bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric evaluation of the Spiritual Coping Strategies scale in English, Maltese, back‐translation and bilingual versions
Authors: Baldacchino Donia R. , Buhagiar Anton 
Published: June 2003

Background. The little research that has been done on the topic considers spiritual coping as consisting mainly of religious coping strategies. This limits spiritual coping solely to believers. However, it is argued that spiritual coping should address both believers and non‐believers. The development of the new Spiritual Coping Strategies (SCS) scale, which consists of both religious and non‐religious coping strategies attempts to fill this research gap. Aim. The aim of this article is to discuss the psychometric assessment of the SCS scale designed in four versions, namely English, Maltese, back‐translation and bilingual. Methods. The Likert‐type SCS scale comprises 20 items, each represented by the frequency and helpfulness of both religious and non‐religious coping strategies. Test–retest of the four versions was conducted between October 1999 and January 2000, with 55 final year nursing students, mean age of 24·5 years, recruited from the same class to facilitate supervision and prevent contamination of results. Test–retest reliability of the scale was investigated by cross‐tabulations, Kappa (κ) measures and Spearman's correlation coefficient. Internal consistency was tested by Cronbach's α. The correlation structure was examined by the multivariate techniques of R‐type cluster analysis and direct oblimin factor analysis. Results. Cross‐tabulations between tests and retests gave highly significant values of chi‐squared (P ≤ 0·0001) for most items in all versions of the scale. These cross‐tabulations also yielded reasonably good values for κ. Additionally, satisfactory values for Spearman's coefficient of correlation resulted between tests and retests. Twelve frequency variables and 13 helpfulness variables had test–retest correlations in the range 0·5 ≤ rs ≤ 0·79 in at least three of the versions. Optimum values of Cronbach's α were observed for the helpfulness variable in retests namely, 0·81 for the English version, 0·73 for the Maltese version, 0·79 for the back‐translation, and 0·82 for the bilingual version. These values were all above the acceptable minimum value of 0·7. The correlation structure identified two factors, namely religious and non‐religious coping strategies. Although the two factors together explained only between 33% and 40% of the variance in the different versions, the religious factor had good reliability, with 0·77 ≤ α ≤ 0·82 for the four versions, whilst thenon‐religious factor also had α ≥ 0·71 for all versions except the Maltese one, for which α = 0·59. Conclusion. Therefore, psychometric assessment suggests that the SCS scale, in any of the four versions, is a reliable tool which can be used in future studies on SCS in Maltese patients.
Symptom status and health‐related quality of life: clinical relevance
Authors: Sousa Karen H. , Williamson Ann 
Published: June 2003

Background. Nursing continues to struggle to identify outcomes that measure quality of care. Health‐related quality of life (HRQOL) has been identified as an outcome indicator that is sensitive to health‐care interventions. However, clinicians remain skeptical about its relevance. Aim. This article discusses the conceptual issues surrounding HRQOL research and provides an example that demonstrates how symptom status can serve as a clinically relevant and measurable dimension of HRQOL. Methods. The study sample (n = 99) were patients presenting to the emergency department of an academic medical centre in the United States of America (USA) between July 1997 and March 1999 with the diagnosis of gastrointestinal bleeding. The mean age was 57·86 (17·52) years and 62·6% of the sample was male. The Short Form‐12 (SF‐12) (measurement used for HRQOL) and a 15‐item symptom checklist were administered within the first 24 hours following the emergency department visit and by phone 1 month after discharge. Results. Regression analysis controlling for age, gender, haematocrit and comorbidities was used to examine the relationships between symptom status and HRQOL. The analysis suggests that symptom status is a key predictor of HRQOL. Study limitations. The sample was a relatively small convenience sample from one emergency department in the USA. Conclusions. Nurses are concerned with improving patients' HRQOL. Certainly, symptoms are amenable to nursing interventions. We provide one example that demonstrates the relationship between symptom status and HRQOL. By tracking and studying trends in the number of symptoms over time we can begin to track HRQOL as an outcome of care. Thus, we conclude that by helping patients manage their symptoms their overall HRQOL would improve.
Pain management in nursing procedures on premature babies
Authors: Halimaa Sirkka‐Liisa 
Published: June 2003

