bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial correlates of fluid compliance among Chinese haemodialysis patients
Authors: Pang Shuk‐King , Ip Wan‐Yim , Chang Anne M. 
Published: March 2003

Psychosocial correlates of fluid compliance among Chinese haemodialysis patients Aims. The present study was designed to determine the psychosocial correlates of fluid compliance among patients receiving haemodialysis at two Hong Kong renal dialysis centres. Background. There has been little consistency in the findings of correlations among any psychosocial variables and compliance behaviour. There is a need to further study these variables in an attempt to predict haemodialysis patient compliance to fluid restriction. Methods. Ninety‐two Chinese haemodialysis patients completed the Center for Epidemiological Studies Depression Scale (CES‐D), The Multidimensional Health Locus of Control Form C Scale (MHLC), the Social Support Questionnaire, Short Form Scale (SSQ6) and a self‐designed socio‐demographic questionnaire. Daily interdialytic weight gain (DIWG) measure was used as an indicator of fluid compliance. Results. The prevalence of compliance behaviour of Chinese haemodialysis patients was higher than that reported in western studies. There were significant negative correlations found between DIWG and total score on internal health locus of control and social support satisfaction score. However, internal health locus of control did not predict a significant portion of the DIWG variance. Significant predictors of DIWG included satisfaction with social support, comorbidity and monthly family income. Satisfaction with social support was the largest predictor of DIWG. Conclusions. The present findings suggest that assessing family income, comorbidity, and satisfaction with social support may be useful in identifying haemodialysis patients potentially at risk for difficulties in compliance with fluid restriction.
The accessibility of research‐based knowledge for nurses in United Kingdom acute care settings
Authors: Thompson Carl , McCaughan Dorothy , Cullum Nicky , Sheldon Trevor A. , Mulhall Anne , Thompson David R. 
Published: March 2003

The accessibility of research‐based knowledge for nurses in United Kingdom acute care settings Background. The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence; evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. Aim. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Design. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Results. Three perspectives on accessibility were identified: (a) the humanist – in which human sources of information were the most accessible; (b) local information for local needs – in which locally produced resources were seen as the most accessible and (c) moving towards technology – in which information technology begins to be seen as accessible. Nurses’ experience in a clinical specialty is positively associated with a perception that human sources such as clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely to perceive local guidelines, protocols and on‐line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text‐based resources available to nurses on the wards had any explicit research base. These, and the remainder were out of date (mean age of textbooks 11 years), and authorship hard to ascertain. Conclusion. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles could act as ‘conduits’ through which research‐based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced.
A social cognitive model for health education/health promotion practice
Authors: Whitehead Dean 
Published: March 2003

A social cognitive model for health education/health promotion practice Aim. To investigate the place and validity of contemporary social cognitive models for health education practice in nursing settings and, in doing so, develop and put forward a specific model for this purpose. Background/rational. The last decade or so has seen a marked increase in the amount of health educational/health promotional activities that nurses are expected to undertake. This has followed on from concerted calls to make health education a familiar and recognized part of nursing practice. Despite this, past and current evidence identifies that nurses have been, and continue to be, ineffective and inconsistent health education practitioners. Where health education activity does take place it tends to centre specifically on social cognitive behavioural change strategies. Subsequently, it is argued here that any failure on the part of nurses successfully to apply health educational initiatives into practice has been compounded by the lack of any nursing‐specific social cognitive model process. This paper seeks to redress this imbalance by putting forward the case for such a model, developing it, and demonstrating how it can be incorporated into the practice setting. Method. A systematic review of the literature has been conducted and the article draws upon this in order to develop an evolving theoretical perspective for health education practice. The proposed model has evolved from this new perspective. Development of this model has drawn on contemporary social cognitive behavioural models – using them as a means to develop a further conceptual framework for nursing. Conclusion. Social cognitive behavioural models are valuable tools that nurses can incorporate routinely into existing frameworks of practice. The proposed model is designed to make the adoption of health‐related behavioural change in clients easier and more realistic. If the current situation continues whereby social cognitive behavioural models are not adopted as a concerted and routine part of nursing practice, then nursing may well continue to fall behind other health professions in the discipline of health education.
A qualitative study of nursing staff members’ interpretations of signs of gerotranscendence
Authors: Wadensten Barbro , Carlsson Marianne 
Published: March 2003

