bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health: integrated network and family‐oriented model for co‐operation between mental health patients, adult mental health services and social services
Authors: Piippo Jukka , Aaltonen Jukka 
Published: September 2004

Background.  Co‐operation between mental health care units and the social services is important in the case of people with social problems who also suffer from mental health problems. However, participation of patients and their families in the treatment process, and co‐operation between them and the professionals, are also important. Communication between the professionals, patients and their family members, and the professionals is a crucial factor for co‐operation.Aims and objectives.  The aim of this study was to elucidate the experiences and importance of co‐operation for the patients. The data consisted of interviews with 22 mental health patients who were also clients of municipal social services.Method.  The grounded theory approach was used, focusing on the informants’ experiences of the integrated network and family‐oriented model for co‐operation.Results.  The findings indicate the importance of the participation of patients and their social networks in psychiatric care or the treatment process. Meetings should be characterized by open and reflexive discussions with all participants’ points of view being included, so that fruitful co‐operation is possible. However, some negative experiences were also reported, all of which were connected with the professionals’ behaviour.Conclusions.  Trust and honesty are essential elements in relations between professionals and psychiatric patients, but it cannot be assumed that they will develop naturally. It is the professionals’ responsibility to adjust their behaviour so that these elements can be created in a mutual process between patients and professionals. Multidisciplinary teams are a necessity in family‐oriented co‐operation between psychiatry and social services, and in a satisfactory caring process.Relevance to clinical practice.  Nurses’ work is often individually oriented and nurses are ruled by routines in their work. The mental health caring process should be seen as a shared process between the patient, his/her human environment and professionals for which nurses need skills to their interaction with patients and their social network.
A framework for understanding clinical reasoning in community nursing
Authors: Carr Susan M 
Published: September 2004

Background.  Clinical reasoning is employed to develop solutions to health needs. The impact of the clinical environment on the organization of knowledge‐guiding practice has received limited attention. This gap in the clinical landscape restricts the sharing of decision‐making processes.Aims.  Focusing on the community, and specifically the patient's home as a context for nursing, this paper describes the creation of a collective conceptual map for a group of community nurses. There is a twofold aim of exploring the process of exposing and articulating the clinical framework and enhancing and sharing understanding of the clinical paradigm in this context.Design.  An interpretive research approach was utilized. Hermeneutic phenomenology guided the level of meaning accessed and constructivism was used to build an educational picture.Methods.  Multiple methods including focus groups, observation and narrative recordings were utilized to collect and analyse research data.Results.  All nurses may engage with the same concepts – health, need, care and partnerships – but organized into particular frames by the guiding practice philosophy and service organization. A four‐stage framework for understanding clinical reasoning in the community setting is presented. This acknowledges the multi‐faceted nature of health, the lived experience of health deficits, and is located in a participation and negotiated model of care. Practice examples are presented to expose the construction of need and response which often occurs in a triadic decision‐making process.Conclusions.  Environment of care has significant implications on need identification and response.Relevance to clinical practice.  Mechanisms to enhance the sharing of clinical reasoning and decision‐making transparency are essential to aid inter‐ and intra‐professional communication. Presentation of a clinical reasoning framework exposes the breath of ‘signals’ encountered in practice and the range of knowledge employed in understanding and responding to patient need.
District nursing – sharing an understanding by being present. Experiences of encounters with people with serious chronic illness and their close relatives in their homes
Authors: Öhman Marja , Söderberg Siv 
Published: September 2004

Background. In the homecare setting, district nurses assume a heavy responsibility and are involved in a variety of care activities. They view themselves as having a central role in care at home that centres on the development of a relationship with those who are ill and their families.Aim. The aim of this study was to elucidate the meaning of district nurses experiences of encounters with people with serious chronic illness and their close relatives in their homes. A purposive sample of 10 district nurses (female) was interviewed using a narrative approach.Method. To achieve the aim, a phenomenological hermeneutic interpretation inspired by the philosophy of Ricoeur was used to interpret the interview text.Results. This study proposes that district nurses’ experiences of encounters with people with serious chronic illness and their close relatives in their homes can be understood as district nurses being welcomed into the ill people's privacy, to share their intimacy and their understanding of being ill. This close relationship enables them to alleviate and to console the suffering and loneliness caused by illness. This is expressed in the three themes: being in a close relationship, sharing an understanding and weaving a web of protection.Conclusion. It seems that by being entirely present, in a close relationship, district nurses share the experiences of illness and through interpretation of the whole persons’ expressions; they share an understanding of this illness experience. In this close relationship, at the home of the ill people and their close relatives, district nurses are available to alleviate people's suffering and loneliness caused by illness.Relevance to clinical practice. This study reveals the need to be entirely present in encounters between the district nurses and people with serious chronic illness and their close relatives. This relation makes it possible to establish a shared understanding of the illness experience. Being aware of the importance of this shared understanding within a relationship, will increase the health care personnel's possibility to alleviate and console those suffering of illness. This proposed interpretation could be useful for reflection of care interventions, in education and supervision of district nurses.
Nurse prescribers’ experiences of prescribing
Authors: Lewis‐Evans Amanda , Jester Rebecca 
Published: September 2004

