bluuebunny/crossref_metadata_2025_split huggingface dataset:
Power, self‐care and health in women living in urban squatter settlements in Karachi, Pakistan: a test of Orem’s theory
Authors: Lee Marilyn Bell 
Published: March 2003

Power, self‐care and health in women living in urban squatter settlements in Karachi, Pakistan: a test of Orem’s theory This was a study of health in women living in urban squatter settlements in Karachi, Pakistan. The study grew out of the author’s concern for the generally poor health status of Pakistani women. Orem’s nursing theory was selected to examine health in these women. The purpose of the study was to examine relationships among basic conditioning factors, self‐care agency (specifically, perception of power as a foundational capability of self‐care agency and the enabling capabilities of self‐care agency), self‐care, and selected health outcomes of Pakistani women. Four hypotheses were developed and tested. They were that in a group of Pakistani women: (1) perception of power as a foundational capability and enabling capabilities of self‐care agency and self‐care will be related to selected basic conditioning factors; (2) perception of power, as a foundational capability of self‐care agency, will be directly and positively related to enabling capabilities of self‐care agency; (3) perception of power as a foundational capability and enabling capabilities of self‐care agency will have a direct and positive relationship with self‐care; and (4) self‐care will be related to selected health outcomes. Hypotheses one, two and three were supported. Findings indicate that the basic conditioning factors, socioeconomic variables, ethnicity and roles, were predictive of perception of power, enabling capabilities of self‐care agency, self‐care and health. Hypothesis four was not supported; basic conditioning factors had more influence on health than self‐care.
Myocardial infarction, spouses’ reactions and their need of support
Authors: Kettunen Sinikka , Solovieva Svetlana , Laamanen Ritva , Santavirta Nina 
Published: March 2003

Myocardial infarction, spouses’ reactions and their need of support The purpose of this study was to investigate the impact of myocardial infarction (MI) on survivor’s spouses in terms of fears and symptoms during the patient’s recovery period. In addition the researchers sought to evaluate the influence of the support by the health care professionals on spouses’ adjustment. A total of 57 Finnish spouses participated in the study. Of the spouses 47 were female and 10 were male. Data were collected using a structured questionnaire distributed to the spouses at a rehabilitation session at 2 weeks–4 months after the MI. Topics covered included fears, emotional and physical symptoms and the spouses’ experience of the sufficiency of the support that they had received from health care professionals during the patient’s recovery. Data were analysed using quantitative methods including descriptive statistics and multivariate methods. Fears and symptoms were classified using factor analyses. For fears two factors emerged which were named: disease‐related fears and personal fears. In respect of symptoms experienced by the spouse three factors emerged: one which describes emotional distress, one which describes dysfunction and one describing spouses’ own vulnerability. The significantly most intensively experienced fears by the spouses were the disease‐related fears followed by the personal fears. The most frequently reported symptom was dysfunction followed by emotional distress and vulnerability. In regression analysis emotional distress was predicted by personal fears, support from the health care professionals, the shock reaction, spouse’s own health and time after MI. Dysfunction was predicted by spouse’s own health and personal fears whereas vulnerability was predicted by spouse’s own health and support from the health care professionals. Study findings show that in the planning of the care of patients with MI it is important to attend to the reactions and needs of spouses. Their resources are required for optimal rehabilitation of the patient.
Post‐positivistic critical multiplism: a beginning dialogue
Authors: Letourneau Nicole , Allen Marion 
Published: March 2003

Post‐positivistic critical multiplism: a beginning dialogueFollowing the recognition that logical positivism was no longer tenable in modern science, post‐positivism and its research methodology, critical multiplism, emerged and offered a new way of thinking about science. Though not a panacea, critical multiplism, in which methodological pluralism is advocated, offers a way around the debate of which conception of science is appropriate for nursing and, as such, poses advantages for nursing scientific knowledge development.
Development and testing of the Family Caregiving Consequences Inventory for home nursing assessment in Taiwan
Authors: Shyu Yea‐Ing Lotus , Lee Hsiao‐Chin , Chen Mei‐Ling 
Published: March 2003

