bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meaning of life for adolescents with a physical disability in Korea
Authors: Kim Shin Jeong , Kang Kyung Ah 
Published: December 2004

Background.  Korean views and attitudes towards disabled people are generally negative. Because of this, living with life‐long disabilities in Korea means pain for oneself and one's family. Also family members think that the disability is detrimental to their social standing and try to hide the disabled person. Koreans believe that having disabilities is the result of the geomantic system of topography, used in choosing auspicious sites for graves and houses, sins committed in a previous existence, the fault of an ancestor, or a wicked ghost.Aim.  The objective of the study was to provide an understanding of how adolescents with physical disabilities see meaning in their lives, with the ultimate aim of encouraging these adolescents to find their own values and meanings of life.Design.  An inductive and descriptive study to understand the perspective of adolescents with physical disabilities.Methods.  Eighty‐eight adolescents with physical disabilities were interviewed in depth and content analysis was used for analyzing the data.Findings.  Adolescents with physical disabilities in Korea experience meaning in their lives when society accepts their existential problems and allows them to live a normal life. This normality includes helping others (as a friend or as a volunteer) and creating opportunities to achieve their own goals in life. The main categories in the findings were ‘accomplishment’, ‘social adaptation’, ‘improvement of the quality of life’, ‘good deeds’, ‘sincerity’, ‘satisfaction’, ‘having a relationship’, ‘achievement of self’, ‘perception of one's own usefulness’, ‘rehabilitation’, and ‘gain recognition by others’.Conclusion.  Adolescents with physical disabilities can understand the meaning of their lives when meaning is framed in the context of being a social issue, and when they are allowed to clarify their own values. Nursing intervention programmes need to be developed to improve the quality of physically disabled adolescents’ lives.
Transition experiences of qualified nurses moving into hospice nursing
Authors: Rosser Megan , King Lindy 
Published: December 2004

Background.  Over a short period of time a number of nurses had joined the staff at a hospice. Many of these nurses were palliative care novices, and thus their transition into hospice nursing constituted a move both to a new workplace and a new clinical specialism.Aim.  The aim of the study was to gain a deeper understanding of the experiences of qualified nurses making the transition into hospice nursing in order to support future nurses in this transition.Method.  A constructivist approach was used; data were collected through semi‐structured interviews with four new nurses, three mentors and four team leaders. Data were analysed using a constant comparative method.Findings.  Five major themes were identified: expectations, personal and professional development, professional respect, mentorship and support. Nurses came to the hospice with individual expectations, some of which were realized. All identified areas of personal and professional development. Whilst it was acknowledged that new nurses brought transferable skills, there was consensus that they needed to develop palliative care knowledge and skills. Professional respect was demonstrated by the degree of acceptance or questioning of new nurses by established staff. New nurses experienced a variety of emotional responses to hospice nursing. Mentorship enhanced the transition experience and strong support was also gained from each other.Conclusions.  New nurses need individual support during their transition into hospice nursing in response to their own expectations, experiences and learning needs. Mentors need preparation and support in their role in order to maximize their positive influence on transitions.
Expert qualitative researchers and the use of audit trails
Authors: Cutcliffe John R. , McKenna Hugh P. 
Published: December 2004

Background. Determining the credibility of qualitative research findings remains a contested area and leaves the way open for additional theoretical and methodological discussion.Aims. In this paper we focus on audit trails and confirmability, within the context of ‘expert’ qualitative researchers. Having outlined the audit trail process, we develop existing arguments about the ‘expert’ qualitative researcher. We then juxtapose the two, highlighting a number of issues in an attempt to advance the debate.Discussion. These issues discussed are: (1) The shifting sands of methodological orthodoxy – the historical context in which audit trails emerged. (2) The individual construction of logic. (3) ‘Grounded in the data’ or ‘going beyond the words’– the key differences between descriptive and interpretive findings. (4) The singular relationship between qualitative researcher and their data. (5) The growing acknowledgement that method alone is insufficient. (6) The challenging example of visionaries.Conclusion. We argue that using audit trails as a means to achieve confirmability of qualitative research findings is an exaggeration of the case for method, and may do little to establish the credibility of the findings. We also introduce a preliminary case for testing the credibility of theory induced by expert qualitative researchers, in part by means of its usefulness; its ‘fit and grab’, rather than by the researcher's adherence to contemporary methodological orthodoxy. In other words, the absence of audit trails does not necessarily challenge the credibility of qualitative findings, particularly if an expert qualitative researcher produced the findings.
Nurses’ autonomy: influence of nurse managers’ actions
Authors: Mrayyan Majd T. 
Published: December 2004

