bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue, psychological distress, coping and quality of life in patients with uterine cancer
Authors: Ahlberg Karin , Ekman Tor , Wallgren Arne , Gaston‐Johansson Fannie 
Published: December 2004

Background. Cancer‐related fatigue (CRF) is a subjectively experienced symptom that is multidimensional and multifactorial. Patients with cancer have identified fatigue as one of the major troubling symptoms and the primary cause of distress in their lives.Aims. The major aim of the study was to examine how patients diagnosed with uterine cancer describe their experience of fatigue, psychological distress, coping resources and quality of life. A secondary aim was to describe the relationship between selected variables.Method. A descriptive and correlational design was used and the study was conducted at a university hospital in Sweden. The study population consisted of women, diagnosed with uterine cancer, who where scheduled to receive curative external radiation therapy. Sixty women participated in the study and data were collected through self‐report instruments. Demographic and clinical data were extracted from patient records. The data were collected during year 2000–2002. The Conceptual Model of Symptom Management was used as a framework to guide the study.Findings. Patients experienced a low grade of fatigue and psychological distress, but their functional status and global quality of life was high. Significant correlations were found between general fatigue and anxiety and also between general fatigue and depression. There was a significant negative correlation between general fatigue and coping resources. Depression explained 44% of the variance in general fatigue.Conclusions. The findings provide knowledge about predictors of CRF in women with uterine cancer, and can serve as a basis for future longitudinal studies in which different prophylactic strategies against therapy‐related fatigue are prospectively studied.
Negotiating multiple roles: link teachers in clinical nursing practice
Authors: Ramage Charlotte 
Published: December 2004

Background.  The background to this study was a concern about the teacher's role in clinical practice. Experience suggested that teachers believed that their role in practice was important but that there were significant forces which impeded their ability to move with ease between education and practice. A discrepancy between previous research findings and theoretical discussions, and the reality experienced by teachers, led to the adoption of grounded theory as a way of exploring uncertainties in the situation.Method.  Data were gathered over a period of 7 years and involved 28 in‐depth interviews with nurses with a range of educational roles, employed in educational institutions and practice settings in inner city and provincial areas in the South of England.Findings.  The data revealed four categories, ‘gaining access’, ‘negotiating credibility’, ‘being effective’ and the core category ‘negotiating multiple roles’. The core category is addressed in this article. Experiences of moving from a position of clinical practitioner to link teacher involved: ‘disassembling the self’ through leaving behind old identities; ‘reconstructing the self’ through clarifying new ways of being; and, finally, ‘realizing the self’ through reciprocal interpersonal activity with students, educational and nursing colleagues.Conclusions.  It is inevitable that an individual with a remit for change entering an established social group will experience difficulties in establishing their role. It is also clear that an individual who changes their role within a group to reflect behaviours not congruent with the primary activity in that setting will experience dimensions of social exclusion. Further work needs to address how educational roles can make a significant impact on the everyday lives of students and nurses working in practice. The findings of this study are as relevant for the new roles of practice educator, clinical facilitator and practice placement co‐ordinator as they are for link teachers and lecturer practitioners. Several suggestions are made to improve links with practice.
Ethical practice in nursing: working the in‐betweens
Authors: Varcoe Colleen , Doane Gweneth , Pauly Bernadette , Rodney Paddy , Storch Janet L. , Mahoney Karen , McPherson Gladys , Brown Helen , Starzomski Rosalie 
Published: December 2004

Background. While contemporary ethical theory is of tremendous value to nursing, the extent to which such theory has been informed by the concerns and practices of nurses has been limited.Purpose. With a view to complementing extant ethical theory, a study was undertaken to explore, from the perspective of nurses, the meaning of ethics and the enactment of ethical practice in nursing.Design and methods. Located in the interpretive/constructivist paradigm, using an emergent design, this inquiry employed focus groups to collect the data. Eighty‐seven nurses from a wide range of practice settings were interviewed in 19 focus groups of three to nine nurses each.Findings. The nurses described ethics in their practice as both a way of being and a process of enactment. They described drawing on a wide range of sources of moral knowledge in a dynamic process of developing awareness of themselves as moral agents. Enacting moral agency involved working in a shifting moral context, and working in‐between their own values and those of the organizations in which they worked, in‐between their own values and those of others, and in‐between competing values and interests.Conclusions. Analysis of the experiences and concerns of the nurses offered new understanding of ethics in nursing and direction for the development of ethical theory pertinent to nursing practice.
Occupational changes in nursing: the situation of enrolled nurses
Authors: Iley Karen 
Published: December 2004