A qualitative study of nursing staff members’ interpretations of signs of gerotranscendence Aims. This study was conducted in Sweden and investigated whether nursing staff working with old people could recognize signs of gerotranscendence and, if so, how they interpreted such signs. Another aim was to describe how the staff addressed and cared for older people, 65 and older, showing signs of gerotranscendence. Background. The theory of gerotranscendence is a theory that, present a new understanding of the ageing process. Gerotranscendence is regarded as a natural developmental process, and the term transcendence implies a shift in an older person’s meta‐perspective and a new outlook on reality. Methods. Proceeding from Tornstam’s description of signs of gerotranscendence, an interview guide was designed, qualitative interviews performed and the theory of gerotranscendence was used as the basis for the qualitative analysis. Findings. Findings showed that staff working with old people noticed signs of gerotranscendence. However, their interpretations were highly variable; in some cases such signs were interpreted as what might be interpreted as ‘pathological’. This is probably because the staff had no theoretical tools with which to make other interpretations. Some signs were interpreted as common and in some cases as ‘normal’. These could be theoretically understood from either an activity or developmental perspective. Conclusions. Staffs’ need an interpretative framework allowing them to understand the signs they sometimes observe in older people. Having an interpretative framework in which these signs are seen as normal aspects of ageing would enable staff to develop a different attitude towards older people and another approach to caring for them.
Initiation factors for substance abuse
Authors: Al‐Kandari Fatimah H. , Yacoub Khawlah , Omu Florence 
Published: March 2003

Initiation factors for substance abuse Aim. The study reported in this paper investigated factors that led to the initial use and abuse of drugs in 237 addicts receiving treatment at the Psychological Medicine Hospital, Kuwait. Method. A self‐administered questionnaire was designed to elicit information regarding socio‐demographic data and initiation patterns. Questions about initiation patterns were related to personal, familial and social variables in addition to accessibility to drugs. Results. Almost all the sample were male (99·2%) and 42·6% were married. The findings were grouped into (1) factors associated with drug abuse and (2) initial/significant factors for drug abuse. One way ANOVA showed that there was a significant statistical association between current age and source of drug. Also, there was a significant statistical association between the age of the addict when first started on drugs, and the source of drugs. Multiple regression analysis was also computed for initial significant factors. One factor ‘excessive unsupervised free time’ was statistically significant. Recommendations. Strategies for primary, secondary and tertiary interventions in addition to recommendation for further studies are suggested.
Children’s rights: a decade of dispute
Authors: Lowden Jacqueline 
Published: March 2003

Children’s rights: a decade of dispute Aim. This paper attempts to raise issues surrounding children’s rights against a backdrop of ethical principles and their subsequent interpretation and application in practice. Method. Key words have been used to search a selection of electronic databases and a range of ‘grey’ literature has been reviewed. Background. Over a decade ago the United Nations (1989) Convention on the Rights of the Child was ratified, with the exception of two member states (UNICEF 2000). The Human Rights Act (Department of Health 1998) became law in October 2000 in the United Kingdom (UK). Despite a decade of recommendations, guidelines and legislation, children’s rights, particularly consent to health care, remain complex and inconsistent. As we move into a new era of human rights involving all members of society, it is timely for nurses in the UK to reflect on the challenges created in attempting to interpret the philosophy of such legislation because such complexity surrounds the interpretation of human rights for many other vulnerable clients within health care. Findings. The interpretation of children’s rights continues to be influenced by the evolution of the meanings of childhood. Adults view children’s rights from multiple perspectives of best interest, which are determined by their beliefs about children’s ability to understand and consent to health care and treatment. An ability and right to consent appears not to be balanced by the right to withhold consent. Inconsistency and ambiguity persist in the law and its interpretation. Adults need to develop a more pragmatic approach to children’s rights. This requires better understanding of children and their experiences of health care. Conclusion. Until adults develop a more pragmatic ideology in relation to children’s rights then a true respect for children’s autonomy will not be achieved. Consent will therefore remain an adult and legal prerogative.
Differences in urinary stress hormones in male and female nurses at different ages
Authors: Deane R. , Chummun H. , Prashad D. 
Published: March 2003

