bluuebunny/crossref_metadata_2025_split huggingface dataset:
The wider implications of an audit of care plan documentation
Authors: GRIFFITHS  , HUTCHINGS  
Published: March 2003

•This article describes how the results of an audit of district nursing care plan documentation have been used to inform practice development in a community trust.•The principle aim of the audit was to discover whether the evaluation of patient care was being adequately recorded in nursing care plans.•To establish this, four commonly occurring areas of district nursing work were selected and an ideal assessment of care developed from the available evidence. The areas were: the management of leg ulceration, bath care, pressure area care and catheter care.•Data capture forms were developed to record whether the features of an ideal assessment of these four areas of care were reflected in the written evaluation of that care.•The results of the audit demonstrated that the evaluation of care was often inadequately recorded, which reflected poor written documentation of the initial nursing assessment.•The implications of the findings of the audit for practice development in the four areas of care are discussed.
A review of the literature on the prevention of suicide through interventions in Accident and Emergency Departments
Authors: REPPER JULIE 
Published: March 2003

• In order to inform the development of a specialist `suicide prevention nurse' to work in an Accident and Emergency department (A&E), a review of literature in the area was undertaken.• Priority was given to papers describing well specified interventions with a carefully defined client group. Only eight such studies were identified and, although they do have clear implications for practice, they provide inadequate information regarding the targeting of all clients at risk of suicide.• The review was therefore broadened to include all UK literature on suicide and parasuicide at population and individual levels. Three distinct groups of A&E attendees at particular risk of suicide were identified: patients attending A&E following deliberate self‐harm; attendees with specific physical problems, and attendees with a known history of mental health problems.• The needs of each of these groups are described, with their implications for the role of a `suicide prevention nurse' in A&E.• In conclusion, action to reduce suicide needs to be taken at all levels of the organization and the role of the suicide prevention nurse needs to include support, training and development as well as specific time limited therapy with a highly targeted group of patients at specific risk.
Looking out for the patient and ourselves – the process of family integration into the ICU
Authors: HUPCEY JUDITH E. 
Published: March 2003

• As more intensive care units (ICU) are adopting the policy of unrestricted family visiting, families are playing an increasing role in the unit. This role may be restricted to being involved in discussions and decisions related to the patient or may entail a caregiving role.• This study examined how families and nurses interact to increase or decrease the family's involvement in the ICU, how nurses maintain control, how families remain on guard, endure and find their niche in the ICU.• The techniques of grounded theory were used to develop a model of the process of family integration into the ICU.• This model was developed around the core variable of `looking out for the patient – looking out for ourselves'.• The perspectives of ICU nurses, families and ICU patients in the process of looking out for the patient while they look out for themselves are discussed, as well as nurses maintaining the position of power and families remaining on guard and enduring the ICU experience.
Nutritional care of the patient: nurses' knowledge and attitudes in an acute care setting
Authors: KOWANKO INGE , SIMON STEPHEN , WOOD JACQUELIN 
Published: March 2003

• Concern is growing about the occurrence of malnutrition in hospitals throughout the developed world. Reduced involvement of nurses in patients' nutritional care may be one of the contributing factors.• This study explored nurses' attitudes and knowledge about nutrition and food service in hospital.• Semi‐structured interviews were conducted with seven nurses from the internal medical service of a large Australian acute care hospital.• Analysis of the interview transcripts revealed that many nurses lacked the in‐depth knowledge needed to give proper nutritional care to their patients.• Although nurses considered nutritional care to be important many had difficulty in raising its priority above other nursing activities, as a result of time constraints and multitasking issues.• Several problems relating to food service arrangements were also highlighted.• The findings suggest a need to raise nurses' awareness of the importance of nutrition in patient outcome.• This study provides information which will guide in‐service nurse education programs about nutrition, and suggests strategies for practice and organizational change.
Studying the careers of nurse diplomates: the importance of branch‐specific questionnaires
Authors: Hardyman Rachel , Tingle Alison 
Published: March 2003

• Questionnaire design is considered in the context of a longitudinal panel study focusing on the careers of people qualifying from all four branches of the UK nurse diploma course.• Separate, but comparable, questionnaires were developed for each branch in order to produce information which reflected the differences between branches, and the experiences of the cohort as a whole.• This approach ensured that participants from the smaller branches did not feel their interests and concerns were overshadowed by those of the largest (adult) branch, as is often the case during the diploma course’s Common Foundation Programme.• The elements that needed to be tailored to each branch emerged during a three‐stage piloting process used to develop and test the questionnaires.• Differences were found between branches in their use of terminology; in certain issues being more relevant to some branches than others; and in questions which concerned all branches benefiting from the inclusion of branch‐specific examples.• The effectiveness of this approach to questionnaire design is borne out by the study’s high response rates.
Reflections on intuition and expertise
Authors: Perry Margaret A. 
Published: March 2003

