bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case study of the effectiveness of nurse‐led screening programmes for cervical cancer among Hong Kong Chinese women
Authors: Twinn Sheila , Cheng Frances 
Published: March 2003

A case study of the effectiveness of nurse‐led screening programmes for cervical cancer among Hong Kong Chinese women Cervical cancer remains a cause of morbidity and mortality among women despite the efficacy of Pap smear screening. Uptake rates for Papanicolaou (Pap) smears among Hong Kong Chinese women remain low and evidence suggests that both intrinsic and extrinsic factors influence women's attendance for Pap smear screening, particularly the practitioner taking the smear. This study examined the experiences and perceptions of Hong Kong Chinese women of having a Pap smear taken by a female doctor or a female nurse using a case study design. A convenience sample of 50 women was selected from the two case study settings. Data collection involved a confidential structured interview, followed by focus group interviews with a sample of women participating in the structured interview. The findings relating to the technical quality and outcome of care provide the focus for this paper. Although women were highly satisfied with the care provided by both practitioners, women were more satisfied with the information given about the procedure by the nurse (P = 0·0130) and had more confidence in the nurse (P = 0·024). One of the five criteria used to assess the quality of smears demonstrated the doctor achieved a statistically significant higher number of smears containing the required percentage of endocervical cells (P = 0·0180). Nevertheless, none of the smears taken by the nurse required repeating due to an inadequate specimen. These findings suggest, despite the need for audit of Pap smears, that appropriately qualified nurses can make an important contribution to the uptake of Pap smears among this population.
Predictors of loneliness in elderly Korean immigrant women living in the United States of America
Authors: Kim Oksoo 
Published: March 2003

Predictors of loneliness in elderly Korean women living in the United States of America The purpose of this study was to examine the predictors of loneliness in elderly Korean immigrant women. The sample was derived from a larger study designed to examine loneliness in elderly Korean immigrants. Subjects were 110 elderly Korean immigrant women who were at least 60 years of age and lived in a large metropolitan city area in the United States of America. Data were collected by telephone interview using the Revised University of California Los Angeles (UCLA) Loneliness Scale (RULS), Social Support Questionnaire, Ethnic Attachment Questionnaire and Instrumental Activities of Daily Living (ADL) Scale. Measures were prepared using translation and back‐translation procedures. Results indicate that elderly Korean immigrant women were more lonely than those found in other studies. Satisfaction with social support, social network size, ethnic attachment and functional status were predictive variables of loneliness. Satisfaction with social support was the largest predictor of loneliness in elderly Korean women. Marital status was not a predictor of loneliness.
Health practices of adult Hispanic women
Authors: Higgins Patricia Grant , Learn Cheryl Demerath 
Published: March 2003

Health practices of adult Hispanic women The purpose of this focused ethnography was to discover the patterns and variability of health practices used by Hispanic women aged 20–40 years. Seven adult Hispanic women from an urban New Mexico county were interviewed four to seven times each about their health practices. The women described their views of good health. They were aware of current health promotion practices such as good nutrition and exercise. They also practised safety measures for themselves and their families. These women did not report any information on specific cultural disease prevention behaviours and described few practices related to their Hispanic culture. A theme that also emerged from the data was an emphasis on the importance of spirituality and the integration of the spiritual dimension as important to healthy living. Implications for health care providers include knowing that urban adult Hispanic women are versed in contemporary health literature and take better care of their families than of themselves.
Medication management: an exploratory study into the role of community mental health nurses
Authors: Jordan Sue , Hardy Billy , Coleman Mick 
Published: March 2003

Medication management: an exploratory study into the role of community mental health nurses The recent emphasis on community care for those with mental illness has changed working patterns and modified inter‐professional role boundaries within multi‐disciplinary teams. Clients with serious mental illness are usually prescribed medications, which have a wide range of side effects. However, it is uncertain who is responsible for monitoring clients for the side effects of their medications, ensuring clients' and carers' understandings of their prescribed medications and optimizing compliance with medication. This paper discusses the findings of the first phase of an ongoing study designed to assess the role of community mental health nurses (CMHNs) in managing clients' medication and the provision of appropriate continuing professional education. Our respondents were 14 CMHNs, seven of whom were preparing to undertake a pharmacology module as part of a higher education diploma, and seven who were to act as comparators. Data from questionnaires, interviews and clinical observations were triangulated. All respondents felt that issues surrounding clients' medication were not accorded a sufficiently high profile and that it was, in part, their responsibility to expand their roles to meet these unmet needs of clients. Administering and managing clients' medications were considered to be the main area of `occupational territory' which distinguished CMHNs from social workers. However, the nurses felt that their practice was limited by lack of appropriate educational preparation.
Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland
Authors: Barr Owen , Gilgunn John , Kane Therese , Moore Gordon 
Published: March 2003

Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland. Over the last 30 years there has been a considerable increase in the life expectancy of people with learning disabilities. This has resulted in changing patterns of morbidity and mortality and an increasing recognition of the health needs of people with learning disabilities. Major strides forward have been made in the reduction of preventable illnesses among the general population. However, among people with learning disabilities such illnesses have received only limited health promotion attention until recently. In the last decade major gaps have been identified in the ability of current primary health services to respond to the needs of people with learning disabilities. The need to respond effectively to this situation has been identified as a priority by the current United Kingdom Government. Following an overview of the literature in relation to the changing health profile of people with learning disabilities and the need for health screening, consideration is given to some of the key difficulties which may be encountered when attempting to utilize current primary health services. The analysis of data derived from the health screening of 373 people with learning disabilities by a community nursing service in Down and Lisburn Health and Social Services Trust reveals the need for further action in relation to cardiovascular status, sensory deficits, mobility and aspects of sexual health.
Chronic sorrow in parents of children with newly diagnosed diabetes: a review of the literature and discussion of the implications for nursing practice
Authors: Lowes Lesley , Lyne Patricia 
Published: March 2003

Chronic sorrow in parents of children with newly diagnosed diabetes: a review of the literature and discussion of the implications for nursing practice Childhood (type 1) diabetes is a chronic, life‐long condition, the diagnosis of which may represent multiple losses for parents. Their emotional responses to the diagnosis have been likened to the grief reactions experienced as a result of bereavement through death. The practice of health professionals who work with these families is informed by two contrasting theoretical views of the progress of grief reactions; the time bound and the chronic sorrow perspectives. This paper provides a critical appraisal of the evidence concerning grief reactions in parents of children with diabetes and evaluates the extent to which this supports the expectations of the time bound theorists, that parents normally reach an end stage of the grieving process, or those of the proponents of chronic sorrow, who anticipate lifelong, recurring sadness. It concludes with a discussion of the implications of the debate for nursing practice.
Child care responsibilities and participation in continuing education and training: issues relating to motivation, funding and domestic roles
Authors: Dowswell Therese , Bradshaw Gwendolen , Hewison Jenny 
Published: March 2003

Child care responsibilities and participation in continuing education and training: issues relating to motivation, funding and domestic roles Changes in the organization and funding of health services and in the education and training of NHS staff have placed increased influence in the hands of employers and individual students as users of continuing professional development. Against this policy context an interview study was carried out with students participating in a range of continuing professional development activities. The sample included 89 participants attending a range of courses. Approximately half of the sample had children. Many of the participants were attending courses in their own rather than in their employers’ time and several were self‐funding. The influence of domestic responsibilities on motivations, along with the impact of course participation on home and family life, were examined. Results revealed that those with children were less likely to perceive continuing education in a positive light compared to those without. The impact of course participation on home and family life was invariably negative and for some the consequences were serious. The policy implications of findings are discussed.
Care pathways: an evaluation of their effectiveness
Authors: De Luc Kathryn 
Published: March 2003

