bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the self‐assessed support needs of women with breast cancer
Authors: Lindop Edward , Cannon Sue 
Published: March 2003

Evaluating the self‐assessed support needs of women with breast cancer Aims of the study.  The first aim of the study was to identify the self‐assessed support needs of women with breast cancer at various points of illness and, secondly, to establish if these needs formed clusters which could provide the basis for developing a standardized scale of needs for use by breast care teams in the evaluation of care. Background.  It has been found that support given to women with breast cancer has a positive effect upon their reactions to the illness and may even prolong their survival. Given that breast cancer affects a large number of women it is obviously important that those affected receive, in addition to the best available medical treatment, the type of support that best meets their needs. This study aimed to provide information on the impact of breast cancer and the need for various types of support by examining women’s own assessment of their needs at different stages of their illness. Design and methods.
A purposive sample of 12 women with a diagnosis of breast cancer was selected in one health authority in England, United Kingdom (UK). Women selected represented a wide age range (between 26 and 58), were married or in long‐term cohabiting relationships and were at different points on the illness trajectory. Women were invited to take part in a semi‐structured interview about their experiences of breast cancer. The data from these interviews were analysed using the software package Qualitative Solutions and Research, Nonnumerical Data Indexing, Searching and Theorizing (QSR*NUDIST). Following this content analysis, a questionnaire was formulated which divided statements into seven categories: diagnosis, treatment, support, femininity and body image, family and friends, information and after care, to be rated on a Likert scale ranging from ‘of no importance’ to ‘extremely important’. Questionnaire data were analysed by means of a one‐way analysis of variance (for three independent variables) or t‐test for two independent variables. Results.  The questionnaire was sent to 971 women and achieved a response rate of 50·4%. The mean score for statements of need reached the level of point 4 on the Likert scale (important) with three exceptions: having professional help with family problems and domestic upheaval, coping with feelings of anger and dealing with the question ‘why me?’ Conclusion.  With the above three exceptions, women experienced a high level of need associated with a diagnosis of breast cancer. Studies of this kind should enable resources to be targeted to areas of highest need.
Feeling at home in nursing homes
Authors: De Veer Anke J.E. , Kerkstra Ada 
Published: March 2003

Feeling at home in nursing homes Aim. The purpose of this study was to examine determinants of feeling at home and in particular the privacy in nursing homes in The Netherlands. The first question was to what extent nursing homes differed in the degree residents feel at home and experience privacy. The second question was whether feeling at home is related to privacy in the nursing homes. Background. Feeling at home is of particular importance to residents of nursing homes because the average length of stay in The Netherlands is about 16 months. A growing number of people are of the opinion that the privacy of the residents has to be improved. Privacy in nursing homes, therefore, has been high on the political agenda over the last few years. Four aspects of privacy were distinguished: privacy related to the characteristics of the building, privacy as a consequence of the attitude of nurses towards residents, privacy in terms of choice and control over time schedules and activities, and privacy related to the amount of disturbance caused by other residents. Design. The data were collected from individual interviews with 686 residents and family‐members in 36 nursing homes in The Netherlands. Results. Following quantitative data analysis, it was found that nursing homes differed in the proportion of residents feeling at home as well as in three aspects of privacy. Differences in feeling at home were found to be related to privacy, especially to the perceived attitudes of nurses and perceived disturbance caused by other residents. A weak relationship was found between residents and their perceived privacy of the building. Conclusions. A significant amount of variation in privacy was found at the nursing home level. This implies that feeling at home is not only individually determined but can be influenced by the nursing home’s management policy.
Triage nurses’ clinical decision making. An observational study of urgency assessment
Authors: Gerdtz Marie F. , Bucknall Tracey K. 
Published: March 2003