Background.  The move to one level of qualified nurse in the United Kingdom (UK) is, in part, a consequence of professionalizing strategies. Registered nurses now undertake technical work previously performed by doctors. The role of enrolled nurses, and their career intentions, have not been considered in light of these changes, despite the fact that many still work in the National Health Service.Aim.  This paper considers the pursuit of professionalization by nurses, illustrating the argument with findings from an empirical study of conversion to registered nurse by enrolled nurses.Methods.  The paper is based on a secondary analysis of a large data set, originally used to explore ethnic inequalities in nursing. Data from 2968 respondents were analysed to answer a number of research questions relating to the characteristics of different groups of enrolled nurses and predictors of conversion to registered nurse. These included demographic characteristics, markers of career orientation, career progression and job satisfaction.Study limitations.  This study used secondary analysis of data and, therefore, exploration of issues was limited, not least because the data were 10 years old. Also, the design was cross‐sectional and respondents’ experiences related to different stages of the phenomenon under study and the same group was not studied over time.Findings.  Enrolled nurses who had converted to registered nurse were more likely than those who had no intention of converting to: be male, be younger, have been nursing longer, not be working on elderly care wards, have a high career orientation, not have taken a career break, and work full‐time. Most of these factors predicted likelihood to convert. Although nurses who converted to registered nurse were more likely to anticipate career progression, they were less likely to be satisfied with their work.Conclusion.  In attempts to define rewarding nursing work, the importance of ensuring that qualified nurses continue to retain basic nursing care skills should be acknowledged. This may offer an uncomfortable view to those seeking to further the professional status of nursing.
Fatigue during pregnancy predicts caesarean deliveries
Authors: Chien Li‐Yin , Ko Yi‐Li 
Published: December 2004

Background. Previous studies on fatigue and pregnancy outcomes were confined to women with occupational fatigue and did not include women who did not work outside the home. Fatigue during mid‐ and late pregnancy has rarely been studied.Aims. This paper reports a study examining the associations between work factors, household factors, and fatigue among low‐risk pregnant women in Taiwan and links the effects of fatigue to preterm births and caesarean deliveries.Methods. The participants were 633 women who were 20–36 weeks pregnant without evidence of obstetrical complications at the time of interview. Pregnancy outcomes were abstracted from the hospital records after delivery. Fatigue was measured using the Fatigue Symptom Checklist. Women were categorized into three groups according to their work status: non‐working, sedentary work, and active work. Other work factors included hours worked and exposure to adverse work environments. Household factors included household work and childcare responsibilities. Multiple linear regression and logistic regression were used for the analysis.Results. The factors significantly associated with fatigue in the regression model were age, infection during pregnancy, bleeding after 12 weeks of pregnancy, and work status. Women who did not work outside of the home had significantly higher fatigue scores than those who did sedentary work outside the home. Younger women had higher fatigue scores than older women. Fatigue scores during pregnancy predicted caesarean deliveries, given that age and obstetrical risks were controlled in the model.Conclusions. Fatigue is a significant problem for pregnant women. Fatigue assessments should include morbidities during pregnancy as well as household and work‐related factors. Special attention should be paid to women who do not work outside the home. Staff should elicit information about fatigue and intervene early, as this may help decrease the number of caesarean deliveries.
Narrative inquiry: locating Aboriginal epistemology in a relational methodology
Authors: Barton Sylvia S. 
Published: December 2004

Background. This methodology utilizes narrative analysis and the elicitation of life stories as understood through dimensions of interaction, continuity, and situation. It is congruent with Aboriginal epistemology formulated by oral narratives through representation, connection, storytelling and art. Needed for culturally competent scholarship is an experience of research whereby inquiry into epiphanies, ritual, routines, metaphors and everyday experience creates a process of reflexive thinking for multiple ways of knowing. Based on the sharing of perspectives, narrative inquiry allows for experimentation into creating new forms of knowledge by contextualizing diabetes from the experience of a researcher overlapped with experiences of participants – a reflective practice in itself.Aim. The aim of this paper is to present narrative inquiry as a relational methodology and to analyse critically its appropriateness as an innovative research approach for exploring Aboriginal people's experience living with diabetes.Nursing application. Narrative inquiry represents an alternative culture of research for nursing science to generate understanding and explanation of Aboriginal people's ‘diabetic self’ stories, and to coax open a window for co‐constructing a narrative about diabetes as a chronic illness. The ability to adapt a methodology for use in a cultural context, preserve the perspectives of Aboriginal peoples, maintain the holistic nature of social problems, and value co‐participation in respectful ways are strengths of an inquiry partial to a responsive and embodied scholarship.
Integration of overseas Registered Nurses: evaluation of an adaptation programme
Authors: Gerrish Kate , Griffith Vanessa 
Published: December 2004