Development and testing of the Family Caregiving Consequences Inventory for home nursing assessment in TaiwanThis paper describes the development and psychometric testing of the Family Caregiving Consequences Inventory (FCCI). Data were collected from a convenience sample of 97 families in Taiwan to examine the validity and reliability of the three FCCI scales: frail elder outcomes, caregiver outcomes and family outcomes. Acceptable test–retest and internal consistency reliabilities were found, though inter‐rater reliability was unsatisfactory. Criterion‐related validity was demonstrated by congruence with home nursing specialists’ assessment of family caregiving outcomes. Confirmatory factor analysis with a good overall model fit supported the construct validity of FCCI. However, a poor fit of the internal measurement structure was found for the frail elder outcomes scale and the family outcome scale. Studies with larger samples are needed to further verify the measurement models used here. Nevertheless, in its current form, the FCCI can be used to increase the sensitivity of home care nurses to family caregiving situations and provide an instrument for studies of family caregiving in Taiwan and other countries with similar home care needs.
Individual and organizational well‐being in psychiatric nursing: a cross‐cultural study
Authors: Thomsen Sarah , Arnetz Bengt , Nolan Peter , Soares Joaquim , Dallender Janie 
Published: March 2003

Individual and organizational well‐being in psychiatric nursing: a cross‐cultural studyAlthough health care systems around the world are undergoing rapid changes, there is an absence of comparative studies of how these changes affect nurses’ well‐being and work life. The purpose of this study was (i) to identify and describe possible differences between the psycho‐social work environments of English and Swedish mental health nurses, and (ii) to attempt to explain these differences. 1016 psychiatric nurses from Stockholm (Sweden) and Birmingham (England) responded to a postal questionnaire on their psycho‐social work environment and feelings of professional fulfilment, mental energy and work‐related exhaustion. The study was given ethical clearance in Stockholm and Birmingham. Results indicated that while the English nurses rated their organizational well‐being more favourably, Swedish psychiatric nurses reported greater individual well‐being than their counterparts. Multiple regression analyses indicated that self‐esteem was important for explaining mental energy and work‐related exhaustion, but less so for explaining professional fulfilment, which was predicted primarily by organizational factors. When controlling for self‐esteem, which was higher amongst the Swedish nurses, the differences in professional fulfilment and mental health were no longer significant. Reasons for the differences in self‐esteem and experiences of the workplace are discussed. Low response rate may have contributed to a selection bias.
Blood gas analysis: a study of blood loss in intensive care
Authors: Andrews Tom , Waterman Heather , Hillier Valarie 
Published: March 2003

Blood gas analysis: a study of blood loss in intensive care This paper describes a quantitative study conducted on an intensive care unit in the north of England. It involved the collection of data from the existing records of 65 patients consecutively sampled from a predetermined date provided that they stayed more than 24 hours and had an arterial line in situ. As patient records were used, ethical approval was not necessary. The objectives of the study were to quantify the mean number of blood gas samples taken per patient and estimate the mean blood loss resulting from this, including discard volume. Limitations include reliance on records and lack of an economic evaluation. The results show that blood loss in this study was greater than that reported elsewhere. Patients who were ventilated for 24 hours or more had a statistically significant greater blood loss when compared to those who were not (P < 0·001). A subgroup of patients undergoing renal replacement therapy had the greatest blood loss (mean 55·18 ml per day). This loss was statistically significant when compared to patients not in acute renal failure (P=0·007). When patients undergoing multiple therapies normally associated with increased sampling were compared to patients not receiving such therapies, there was no statistically significant difference in blood loss. The need to change current nursing practice to reduce iatrogenic anaemia is emphasized.
Physical touch in nursing studies: a literature review
Authors: Routasalo Pirkko 
Published: March 2003

Physical touch in nursing studies: a literature review In nursing contexts a distinction is made between two types of touch: physical touch and therapeutic touch. Physical touch may be experienced as therapeutic, but that is not its explicit purpose in the same way as with therapeutic touch. Most of the touch studies reviewed in this article are from the United States of America, Canada and the United Kingdom and thus represent the culture of modern western society. The area covered by these studies is far from coherent, and even the results are to some extent contradictory. It follows that it is difficult to draw any firm conclusions from this review of the concepts, methods and main results of touch studies.
Psychiatric nursing in prison: the state of the art?
Authors: Polczyk‐Przybyla Mark , Gournay Kevin 
Published: March 2003

