bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing staffs' perceptions of persons suffering from mania in acute psychiatric care
Authors: Hummelvoll Jan Kåre , Severinsson Elisabeth 
Published: March 2003

Nursing staffs' perceptions of persons suffering from mania in acute psychiatric care Aim. The aim of this study was to illuminate nursing staff perceptions of persons suffering from mania and how this influences the provision of nursing care. Background. Nursing staffs' experiential knowledge in relation to their work with persons with manic illness is explored, guided by a theoretical framework of mania as suffering. Methods. The study was carried out with a participatory inquiry design, and focus group interviews were employed for the collection of data. The data analysis followed the qualitative content analysis procedure. Findings. Four main themes emerged from the analysis: staff views of patients' self‐image, needs and desires, a united stance, nursing strategies, and ethical dilemmas. Nursing staff discern the `disease suffering' based on what is typical in the patient's behaviour, apprehend the existential suffering through the uniqueness of the patient's situation, and finally, realize the various ways in which patients can experience suffering as a consequence of nursing care and treatment. The findings further revealed that one of the greatest challenges of working with persons suffering from mania is that they are often admitted against their will and do not perceive themselves as being ill or in need of help. Conclusions. In conclusion, the findings from this study are theoretically transferable to similar contexts. We suggest that the themes identified above could be used by nursing staff to reflect on their perceptions of and encounters with persons suffering from mania. Furthermore, value‐based psychiatric nursing practice, focusing on patients' experiential knowledge, is needed in order to assess the influence of suffering on a person's life and their experiences of treatment and care.
A path model of factors influencing the academic performance of nursing students
Authors: Ofori Richard , Charlton John P. 
Published: March 2003

A path model of factors influencing the academic performance of nursing students Aims. The aim of this study was to build and test a model describing some of the psychological processes underlying nursing students' academic performance. The model hypothesized that age and entry qualifications influence students' academic motivation (locus of control, academic worries, self‐efficacy, and expectations), and that this in turn affects their decisions to seek support, which subsequently influences their academic performance. Rationale and background. A literature search showed that previous academic motivation research is piecemeal. The present work sought to integrate previous findings into a coherent framework as a way of advancing our understanding of the complex interactive nature of the factors influencing student performance. Method. Path analysis was performed on data obtained from questionnaires and university records for 315 students undertaking a preregistration diploma course in nursing at a university in the Northwest of England. Results. Support‐seeking was more predictive of student performance than entry qualifications. Support‐seeking also mediated the age–performance relationship: greater willingness to seek support led to the better academic performance of older students. Other features of the accepted model suggested that students who judged their self‐efficacy to be higher expected higher grades and that these highly optimistic expectations led to less support‐seeking. Academic worries and internal control beliefs were also found to have positive influences on support‐seeking. The model developed accounted for 24% of the variance in students' academic performance. Discussion. Implications for nurse education, and interventions that focus on improving students' academic motivation are discussed in the context of the `personal teacher' support framework.
Developing and supporting extended nursing roles: the challenges of NHS walk‐in centres
Authors: Rosen Rebecca , Mountford Lesley 
Published: March 2003

Background.  National Health Service (NHS) walk‐in centres offer immediate access to nurse‐led primary care. Forty ‘pilot’ centres are now open, of which nine are in London. In providing clinical assessment, health information and a limited range of treatments to users, they exemplify new nursing roles that are emerging in primary care. Aim.  To describe the emerging roles of walk‐in centre nurses, and explore thecauses of role stress and review arrangements for training, development and support. Methods.  Semi‐structured interviews with 29 managers and nurses from the nine London walk‐in centres and with 10 stakeholders providing other primary care services near to three of the walk‐in centres. Findings.  Walk‐in centre nurses are drawn from a wide range of clinical backgrounds. Emerging roles include diagnosing, developing clinical management plans, prescribing and discharging patients. Most find the roles challenging, but at times also stressful. There is no consensus on the most appropriate nursing skill mix for a walk‐in centre nor on the core competencies required by the nurses working there. As a result there is no standardization of induction, training or support for walk‐in centre nurses – particularly on the balance between taught and apprenticeship‐type training. Conclusions.  Agreement is required on the competencies required for walk‐in centre nursing and on appropriate ways to develop and support nurses in their practice. Lessons could be learned from general practitioner training.
A qualitative study of nurses' attitudes and practices regarding brief alcohol intervention in primary health care
Authors: Lock Catherine A. , Kaner Eileen , Lamont Sharon , Bond Senga 
Published: March 2003