Background.  The growth in overseas nurse recruitment to address staff shortages in the United Kingdom (UK) has led to the proliferation of adaptation programmes for overseas nurses to gain appropriate experience and enable them register with the Nursing and Midwifery Council. This paper reports on selected findings from an independent evaluation of an adaptation programme for overseas Registered Nurses offered by a large acute National Health Service trust.Aim.  This paper reports on a study to evaluate the programme with reference to its objectives, outcomes and overall success from the perspective of various stakeholders.Methods.  A pluralistic evaluation research model was adopted to identify the criteria that stakeholders used to judge the success of an adaptation programme, and then to use these criteria to judge the programme in question. Data were collected by means of focus group and individual in‐depth interviews with overseas nurses, ward managers, mentors, senior nurse managers and educators over a 12 month period and analysed by drawing on the principles of dimensional analysis. The criteria for success identified by the various stakeholders provided a framework through which the overall success of the initiative could be judged.Findings.  Five meanings of success were identified: gaining professional registration; fitness for practice; reducing the nurse vacancy factor; equality of opportunity and promoting an organizational culture that values diversity. Key findings relating to each of these are presented. The ease with which nurses gained UK registration and integrated into the nursing workforce was influenced by the characteristics of the work environment, level of support, and organizational context.Conclusion.  Industrialized nations recruiting from the global nursing market need to invest in providing appropriate support to enable overseas nurses to adapt to working in a different health care system and social and cultural context.
Psychosocial interventions for people with a milder dementing illness: a systematic review
Authors: Bates Jane , Boote Jonathan , Beverley Catherine 
Published: December 2004

Introduction.  Over the last three decades, interest has grown in the use of psychosocial interventions for people with dementia. Empirical studies and systematic reviews have been undertaken on a range of such interventions to examine their effectiveness. However, little account has been taken of the appropriateness of psychosocial interventions for people in different stages of the illness. This raises important questions about the degree to which the research evidence can be generalized for people in the milder and the more severe stages of dementia. This systematic review was undertaken therefore to investigate the effectiveness of psychosocial interventions for people with a milder dementing illness.Methods.  A comprehensive search was undertaken using all the major health care databases, as well as various grey literature sources. For studies to be included in the review, they must have investigated the effect of one or more psychosocial intervention on people with a milder dementing illness, employing a controlled trial design, and measuring outcomes such as cognitive ability, communication, functional performance and well‐being. Identified studies were critically appraised, and where suitable for inclusion, data were extracted.Results.  Four studies met the final inclusion criteria for the review, and covered three psychosocial interventions: reality orientation, procedural memory stimulation and counselling. No evidence was found for the effectiveness of counselling and procedural memory stimulation on the outcome measures used. However, some evidence was found that reality orientation is effective in improving cognitive ability, with a demonstrable long‐term gain using follow‐up data.Conclusions.  The review provides some evidence for the use of reality orientation for people in the milder stages of dementia. However, due to the small sample sizes in all the included studies, more research is needed into the effectiveness of psychosocial interventions for this client group. Implications for nursing practice are discussed, and recommendations for future research are set out.
Thyroid status affects the rat cardiac β‐adrenoceptor system transiently and time‐dependently
Authors: Zwaveling J. , Batink H.D. , Taguchi K. , de Jong J. , Michel M.C. , Pfaffendorf M. , van Zwieten A. 
Published: December 2004

Summary

The aim of this study was to investigate the time‐dependency of the influence of dysthryoid states on the β‐adrenoceptor system in rat heart left ventricle. Therefore, the influence of acute and chronic hyper‐ and hypothyrodism on β‐adrenoceptor‐induced left ventricular responses, β‐adrenoceptor density, cardiac noradrenaline tissue concentrations, Gsα‐proteins, and basal and stimulated adenylate cyclase activities was determined.
Hyperthyroid rats were obtained by feeding with thyroxine (T4)‐containing rat‐chow for 1,4 and 8 weeks. Hypothyroidism was induced by adding 0.05% propylthiouracil (PTU) to the drinking water. Rats of varying ages were used in order to compensate for the differences in the duration of the treatments. Rats were aged 3 and 5 months at the end of the experiments.
Thyroxine treatment for 4 and 8 weeks increased the cardiac sensitivity to isoprenaline, but maximal induced inotropic responses were decreased. Cardiac ventricular β‐adrenoceptor density was increased only in rats treated with T4 for 1 week. This transient effect of hyperthyroidism on cardiac β‐adrenoceptor density was not observed in older rats. The PTU treatment resulted in a stable decrease of cardiac β‐adrenoceptor density.
Left ventricular tissue noradrenaline concentrations were unaffected by hyperthyroidism, where a decrease was observed in hypothyroid rats. Density of Gsα proteins was increased in hearts from chronic hyperthyroid rats.
These results indicate that the increased sensitivity to β‐adrenoceptor‐mediated stimulation in chronic hyperthyroidism cannot be attributed to changes in cardiac β‐adrenoceptor density, but is probably caused by an enhanced content of Gsα. Accordingly, in hyperthyroidism, the β‐adrenoceptor system is influenced time‐dependently, whereas hypothyroidism affects the β‐adrenoceptor system independent of time.
Cardiac anticholinergic effects of procainamide and its N‐acelylated metabolite: experimental pharmacological and radioligand binding studies
Authors: Boucher M. , Chassaing C. , Laborde P. , Breysse C. , Herbet A. 
Published: December 2004