Background.  Nurse prescribing has advanced rapidly over the previous decade and is clearly on the agenda for the future. Previous research considers nurse prescribing from the patient's perspective, the medical professions’ stance and the legal and ethical implications. However, there is a paucity of literature that explores the experiences of nurse prescribers’ within their current role. These experiences need investigating to ensure nurse prescribing is able to advance in ways that provide benefit to nurses and thus provides the impetus for the study.Aim.  To explore and review nurse prescribers’ experiences of prescribing.Design methods.  A purposeful sample of seven nurse prescribers currently prescribing within a West Midlands Community Trust underwent minimally structured interviews in this qualitative study. Transcribed interviews were analyzed using thematic analysis.Findings.  Four themes were generated from analysis of the interviews, ‘patient centred care’, ‘benefits of nurse prescribing’, ‘support and role satisfaction’ and finally ‘prescribing difficulties’.Conclusions.  Nurse prescribers’ perceive prescribing as a predominantly positive experience, frequently asserting the advantages that prescribing saves the patient and nurse time, is more convenient for the patient and increases the nurses’ autonomy and role satisfaction. However, negative experiences of restrictions to practice as a result of nurse prescribers’ formulary limitations and duplication of documentation were also described.Relevance to clinical practice.  Nurse prescribing is a rapidly evolving area of practice with the potential to advance nursing roles. This research aims to provide an insight into the experiences of current nurse prescribers that may then be disseminated and applied to future practice.
Lecturer practitioners in UK nursing and midwifery: what is the evidence? A systematic review of the research literature
Authors: Williamson Graham R 
Published: September 2004

Background.  Lecturer practitioner roles have been widely established in the UK, and are seen as having the ability to overcome the theory–practice gap in nursing, as well as offering other benefits including functioning as a link between education and practice.Aims and objectives.  This article systematically reviews the research literature on UK lecturer practitioner roles in nursing and midwifery, in order to construct a picture of the themes that emerge from their national implementation.Conclusions.  Only eight published research studies meeting the inclusion criteria were identified in journals, and five more included from the ‘grey literature’, totalling 13 suitable research reports. Of these 13 papers, six involved nurses and midwives. Key themes from the literature are outlined and discussed. There is an overwhelming preference for qualitative methodologies, although there is a strong argument for quantitative work in mixed‐methods studies.Relevance to clinical practice. Lecturer practitioner roles can make an important contribution to nursing and midwifery education, but this is problematic. It is essential that managers clarify the purpose, responsibilities, support and review of lecturer practitioner roles if they are to be successful.
Management of fluid and hydration in patients with acute subarachnoid haemorrhage – an action research project
Authors: Cook Neal F , Deeny Pat , Thompson Kate 
Published: September 2004

Background.  The contemporary role of the nurse in managing fluid and hydration in patients is currently ill‐defined. Considering the pivotal function nurses have in the delivery of fluid therapies, and the high priority such therapies have in the successful treatment and prevention of secondary brain injury in subarachnoid haemorrhage, the clarification of this role is essential.Aims and objectives.  This research aims to clarify the nurse's role in fluid therapies in relation to subarachnoid haemorrhage. The objectives were to determine how nurses presently see their role in relation to fluid management in patients with subarachnoid haemorrhage, to determine the cues to guide their practice, and how this role corresponds to current patient care. A final objective was to identify how the nurse's role can be maximized to provide optimal patient care.Methodological design.  This project takes an action research approach to examining the nurse's role in the care of patients with subarachnoid haemorrhage. A combination of focus groups, physiological data, nursing and medical documentation and a review of recent literature were used to meet the aims and objectives of the project.Results.  The results illustrate that, while nurses involved in the study are knowledgeable about fluid and hydration in subarachnoid haemorrhage, they have an ambiguity surrounding their role. Improvements can be made in the quality of patient care through educational sessions for staff and clarification of medical and nursing interdisciplinary roles.Conclusion.  This action research project has gone a considerable distance towards begin clarifying this role, and has illustrated clearly that the nurse's role is pivotal to the successful implementation of such treatments. With further education and collaboration with the interdisciplinary team the nurses’ role can be expanded to provide optimal, and dynamic patient‐centred care.Relevance to clinical practice.  The results of this study highlight gaps within contemporary nursing and medical approaches to patients with subarachnoid haemorrhage, highlighting areas for improvement. It also begins to clarify the role of the nurse, with evidence of the cues they use to guide their practice.
Concordance with community mental health appointments: service users’ reasons for discontinuation
Authors: Hostick Tony , Newell Rob 
Published: September 2004