Triage nurses’ clinical decision making. An observational study of urgency assessment Background. Researchers have described both the various decision tasks performed by triage nurses using self‐report methods and identified time as a factor influencing the quality of triage decisions. However, little is known about the decision tasks performed by triage nurses when making acuity assessments, or the factors influencing triage duration in the real world. Aims. The aims of this study were to: describe the data triage nurses collect from patients in order to allocate a triage priority using the Australasian Triage Scale (ATS); describe the duration of nurses’ decision making for ATS categories 2–5; and to explore the impact of patient and nurse variables on the duration of the triage nurses’ decision making in the clinical setting. Design. A structured observational study was employed to address the research aims. Observational data was collected in one adult emergency department located in metropolitan Melbourne, Australia. A total of 26 triage nurses consented and were observed performing 404 occasions of triage. Data was collected by a single observer using a 20‐item instrument that recorded the performance frequencies of a range of decision tasks and a number of observable patient, nurse and environmental variables. Additionally, the nurse–patient interaction was recorded as time in minutes. Results. It was found that there was limited use of objective physiological data collected by the nurses’ in order to decide patient acuity, and large variability in the duration of triage decisions observed. In addition, analysis of variance indicated strong evidence of a true difference between triage duration and a range of nurse, patient and environmental variables. Conclusion. These findings have implications for the development of practice standards and triage education. In particular, it is argued that practice standards should include routine measurement of physiological parameters in all but the collapsed or obviously unwell patient, where further delay may impede the delivery oftime‐critical intervention. Furthermore, the inclusion of arbitrary time frames for triage assessment in practice standards are not an appropriate method of evaluating triage decision making in the real world.
Exploring Spanish emergency nurses’ lived experience of the care provided for suddenly bereaved families
Authors: Socorro Lourdes López , Tolson Debbie , Fleming Valerie 
Published: March 2003

Exploring Spanish emergency nurses’ lived experience of the care provided for suddenly bereaved families Aim of the study. To investigate the experience of emergency nurses caring for suddenly bereaved family members in the clinical setting, particularly after they are informed about the loss of a loved one. Design/methods. Data was obtained from semi‐structured interviews with seven emergency nurses drawn from emergency nursing staff working in a Spanish Hospital. Interviews were tape recorded, and hermeneutic‐phenomenological analysis was applied to gain understanding from the emergency nurses’ experiences. Setting. The Accident and Emergency department in the Hospital Universitario Insular de Gran Canaria (Spain). Study undertaken in partial fulfillment of the main author’s MSc (Department of Nursing and Community Health) at Glasgow Caledonian University. Results. Several themes emerged from those interviews, which appeared to form the basis of the emergency nurses’ reality: knowing, relationships, culture and reality. They showed the need to reflect on personal and professional experiences to facilitate personal growth, discover meaning for emergency nurses and examine the possible implications for clinical care. Conclusions. This study enabled both participants and the researcher to evaluate critically what was troublesome from their perspective and to identify sources of innovation and liberation within everyday practices.
Intuition: an important tool in the practice of nursing
Authors: McCutcheon Helen H.I. , Pincombe Jan 
Published: March 2003

Intuition: an important tool in the practice of nursing Aim. The aim of the study reported here was to evaluate the role of intuition, to examine nurses’ understanding of intuition and their perceptions of their use of intuition, and to assess the impact of intuition on nursing practice. Background. When we read the dictionary definition of intuition, we have a sense of the meaning but there is also a sense of something still not quite defined. Yet we instinctively know what intuition is. That is, of course, an example of intuition in itself: an understanding of the concept based on our feelings, knowledge and experience. Intuition is a concept neither clearly articulated nor adequately theorized in nursing. There is evidence to suggest that practising nurses use intuition and that its use can change outcomes for patients. Because of its influence on patient well being, it needs to be recognized as an important tool in the practice of nursing. The very nature of intuition determines that there will be little agreement on a precise definition and little empirical evidence to support its existence or worth. Neither of these issues detracts from the fact that intuition is an important part of nursing. Methods. Grounded theory was used as the overarching theoretical and methodological framework for this study. Using focus group interviews and the Delphi survey technique, data were collected from 262 Registered Nurses who volunteered to take part in the study. Findings. The theory that emerged from this study provides nurses with a way of articulating their understanding of intuition and their perceptions of its use in nursing practice. Conclusions. Intuition is not some mystical power that appears from nowhere, with no rational explanation or basis. The findings from this study show that it is a product of the synergy that occurs as a result of the interaction of a number of factors.
The needs of parents with chronically sick children: a literature review
Authors: Fisher Helen R. 
Published: March 2003

The needs of parents with chronically sick children: a literature review Aims. This paper aims to provide health care professionals with an enhanced knowledge of the needs of parents with chronically sick children. Design. The article takes the form of a critical literature review and examines eight research studies that were carried out from 1987 to 1997, written in the English language and analysing solely the needs or experiences of both parents with at least one chronically sick child. Findings. Appropriately all eight studies were carried out from the naturalistic paradigm and yielded rich data. The synthesis of the results of the papers found three main themes emerging: the need for normality and certainty, the need for information, and the need for partnership. Conclusion. The results of the review serve to emphasize and reiterate the burden of the demands made on these parents, and act as a reminder of the need for empathetic care delivery.
Different effort constructs and effort–reward imbalance: effects on employee well‐being in ancillary health care workers
Authors: Van Vegchel Natasja , De Jonge Jan , Meijer Titia , Hamers Jan P. H. 
Published: March 2003