Background.  Autonomy plays an important part in nurses’ job satisfaction and retention, but the literature shows that they are often dissatisfied with this aspect and want better working conditions and greater autonomy in decision‐making.Aims.  The aim of this study was to examine the role that nurse managers have in enhancing hospital staff nurses’ autonomy.Methods.  The study used a comparative descriptive survey design. Data collection took place over the Internet through the use of selective listservs in the United States of America (USA), Canada, and the United Kingdom. Of the 317 hospital nurses participating, 264 (83·3%) were from the USA. Differences relating to nurses, nurse managers, and hospital settings were controlled in the analysis.Results.  Nurses were more autonomous in making patient care decisions than unit operational decisions, and they perceived their autonomy to be at a moderate level. Those who were autonomous in patient care decision‐making were also likely to be autonomous in unit operation decision‐making. Nurse managers’ actions had a strong relationship with nurses’ autonomy in deciding on patient care and unit operation decisions, and with total autonomy. The three important variables that were reported by staff nurses to increase their autonomy were supportive management, education and experience. The three most important factors that were reported to decrease nurses’ autonomy were autocratic management, doctors and workload.Discussion.  Technical issues such as the availability of listservs, valid e‐mails, viruses, and familiarity with the Internet and its applications were the major limitations of this study. Nurses’ autonomy over patient care and unit operations decisions needs to be enhanced, and nurse managers should promote this. Similarly, there is a role for nurse education, both in preregistration programmes and in continuing education for managers. Further research needs to explore the barriers that nurses face in autonomous decision‐making and how nurses’ participation in unit operational decisions can be promoted.Conclusions.  Hospital staff nurses have moderate autonomy which could be increased by more effective support from nurse managers. The use of electronic questionnaires is a promising data collection method.
Enhancing critical thinking in the preceptorship experience in nursing education
Authors: Myrick Florence , Yonge Olive 
Published: December 2004

Background.  To date no research has been conducted to examine the process used in the preceptorship experience to enhance critical thinking at the graduate level. This study provides data that could revitalize the preceptor/learner relationship and in turn influence future preceptorship programmes in graduate nursing education.Aim.  The purpose of this study was to examine the preceptorship experience and its role in the enhancement of critical thinking in graduate nursing education.Design.  A grounded theory approach was employed, through semi‐structured, tape‐recorded interviews. Overall, 45 interviews were completed with graduate nursing students ranging in age from 26 to 53 years, and master's and doctorally prepared preceptors who ranged in age from 47 to 58 years. In addition, a journal of personal reflections was kept by each of the researchers. Analysis of data included the process of open coding, theoretical coding, selective coding, reduction and comparison.Findings.  Data revealed that a process, designated The Relational Process, occurred in the preceptorship experience to enhance the critical thinking ability of graduate nursing students. This process was found to be a complex, ongoing interpersonal dynamic between the graduate student and assigned preceptor.Conclusions.  The relational process that emerged from this study indicates that specific preceptor behaviours are pivotal to the enhancement of critical thinking of graduate nursing students and ultimately impact on the success or failure of the preceptorship experience.
Cancer‐related pain in palliative care: patients’ perceptions of pain management
Authors: Boström Barbro , Sandh Marie , Lundberg Dag , Fridlund Bengt 
Published: December 2004

Background.  Pain is still a significant problem for many patients with cancer, despite numerous, clear and concise guidelines for the treatment of cancer‐related pain. The impact of pain cognition on patients’ experiences of cancer‐related pain remains relatively unexplored.Aim.  The aim of this study was to describe how patients with cancer‐related pain in palliative care perceive the management of their pain.Method.  Thirty patients were strategically selected for interviews with open‐ended questions, designed to explore the pain and pain management related to their cancer. The interviews were analysed using a phenomenographic approach.Findings.  Patients described 10 different perceptions of pain and pain management summarized in the three categories: communication, planning and trust. In terms of communication, patients expressed a need for an open and honest dialogue with health care professionals about all problems concerning pain. Patients expressed an urgent need for planning of their pain treatment including all caring activities around them. When they felt trust in the health care organization as a whole, and in nurses and physicians in particular, they described improved ability and willingness to participate in pain management. While the findings are limited to patients in palliative care, questions are raised about others with cancer‐related pain without access to a palliative care team.Conclusion.  The opportunity for patients to discuss pain and its treatment seems to have occurred late in the course of disease, mostly not until coming in contact with a palliative care team. They expressed a wish to be pain‐free, or attain as much pain relief as possible, with as few side effects as possible.
Coping and stress: a conceptual analysis
Authors: Keil Ruth M.K. 
Published: December 2004

