating and participating in a community development project. This paper provides evidence of how one organization successfully engaged the broader community on a respite care project. Method. Using qualitative research methods and guided by the principles and practices of participatory action research, this evaluation engaged with the community in data collection, analysis, dissemination of finding, and in promoting effective change. Results. Four themes emerged that provide insight into how one HIV/AIDS organization successfully undertook community development. These themes include: (a) identifying a community need; (b) addressing the various components identified in the community development process; (c) highlighting the strategies used to engage in successful community development; and (d) attending to factors that influence community development. Conclusion. The results of this research contribute to the body of knowledge related to engaging in the process of community development. By highlighting the experiences of one community group, it is hoped that nurses can learn and incorporate this knowledge into practice.