Background. Pain can be caused to premature babies when nursing and other procedures are carried out. Procedural pain management for these babies raises challenging questions for health care professionals. Optimal pain management for premature babies can be reached by using and further developing existing pharmacological and non‐pharmacological pain alleviation methods for procedural pain before, during, and after procedures. Aims. The aims of this study were to describe the environment of pain management in nursing procedures and examinations with premature babies; to describe preparation of the baby for the procedure; to describe non‐pharmacological pain alleviation methods during and after the procedures; and to develop a process describing procedural pain management in premature babies. Method. The material for this study consisted of journal articles on non‐pharmacological procedural pain alleviation in infants published between 1994 and 2002. During this period knowledge of pain management in premature babies has improved considerably. The study was based on the method of content analysis. Findings. Procedural pain management in premature babies was described by researchers as a process comprising: (1) an environment that is favourable to effective pain management, (2) safe preparation of the baby for the procedure, (3) pain alleviation during the procedure, and (4) restoring the baby's sense of security after the procedure. Pain management is recommended to be used alone or together with pharmacological interventions. Additionally, systematic pain management requires documentation of the whole pain management process. Conclusion. Pain management can be described as a process. It is important to test and assess this process and individual non‐pharmacological pain management methods in practical nursing situations. The findings of this review can be used to improve pain management methods in premature babies.
Life with a rare chronic disease: the scleroderma experience
Authors: Joachim Gloria , Acorn Sonia 
Published: June 2003

Background. Little is known about the experience of living with a rare disease and how people with rare diseases cope with not only the disease but also the reactions of others. Scleroderma is a rare chronic connective tissue disease that results in fibrotic changes involving all or some organs of the body. The two types of scleroderma are systemic scleroderma, which involves the skin and internal organs and is the more serious type, and local scleroderma, which attacks the skin and surrounding tissues. Some people with scleroderma have signs that are visible to outsiders, while others have invisible signs. Having this chronic condition and being different from the general population may subject people with scleroderma to stigmatization by others.Aim. The aim of this study was to understand, from the individual's perspective, the experience of living with scleroderma.Method. Focus group interviews were conducted with two groups of individuals with scleroderma. Because of the rarity of the disease and the illness of the participants, only two groups were held. The same questions were asked of both groups. A moderator and assistant guided the groups.Findings. Data analysis revealed five themes: physical manifestations, disclosure/non‐disclosure to others, living, being normal and facing the future. The data are discussed in light of participants' having visible signs, invisible signs and the rarity of their condition. For those with visible signs, disclosure was automatic. They were conscious of being different from others without scleroderma. Those with invisible signs managed their disease information in such a way as to minimize the stigma of being different. The rarity of the disease added the problem of others not understanding their difficulties. Those who disclosed their disease not only had to deal with the reactions of others, but faced the additional burden of having to explain their condition.Conclusion. Nurses may have little knowledge about scleroderma. It is possible that they, through their ignorance of such rare conditions, may stigmatize individuals. Through understanding about rare diseases will they be able to teach patients the skills necessary to help them cope with their symptoms, as well as the reactions of others to their diagnosis and appearance.
The impact of incontinence on older spousal caregivers
Authors: Cassells Colin , Watt Elizabeth 
Published: June 2003

Background. The role of informal spousal caregivers has increased as the population ages, levels of disability in society increase, and governments seek to restrain expenditure on the provision of institutional health care. Care giving has attracted a vast body of research, largely directed at caregiver burden. Incontinence, however, has been relatively unexplored, despite being a common problem faced by caregivers, and being recognised as a major caregiver burden and predictor of institutional placement. Aims. This study began to explore the impact of care recipient incontinence on major care providers, that is, their spouses. Approach. A qualitative approach based on the grounded theory method was used. Eight home‐based caregivers of spouses with incontinence were interviewed. Findings. Data analysis revealed a number of categories, grouped under three major themes: underpinnings, processes and consequences. The underpinnings were lifelong love and friendship, and acceptance; the processes were problem‐solving and constant watchfulness. The consequences were role change, financial cost, decreased intimacy, emotional responses, sleeping issues and social isolation. Discussion. The research highlighted the interconnectedness of factors in the experiences of carers, reinforcing the need for holistic assessment beyond a focus on the ‘continence issue’ alone. Nevertheless, simple interventions could make substantial differences. A framework is proposed which may guide nursing assessment.
Spring hunting changes the regional movements of migrating greater snow geese
Authors: Béchet Arnaud , Giroux Jean‐Francois , Gauthier Gilles , Nichols James D. , Hines James E. 
Published: June 2003

