bluuebunny/crossref_metadata_2025_split huggingface dataset:
Students’ perceptions of the effectiveness of mentors in an undergraduate nursing programme in Hong Kong
Authors: Suen Lorna K.P. , Chow Filomena L.W. 
Published: March 2003

Students’ perceptions of the effectiveness of mentors in an undergraduate nursing programme in Hong Kong Aim of the paper. This paper reports the results of a multiple‐phase study on a mentoring scheme for nursing students in one of the universities in Hong Kong. Using a qualitative approach, students’ perceptions of the various roles of mentors were collected, and this information was used as the basis to design a tool for subsequent evaluation of the mentoring scheme. Background. The nursing department in one of the universities in Hong Kong initiated and developed the idea of an ‘Honorary Clinical Instructors’ scheme (HCI scheme) for the supervision of the pre‐registration nurses. The scheme was examined in a local context, where the Chinese culture dominated, so that a standardized protocol that takes into account the potential cultural dimensions could be established. Design. The mentoring roles outlined by the English National Board (ENB) for Nursing, Midwifery, Health Visiting were used as a framework to identify undergraduate nursing students’ perception of the effectiveness of mentors. Information gathered from interviews with Year 2 students (n=12) and Year 3 students (n=10) was used as the basis to design a questionnaire for subsequent programme evaluation. An evaluation questionnaire based on the interviewing results was developed for further evaluation of the mentoring scheme. Findings. After the mentoring scheme was evaluated in semester one, a series of strategies were designed to improve the preparation of mentors and the implementation of the scheme. The strategies were identified as effective by the significant differences in the perceptions students had towards the mentoring scheme in semester one and semester two (t189=–4·80, P < 0·001), with semester two (n=81) having a mean score difference of 8·69 higher than in semester one (n=110). Conclusions. It was concluded that the questionnaire developed in the project could be adopted as a useful instrument to evaluate the effectiveness of mentoring programmes for nursing courses, and that the results of this study may also stimulate more research interest in this area to improve the quality of clinical teaching in the pre‐registration nursing education programmes in the future.
Substitution model with central role for nurse specialist is justified in the care for stable type 2 diabetic outpatients
Authors: Vrijhoef H.J.M. , Diederiks J.P.M. , Spreeuwenberg C. , Wolffenbuttel B.H.R. 
Published: March 2003

Substitution model with central role for nurse specialist is justified in the care for stable type 2 diabetic outpatients Aim of the study. Assessment of effects on quality of care, in terms of patient outcomes, when tasks in the care for outpatients with stable type 2 diabetes are transferred from internist to nurse specialist and from outpatient clinic to general practice. Background. For the management of chronic diseases with a high prevalence and requiring current monitoring, it is suggested that substitution of care may be an appropriate solution to safeguard high quality care. Design and methods. A 12‐month nonequivalent control group design was used. General practitioners (GPs) referring diabetes patients to the University Hospital Maastricht were asked to choose for the traditional model or the nurse specialist model. Informed consent was obtained from patients with stable diabetes type 2 attending these practices. All patients received care according to the model chosen by their GP. Identified outcomes were: clinical status, health status, self‐care behaviour, knowledge of diabetes, patient satisfaction, and consultation with care‐providers. Results. In the control group (n=47) no patients were treated with oral hypoglycaemic agents (OHA) only. The control group was compared with an intervention subgroup (n=52) also without patients receiving OHA only. Clinical data were available for all patients. Patients without complete data from questionnaires had better mean concentration of HbA1c than patients with complete data (P=0·004). The traditional care model and the nurse specialist model achieved equal outcomes, while glycaemic control of patients in the nurse specialist model improved (from 8·6% to 8·3%) but deteriorated in the traditional model (from 8·6% to 8·8%; P‐value between groups=0·001). Conclusions. The model with nurse specialists taking on roles and tasks beyond those traditionally regarded as their remit as well as new ones, is effective for the care of stable diabetic outpatients.
Nurses’ behavioural intentions towards self‐poisoning patients: a theory of reasoned action, comparison of attitudes and subjective norms as predictive variables
Authors: McKinlay Andy , Couston Maggie , Cowan Sue 
Published: March 2003