Summary

The cardiac anticholinergic effects of procainamide (1 mg kg−1min−1) and its N‐acetylated metabolite (NAPA) at equimolar dose (1.16 mg kg−1min−1) were studied using in vivo experimental pharmacological and in vitro radioligand binding studies.
Procainamide and NAPA progressively reduced vagal stimulation‐induced bradycardia in chloralose‐anaesthetized dogs. As indicated by the ED50, the vagolytic activity of NAPA is 1.5–2.0 times weaker than that of procainamide. Both drugs increased heart rate, with lowering of mean blood pressure during the second part of procainamide infusion, but not during NAPA infusion.
Binding studies on rat heart membranes yielded Ki values that were 1.5 times higher for NAPA than for procainamide.
These results show that NAPA exerts a weaker cardiac vagolytic action than procainamide, which is probably linked to a lower ability to bind to cardiac muscarinic receptors.
Family dynamics of postnatally depressed mothers – discrepancy between expectations and reality
Authors: Tammentie Tarja , Paavilainen Eija , Åstedt‐Kurki Päivi , Tarkka Marja‐Terttu 
Published: December 2004

Background.  The birth of a new family member always brings changes to family dynamics. The family has to adjust to a new situation and, although the time after childbirth is happy for most families, postnatal depression affects 10–15% of mothers annually.Aims and objectives.  The purpose of this study was to ascertain families’ experiences of family dynamics when the mother suffers from postnatal depression.Design.  Nine families (nine mothers, five fathers) where the mother had displayed symptoms of postnatal depression took part for the study.Methods.  Data were collected through interviews with nine families where the mother had scored 13 or more on the Edinburgh Postnatal Depression Scale, completed 6–8 weeks after childbirth. Families were offered the opportunity to volunteer for the interview while taking part in a follow‐up study of postnatal depression in Finland. Interviews were analysed using the principles of grounded theory.Results.  The findings showed that there was great discrepancy between expectations and reality in the depressed mothers’ families. Parents, especially mothers, strove for perfection, perceived the infant to tie them down and had high expectations of family life.Conclusions.  Everyday family life and human relationships change, the depression and the parents’ attitudes towards the infant manifest themselves in different ways, and support is of great importance.Relevance to clinical practice.  Women, especially those expecting their first child need a great deal of information about mood changes after childbirth and the opportunity to discuss the changes brought about by the birth of a child.
Communication with dying patients – perception of intensive care units nurses in Brazil
Authors: Trovo de Araujo Monica Martins , Paes da Silva Maria Julia 
Published: December 2004

Aims and objectives.  This study aimed to assess whether nurses working in intensive care units view the establishment of communication with patients beyond therapeutic possibilities as an effective palliative therapeutic resource, and which aspects of this communication they valued most.Method.  Data were collected in November 2002, by semi‐structured interviews with 10 nurses of both clinical and surgical intensive care unit at a school hospital in Sao Paulo city, Brazil. Interviews were recorded and transcribed to be further analysed according to the qualitative methodology of content analysis.Results.  Four categories of thematic order raised from the collected statements, which clarify (i) the value of communication with terminal patients; (ii) the obstacles found during this process; (iii) the need to identify the individual demands of each patient, (iv) be able to use communication as a tool in the palliative care of the dying patient.Conclusion.  In conclusion, we found that the nurses working at the intensive care unit do consider communication with dying patients an effective therapeutic resource, in spite of their own difficulties in communicating with dying patients, viewing themselves as ill prepared to the task, and often, distancing themselves from the dying patients because of their inability to deal with their own feelings, which were brought forth by the confrontation with the imminence of death.Relevance to clinical practice.  Although the number of interviewed nurses in our study was small, the results corroborated the findings of other studies and revealed an educational aspect in nursing training that deserves serious consideration.