Background.  Excessive alcohol consumption causes significant mortality, morbidity, economic and social problems in the United Kingdom (UK). Despite strong evidence for the effectiveness of brief intervention to reduce excessive drinking in primary health care, there is little indication that such intervention routinely occurs. Aims.  This study aimed to explore primary health care nurses' attitudes and practices regarding brief alcohol intervention in order to understand why it is underexploited. Methods.  The study design was qualitative, using a grounded theory approach to data collection and analysis. Semi‐structured in‐depth interviews were conducted with 24 nurses from practices that had previously been involved in a General Practitioner (GP) led brief alcohol intervention trial in the North‐east of England. A combination of convenience and purposive sampling was used to recruit subjects and gain a broad range of perspectives on issues emerging from ongoing data‐analysis until data saturation occurred. Results.  It was clear that although primary health care nurses have many opportunities to engage in alcohol intervention, most have received little or no preparation for this work. This has left nurses at a disadvantage as alcohol consumption is a confusing and emotive area for both health professionals and patients. An analysis of factors influencing nurse involvement in alcohol intervention outlined a requirement for clear health messages about alcohol, training in intervention skills, facilitation to enhance confidence regarding intervention and support to help deal with negative patient reactions. Conclusions.  As current health policy is to encourage, sustain and extend the health promotion and public health role of primary care nurses, more attention should be given to providing them with better preparation and support to carry out such work.
Preparing for change in the secondary prevention of coronary heart disease: a qualitative evaluation of cardiac rehabilitation within a region of Scotland
Authors: Clark Alexander M. , Barbour Rosaline S. , McIntyre Paul D. 
Published: March 2003

Background.  Secondary prevention of Coronary Heart Disease (CHD) is often poorly managed and its benefits attained in only a minority of those with CHD. Guidelines developed in the United Kingdom and North America suggest that in future cardiac rehabilitation programmes should provide services through individualized programmes that cater for a wide range of conditions associated with CHD. This will involve substantial and costly changes to current programmes that are mostly standardized and for postmyocardial infarction patients. Based on change theory, this study examined the dynamics, strengths and weaknesses of an existing programme in a Scottish region which was due to undergo the changes suggested by guidelines. Aim.  To examine the perceived provision of secondary prevention services for CHD from the perspectives of health professionals within one region in the West of Scotland. Methods.  A purposive sample of 14 health professionals (eight primary and six secondary care health professionals) was selected to cover a range of professional roles including both specialists and generalists. Separate focus group discussions (2) were held with primary care and secondary care professionals. Findings.  Whilst the health professionals were enthusiastic about CHD prevention and their involvement, they perceived barriers to the success of the existing service as being complex and multifactorial, including patient, social and service‐related factors. Although both groups identified motivation as the most influential personal factor, secondary care staff tended to focus on the importance of patient factors in influencing motivation to change, whereas the primary care staff referred more to the cumulative effects of social and cultural factors. Professionals highlighted weaknesses in the transition between hospital and community‐based services with regard to the information flow between primary and secondary care. Conclusions.  Although the study has immediate relevance for the local area, it highlighted issues of more general relevance to cardiac rehabilitation programme development and intersectoral working, such as communications and role perceptions in multi‐professional working and the need to adapt services to local socio‐economic conditions.
Stress and stressors of myocardial infarction patients in the early period after discharge
Authors: Al‐Hassan Musa , Sagr Laila 
Published: March 2003