Nurses’ behavioural intentions towards self‐poisoning patients: a theory of reasoned action, comparison of attitudes and subjective norms as predictive variables Background. The incidence of self‐poisoning is on the increase. Most patients who self‐poison are dealt with initially in the general hospital. Therefore, the type and quality of care self‐poisoning patients receive will depend, in part, on how they are viewed by nursing staff within the general hospital setting. A knowledge and understanding of the attitudes held by nurses towards self‐poisoning patients is therefore important to those involved in the planning and delivery of care towards this client group. Previous studies have examined health care professionals’ attitudes towards people who self‐poison. Usually, however, these have not focused specifically on nurses’ attitudes, and they have ignored the relationship between the attitudes expressed by staff and their intentions to engage in subsequent caring behaviour of one sort or another. It is hence unclear how the findings of such studies are relevant or applicable to nursing policy and practice. Aims. The present study aims to address these limitations using a methodology informed by the theory of reasoned action. The study aims to separate out the distinctive roles played by nurses’ own attitudes, and the social pressures represented by other people’s attitudes, in determining the types of caring behaviour in which nurses intend to engage when dealing with self‐poisoning patients. Design/Methods. The study adopts a questionnaire‐based approach incorporating two specially designed vignettes. Results. The results show that nurses’ own attitudes, and what they believe about the attitudes of others, predict their behavioural intentions towards self‐poisoning patients. The study also shows that nurses with a more positive orientation towards self‐poisoning patients differ in behavioural and normative beliefs from nurses who have a less positive orientation. Conclusions. The implications for future attempts to explore the relationship between nurses’ attitudes and subsequent caring behaviour are considered, along with implications for nursing policy and practice.
Developing critical reflection for professional practice through problem‐based learning
Authors: Williams Bev 
Published: March 2003

Developing critical reflection for professional practice through problem‐based learning Aims. To explore the influence of current learning traditions in nursing on the development of reflection and critical reflection as professional practice skills and to offer suggestions for nursing education that will specifically facilitate the development of critical reflection. Organizational constructs. Mezirow’s transformative learning theory, Barrows conceptualization of problem‐based learning (PBL). Methods. Integrative literature review of published literature related to nursing, health science education and professional education from 1983–2000. Findings. Professional education scholars concur that specialized knowledge is clearly essential for professional practice, however, they also suggest that self‐consciousness (reflection) and continual self‐critique (critical reflection) are crucial to continued competence. While strategies to facilitate reflection have been outlined in the literature, specific strategies to facilitate the development of critical reflection and implications for nursing education are much less clear. Advocates of reflective and critically reflective practice suggest that the development of these abilities should be inextricably linked to professional development and can be developed through active repeated guided practice. In health care, PBL based on constructivism, has been identified as one way to facilitate the development of these skills. Conclusions. Nursing learners exposed to PBL develop the ability to be reflective and critically reflective in their learning and acquire the knowledge and skill within the discipline of nursing by encountering key professional practice situations as the stimulus and focus of their classroom learning. The learners’ ability to be both reflective and critically reflective in their learning is developed by critical questioning of the faculty tutor during situational analysis, learning need determination, application of knowledge, critique of resources and personal problem‐solving processes, and summarization of what was learned.
Reliability and validity of the nutritional form for the elderly (NUFFE)
Authors: Söderhamn Ulrika , Söderhamn Olle 
Published: March 2003

Reliability and validity of the nutritional form for the elderly (NUFFE) Aim. The aim of this study was to test the reliability and validity of the Nutritional Form for the Elderly (NUFFE). Background. The prevalence of undernutrition among older people in nursing homes and hospitals reaches high levels. Assessment of older patients’ nutritional status is an important task for nurses in clinical care. To use a simple nutritional assessment instrument for older people is one approach for nurses. Examples of such instruments are the well validated Mini Nutritional Assessment (MNA) and the newly developed NUFFE. Methods. A total of 114 consecutively chosen, newly admitted older patients in an elder care rehabilitation ward in western Sweden were interviewed using the NUFFE and MNA. Arm and calf circumferences, body mass index (BMI), and presence of pressure sores and skin ulcers were noted as part of the MNA on admission. Weight was monitored and BMI calculated on discharge. Serum albumin levels on admission and discharge were used if these were available in the records. Reliability of the NUFFE was measured as homogeneity. Criterion related validity, concurrent validity, construct validity, and predictive validity were assessed with different statistical methods. The regional research ethics committee approved the study. Results. The results showed that the NUFFE is a fairly reliable and valid instrument for identifying actual and potential undernutrition among older patients. Conclusion. The NUFFE is a simple tool for nurses to use to assess older patients with the aim of detecting undernourished individuals and those at risk for undernutrition. When doing a nutritional assessment with the NUFFE, the BMI ought also to be calculated. The assessment could also be combined with food intake recording for a period of time.
Spirituality and health: towards a framework for exploring the relationship between spirituality and health
Authors: Coyle Joanne 
Published: March 2003