Care pathways: an evaluation of their effectiveness This paper reports on a quasi‐experimental case study of two care pathways — a midwifery‐led maternity pathway and a breast disease pathway developed within one British National Health Service Trust. Of the aspects evaluated, those reported here are: a comparison of clinical care delivered before (the control group) and after the introduction of the two pathways; a comparison of patient satisfaction levels before (the control group) and after the introduction of the two pathways; and views of staff involved in the development and operation of the two pathways. The results are mixed. In the breast disease pathway five of 12 clinical indicators showed change, but only two of these showed statistically significant changes; three were considered of clinical significance but could not be tested statistically. In the maternity pathway, after allowing for the effect of gravid status, five of 10 indicators showed changes between the pre‐pathway and pathway users and of these four showed statistically significant changes. Patient satisfaction levels showed little overall change — only 15% of the questions for breast disease and 9% for maternity showed any statistically significant change. However, both surveys indicated precise areas where a change resulting from the introduction of the pathway could be linked to an increase in satisfaction. The clinical staff interviewed highlighted many positive features of the tool (26/40 comments). The most frequently cited favourable comment was its ability to make staff focus on the clinical care they were providing and how this could be improved. It also highlighted some areas for concern, in particular the introduction of pathway documentation.
John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital
Authors: Alsop‐Shields Linda , Mohay Heather 
Published: March 2003

John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital Aims. John Bowlby and James Robertson, two men who were extremely influential in the latter part of the 20th Century, combined scientific theory with evangelism to bring about changes in the way in which children were cared for in hospitals and other institutions. This paper discusses their work together, their theories and their influence on the care of children and paediatric nursing. Background. Bowlby and Robertson collaborated early in their working relationship on research about separation of mother and child. Bowlby was the scientist who developed classic theories about maternal separation. Robertson focused his research on separation of mother and child due to hospital admission. Between the two of them, they derived a classic theory about the phases of ‘protest’, ‘despair’ and ‘denial’ (Bowlby called this last stage ‘detachment’) through which small children pass when isolated from their mothers for a length of time. Discussion. Bowlby became an internationally recognized theorist, widely acclaimed and considered an expert in the field of maternal care and child development. Robertson, with his wife, Joyce, not only continued Bowlby’s work investigating children separated from their mothers, but also took on the role of campaigner for the welfare of children in hospital. James Robertson, with his impressive speaking powers, established an international reputation proselytizing the need to admit parents to hospital with their children.  The work of Bowlby and Robertson coincided with new knowledge about cross‐infection, which had been one of the reasons for excluding parents from hospital wards. At the same time, and influenced by their work, community groups, which championed the idea of admitting parents with their children, developed. The combination of these factors provided a catalyst for changes within the health systems of many developed countries. Because of the theoretical work of Bowlby and Robertson’s missionary zeal, government policies, staff attitudes and parents’ expectations changed. Children’s wards and hospitals in developed countries today admit parents as part of normal routine and actively involve them in the planning and implementation of their child’s care.
Case studies of food shopping, cooking and eating habits in older women with Parkinson’s disease
Authors: Andersson Ingegerd , Sidenvall Birgitta 
Published: March 2003

Case studies of food shopping, cooking and eating habits in older women with Parkinson’s disease Aims. The principal aim of this study was to investigate how married and single‐living older women diagnosed with Parkinson’s disease managed to shop for food, cook and carry out their meals; and to observe whether their nutritional needs were satisfied. A secondary aim was to identify women with severe motor problems and describe their food‐related situation. Background. Parkinson’s disease is associated with motor and eating problems, which, combined with age‐related declines in physical functioning, may affect activities of daily living and dietary intake. Methods. Qualitative interviews and food survey were carried out in the homes of 10 women aged 67–80 years. The sample was recruited from outpatient registers. Results. Decreased sense of smell, appetite and taste in combination with problems transporting food to the mouth and swallowing were risks for nutritional well‐being. Food shopping was most difficult to manage, but six cooked even if their cooking style was changed. Married women with healthy husbands received support from their spouses. Single‐living women suffering from motor problems had to call for help, which represented a threat to their well‐being. Independence was given high priority. Conclusions. The whole situation – including psychosocial and stress factors – must be taken into account when discussing shopping, cooking and eating among old women with Parkinson’s disease. A home‐helper should not take over but facilitate procedures so that the woman can manage as long as possible. This gave them self‐esteem.
Information and support needs of women with primary relatives with breast cancer: development of the Information and Support Needs Questionnaire
Authors: Chalmers Karen I. , Luker Karen A. , Leinster Samuel J. , Ellis Ian , Booth Katie 
Published: March 2003