Differences in urinary stress hormones in male and female nurses at different ages Aim. The aim of this study was to assess the levels of urinary stress hormones in male and female nurses and to determine their contribution to sex‐determined health outcomes. Rationale/background. While the use of questionnaires have shown that there is a high degree of stress in health care workers, these results are inconclusive. In this study a more objective approach was used by assessing the levels of urinary stress hormones, adrenaline, noradrenaline and cortisol. In premenopausal women oestrogen may attenuate sympathetic nervous system activity and the secretion of adrenaline and cortisol and therefore lower the stress response and incidence of stress‐related illnesses. Methods. Three hundred and fifteen nurses of both sexes were separated into two age groups, 20–40 and 45–60 years, and for postmenopausal women into those taking or not taking hormone replacement therapy (HRT). Early morning urine sample were collected and stress hormones determined by high performance liquid chromatography (HPLC). Results. Urinary cortisol, adrenaline and noradrenaline levels were all increased with age in both sexes, with a greater difference in the younger age group compared with the older group. These hormones were lower in premenopausal women compared with male nurses of similar age. The difference between the sexes in the high age group was less compared with the lower one. Postmenopausal women on HRT had lower levels of these hormones. Conclusion. The age‐related changes were surprising but may be because of higher stress levels in the older groups of both sexes. However, the gender difference supports the view that oestrogen reduces sympathetic activity and the secretion of cortisol and adrenaline. HRT reduces the stress response and therefore may have additional benefits by reducing the level of stress‐related illnesses. These results were surprising but may suggest that oestrogen reduces the stress response in women and therefore offers protection against stress‐related disorders.
Student–teacher connection in clinical nursing education
Authors: Gillespie Mary 
Published: March 2003

Student–teacher connection in clinical nursing education Background. The trend toward humanistic nursing education has called for a transformed student–teacher relationship that fosters learning and growth of students and teachers. Although such a relationship has been claimed to form the basis for student–teacher connection and to be a positive influence on students’ learning outcomes, there is a paucity of research exploring these claims. Neither the nature of student–teacher connection nor the processes by which it occurs have been described. Aims. A research study was undertaken to explore and describe undergraduate nursing students’ experiences of connection within the student–teacher relationship and the effects of student–teacher connection on students’ learning experiences in clinical nursing education. Research design. The qualitative research approach of interpretive description was chosen for this study. Unstructured interviews and a focus group were used to collect data from eight undergraduate nursing students. Data were analysed using the process of constant comparative analysis, and revealed four interrelated major categories that formed a description of the students’ experience of student–teacher connection. Findings. This article presents part of the findings of this study. After describing the nature of student–teacher connection, the discussion focuses on the influence of teachers and other factors on the formation of student–teacher connection. Relevance is given to this discussion by describing the outcomes of connection for students’ clinical learning experiences.
Getting your paper to the right journal: a case study of an academic paper
Authors: Van Teijlingen Edwin , Hundley Vanora 
Published: March 2003