Spirituality and health: towards a framework for exploring the relationship between spirituality and health Background. A growing body of evidence has found that spirituality enhances health. However, spirituality is an elusive concept that defies clear definition. This inevitably presents difficulties when comparing the findings of studies. Therefore conceptual clarification is essential if practitioners are to better understand the relationship between spirituality and health. Aims. The aim of this paper is to develop a conceptual framework, which can be used to explore the relationship between spirituality and health. Methods. The concept‐indicator model was used to analyse spirituality in the literature. The literature was searched for empirical indicators or what are taken as essential attributes of spirituality. Similarities and differences between approaches were identified and these formed the basis of a framework. Findings. The analysis identified three approaches (a trichotomy) to spirituality in the literature. These were termed the transcendent, the value guidance and the structuralist–behaviourist approaches. The paper shows how by clarifying the different conceptualizations of spirituality and the interrelationship between them researchers can also clarify their respective contributions to health. Thus a contribution is made towards making more explicit the ways in which key aspects of spirituality such as transcendence, meaning and purpose, connectedness, hope, and faith, work to produce health benefits in terms of prevention, recovery from illness, or coping with illness. Conclusions. The framework (or trichotomy) will enable practitioners to understand better the connection between spirituality and health. In particular, it will show that to appreciate the benefits that patients might experience from their value or belief systems, practitioners must actively explore the content of those systems in a respectful way.
Cardiovascular health and physical activity in older adults: an integrative review of research methodology and results
Authors: Houde Susan Crocker , Melillo Karen Devereaux 
Published: March 2003

Cardiovascular health and physical activity in older adults: an integrative review of research methodology and results Purpose of the paper. The purpose of this article is to review the literature on physical activity and its relationship to cardiovascular risk factors and mortality in older adults, in an effort to clarify the specific benefits and optimal level of physical activity for cardiovascular health in the older adult population. Background/rationale. Despite physical activity being recognized as an important factor in the quality of life of older adults, there is a lack of clarity about the optimal level of physical activity that results in positive cardiovascular health benefits. Design/methods. An integrative review of the literature using the MEDLINE and CINAHL databases from 1990 through August 2000 was conducted identifying articles related to physical activity and cardiac risk factors, cardiovascular health, or mortality in the older adult. Results/findings. Forty‐four research articles were reviewed. The intervention studies generally provided support for positive cardiovascular changes with exercise, but the results were inconsistent, sample sizes were small, and the outcomes, interventions, and measures of physical activity differed between studies. There was wide variation in the method of measurement of physical activity in the studies. Studies showed an increase in mortality in those who had a sedentary lifestyle compared to those who were more physically active. Results were mixed related to plasma lipids levels. Three studies showed a positive effect of physical activity on blood pressure (BP), while three studies showed no relationship. Each of the studies that evaluated the relationship between physical activity and pulse rate showed a decreased rate with increased physical activity. Conclusions. The quantity and type of physical activity that should be recommended to bring about positive effects on cardiovascular health and mortality is unclear. There is support, however, that an active lifestyle decreases mortality. There is conflicting evidence to support positive effects of physical activity on cardiac risk factors. Further research is needed with larger sample sizes, better control of extraneous variables, and using measurements of physical activity that have undergone adequate psychometric testing.
A framework for the role of Registered Nurses in the specialty practice of rehabilitation nursing in Australia
Authors: Julie Pryor BA MN RN CM MRCNA  , Smith Clair 
Published: March 2003

Aim of the study.  This study sought to explore systematically the role of Registered Nurses working in rehabilitation in Australia. Background.  Rehabilitation has been identified as an important aspect of health care. However, evidence of a comprehensive investigation of the nurses' role in rehabilitation cannot be found. From Australia, in particular, no research has been published in this area. Methods.  This study used a qualitative approach by engaging 13 nurses in one‐to‐one interviews and a further 21 in focus group discussions. Thematic analysis was conducted on the interview and focus group data. Findings.  Seven domains of practice were identified and are suggested as a framework for the specialty practice of rehabilitation nursing. They capture the ‘how’ and ‘what’ of rehabilitation nursing practice. Central to this practice is a rehabilitative approach to patient care, teaching and coaching, and continual assessment. The nurses explained in detail how these aspects of rehabilitation nursing differentiate their practice from that of their acute care colleagues. Conclusion.  The rehabilitative approach is one of a variety of approaches to nursing care, but should not be seen as the exclusive domain of rehabilitation nurses. Rehabilitation belongs in every nurse's toolkit.
The nursing contribution to qualitative research in palliative care 1990–1999: a critical evaluation
Authors: Bailey Chris , Froggatt Katherine , Field David , Krishnasamy Meinir 
Published: March 2003