Information and support needs of women with primary relatives with breast cancer: development of the Information and Support Needs Questionnaire Aims of the study. The aim was to develop and pilot test a newly developed measure, The Information and Support Needs Questionnaire (ISNQ), for use with women with primary relatives with breast cancer. Background/rationale. Breast cancer is a major risk to the health of women in the United Kingdom (UK). Increasingly, research is documenting women’s needs for information and support, particularly at the time of diagnosis. However, to date there is little understanding of the information and support needs of women who have a family history of breast cancer. Contributing to the dearth of understanding of female relatives’ needs is the lack of valid and reliable instruments for use in descriptive and intervention research with this population. Design/methods. The ISNQ and survey items documenting family history, sources of information and support for breast cancer risk, breast self‐care practices, and other variables were pilot tested for the acceptability of the measures, appropriateness of the data collection methods, initial psychometric properties of the ISNQ, and time and financial costs of administration. Data were collected from 39 women living in the North‐west of England who had primary relatives with breast cancer using mailed questionnaires and follow‐up telephone interviews. Findings. The items on the ISNQ were reported to be clear, acceptable to women and to yield relevant data. The psychometric properties of the new measure were satisfactory with a high reliability coefficient alpha. Descriptive findings indicate that women had moderate to high needs for information and support, but reported that these needs were not well met. Conclusions. The results of this pilot are guiding the development of a larger study in which the information and support needs of women with a family history of breast cancer are explored.
The well‐being of gays, lesbians and bisexuals in Botswana
Authors: Ehlers V.J. , Zuyderduin A. , Oosthuizen M.J. 
Published: March 2003

The well‐being of gays, lesbians and bisexuals in Botswana Aims. To investigate the level of well‐being of gays, lesbians and bisexuals (GLBs) in Botswana, how this level of well‐being could be promoted and whether their health care needs were met by health care professionals. Rationale. It is illegal to engage in same‐sex activities in Botswana, punishable by imprisonment. Although Botswana’s citizens have one of Africa’s best health care systems, little is known about the health status, health care needs and general well‐being of Botswana’s GLBs. This survey attempted to uncover some of these potential health care needs, impacting on the GLBs’ well‐being. Design/methods. The research framework adopted was the health and human rights approach, placing dignity before rights. A survey design, with structured questionnaires, was used. Snow‐ball sampling techniques were used. Results. Results indicated that varying degrees of distress were experienced by 64% of the GLBs in this study. The GLBs identified a need for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and had concerns about their general health, discrimination against them and vulnerability to violence including sexual assaults. Conclusions. The well‐being of the GLBs in Botswana was influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Health care professionals played insignificant roles in the promotion of GLBs’ well‐being, and could make greater inputs into health education efforts, and more significant contributions towards enhancing the GLBs’ levels of well‐being. Enhanced collaboration between health professionals and human rights activists are recommended to reduce violations of Botswana’s GLBs’ dignity and to improve their quality of life, including enhanced access to and utilization of health care services.
Midwives’ perceptions of the use of technology in assisting childbirth in Northern Ireland
Authors: Sinclair Marlene , Gardner John 
Published: March 2003

Midwives’ perceptions of the use of technology in assisting childbirth in Northern Ireland Aim of the paper. The aim of this paper is to report a survey of midwives’ views on the use of technology in assisting births. Background. The research was designed to provide a deeper understanding of the integration of technology into midwives’ practice and to identify and examine aspects of training needs. Methods. Over 400 midwives responded to a questionnaire seeking information on their experiences and perceived competence with labour ward technology, with a particular focus on the use of cardiotocograph machines (CTGs) for electronic foetal monitoring. The survey sought views on the extent to which midwives trust the technology, their perceived levels of training and competence, their awareness of policy relating to technological intervention and the issue of women’s choice in whether the progress of their delivery is technologically monitored. Findings. The majority of midwives in this survey trust the use of technology but have concerns about issues of safety in relation to potential faults, and to their perceived lack of training in technology usage. The majority also indicated that they prefer a nontechnological birth although many point to the benefits of technological support when difficulties are encountered. The use of technology is seen as multi‐professional and there was much support among the respondents for multi‐disciplinary training in the use of technologies in future curricula. Conclusions. If the various findings of this sample survey were to be consolidated for midwives as a whole, they suggest that provisions for continuing professional development may need to address technological awareness and competence in a more focused manner than is discernible at present.