Background.  Quality issues are being given renewed emphasis through clinical governance and a drive to ensure service users’ views underpin health service development.Aims.  To establish service users’ reasons for discontinuation of community based mental health appointments in one National Health Service Trust.Method.  A two‐phase survey of all non‐completers over a year. Phase one using a structured postal questionnaire. Phase two using structured interviews with respondents to phase one by post, telephone and face to face.Results.  A total of 243 discharges because of non‐completion were identified by local services over the 12 months of the study and followed up by initial questionnaire. This represents 8.19% of all discharges (2967) within the same period. Forty‐four users were engaged and followed up within phase two of the survey. Data were subject to both quantitative and qualitative analysis.Conclusions.  Analysis of responses suggests that the main reasons for non‐completion are because of dissatisfaction although the reasons are varied and the interplay between variables is complex. Whilst this user group are not apparently suffering from ‘severe mental illness’, there is clear, expressed need for a service.Relevance to clinical practice.  Whoever provides such a service should be responsive to expressed need and a non‐medical approach seems to be favoured. If these needs are appropriately met then users are more likely to be engaged and satisfaction is likely to be improved. Although this in itself does not necessarily mean improved clinical outcomes, users are more likely to stay in touch until an agreed discharge. Practical problems of applied health service research are discussed and recommendations are made for a review of referral systems, service delivery and organization with suggestions for further research.
Stroke and eating difficulties: long‐term experiences
Authors: Carlsson Eva , Ehrenberg Anna , Ehnfors Margareta 
Published: September 2004

Background.  Previous studies have shown that eating difficulties after stroke are common and often associated with communication problems. These difficulties, however, have mainly been studied from a professional perspective. Although numerous aspects of dysfunction have been identified, little knowledge exists about the experiences of living with eating difficulties.Aim.  To explore how people affected by stroke experience living with eating difficulties, during a prolonged period.Design.  Explorative, qualitative case study.Methods.  Repeated interviews and participant observations with three persons 1.5–2 years after their last stroke. Data were analysed using qualitative analysis.Results.  Eating difficulties after stroke were experienced as Striving to live a normal life, with the subthemes Abandoned to learn on one's own, Experiences of losses and Feeling dependent. The process of getting back to a life that resembled life before the stroke was experienced as long‐lasting and hard work. The informants felt that they were abandoned to manage eating training on their own. The informants experienced a loss of functional eating ability and the ability to perform activities related to food and meals. Feelings of dependence were experienced in mealtime situations.Conclusion.  Living with eating difficulties after stroke is a complex phenomenon. The informants felt abandoned because of lack of support from the nursing staff. They were left on their own to deal with the difficult process of adjusting to a new way of eating and losses regarding mealtime activities. The combination of repeated interviews and participant observations seemed to be an approach that should be tested in larger studies.Relevance to clinical practice.  This case study indicates a need for nurses to develop and use evidence‐based guidelines for eating training during the continuum of care. Nurses need to assess patient's habits and desires related to eating, and to adjust environment according to patient preferences.
Families in home care – a resource or a burden? District nurses’ beliefs
Authors: Benzein Eva , Johansson Birgitta , Saveman Britt‐Inger 
Published: September 2004

Background.  Caring for families in home care is a growing part of Swedish district nurses’ professional work. District nurses’ facilitative and constraining beliefs about families guide the extent to which families are acknowledged and engaged in the care.Aims and objectives.  The aim of the study was to explore district nurses’ beliefs about families in home care.Design.  Explorative, descriptive.Methods.  Five district nurses participated in focus group interviews on three separate occasions. Each interview lasted approximately 90 minutes, was audio taped and transcribed verbatim. A thematic content analysis was used for analyses of the data.Results.  The result revealed two underpinning beliefs held by the district nurses towards families in home care: families are a resource and Families are a burden. Families could be a resource for the patient, for the other family members as well as for the district nurses themselves. Families could be a resource for the patient both practically and emotionally by e.g. being present and listening. Being open in communication with other family members and district nurses was also considered as a resource. The district nurses considered families as a burden when they were experienced as demanding in various ways, for example, when family members did not act in a way that pleased the district nurses or when family members showed their suffering.Conclusions.  This study highlight some facilitating and constraining beliefs held by district nurses: families can be both a resource and a burden.Relevance to clinical practice.  It is important that district nurses are aware of what beliefs they hold as their beliefs guide their actions towards the families.
Chinese inpatients’ subjective experiences of the helping process as viewed through examination of a nurses' focused, structured therapy group
Authors: Hsiao Fei‐Hsiu , Lin Shu‐Mei , Liao Hsiao‐Yuan , Lai Mei‐Chih 
Published: September 2004