Background.  The period immediately following discharge after hospitalization for a first‐time myocardial infarction (MI) is stressful. Recovery‐related stressors include anticipation of or actual difficulties in resuming social and physical activities, and adopting recommended health actions. Rationale.  Stress level and sources of stress in the early discharge period need to be evaluated. Identifying patient charcteristics that contribute to high stress is essential to facilitate patients' adjustment. Aims.  To evaluate stress level, identify sources of stress, and examine the significance of sociodemographics and health characteristics in predicting stress in MI patients in the early discharge period. Methods.  In this cross‐sectional study, data were collected from 84 MI patients 2–16 weeks after discharge. The patients, aged 20–70 years, were attending cardiology clinics of four Jordanian public hospitals and had experienced myocarial infarction for the first time. Instruments.  A structured interview guide including a stress discharge assessment tool was used to identify stress level and sources of stress experienced after discharge. Findings.  Most patients experienced a moderate level of stress, with 20% reporting high stress levels. They perceived ‘having many persons to provide care to, worrying about having another heart attack, and my partner worries too much about me’ as their most important concerns. Age, gender, income, frequency of chest pain episodes, and physicians' recommendations to quit smoking were the most significant predictors of stress. Conclusion.  The findings suggest that in the early discharge period MI patients worry about their social role, interpersonal relations and personal health, which can exacerbate symptoms and complicate their future care.
A personal and historical investigation of the career trends of UK graduate nurses qualifying between 1970 and 1989
Authors: Ring Nicola 
Published: March 2003

Aim.  To explore from a personal and historical perspective key career trends of UK graduate nurses qualifying between 1970 and 1989. Background.  During the 1970s and 1980s, graduate nurses qualifying from UK academic institutions with nursing and degree qualifications were a controversial minority. Concerns about their practical ability and role resulted in considerable quantitative research about graduate nurse careers. Whilst such research identified key graduate nurse career trends, these trends have yet to be explored from a qualitative perspective. Design.  This descriptive study used a phased approach: first, a literature review of earlier studies to identify key career trends of UK graduate nurses qualifying between 1970 and 1989, and second, an exploration of these trends from the perspective of six graduate nurses qualifying during this period using semi‐structured interviews. Third, archival material was used to set career trends and interview data within their historical context. Findings.  The literature indicated that most graduate nurses remained clinically based, especially in community and intensive care, with few in senior posts above charge nurse/health visitor level (G‐grade). Analysis of interview data revealed four major themes significantly influencing graduate nurse careers: wanting to be clinical nurses, the effect of organizational structures and systems, being a woman, and careers by accident not design. Conclusion.  Graduate nurses interviewed aspired to clinical posts, yet this was not what some in nursing expected of them during the 1970s and 1980s. The ability of these graduate nurses to fulfil personal career aspirations and develop their careers depended on many factors, not fully acknowledged in earlier studies. For example, organizational structures and systems often delayed fulfilment of career aspirations. Significantly, gender issues embedded within nursing adversely affected career progression of those interviewed, even in the 1990s. In particular, although nurses can combine work and family commitments, for those interviewed this was often at the expense of their career development.
Living with persistent pain: experiences of older people receiving home care
Authors: Blomqvist Kerstin , Edberg Anna‐Karin 
Published: March 2003

Background.  Although the topic of pain among older people has received increasing interest, little is still known about how pain is experienced or handled by those who no longer manage independently but depend on professionals for help with daily living. Developing pain management for older people requires such knowledge. Aim.  To explore sense of self, sense of pain, daily living with pain, sense of others and ways of handling pain in older people with persistent pain. Methods.  Interviews with 90 older people receiving home care from nursing auxiliaries in their own homes or in sheltered accommodation were collected from January to June 2000. A typology of older people in persistent pain was developed. Activities for handling pain were examined using content analysis. Findings.  Respondents' experiences of themselves and their pain varied. Two groups of older people, considered as ‘competent and proud’ and ‘confident and serene’, expressed satisfaction in spite of pain, while the groups ‘misunderstood and disappointed’ and ‘resigned and sad’ expressed dissatisfaction. The most common strategies used were medication, rest, mobility, distracting activities and talking about pain. Respondents chose strategies by balancing the advantages of the activities against the disadvantages these brought for their daily living. Conclusion.  This study indicates that characteristics of the older people, such as their way of experiencing themselves, how pain affects their daily life and how they perceive effects and side‐effects of pain management are areas that need to be identified when staff assess pain and plan pain management. Caring for older people in pain could be improved by listening to and believing their complaints, evaluating effects and side‐effects from medications and nonpharmacological pain management and by emphasising the importance of common everyday activities such as mobility and distraction to relieve pain.
Early support needs of Finnish families with small children
Authors: Häggman‐Laitila Arja 
Published: March 2003