Different effort constructs and effort–reward imbalance: effects on employee well‐being in ancillary health care workers Aims of the study. The present study investigates the relationship between Effort–Reward Imbalance (ERI) and employee well‐being, using three different concepts of efforts (i.e. psychological demands, physical demands and emotional demands). Background. The ERI model had been used as a theoretical framework, indicating that work stress is related to high efforts (i.e. job demands) and low occupational rewards (e.g. money, esteem and security/career opportunities). The ERI model also predicts that, in overcommitted workers, effects of ERI on employee well‐being are stronger compared with their less committed counterparts. Methods. A cross‐sectional survey among 167 ancillary health care workers of two nursing homes was conducted. Multiple univariate logistic regression analyses were used to test the relationship between ERI and employee well‐being. Results. Results of the logistic regression analyses showed that employees with both high (psychological, physical and emotional) efforts and low rewards had higher risks of psychosomatic health complaints, physical health symptoms and job dissatisfaction (odds ratios (ORs) ranged from 5·09 to 18·55). Moreover, employees who reported both high efforts and high rewards had elevated risks of physical symptoms and exhaustion (ORs ranged from 6·17 to 9·39). No support was found for the hypothesis on the moderating effect of overcommitment. Conclusion. Results show some support for the ERI model; ancillary health care workers with high effort/low reward imbalance had elevated risks of poor employee well‐being. In addition, results show that the combination of high efforts and high rewards is important for employee well‐being. Finally, some practical implications are discussed to combat work stress in health care work.
Facilitating and obstructing factors for development of learning in clinical practice: a student perspective
Authors: Löfmark Anna , Wikblad Karin 
Published: March 2003

Facilitating and obstructing factors for development of learning in clinical practice: a student perspective Aim of the study. The aim of this study was to provide information on what the student nurses found facilitating and obstructing for their learning during clinical practice. Background. Earlier studies of experiences of learning in clinical practice have shown that factors as the possibilities of variations of experiences, the culture of the workplace, and communication between the educational institution and health care facilities are of importance. Less is known about the opportunities which students are given in order to practise the skills that they will be expected to perform as new graduate nurses. Methods. The experiences of 47 degree student nurses from two colleges in Sweden were gathered in weekly diaries during their final period of clinical practice. A content analysis technique was used to analyse their diaries. Results. The students emphasized responsibility and independence, opportunities to practise different tasks, and receiving feedback as facilitating factors. Other perceived promoting factors included perceptions of control of the situation and understanding of the ‘total picture’. Examples of obstructing factors were the nurses as supervisors not relying on the students, supervision that lacked continuity and lack of opportunities to practise. Perception of their own insufficiency and low self‐reliance were drawbacks for some students. Conclusions. Recommended proposals are presented to lecturers and supervising staff concerning organizational and educational changes, and changes of attitudes for elucidating the students’ experiences of different facilitating and obstructing factors. Changes may contribute to making easier the students’ transition into the nursing profession.
The role of the nurse within the multi‐professional rehabilitation team
Authors: Long Andrew F. , Kneafsey Rosie , Ryan Julia , Berry Judith 
Published: March 2003

The role of the nurse within the multi‐professional rehabilitation team Aim of the study/paper. To identify the contribution of the nurse within the multi‐professional rehabilitation team. Background. The requirement for nurses to work effectively within the multi‐professional rehabilitation team is increasingly important with the higher incidence of chronic disease, growing numbers of older people and enhanced survival from major trauma. Methods. A 2‐year qualitative investigation was undertaken centred on three contrasting condition case studies (fractured neck of femur, rheumatoid arthritis and stroke). Clients were theoretically sampled, with their ‘rehabilitation pathway’ through different services providing the window through which the nurse’s contribution was explored. Multiple methods and points of data collection were used, including observation, face to face interviews (clients, carers and staff) and record review. To enhance generalisability, a series of national expert workshops were undertaken with four groups: users, carers and carers’ organizations; nurses; members of the multi‐professional team; and educationalists. Findings. Six interlinked roles for the nurse were identified: assessment, co‐ordination and communication, technical and physical care, therapy integration and therapy carry‐on, emotional support, and involving the family. Of particular significance is the creation of a supportive environment for rehabilitation to occur. Some nurses undertook aspects of all of these roles at any one time while others were only involved in one or two areas. While nurses expressed a desire to integrate therapy into their care delivery, the actual achievement of this goal was variable. Conclusions. Key elements of the nurse’s contribution within rehabilitation should aim to maximize client choice to enhance independent living in the client’s future environment. At a nursing educational policy level the nurse needs to have a full understanding of the principles and models of rehabilitation. At a practice level, the nurse’s role must be valued and recognized, by nurses themselves and other team members.
What is the evidence on evidence‐based nursing? An epistemological concern
Authors: French Peter 
Published: March 2003