Psychiatric nursing in prison: the state of the art? Psychiatric nursing in prisons has received criticism from within and outside the profession in recent years. In England and Wales this amongst other issues has prompted a review of forensic health care by the United Kingdom Central Council for Nursing, Midwifery & Health Visiting (UKCC). The status of forensic psychiatric nursing as a specialty has also been disputed in the literature and the role of nurses working in this field is seen by some to be more about social control than caring. These arguments are set in the present situation of increasing numbers of mentally ill individuals in the prison system and a crisis in the availability of beds in secure units, a situation that is paralleled throughout the western world. The standard expected of health care services in prisons is equivalence with the service the public receives from the National Health Service (NHS). The number of prisoners needing transfer to hospital has increased during the last decade, resulting in competition for a limited number of suitable beds. The effect on health care centres (HCCs) in English prisons is that they now must provide long‐term care for seriously mentally ill prisoners. This paper outlines the development of British psychiatric services in prisons. It then describes the HCC in Her Majesty’s prison (HMP) Belmarsh and reports on recent radical changes in the management structure of this service. The aim of these changes is to produce a clinical environment in which psychiatric nurses can deliver high quality care in an area beset with difficulties for clinicians and managers and to further progress towards the goal of equivalence. These advances have been achieved through a shift of emphasis in management structure that increases the number of clinical posts and minimizes administrative and security‐based responsibilities held by clinical grades. We conclude that although external contracts are necessary, much can be achieved through internal review and changes in policy.
A national survey of practice nurse involvement in mental health interventions
Authors: Gray Richard , Parr Ann‐Marie , Plummer Susan , Sandford Tom , Ritter Susan , Mundt‐Leach Rosie , Goldberg David , Gournay Kevin 
Published: March 2003

A national survey of practice nurse involvement in mental health interventions Background: The move in the United Kingdom (UK) from institutional to community care has led to an inevitable increase in the involvement of practice nurses (PNs) in mental health care. Around 20 000 PNs are currently working in the United Kingdom (UK). However, the extent and nature of PN involvement in delivering mental health interventions has not been adequately explored. Aim: This study aimed to quantify practice nurses’ involvement in delivering mental health interventions in primary care settings. Method: A questionnaire was sent to a random sample of 1500 practice nurses registered with the Practice Nurse Forum at the Royal College of Nursing. Sixty per cent of questionnaires were returned; however, once non‐eligible respondents were removed an adjusted response rate of 54% was achieved. Results: Practice nurses play a significant role in the assessment and treatment of mental health problems, most frequently via the administration of depot antipsychotics and the screening for depression. However, antipsychotic side‐effects were infrequently monitored and PNs’ understanding of treatment issues in depression is poor. These findings may be associated with the reported lack of mental health training that PNs have received. Conclusions: The findings of this study have important implications for the training of practice nurses in mental health, specifically in the areas of medication management and the detection of mental disorders.
A discussion of the legal aspects of female genital mutilation
Authors: Hopkins Susan 
Published: March 2003

A discussion of the legal aspects of female genital mutilation The purpose of this paper is to examine the position of the nurse/midwife in the United Kingdom when involved with the care of a woman or female child who has suffered genital mutilation, which is an illegal practice in this country and most other areas of the world. The types of circumcision commonly practised are introduced, the prevalent reasons for the continuation of the practice among certain ethnic groups are presented, and the range of issues to be considered by the nurse is examined. These include international and national legal aspects which do not exist in isolation and are considered in context with cultural, medical, human rights and gender issues. Nursing legal issues include child protection, consent, advocacy and confidentiality, which invoke the Code Of Professional Conduct of the United Kingdom Central Council for Nursing Midwifery & Health Visiting. Midwives and nurses working in the field of gynaecology have raised questions regarding possible courses of action to take when presented with this issue. Increased knowledge can help to inform those decisions. Therefore, implications for future practice are addressed, together with recommendations to assist nurses with decision making when faced with this scenario in the future.
Making sense of problem‐based learning: the perceptions and experiences of undergraduate nursing students
Authors: Biley Francis C. , Smith Keri L. 
Published: March 2003

Making sense of problem‐based learning: the perceptions and experiences of undergraduate nursing students This paper reports the findings of one stage of an ongoing project to evaluate a problem‐based learning (PBL) curriculum. Focusing on the students themselves, the ethnographic study explored how undergraduate nursing students (n=17) managed and made sense of a PBL programme. Fieldwork and ethnographic interviews revealed the students’ perceptions of the purpose of PBL and further issues that were of concern were identified and labelled the uncertainty of functioning without a clearly delineated educational structure, perceptions of knowledge acquisition, understanding of group interactionprocesses, and the role of the facilitator. These findings and the implications that arise as a result are discussed.
Predictive validity of the BRASS index in screening patients with post‐discharge problems
Authors: Mistiaen Patriek , Duijnhouwer Ellen , Prins‐Hoekstra Anja , Ros Wynand , Blaylock Ann 
Published: March 2003