• Reflective practice now appears firmly established in the English speaking world of professional nursing practice and development. Outside this linguistic context, however, the concept seems less well‐known.• This paper describes an experience drawn from clinical practice and education in French‐speaking Switzerland followed by explicit reflection grounded in questions generated by Johns’ model for structured reflection. Thus, a concept well‐described in the English‐language literature underpins an innovative approach to a French‐language clinical teaching situation.• The professional implications of this situation are explored through meaningful reflection providing new insight into familiar circumstances as they relate to the nurse tutor’s role.• This exploration is followed by a critical approach to the experience and the subsequent structured reflection in order to address relationships between intuition and expertise and self‐awareness through reflection.• A hermeneutic perspective provides additional insight into the nurse–patient relationship where both come to the situation with their own ‘pre‐understandings’. Individual horizons thus endorse a new understanding going beyond taken‐for‐granted meanings.
Assessment and prevention of shivering in patients with severe cerebral injury. A pilot study
Authors: Sund‐Levander Märtha , Wahren Lis Karin 
Published: March 2003

• Low body temperature is induced by surface cooling to reduce metabolic demands in patients with severe cerebral injury. Shivering, which increases energy expenditure, is a common effect of surface cooling.• The aim of this pilot study was to investigate whether increased gradient between the set point and peripheral temperature is related to shivering and whether modifying the loss of body heat during surface cooling decreases the frequency of shivering.• Seven cerebrally injured patients at a neurosurgical ICU were studied. Shivering, surface cooling and the temperature gradient measured as the tympanic and the tip toe temperatures were registered every 30 min. Shivering was assessed at three levels: no shivering, mild shivering and severe shivering. In four patients the arms and legs were covered with a cotton cloth for part of the observation time to modify the rate of heat loss. The temperature measurements were repeated in each patient between 13 and 42 times.• Four patients out of seven shivered. There was a significant association between increased temperature gradient and shivering (P < 0.01). Modifying the rate of heat loss decreased the temperature gradient (P < 0.001).• By simultaneously measuring the tympanic and tip toe temperatures it may be possible to detect shivering earlier and decrease its frequency by modifying the loss of body heat during surface cooling.
Individualized care in a Finnish healthcare organization
Authors: Suhonen Riitta , Välimäki Maritta , Katajisto Jouko 
Published: March 2003

• This paper reports the findings of a study exploring the provision of individualized care in a regional hospital in Finland.• Individualized care was defined in terms of how patient individuality was taken into account and how patient participation in decision‐making was facilitated.• The data were collected from hospitalized patients (n = 203) using a questionnaire specially developed for this study. The response rate was 89%.• A strong support to facilitate patient participation in decision‐making was reported. Most shortcomings concerning the provision of individualized care related to consideration of the patient’s cultural background and the involvement of the patient’s family in the planning of care.• Patients’ age and the type of ward were associated with the provision of individualized care: patients aged 65 or over were more satisfied than younger age groups with the way in which their personal life situation had been taken into account. Patients from the gynaecological ward thought, more than patients from the surgical ward, that their situation had been taken into account during hospitalization.
The design of written information for cardiac patients: a review of the literature
Authors: Walsh Dawn , Shaw David G. 
Published: March 2003

• Written information is a form of communication that is being recognized by nurses as increasingly important, and a large amount of information is now being produced.• Now that patient turnover is becoming more rapid and hospital stays shorter, thus leaving less time for face‐to‐face patient education, nurses are increasingly relying on the written word to supplement verbal information‐giving.• It is vital that written materials, whatever their source, should be of the highest quality. Nowhere is this more relevant than in the case of post‐coronary patients.• In view of the dearth of research‐based cardio‐specific literature, this review examines the broader literature and offers guidelines for nurses who wish to produce their own information.• Format and presentation of written materials rather than content are the focus and the issues and conclusions are applicable to nurses working in fields other than cardiac nursing.
Collaboration in cancer nursing practice
Authors: Kearney Nora , Miller Morven , Sermeus Walter , Hoy Derek , Vanhaecht Kris 
Published: March 2003