Aims and objectives.  This study examined Chinese inpatients’ views on what aspects of a nurses' focused, structured therapy group worked to help their psychological and interpersonal problems and what traditional Chinese cultural values influenced their viewpoints.Methods.  Nine Chinese inpatients with mental illness participated in the four‐session nurses' focused, structured therapy group. After they completed the last session of therapy, they were invited to participate in a structured interview and a semi‐structured interview regarding their perceptions of the change mechanisms in nurses' focused, structured group therapy. The semi‐structured interviews were recorded and transcribed to be further analysed according to the principal of content analysis.Results.  The results indicate that (i) all patients believed that a nurses' focused, structured group psychotherapy enhanced their interpersonal learning and improved the quality of their lives, (ii) traditional Chinese cultural values – those emphasizing the importance of maintaining harmonious interpersonal relationships – influenced the Chinese inpatients’ expression of negative emotions in the group and their motivation on interpersonal learning.Conclusion.  In conclusion, we found that transcultural modification for applying Western group psychotherapy in Chinese culture was needed. The modification included establishing a ‘pseudo‐kin’ or ‘own people’ relationship among group members and the therapists, organizing warm‐up exercises and structured activities, applying projective methods and focusing on the issues of interpersonal relationships and interpersonal problems.Relevance to clinical practice.  The small sample size of the present study raises questions regarding how representative the views of the sample are with respect to the majority of Chinese inpatients. Nevertheless, this preliminary study revealed a cultural aspect in nursing training that requires significant consideration in order to work effectively with Chinese patients.
Resistance to quinclorac and ALS‐inhibitor herbicides in Galium spurium is conferred by two distinct genes
Authors: Van Eerd L L , McLean M D , Stephenson G R , Hall J C 
Published: September 2004

SummaryClassical Mendelian experiments were conducted to determine the genetics and inheritance of quinclorac and acetolactate synthase (ALS)‐inhibitor resistance in a biotype of Galium spurium. Plants were screened with the formulated product of either quinclorac or the ALS‐inhibitor, thifensulfuron, at the field dose of 125 or 6 g active ingredient (a.i.) ha−1 respectively. Segregation in the F2 generation indicated that quinclorac resistance was a single, recessive nuclear trait, based on a 1 : 3 segregation ratio [resistant : susceptible (R : S)]. Resistance to ALS inhibitors was due to a single, dominant nuclear trait, segregating in the F2 generation in a 3 : 1 ratio (R : S). The genetic models were confirmed by herbicide screens of F1 and backcrosses between the F1 and the S parent. F2 plants that survived quinclorac treatment set seed and the resulting F3 progeny were screened with either herbicide. Quinclorac‐treated F3 plants segregated in a 1 : 0 ratio (R : S), hence F2 progenitors were homozygous for quinclorac resistance. In contrast, F3 progeny segregated into three ratios: 1 : 0, 3 : 1 and 0 : 1 (R : S) in response to ALS‐inhibitor treatment. This segregation pattern indicates that their F2 parents were either homozygous or heterozygous for ALS‐inhibitor resistance. Therefore, there were clearly two distinct resistance mechanisms encoded by two genes that were not tightly linked as demonstrated by segregation patterns of the F3.
The effect of non‐inversion tillage and light availability on dispersal and spatial growth of Cynodon dactylon
Authors: Guglielmini A C , Satorre E H 
Published: September 2004

SummaryThe invasive ability of Cynodon dactylon is dependent on self dispersal and on cultivation practices. Tillage can seriously change patch biomass and spatial structure, spreading vegetative propagules of the weed. The objectives of this study were: (i) to quantify the effect on non‐inversion tillage on dispersal, establishment and colonization of C. dactylon and (ii) to propose a simple model considering soil cultivation effects and light availability on spatial growth of weed patches. Two experiments were carried out, exploring different soils and environmental conditions. Spatial distribution of vegetative units differed when tillage was conducted with different non‐inversion implements and could be described by simple functions. A minimum patch biomass seems necessary before vegetative structures are vulnerable to movement by cultivation. Only a small proportion of the biomass dispersed from original patches was able to establish. However, simulation showed that the area colonized by C. dactylon mostly increased by means of tillage dispersal, both with and without crop competition, in one growing cycle. It appears sensible to consider changing cultivation practices to reduce weed dispersal and to use crop competition for light to create unsuitable habitats limiting weed colonization.