bluuebunny/crossref_metadata_2025_split huggingface dataset:
The patient and the primary care team: a small‐scale critical theory
Authors: Timpka  
Published: March 2003

The patient and the primary care team: a small‐scale critical theory For increasing the understanding of team‐based delivery of primary care, ratings of care satisfaction and stimulated‐recall interviews were used to compose a small‐scale critical theory. Three teams and 24 patients at a community health care centre participated in the study. It was found that the multiprofessional team was vulnerable to discrepancies between the health service policy and the available care resources. If pre‐paid patients arrive with too high expectations and demands on the service, a significant part of the team’s attention is used for economizing with care procedures. When health and economics are entangled for the team, the patients are not invited to share decisions about their health. The patients’ concerns are instead turned to the social arena, which is separated by language and context from the health analysis. Simultaneously, when the teams are led to solve the health problems without involving the patients in the process, the team members convert these to their own personal distress when they fail. The conclusion is that the discrepancy between care policy and factual resources is an important cause of imbalance in patient–primary care team interaction. If service strategy and team organization and resources are not continuously adjusted to each other, the effects will continue to obstruct communication during consultations.
The information content of the nurse change of shift report: a comparative study
Authors: Lamond Dawn 
Published: March 2003

The information content of the nurse change of shift report: a comparative study This study examines the role which the nursing change of shift report may have in aiding nurses to process information and plan care. It also aims to identify whether any of the information found in the shift report can be considered as ‘forceful feature’ information, the key features of a situation which allow an individual to access appropriate knowledge within their long‐term memory store. The content of the medical notes, nursing documentation and shift reports for a total of 60 patients, selected from two acute medical and two acute surgical wards across two National Health Service Hospital Trusts in south‐east England were subjected to content analysis. The types and amount of information contained in each source were examined, along with the order of information given in the shift reports. A multidimensional scalogram analysis (MSA) was also carried out on the data to examine the patterns of information content across sources. In general, more information was recorded in the patients’ notes than communicated during the shift report. However, both the frequency data and the MSA plots indicated that particular types of information (identified here as global judgements) were often communicated in the shift report but not recorded in the patient notes. The results suggest that there is evidence that the change of shift report contains ‘forceful feature’ information. The presence of such ‘forceful features’ may facilitate the processing of patient information during the shift report communication, leading to more efficient care planning.
The incidence of smoking amongst nurses: a review of the literature
Authors: Rowe Kathy , Clark Jill Macleod 
Published: March 2003

The incidence of smoking amongst nurses: a review of the literature Over the years there has been an ongoing debate about the implications of the smoking behaviour of nurses in relation to their own health and in the context of their professional role and responsibilities. However it is difficult to determine with any degree of accuracy the current incidence of smoking amongst nurses and most of the available research is based on small samples which embrace nurses of different levels and status. Very few recent studies in the United Kingdom or elsewhere have focused on this issue. A confused picture therefore emerges. This paper presents a critical overview of the literature and where appropriate provides data about the incidence of smoking in comparable groups of the general population.
Differences between men and women on the waiting list for coronary revascularization
Authors: Bengtson Ann , Karlsson Thomas , Herlitz Johan 
Published: March 2003

Differences between men and women on the waiting list for coronary revascularization This study aims to examine the situation for patients on the waiting list for possible coronary revascularization in terms of waiting time, treatment and various aspects of well‐being in relation to gender. Patients on the waiting list for coronary angiography, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting in September 1990 were approached with a questionnaire dealing with various aspects as described above. Of the 831 patients who participated in the evaluation, 174 (21%) were women. Although age was similar for men and women, men had a higher prevalence of previous myocardial infarction and a lower prevalence of previous hypertension. In terms of medication, women were more frequently treated with diuretics and sedatives than men. Women reported a higher frequency than men with regard to the following symptoms: chest pain at rest and at night, dyspnoea when walking, tachycardia, tiredness, headache, dizziness and sweating. Women also suffered more frequently from difficulty going to sleep, difficulty waking up, repeated awakening and insomnia. Men, on the other hand, suffered more frequently from restlessness, inability to act and irritability. Among patients on the waiting list for possible coronary revascularization, women differed from men by being more frequently treated with diuretics, reporting a higher frequency of various cardiovascular symptoms including chest pain and dyspnoea and, furthermore, reporting more sleeping disorders. Gender differences were found but they were not consistent.
The introduction of a routine monitoring system in primary care for patients with a first episode of cardiovascular disease
Authors: McCarney Rob , Shapley Mark , Goodwin Rosemarie , Croft Peter 
Published: March 2003