Summary

Human‐induced disturbance such as hunting may influence the migratory behaviour of long‐distance migrants. In 1999 and 2000 a spring hunt of greater snow geese Anser caerulescens atlanticus occurred for the first time in North America since 1916, aimed at stopping population growth to protect natural habitats.
We evaluated the impact of this hunt on the staging movements of geese along a 600‐km stretch of the St Lawrence River in southern Quebec, Canada.
We tracked radio‐tagged female geese in three contiguous regions of the staging area from the south‐west to the north‐east: Lake St Pierre, Upper Estuary and Lower Estuary, in spring 1997 (n = 37) and 1998 (n = 70) before the establishment of hunting, and in 1999 (n = 60) and 2000 (n = 59) during hunting.
We used multi‐state capture–recapture models to estimate the movement probabilities of radio‐tagged females among these regions. To assess disturbance level, we tracked geese during their feeding trips and estimated the probability of completing a foraging bout without being disturbed.
In the 2 years without hunting, migration was strongly unidirectional from the south‐west to the north‐east, with very low westward movement probabilities. Geese gradually moved from Lake St Pierre to Upper Estuary and then from Upper Estuary to Lower Estuary.
In contrast, during the 2 years with hunting westward movement was more than four times more likely than in preceding years. Most of these backward movements occurred shortly after the beginning of the hunt, indicating that geese moved back to regions where they had not previously experienced hunting.
Overall disturbance level increased in all regions in years with hunting relative to years without hunting.
Synthesis and applications. We conclude that spring hunting changed the stopover scheduling of this long‐distance migrant and might further impact population dynamics by reducing prenuptial fattening. The spring hunt may also have increased crop damage. We propose that staggered hunt opening dates could attenuate secondary effects of such management actions.
Restoring tropical diversity: beating the time tax on species loss
Authors: Martínez‐Garza Cristina , Howe Henry F. 
Published: June 2003

Summary

Fragmentation of tropical forest is accelerating at the same time that already cleared land reverts to secondary growth. Fragments inexorably lose deep‐forest species to local extinction while embedded in low‐diversity stands of early successional pioneer trees.
Pasture matrices undergoing passive secondary succession become a ‘pioneer desert’ from the vantage of remnant immigration, imposing a ‘time tax’ of loss of deep‐forest plants from forest fragments. However, if seeds of deep‐forest trees find pastures, or seedlings are planted there, many will prosper.
Bypassing early domination of pioneer trees in regenerating matrices, or enriching matrices with animal‐dispersed forest trees, may stem the loss of species from forest fragments and accelerate succession far from the edges of old forest.
Synthesis and applications. Planting disperser‐limited trees that establish in open ground may bypass 30–70 years of species attrition in isolated remnants by attracting animals that encourage normal processes of seed dispersal into and out of the fragments. Development of criteria for selection of persistent, reasonably rapidly growing, animal‐dispersed species that are mixed with planted or naturally arriving pioneers will be an important component of enrichment planting.
Use of nitrogen to phosphorus ratios in plant tissue as an indicator of nutrient limitation and nitrogen saturation
Authors: Tessier Jack T. , Raynal Dudley J. 
Published: June 2003

Summary

Ratios of nitrogen to phosphorus (N:P) in plant foliage have been used to assess nutrient limitation in wetland ecosystems and to indicate nitrogen saturation. Extension of this application to ecosystems other than wetlands remains to be evaluated.
We compared published N:P ratios as thresholds of nutrient limitation with published accounts from nutrient‐addition experiments and the N:P ratios of understorey vegetation (Acer spp., Dryopteris intermedia, Erythronium americanum, Lycopodium lucidulum, Oxalis acetosella and Viola macloskeyi) from the Catskill Mountains of New York State, USA. We also performed a nutrient‐addition experiment to test the response of these understorey plant species to inputs of N and P.
N:P ratios of Catskill understorey species indicated they were at or near P limitation relative to N:P ratios from other upland ecosystems. Our experiment supported this finding in that none of the species responded to N addition but all increased in P concentration and one increased in biomass with added P. Collectively, these results suggest that the understorey vegetation of the Catskill Mountains is not nitrogen limited, providing further evidence that hardwood forests in this area are nitrogen‐saturated.
Synthesis and applications. This study demonstrates that N:P ratios can be effective predictors of nutrient limitation in upland ecosystems. Therefore N:P ratios can be used for management and monitoring purposes in considering the nutrient status of upland ecosystems with particular relevance to the continued deposition of elevated atmospheric N and to the diagnosis of nitrogen saturation.
Demography and management of the invasive plant speciesHypericum perforatum. I. Using multi‐level mixed‐effects models for characterizing growth, survival and fecundity in a long‐term data set
Authors: Buckley Yvonne M. , Briese David T. , Rees Mark 
Published: June 2003