What is the evidence on evidence‐based nursing? An epistemological concern Aim. This paper adopts an epistemological perspective in order to support the assertion that there is very little evidence to support the existence of evidence‐based nursing as a distinct construct or process. Rationale. This analysis of concept meaning is based on the theory of symbolic interactionism. By adopting this theory the commonalities and inconsistencies in the use of evidence‐based symbolism by nurses and other health care professionals can be used to evaluate the perceived meaning of the term. Methods. A frequency analysis of relevant key words in one publications data‐base demonstrates the increasing use of evidence‐based terminology and its euphemistic status visa vi research. An epistemological analysis is conducted on a sample of concept clarification statements taken from the popular literature, defining the nature of `evidence' and `evidence‐based practice'. Findings. The results of the frequency analysis show that the keywords `evidence‐based medicine' revealed 5612 papers, evidence‐based practice (EBP) 432 papers, evidence‐based nursing 47 papers, evidence‐based health care 60 papers, and evidence‐based decision making 43. Almost all of these papers have been published since 1995 and the earliest use of the symbol `evidence‐based' is 1992. There is also an increase in papers adopting `evidence‐based' symbolism along with a commensurate decrease in the use of the term `research' in the nursing context. Conclusion.  `Evidence‐based practice' is commonly a euphemism for information management, clinical judgement, professional practice development or managed care. There is insufficient evidence to demonstrate that evidence‐based nursing is a single construct or process that can be distinguished from its concomitants. The term adds little more to the existing long standing traditions of quality assurance and research‐based practice. Nurses must avoid the inefficiency brought about by the `intense enthusiasm followed by sad disenchantment' that has been associated with other attempts to introduce innovation in health care delivery (Fienstein & Horowitz 1997).
The application of vignettes in social and nursing research
Authors: Hughes Rhidian , Huby Meg 
Published: March 2003

The application of vignettes in social and nursing research Aim. The aim of this paper is to review the potential for, and the limitations of, the use of vignettes in research that seeks an understanding of people's attitudes, perceptions and beliefs, particularly with regard to sensitive subjects such as health care. Background. Vignettes, in the form of text or pictures presented to research participants to prompt responses to interview questions, are widely used throughout the social sciences although their use in nursing research is less developed. Review focus. This review paper begins by addressing the differences between vignettes and real life processes. The following sections explore some of the practical advantages and pitfalls of using vignettes in social and nursing research. Conclusion. The paper demonstrates how vignettes can be very useful research tools yielding valuable data when studying people's attitudes, perceptions and beliefs in social and nursing research.
Intuition and the development of expertise in surgical ward and intensive care nurses
Authors: King Lindy , Clark Jill Macleod 
Published: March 2003

Intuition and the development of expertise in surgical ward and intensive care nurses Aim. The aim of this study was to explore and identify nurses' clinical expertise in surgical ward and intensive care settings in England. One of the objectives of the study and the focus of this paper was the exploration of these nurses' understanding and use of intuition in the context of their practice. Background. Since 1980 many studies have investigated qualified nurses' use of intuition within aspects of their practice. However, it was Benner's (1982, 1984) seminal work that firmly established the relationship between intuition and expert clinical practice. Since that time a possible relationship between intuitive components of decision‐making and nonexpert nurses' practice has remained relatively unexplored until recently. Methods. This constructivist qualitative study incorporated observation and interview to explore 61 qualified nurses' expertise through their assessment of patients following major surgery. Findings. Specific findings highlighted refinement in nurses' use of intuitive and analytical elements of decision‐making across the four identified levels of expertise. The most fluent and effective use of intuitive and analytical components of decision‐making was found in the expert group. Concluding remarks. These results are discussed in relation to current understanding of the components of expert decision‐making in nursing practice. Both intuitive and analytical elements should be recognized in any model that seeks to depict the true nature of nurses' decision‐making as they develop clinical expertise.