• Although nursing represents around half of Europe’s healthcare budgets, its impact is seldom evaluated. However, given the current era of cost‐containment, nursing must prove the value of its clinical effectiveness.• Through European collaboration, the WISECARE project is working towards identifying the unique contribution of cancer nursing.• This paper will explain the rationale and goals of the WISECARE project and demonstrate the collaborative processes involved within such a project.• The latest results of the project will be presented to prove the value of collaboration in ensuring the development of European standards of nursing care.
Cognitive behavioural therapy for clients with schizophrenia: implications for mental health nursing practice
Authors: CHAN SALLY WAI‐CHI , LEUNG JESSIE KA‐YI 
Published: March 2003

• This paper discusses the application of cognitive behavioural therapy (CBT) in the treatment of clients with schizophrenia and the implications for mental health nursing practice.• The literature shows that CBT has positive effects for clients in improving mental state and reducing relapse rate.• Because of their direct client contact, mental health nurses are in the best position to assess, address and manage clients' psychotic symptoms and problems.• A nursing care plan is used to illustrate how the principles of CBT could be incorporated into nursing care.• Education and training are important to equip nurses with the necessary knowledge and skills to implement the therapy.• Nurses have to take into account cultural issues related to the use of CBT.• Culturally sensitive research needs to be conducted to assess the outcome of the therapy.
Health and social care futures in Ireland: the need for cross‐boundary work
Authors: MCILFATRICK SONIA , MCKENNA HUGH , GRAY ANN‐MARIE , HINDS MARY 
Published: March 2003

• Fundamental changes are taking place in health and social care. The drivers for these changes include new discoveries, new treatments and globalization and the need to examine and consider cross‐boundary work.• This paper will outline some of the issues generated from a research project that aimed to provide an all‐Ireland perspective on health and social care futures and to examine the implications of these trends both for nursing specifically and health and social care generally.• Cross‐boundary working is important in relation to health and social care futures. This incorporates cross‐boundary working to include interprofessional, intraprofessional and interagency but also cross‐border working with the Republic of Ireland.• There is a great potential for cross‐boundary work in nursing as we look towards the future. Nonetheless, it needs to be acknowledged that working across sectors, departments and even borders is not easy and barriers do exist.• Some of the implications for nursing include the need to re‐examine nursing roles and span the boundaries of our profession with the increasing development of nurse‐led services. In addition nurses need to develop ways of `working together' strategically with others to achieve the public health agenda.
Social support and its relation to fear and anxiety in patients awaiting coronary artery bypass grafting
Authors: Koivula Meeri , Paunonen‐Ilmonen Marita , Tarkka Marja‐Terttu , Tarkka Matti , Laippala Pekka 
Published: March 2003

Summary• The purpose of this study was to ascertain social support resources available for patients awaiting coronary artery bypass grafting (CABG) and the effect of social support on their fear and anxiety.• A postal questionnaire was sent to 270 patients awaiting CABG in one hospital, 207 of whom responded. Norbeck's Social Support Questionnaire (NSSQ) was used. The quality of basic cardiac information (QBCI) and the social support wanted (WSS) by patients were measured with an instrument developed for this study. Fear was measured with the Bypass Grafting Fear Scale (BGFS) developed for this study. Anxiety was measured with Spielberger's State‐Trait Anxiety Inventory (STAI). The results were analysed using frequency and percentage distributions, cross‐tabulation, non‐parametric tests and logistic regression.• Heart patients' spouses provided the most emotional and tangible aid. Low emotional support from the social network was associated with high anxiety. Half the patients rated the quality of basic information as good or excellent. Those who perceived the quality of information to be excellent experienced mild fear. Those who displayed high fear wanted informational support from nurses more often than patients with lower fear.• We conclude that the fear and anxiety of patients awaiting CABG are connected with their social support resources.
Correlates of apparel significance among older men and women
Authors: Chowdhary Usha 
Published: March 2003

AbstractA total of 978 older men and women (over 65 years) were systematically identified from a list of registered voters and asked to participate in a study examining the correlates of apparel significance (extent to which apparel is considered important by an individual). A postal survey technique was used to collect the data. Both descriptive and inferential statistics were used to analyse and interpret the data. The condition number index was used to test for multicollinearity of data. Pearson product moment correlation coefficients, analysis of variance and stepwise multiple regression were used to analyse the data. The findings revealed that apparel significance was positively related to self‐esteem, age perception, media usage, opinion leadership and social participation. Stepwise multiple regression results indicated that 65·3% of the variance was explained by media usage, opinion leadership and sex.
An Anglo‐Japanese study of young people and some domestic tasks related to food
Authors: Okuda Kazuko , Adams Jeff , Hackett Allan F. 
Published: March 2003