SummaryHypericum perforatum, St John's wort, is an invasive perennial herb that is especially problematic on waste ground, roadsides, pastures and open woodland in south‐eastern Australia. We use detailed data from a long‐term observational study to develop quantitative models of the factors affecting growth, survival and fecundity ofH. perforatumindividuals.Multi‐level or hierarchical mixed‐effects statistical models are used to analyse how environmental and intrinsic plant variables affect growth and reproduction within a complex nested spatial and temporal context. These techniques are relatively underused in ecology, despite the prevalence of multi‐level and repeated‐measures data generated from ecological studies.We found that plant size (rosette or flowering stems) was strongly correlated with all life stages studied (growth, probability of flowering, asexual reproduction, survival and fruit production). Environmental variables such as herbivory, ground cover and rainfall had significant effects on several life stages.Significant spatial variation at the quadrat level was found in the probability of flowering, flowering stem growth and fruit production models; variation at all other spatial levels in all models was non‐significant. Yearly temporal variation was significant in all models where multi‐year data were available.Plants in shaded habitats were smaller but had higher survival probabilities than plants in open habitats. They are therefore likely to have slightly different population dynamics.Synthesis and applications.Analysis of these models forH. perforatumhas provided insights into which plant traits and environmental factors determine how populations increase and persist in exotic ecosystems, enabling population management strategies to be most effectively targeted. Spatially and temporally correlated data are often collected in long‐term ecological studies and multi‐level models are a way in which we can fully exploit the wealth of data available. Without these tools data are either underexploited or crucial assumptions of independence on which many statistics are based are contravened.
Evaluating and synthesizing qualitative research: the need to develop a distinctive approach
Authors: Barbour Rosaline S. , Barbour Michael 
Published: June 2003

AbstractThe growing popularity of qualitative research has led to calls for it to be incorporated into the evidence base. It is argued that, in seeking to respond to this challenge, it is important that we recognize the important differences between qualitative and quantitative research and that we take this into account in developing a distinctive approach. This paper outlines the distinctive contribution made by qualitative research with regard to the nature of the curiosity involved, the iterative research process and its treatment of data, analysis and findings. We caution against simply importing templates developed for systematic review of quantitative work, and make suggestions with regard to developing a new model for evaluating and synthesizing qualitative work. The proposed new model takes a critical look at some of the assumptions underpinning systematic review, such as the process of literature searching and selection of relevant material. Although there is potential for checklist items – such as purposive sampling, respondent validation, multiple coding, triangulation and grounded theory – to be used over‐prescriptively in evaluating qualitative papers, it is argued that a more creative engagement with these concepts could yield a distinctive approach more appropriate for this type of work. Moreover, we speculate that some of the questions thereby raised might be usefully applied to consideration of established procedures for reviewing quantitative work.
Are performance indicators generic? The international experience of the Quality Indicator Project®
Authors: Kazandjian Vahé A. , Matthes Nikolas , Wicker Karol G. 
Published: June 2003

AbstractPerformance indicators for healthcare organizations represent a strategy for accountability worldwide. A universal approach to either the design for indicators or their applicability to local needs remains a work in progress. The Maryland Hospital Association's Quality Indicator Project® (QIP) is the only indicator‐based performance measurement system used worldwide. This paper presents, for the first time in QIP's 17 years of existence, data showing why MHA's QIP may qualify as the most accepted generic methodology for healthcare performance measurement and evaluation.
Evaluating change in health care practice: lessons from three studies
Authors: Redfern Sally , Christian Sara , Norman Ian 
Published: June 2003

AbstractImplementation and evaluation of evidence‐based practice are high on the policy agenda in the UK National Health Service. Over the last 30 years evaluation of practice in the health services has moved from a (medical) profession‐led mode to a politically and managerially led mode in which objectives are pre‐set by those who legitimate and fund the services. Against this background we describe three recent evaluations of nursing practice as examples to illustrate challenges encountered when evaluating changes in practice developments in health care. If evaluations are to contribute to improvements in practice, a shift is needed from an over‐reliance on one‐off outcome evaluations to those that have a cumulative component and take account of context and process as well as outcome. The merits of realistic evaluation are suggested as a solution to the methodological limitations of traditional approaches and to developing generalizable theory.
Public disclosure of comparative clinical performance data: lessons from the Scottish experience
Authors: Mannion Russell , Goddard Maria 
Published: June 2003

AbstractThere is growing international interest in making information available on the clinical quality and performance of health care providers. In the United States of America, where public reporting is most advanced, comparative performance information in the form of ‘report cards’, ‘provider profiles’ and ‘consumer reports’ has been published for over a decade. In Europe, Scotland has been at the forefront of releasing clinical performance data and has disseminated such information since 1994. This paper reviews the Scottish experience of public disclosure and distils the key lessons for other countries seeking to implement similar programmes. It is based on the findings of the first empirical evaluation of a national clinical reporting initiative outside the United States. The study examined the impact of publication of Scottish (CRAG) clinical outcome indicators on four key stakeholder groups: health care providers, regional government health care purchasers, general practitioners and consumer advocacy agencies. We conclude that those responsible for developing clinical reporting systems should not only pay close attention to developing technically valid and professionally credible data which are tailored to the information needs of different end users, but should also focus on developing a suitable incentive structure and organizational environment that fosters the constructive use of such information.