Getting your paper to the right journal: a case study of an academic paperBackground. The scientific community views the publication of academic papers as a means of disseminating information, ensuring transparency and good practice in terms of research utilization. However, the choice of journal in which to publish is frequently influenced by other, less obvious, factors. This paper describes the lengthy route taken to get a methodological paper about pilot studies into print.Aim and method. This paper shares some of our experiences and discusses the lessons that we learned about the process of getting into print. A case study approach is adopted to help the reader understand the different influences on this process.Findings. Our methodological paper was submitted to six different academic journals before it was finally accepted for publication. The choice of journal was influenced by the need to reach an appropriate academic audience, the estimated turn around time (the time taken between submission of a paper and its subsequent publication) and the level of academic credibility of the journal (often assessed by the journal’s Impact Factor). Publishing in ‘high impact’ academic journals assumed considerable importance for us in view of the UK Research Assessment Exercise (RAE). However, the consequence of going down the journal status hierarchy was that we lost about 1 year through submitting, rewriting according to each of the journal’s specific requirements and resubmitting. The case study also demonstrates that getting into print often depends on a range of factors, not just the quality of the written text.Conclusions. Getting a paper published may depend not only on the intrinsic quality of the paper, but also whether it is submitted to the ‘right’ academic journal. Moreover, if journals do not take certain papers (e.g. ones with negative findings or those reporting multi‐disciplinary studies) then this can lead to publication bias.
Promoting a good life among people with Alzheimer's disease
Authors: Zingmark Karin , Sandman P.O. , Norberg A. 
Published: March 2003

Promoting a good life among people with Alzheimer's disease Aim.  To illuminate the meaning of offering care and a place to live to people with Alzheimer's disease in a special care unit. Rationale.  There is a need to gain a deeper understanding about so called `homelike' care settings, and about how to promote experiences of being at home in residents with Alzheimer's disease. The study is part of a long‐term study in a special care unit. Methods.  The study comprises phenomenological hermeneutic interpretation of interviews with 10 care providers. Results.  The analyses revealed a number of caring aspects such as, for example, `viewing dignity and striving to preserve a sense of self in the resident', `encouraging a sense of belonging', `offering relief' and `promoting a sense of power and control in the resident', although integrated and reflected in each other. The caring aspects constituted the themes confirmation, familiarity, communion and agency considered as dimensions of the good life. Conclusion.  To avoid simplification in which, for example, the furniture from a certain decade become the standard for good care, it seems important to focus upon the meaning of the good life. Care that promotes a good life of people with Alzheimer's disease seemed relationship centred.
Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice
Authors: Tomlinson Patricia S. , Thomlinson Elizabeth , Peden‐McAlpine Cynthia , Kirschbaum Mark 
Published: March 2003

Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice Aim. To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. Background and rationale. Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. Conclusions. Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.
Using the Zelen design in randomized controlled trials: debates and controversies
Authors: Homer Caroline S.E. 
Published: March 2003

Using the Zelen design in randomized controlled trials: debates and controversies Background. The use of the randomized consent design (commonly known as the Zelen design) is a controversial issue in randomized controlled trials. In the Zelen design, participants are randomly allocated prior to seeking consent. Those participants allocated to the intervention group are then approached and offered the intervention, which they can decline or accept. Zelen first proposed the design in 1979. It has been used infrequently since this time, although there are some notable exceptions in nursing, midwifery and some medical specialities. Aim. This paper describes the Zelen design, including the two forms used (the single and double consent versions) and discusses the advantages and disadvantages of using such a design. Methods. An explanation of the differences between the Zelen design and a conventional randomized controlled trial is presented. In a conventional design, detailed knowledge of the alternative interventions is given to the prospective participant. The participant gives consent and is allocated to one of the groups. In a Zelen design, participants are randomly allocated and then approached and offered the group to which they were allocated. The Zelen design is used firstly, to reduce disappointment bias in the conventional consent‐randomization process, and secondly, to remove subjective bias in the recruitment process.There are concerns relating to the use of the Zelen design, including ethical concerns relating to the timing of random allocation and consent and the collection of clinical data. Conclusion. It is hoped that by presenting issues pertaining to the Zelen design, other nursing and midwifery researchers may be prompted to consider its use when designing clinical research. The Zelen design is controversial, and debate about its merits and shortcomings is useful. This paper contributes to the ongoing debate.