The introduction of a routine monitoring system in primary care for patients with a first episode of cardiovascular disease A study at a group general practice in the English midlands found that health promotion advice had not been routinely provided to some patients with cardiovascular disease and stroke. The purpose of this project therefore was to introduce a monitoring system to ensure that health promotion issues were covered systematically with patients following a first episode of cardiovascular disease. Patients with a first episode of a relevant condition would be identified by an automated search on the practice database, and contacted by the health visitor. A checklist would ensure that all appropriate issues were covered. The system was easily introduced at the practice and no difficulties were experienced with its administration. A total of 62 patients were seen during the year. A substantial number of secondary prevention issues were addressed through advice and information leaflets. The project was felt to be a useful addition to care by the workers involved. Although some of the issues may have been addressed in routine care, early organized nurse contact ensures systematic coverage and early referrals where necessary, as well as potential psychological benefit to patients.
Is there a concept of autonomy that can usefully inform nursing practice?
Authors: Aveyard Helen 
Published: March 2003

Is there a concept of autonomy that can usefully inform nursing practice? This paper examines evidence that the contemporary use of the term autonomy is interpreted differently by different nurses. This is important because an understanding of autonomy is crucial to our approach to informed consent prior to nursing care procedures. There are many theories of autonomy. This may account for various interpretations of the term amongst nurses. In this paper it is argued that clarity may be achieved by commitment to one particular theory of autonomy. It is suggested that this commitment should be the subject of further debate within the nursing profession. It is argued that the ambiguous use of the term autonomy should be replaced by a concept that has specific meaning for nurses and which gives a working definition to a concept that is central to respect for patient choice and independence.
Do parents or surrogates have the right to demand treatment deemed futile? An analysis of the case of Baby L
Authors: Clarke Clare M. 
Published: March 2003

Do parents or surrogates have the right to demand treatment deemed futile? An analysis of the case of Baby L The purpose of this discussion paper is to address and analyse the ethical issues arising from the following questions: Do parents or surrogates of newborn infants have the right to demand treatment deemed ‘futile’? Should the religious beliefs of the infant's parents be given special consideration when deciding on the correct course of action? The case of Baby L, an infant born with severe disability will be used to aid the analysis. It is argued that health care providers have no obligation to provide ‘futile’ treatment based on the surrogates’ right to autonomy, but an obligation may arise from a duty of benevolence. However, acting from a duty of benevolence can ignore considerations of justice and fairness and does not always prompt the right course of action. Any decision regarding treatment options will involve ranking the beliefs and values of the parents or surrogate against the integrity of the health care team and the interest of society as a whole. The consequences of continuing or discontinuing life‐sustaining treatment for the infant, the parents and the health care team will also be considered and examined.
Understanding beliefs and meanings in the experience of cancer: a concept analysis
Authors: Richer Marie‐Claire , Ezer Hélène 
Published: March 2003

Understanding beliefs and meanings in the experience of cancer: a concept analysis Although the concepts of belief and meaning are commonly used in the cancer literature, there is often an overlap in the use of the terms. Some consider the two terms as synonyms while others link them as successive elements in adjustment. Using an adaptation of the methods of concept analysis, this article differentiates belief and meaning, and also suggests that meaning exists at two levels. The defining attributes and antecedents of these closely related concepts are identified and a model case illustrating each is presented. Clarity in the conceptual definitions of beliefs and meanings can help researchers select measures that accurately reflect the phenomenon of interest. Similarly, differentiation between the concepts can help practitioners in planning focused interventions that explore clients’ existing beliefs and situational and existential meanings.
Diary data enhancing rigour: analysis framework and verification tool
Authors: Clayton Ann‐Marie , Thorne Terry 
Published: March 2003