AbstractHousework, in particular related to food preparation, has received little attention. Tasks are performed in line with gender stereotypes which are culturally specific and change with time. A comparison has been made between the domestic tasks and behaviours and attitudes related to food in young people in Japan and England. Gender stereotyping was apparent in both countries to a remarkable and fairly similar degree (very few children thought that men should have responsibility for tasks related to food) although many aspects were different; English children were more involved in preparing food and fewer Japanese children claimed to like cooking. Fewer Japanese boys (almost half) than English boys (14%) helped to clear up after meals. Almost all Japanese children ate sitting at a table compared with about 75% of English children for whom it was more common to have to be careful to keep their mouths closed when eating. Japanese culture however, does seem to be becoming more Westernized. Even ‘liberated women’ and ‘new age men’ may acquiesce to a degree of stereotyping in order to ensure that their children are ‘normal’. Curiously, the high media attention given to food and food preparation does not seem to be resulting in increased involvement in cooking by young people. This lack of involvement by young people in food preparation may have consequences for nutritional skills and so compromise health in later life.
Temporal and spatial variation in soil resources in a deciduous woodland
Authors: Farley R. A. , Fitter A. H. 
Published: March 2003

Summary1 Plants can respond to nutrient‐rich patches by proliferation of roots or by increased rates of ion uptake; such patches are therefore considered to be an important source of nutrients for plant growth. However, little is known about the spatial and temporal heterogeneity of nutrient concentration at scales that are applicable to the development of root systems of herbaceous perennial plants.2 A woodland site in North Yorkshire (UK) was studied to measure the scale and extent of nutrient heterogeneity. Phosphate, nitrate, ammonium, pH and soil moisture were measured by destructive soil coring over a period of 2 years, and phosphate, nitrate and ammonium were also measured at a smaller scale using Rhizon Soil Solution Samplers.3 Soil moisture was relatively constant at 0.6 g g–1fresh soil weight. Temporal variation was found in all other variables, but the timing of peaks in nutrient concentration was not predictable.4 Soil coring showed differences in phosphate, ammonium and nitrate concentrations at a scale of over 2 m, which may be too large a scale to affect individual herbaceous perennial plants but might be important for trees. However, the soil solution sampling showed two‐ to fivefold differences in nitrate and ammonium at scales of 20 cm; the root systems of many herbaceous plants will spread over such distances.5 Peaks in nutrient concentration that occurred in localized areas lasted no more than 4 weeks. Therefore if these nutrient‐rich patches are to be utilized by plants, their roots must respond rapidly.6 The study showed that localized nutrient‐rich areas may form an important source of nutrients for plants in some natural habitats, especially when the general levels of nutrient availability are low. Hence the patchy nature of the soil should be considered in root foraging and population studies.
The effects of environmental heterogeneity on the performance of Glechoma hederacea: the interactions between patch contrast and patch scale
Authors: Wijesinghe Dushyantha K. , Hutchings Michael J. 
Published: March 2003

Summary 1
We report on an experimental investigation into the effects of contrast in patch quality and patch size upon the performance of the clonal herb Glechoma hederacea in nutritionally heterogeneous environments. 2  There were six treatments providing different degrees of patch contrast. These ranged from maximum contrast, in which patches consisted entirely of compost or sand, to homogeneity, in which all patches contained 50% of each. These were combined factorially with two patch size treatments. Overall, all treatments provided the same quantity of compost and sand, and the same area and volume of higher and lower quality patches. 3  Clones in the large‐patch environments produced significantly more root biomass in both rich‐ and poor‐ quality patches than the clones in the small‐patch environments. At both scales there was a decline in root biomass in the rich patches, accompanied by an increase in root biomass in the poor patches, as patch quality converged. 4  The proportion of the root biomass of clones that was located in nutrient‐rich patches was greatest at high contrast and declined gradually to become equal in all patches, as contrast between patches diminished to homogeneity. This effect was independent of patch scale. There was a close match between root placement and nutrient availability in different quality patches in all treatments except that with the highest contrast. 5  At both patch scales, root : shoot ratios of clone parts in rich patches rose (and those in poor patches declined) as patch contrast increased. This species is therefore capable of morphological specialization at a local level when clones grow in heterogeneous environments. These effects were also greater at the larger patch scale. 6  The effect of patch contrast on total clone yield was significantly modified by patch scale. At lower contrast, yield was similar at both scales, whereas at higher contrast, yield was significantly greater in the large‐patch treatment. 7
Although G. hederacea can match its morphology to environmental heterogeneity in some habitats, it is less able to do so when patches are small‐scale and highly contrasting. These limitations cause considerable differences in the yield that can be achieved from a given quantity of resource provided in different configurations.