Predictive validity of the BRASS index in screening patients with post‐discharge problems Rationale: Discharge planning is a nursing intervention that aims to ensure continuity of care; it consists of several steps of which selecting patients in need of it is the first one. The Blaylock Risk Assessment Screening Score (BRASS) index is a risk screening instrument which can be used early after admission to identify those patients in need of discharge planning. Aim: To test the predictive validity of the BRASS index in screening patients with post‐discharge problems. Design: Prospective longitudinal design with prediction instrument measured at admission, and outcomes measured at discharge and 7 and 30 days after discharge. Outcomemeasures: length of stay, discharge destination, status after discharge. Instruments: BRASS index, Problems after discharge Questionnaire, Nottingham Health Profile, COOP/WONCA charts. Research method: 503 elderly patients were screened at admission with the BRASS index. Length of stay and discharge destination were measured at discharge in these same patients. Outcomes after discharge were gathered only in patients who were discharged home and with length of stay of more than 3 days (n=226); outcomes were measured by postal questionnaires at day 7 and day 30 after discharge. Results: patients identified by the BRASS index as high risk are frequently not discharged home and have a longer length of stay. The BRASS scores correlate significantly with the outcome scores after discharge: the higher the BRASS score, the higher the difficulty score after discharge on all domains. However, the sensitivity of the BRASS index is rather low. Conclusion: This study demonstrates that the BRASS index is a good predictor instrument for indicating patients who are not discharged home, that the BRASS scores correlate significantly with problems experienced after discharge and that it has high specificity to predict patients with problems after discharge. Clinical use, however, is limited due to the low sensitivity. The BRASS index is a promising case‐finding instrument for discharge planning, but needs further development.
Evidence and outcomes: agendas, presuppositions and power
Authors: Ray Lynne 
Published: March 2003

Evidence and outcomes: agendas, presuppositions and power This paper explores philosophical and methodological issues involved in determining ‘What counts as making a meaningful difference?’— the fundamental question in health outcomes research and evidence‐based practice. Eight diverse stakeholders are identified along with the competing agendas they bring to the debate. The power to define what counts as meaningful change in health status is typically rooted in disciplinary socialization, linguistic traditions and an orthodox consensus that circumscribes acceptable research foci and methods. The various implicit assumptions and sites of definitional authority have consequences both for health researchers and for the public being served. For researchers, their designs may be driven by available instrumentation, short political time lines, and statistical rather than clinical significance. Because methods to capture salient health outcomes are still being developed, failure to capture significant outcomes may be methodological in origin. The public may experience the consequences of subsequent programmatic funding decisions and the exclusionary potential of different categorization schemes. Despite this, the public seldom has a voice in deciding what constitutes a meaningful health outcome. Researchers are urged to involve their target population in designing studies to help rebalance relative stakeholder power, and to consider the consequences of their methodological decisions.
The essential elements of spirituality among rural Thai elders
Authors: Tongprateep Tassanee 
Published: March 2003

The essential elements of spirituality among rural Thai elders The purpose of the study reported here was to understand and describe the essential elements of spirituality among rural Thai elders. The research question that guided the study was: How do rural Thai elders experience and describe spirituality in their daily lives? This question was explored through in‐depth, audio‐taped, face‐to‐face interviews with 12 rural Thai elders living in the Nakhorn Prathom Province in the central part of Thailand during the period from January to March 1998. Prior to implementing the study, approval to conduct this study was granted from the Institutional Review Broad of the University of Alabama at Birmingham. Through the process of hermeneutic phenomenological data analysis, three categories and nine themes emerged. The findings of the study provide a knowledge base for Thai nurses to explore and explain spirituality to enhance nursing science and provide holistic nursing care. Further research should be conducted throughout the health and illness continuum with all age groups and with individuals of different cultures and belief systems.
The role of the haemoglobinopathy nurse counsellor: an exploratory study
Authors: Gould Dinah , Thomas Veronica , Darlison Matthew 
Published: March 2003

The role of the haemoglobinopathy nurse counsellor: an exploratory study The haemoglobin disorders are among the most common genetically inherited conditions within the United Kingdom. Individuals who are fully affected have severely impaired health while carriers may be faced with difficult reproductive decisions although generally they are well. Policy makers agree that counselling for families at risk should be undertaken in primary care settings and since the early 1980s this service has been undertaken mainly by specialist haemoglobinopathy nurse counsellors. Despite a number of government reports and recommendations for best practice, problems with service provision continue to be highlighted. However, there is little documented information about the work undertaken by the counsellors or how they perceive their role. A descriptive study was therefore conducted to fill this gap. It took the form of a questionnaire survey undertaken with 26 counsellors. The results were analysed by content and used to develop an interview schedule which was employed to obtain more detailed information from staff in four centres. The counsellors suggested that most of their time was spent in client‐centred activities and most clients were first seen antenatally. However, there were significant barriers which prevented optimal service provision. These included: problems of communication with other health professionals, obtaining laboratory results crucial to the early identification of couples at risk, late referral from general practitioners and poor facilities for administration, especially maintaining computer databases essential for record keeping. Developing and obtaining written information suitable for families was particularly time‐consuming.