Aims. This study describes the early needs for support that families with small children have in the context of their own life situations. The study population consisted of Finnish families (n = 551) who participated in a project titled ‘Families with Children’ (1996–2001). The project supplemented the existing public services. The information provided by the study was utilized in supporting families and developing family work in seven experimental areas. Methods. The data were collected between 1997 and 2000 using family service plans and client reports. The data were analysed with inductive content analysis and using the SPSS software (version 7·5). Findings. The families needed support in the areas of parenthood, upbringing and child care, marital problems and social support networks. The need for early support was also connected to health problems of the children or the parents, problems with work or studies, unemployment, problems in economic or living conditions, or family crises. In addition to support, the families searched for help from family workers in disputes over child custody and visitation rights, intoxicant abuse and violence, and problems in adjusting to society. Each family had 4–5 needs for early support. Conclusions. The results demonstrate that families with small children have many needs for which they seek help when there are available services supplementing the existing public services. The information provided by the study can be utilized in maternity and child welfare clinics, in social services and in family work provided by civic organizations to define the early needs of families for support and to develop services.
Density‐dependent population dynamics in clonal organisms: a modelling approach
Authors: Tanner Jason E. 
Published: March 2003

1. Density dependence may act at several stages in an organisms life‐cycle (e.g. on mortality, fecundity, etc.), but not all density‐dependent processes necessarily regulate population size. In this paper I use a density manipulation experiment to determine the effects of density on the transition rates between different size classes of the clonal zoanthid Palythoa caesia Dana 1846. I then formulate a density‐dependent matrix model of population dynamics of Palythoa, and perform a series of sensitivity analyses on the model to determine at what stage in the life‐cycle regulation acts. 2. Seven of the 16 transition probabilities decreased with density, most of them being shrinkage (due to loss of tissue or fission) and stasis (the self–self transition) of medium and large colonies. The only probability to increase was for the stasis of large colonies. Recruitment was quadratically dependent on density, peaking at intermediate densities. 3. Equilibrium cover in the model was 84% and was reached in ≈40 years. To determine which density‐dependent transitions were involved in population regulation, the strength of density dependence was varied in each independently. This sensitivity analysis showed that only changes in the probabilities of large colonies remaining large and producing medium colonies, were regulating. 4. These results suggest that regulation is primarily acting on fission of large colonies to produce intermediate‐sized colonies, in combination with size specific growth rates. Fission rates decrease greatly with density, resulting in a greater proportion of large colonies at high densities and large colonies grow more slowly than small. Overall, this behaviour is very similar to that of clonal plants which have a phalanx type life history.
Barn swallows trade survival against offspring condition and immunocompetence
Authors: Saino Nicola , Calza Stefano , Ninni Paola , Møller Anders Pape 
Published: March 2003

Summary1. Organisms are continuously faced with the problem of making decisions about allocation of limiting resources to maintenance and reproduction. This paradigmatic principle leads to the prediction that each individual will have to trade competing activities affecting fitness, with natural selection favouring the evolution of optimal life‐history strategies.2. In the present study we tested for the existence of a trade‐off between parental survival and progeny quality and number in the biparental barn swallow (Hirundo rustica, Linnaeus) by recording survival from one breeding season to the next of adults, whose first brood size had been either increased or reduced by one nestling.3. Quality of offspring was expressed as body mass, body size and the ability to mount a T‐lymphocyte cell‐mediated immune response,in vivo, to a mitogenic stimulus, mimicking the reaction to an antigenic challenge to the immune system.4. Both adult male and female barn swallows were less likely to survive when their offspring had greater immunocompetence. Adult females were also less likely to survive when offspring had larger body size but smaller body mass. Brood enlargement reduced survival of adult males and had a differentially larger negative effect on survival of double‐brooded than single‐brooded adult females. Double‐broodedness did not covary with adult male survival but had a differentially larger effect on survival of adult females with enlarged compared to reduced broods. Males with relatively long ornamental tail feathers were more likely to survive than those with short tails.5. We conclude that parent barn swallows trade their own survival against features of nestlings that affect their probability of recruitment. Because immunity is one of the principal defences available to hosts against parasites, this study suggests that host–parasite interactions may have played a part in the evolution of optimal parental strategies.