Background. Qualitative research plays an important part in providing evidence for practice in nursing, and is gaining greater acceptance within medicine. However, questions remain about what criteria are most appropriate for evaluating qualitative research. To date, little systematic evaluation of qualitative research in palliative care has been conducted.Aims. This paper is based on a larger study in which we conducted a critical review of qualitative research in palliative care from nursing, medicine, specialist palliative care, sociology, death studies, medical anthropology, and gerontology journals published between 1990 and 1999. The aim of this paper is to present an account of the strengths and weaknesses of qualitative palliative care research in nursing, using data from this review.Methods. In the larger study, 138 papers from 50 journals were reviewed critically using a tool developed to assess both content and quality; in one part of this tool reviewers recorded open‐ended comments on the strengths and weaknesses of each paper. In this paper, we present a thematic analysis of reviewers' comments on a subgroup of 67 nursing papers from the main review, together with an analysis of comments on 29 papers from a comparison group of death studies, medical anthropology, and sociology journals. Patterns of positive and negative evaluation are identified and used to generate an account of strengths and weaknesses in qualitative palliative care research in nursing.Findings. Over 40% of the subgroup of papers from nursing journals received positive comments on topic and quality of writing; around 30% received positive comments on contribution to understanding, practical value, and conceptual or theoretical issues. Less than 20% received positive comments on other critical dimensions. Over 40% of nursing papers received negative comments on the link between data, analysis, and findings, other aspects of method and theoretical and conceptual issues. A higher proportion of papers in the comparison group received positive comments on conceptual and theoretical issues and contribution to understanding.Conclusions. Nearly half the nursing papers reviewed were judged to be well written or to have a well‐chosen topic. However, more than 40% of papers drew negative comments about key methods‐related issues. Arguably therefore efforts to improve the quality of research evidence should focus on this area.
Issues concerning the on‐going care of patients with comorbidities in acute care and post‐discharge in Australia: a literature review
Authors: Williams Allison , Botti Mari 
Published: March 2003

Issues concerning the on‐going care of patients with comorbidities in acute care and post‐discharge in Australia: a literature review Background.  Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most western countries. This has resulted in an ageing population with a concomitant growth in the number of people who are living with chronic illnesses. Indeed a significant number of younger people experience more than one chronic illness. Large numbers of these may require repeated admissions to hospital for acute or episodic care that is superimposed upon the needs of their chronic conditions. Aim.  To explore the issues that circumscribe the complexities of caring for people with concurrent chronic illnesses, or comorbidities, in the acute care setting and postdischarge. Methods.  A literature review to examine the issues that impact upon the provision of comprehensive care to patients with comorbidities in the acute care setting and postdischarge. Findings.  Few studies have investigated this subject. From an Australian perspective, it is evident that the structure of the current health care environment has made it difficult to meet the needs of patients with comorbidities in the acute care setting and postdischarge. This is of major concern for nurses attempting to provide comprehensive care to an increasingly prevalent group of chronically ill people. Conclusion.  Further research is necessary to explore how episodic care is integrated into the on‐going management of patients with comorbidities and how nurse clinicians can better use an episode of acute illness as an opportunity to review their overall management.
Community perspective on a model to reduce teenage pregnancy
Authors: Tabi Marian M. 
Published: March 2003

Design. Qualitative methodology was used to validate elements of an educational career youth developmental model (ECYDM) to reduce teenage pregnancy among African American teens in two inner city urban communities. The specific aims of the study were to gain understanding of the factors contributing to teenage pregnancy and to identify a pregnancy prevention programme relevant to the needs of African American youth. Methods. Data were collected from a convenience purposive sample of 43 African American teens and adults. Teen participants included males and non‐pregnant, pregnant, and parent females. Adult participants included parents, school staff, and community clergies. Data were collected using demographic questionnaires, structured individual and focus group interviews. Approval from the Institutional Review Board was obtained before conducting the study. Findings. Findings supported elements of the ECYDM as a pregnancy prevention programme for African American teens in inner city urban communities. Participants identified an educational‐career motivational programme that utilizes mentoring to teach, counsel, and provide information to improve youths' health, education, career, and social outcomes as the pregnancy prevention programme for youth in urban communities. Conclusions. These findings have important implications for future programme design and research. Teenage pregnancy must be addressed within the context of the individual, family, and community. Community partnership and collaboration of resources is necessary to reduce teenage pregnancy. Educational‐career programmes are needed to provide information and knowledge to young men and women to make sound informed decisions. Continued qualitative research is also needed to gain understanding of pregnancy prevention programmes.