Background.  Much work has been done towards the classification of clinical concepts in nursing. However, there is a comparative lack of analysis of non‐technical terms, which nevertheless bear closely on professional practice in nursing. Within nursing classifications, the term ‘coping’ functions as an element in more complex conceptual structures, the term itself being left relatively undefined. The case is similar for the term ‘stress’– the set of circumstances with which the individual is attempting to cope.Aims.  The aim of this paper is to arrive at grounds for consensus over the use and meaning of the widely used terms ‘stress’ and ‘coping’.Methods.  A conceptual analysis of the terms ‘stress’ and ‘coping’ was carried out, looking at etymology, ordinary usage and theoretical contingencies, in order to generate paradigmatic cases. A range of nursing and non‐nursing literature was examined in order to illustrate further the range of the terms.Conclusions.  ‘Stress’ and ‘coping’ are terms which are widely used in nursing; their significance has varied overtime and in the literature, and there continues to be lack of clarity over their precise meaning and use.
Ryanodine‐ and cyclopiazonic acid‐sensitive components in human vas deferens contractions to noradrenaline
Authors: Amobi N. I. B. , Smith I. C. H. 
Published: December 2004

Summary

The role of calcium stores in noradrenaline‐ (NA) and caffeine‐induced contractions of human vas deferens were investigated using ryanodine and cyclopiazonic acid (CPA) in the presence of the calcium antagonist, nifedipine (1 μM) or in calcium‐free/EGTA (1 mM) medium.
In either media, NA (100 μM) evoked biphasic contractions of longitudinal muscle and tonic circular muscle contractions. Caffeine (20 mM) evoked longitudinal but not circular muscle contractions.
Ryanodine (1–30 μM) or CPA (1–30 μM) inhibited contractions of circular muscle, and the initial but not secondary component of longitudinal muscle contraction to NA.
In the presence of nifedipine, pre‐exposure to caffeine caused a potentiation of circular muscle, and the initial but not secondary longitudinal muscle contractions to NA. The presence of ryanodine or CPA during the caffeine pre‐exposures effectively blocked the potentiation of the initial component and reduced the secondary component of the subsequent responses to NA in longitudinal muscle.
In calcium‐free media, caffeine pre‐exposures had little effect on subsequent NA‐induced contractions in circular muscle, but reduced both components in longitudinal muscle. The presence of ryanodine or CPA during caffeine pre‐exposures produced no further effects on either component of the subsequent NA‐induced contraction in longitudinal muscle.
In the presence of nifedipine or in calcium‐free media, repeated applications of caffeine evoked contractions in longitudinal muscle which were not blocked by either ryanodine or CPA.
These results suggest that circular muscle contraction by NA and the initial component of longitudinal muscle to NA both utilize an intracellular pool of calcium that is triggered via a ryanodine‐sensitive mechanism and replenished via a CPA‐sensitive Ca2+‐ATPase.
In longitudinal muscle, both the secondary component of its response to NA and contraction to caffeine appear to involve an unusual but pharmacologically distinct (ryanodine‐ and CPA‐ insensitive) pathway.
The quiescence to caffeine of circular muscle may be caused by a relative absence of the ryanodine‐ and CPA‐insensitive pathway.
Pharmacology of neurotransmission to the smooth muscle of the rat and the guinea‐pig prostate glands
Authors: Lau W. A. K. , Ventura S. , Pennefather J. N. 
Published: December 2004

Summary

Histochemical studies carried out on sections of rat and guinea‐pig prostate glands revealed the presence of acetylcholinesterase‐ and noradrenaline‐containing nerve fibres in the fibromuscular stroma. Positive staining for acetylcholinesterase but not for noradrenaline was also seen in the epithelium.
Electrical field stimulation with trains of 0.5 ms pulses, dial setting of 60 V, delivered at 130 Hz for 10 s at 5 min intervals, was applied to nerve terminals within the rat and guinea‐pig isolated prostate glands. The evoked contractions were frequency‐dependent. Tetrodotoxin (1 μM) abolished contractions evoked by short pulse repetitive stimulation (trains of 20 0.5 ms pulses at 10 Hz every 100 s) in tissues from both species.
The field stimulation‐induced contractions of the prostatic smooth muscle were markedly attenuated by guanethidine (10 μM) and prazosin (0.1 and 1 μM) indicating that neurotransmission to the prostatic smooth muscle in both species is predominantly sympathetic and noradrenergic, and that noradrenaline released during field stimulation acts at postjunctional α1‐adrenoceptors.
Atropine (0.1 and 1 μM) caused a slight but significant reduction of the field stimulation‐induced contractions of prostate smooth muscle from both the rat and the guinea‐pig. In the guinea‐pig, cholinesterase inhibition by physostigmine and neostigmine, both at 10 μM, enhanced the field stimulation‐induced contractions of the prostatic smooth muscle. This enhancement was reversed by atropine (0.1 μM) but not by hexamethonium (0.1 mM). These data are compatible with some participation of acetylcholine, acting at muscarinic receptors, in neurotransmission to prostatic smooth muscle.
Cognitive therapy integrated with life review techniques: an eclectic treatment approach for affective symptoms in older adults
Authors: Puentes William J. 
Published: December 2004

Background.  An important aspect of nursing theory development has been the adaptation of theory from other disciplines within the metaparadigm of nursing. This eclectic approach to theory development enhances the broad humanistic theory base on which effective, professional nursing practice is based.Aims and objectives.  The aim of this article is to describe the process of integrating two distinct psychotherapeutic approaches into one coherent mental health nursing intervention for the treatment of affective symptoms in older adults. Guidelines for using this integration process in psychiatric mental health nursing clinical practice are presented and illustrated through the case study approach.Methods.  A case study is presented describing a clinical situation in which life review techniques were used to enhance the outcomes of a cognitive therapy experience for older adults enrolled in outpatient psychotherapy treatment for acute adjustment disorder with an affective component.Conclusions and relevance to clinical practice.  The advanced practice psychiatric mental health nurse who approaches psychotherapeutic interventions with older adult clients from an eclectic approach can achieve successful outcomes by having a clear understanding of (i) the dynamics of the various psychotherapeutic approaches, (i) the skill level of the practitioner, (iii) the psychosocial sophistication of the client, and (iv) the pathology being treated. In addition, active involvement by the client in a treatment process that matches his/her psychosocial skill and coping resource level will contribute to effective resolution of pathology. A cognitive therapy approach supplemented by life review techniques is an excellent example of an effective, eclectic treatment approach of affective disorders in older adults.
Midwifery care: development of an instrument to measure quality based on the World Health Organization's classification of care in normal birth
Authors: Sandin Bojö Ann‐Kristin ‘Fia’ , Hall‐Lord Marie‐Louise , Axelsson Ove , Udén Giggi , Wilde Larsson Bodil 
Published: December 2004

Aims and objectives.  The aim of the study was to develop an instrument to measure midwifery care in relation to World Health Organization's classification of care in normal birth and to test the instrument for content validity and inter‐rater reliability.Methods.  The Delphi method was used for development of the instrument and to elicit evidence of content validity. Six experts from three different geographical regions in Sweden, representing clinically working midwives, lecturers in midwifery and obstetricians, participated in the first part of the study. The instrument was tested for inter‐rater reliability in an exploratory study by two midwives and one of the authors. Data were analysed using percentage of agreement level and the Kappa coefficient.Results.  Five expert rounds were needed to reach consensus for content validity. The inter‐rater reliability test showed high agreement levels (95.9, 94.2 and 95.7%) and good to very good Kappa coefficients (0.74–1.0). The final instrument consisted of 78 items divided into five sections: background (five items); practices which are demonstrably useful and should be encouraged (55 items); practices which are clearly harmful or ineffective and should be eliminated (five items); practices for which insufficient evidence exists to support a clear recommendation and which should be used with caution while further research clarifies the issue (four items); and finally practices which are frequently used inappropriately (nine items).Conclusions and relevance to clinical practice.  The instrument can be used at a labour ward to measure documented care and quality of midwifery care. The results can be used to identify areas for improvements, to develop guidelines towards evidence‐based care and to improve documentation. However, the present study should be regarded as an exploratory study and the feasibility of the instrument remains to be tested in empirical studies.
Improving networks between acute care nurses and an aged care assessment team
Authors: Robinson Andrew , Street Annette 
Published: December 2004

Background.  Acute care nurses have an important role in the discharge planning of older people from hospital to home. However, few nurses understand the changing aged care system or the consequences of poor referral on the lives of older people postdischarge.Aims and objectives.  This paper reports the findings of a research project, which aimed to investigate the possibilities for facilitating the transition of older people from hospital to home through improving the working relationship between nurses and members of a multidisciplinary aged care assessment team (ACAT).Design and methods.  The paper reports one action research cycle from a larger project. Action research was chosen because its focus on knowledge development and action leads to practical solutions to clinical problems. The research approach included interactive forums designed to facilitate effective collaboration between the nurses and ACAT in the discharge planning of older people. Data collection strategies included audiotapes of ACAT research discussions, field notes, policy documents, referral forms and an evaluation tool.Results and conclusions.  The findings illustrate that ward nurses have, at best, a limited knowledge and understanding of the aged care system, its function, or how to access services. They need assistance to develop their knowledge of services available to support older people following discharge. The conduct of interactive forums, which utilize a case study approach, facilitated such knowledge development and empowered the nurses to become more involved in discharge planning. Participation in the forums also facilitated new collaborative partnerships between the nurses and ACAT, which enhanced effective discharge planning.Relevance to clinical practice.  The paper outlines practical strategies to support collaboration between ward nurses and community providers and/or multi disciplinary assessment services. It provides a list of key considerations for the development of effective ward/community networks to facilitate the discharge of older people.