Diary data enhancing rigour: analysis framework and verification tool This paper outlines a stage‐by‐stage framework for the analysis of data obtained from qualitative semistructured diaries. As the framework for analysis was developed, it became apparent that the methodological problem of verifying the initial analysis, required serious consideration. The research literature available was found simply to identify the difficulty, but offered no solutions. Recognizing that trustworthiness is a hallmark of qualitative research, a data analysis verification tool (DAViT) was designed. This proved to be extremely effective in enhancing the trustworthiness of a qualitative study in a number of ways. The analysis framework and verification tool together offers an eclectic approach for qualitative diary data analysis. It is further advocated that they are amenable to the analysis and verification of qualitative data obtained from semistructured interviews.
Gender differences of parental distress in children with cancer
Authors: Yeh Chao‐Hsing 
Published: March 2003

Background.  Reports published over the last few decades present contradictory findings about the psychological distress and coping patterns of parents whose children have cancer. Although an increasing number of studies have focused on psychological distress and the adjustment process that parents experience when their children are diagnosed with cancer, few of these studies have been conducted in Taiwan. Aims.  Gender differences of parental distress experienced by Taiwanese mothers and fathers (164 couples) whose children were undergoing treatment for cancer were investigated. Methods.  Parenting stress, psychological distress, somatization, as well as marital satisfaction were compared between mothers and fathers whose children had cancer. Results.  Mothers averaged significantly higher levels than fathers for all forms of distress. Mothers and fathers whose children had been diagnosed within the previous 2 months reported higher levels of depression, anxiety, and global stress than those in the other groups. Both mothers and fathers whose children had been diagnosed within the past 2 months reported greater marital dissatisfaction than parents whose children were in the other treatment groups. Conclusions.  This finding indicates the need for a thorough psychiatric consultation at the time of diagnosis for children who have cancer and their families. Ongoing psychosocial support and education should have been integral components of the treatment program when relapse occurred.
A longitudinal study of perceived level of stress, coping and self‐esteem of undergraduate nursing students: an Australian case study
Authors: Lo Ruth 
Published: March 2003

Aim.  The aim of this study was to investigate the perception and sources of stress, coping mechanisms used, and self‐esteem in nursing students during 3 years of their undergraduate nursing programme. Methods.  The sample consisted of a cohort of nursing students going through 3 years of a nursing programme. The method was a descriptive corelational design. The questionnaire consisted of demographic data, the General Health Questionnaire (GHQ‐12), Self‐esteem Scale, and the modified Ways of Coping Scale. Data were analysed using frequency distributions, content analysis, and measures of correlation. Results.

Results indicated that students in year 1 experienced significantly less transient stress as compared with year 2; students in year 3 had more positive self‐esteem than year 2 students. There were no significant differences with regard to chronic stress, avoidance and proactive coping, and negative self‐esteem. Chronic and transient stress, as measured by GHQ, were significantly correlated (
P

< 0·01) with avoidance coping behaviours, and negative self‐esteem. Positive self‐esteem was significantly correlated (
P  < 0·01) with proactive coping behaviours. The four main stressors in the last three years for this cohort of students, in descending order are nursing studies, finance, family and health. They coped by using both problem‐focused and emotion‐focused coping skills. There is a need to review the nursing curriculum and evaluate what impacts on students' stress levels, and also introduce strategies to reduce the stress levels of nursing students.
The validity of Antonovsky’s Sense of Coherence measure in a sample of schizophrenic patients living in the community
Authors: Bengtsson‐Tops Anita , Hansson Lars 
Published: March 2003

The validity of Antonovsky’s Sense of Coherence measure in a sample of schizophrenic patients living in the community Aim of the study. To examine the construct and predictive validity of Antonovsky’s Sense of Coherence (SOC) concept in a sample of schizophrenic persons living in the community. Background. The salutogenic model of Antonovsky proposes that the individual’s sense of coherence, which is a personal orientation towards life, determines the health experience. The salutogenic perspective might in several advantageous aspects contribute to the care and support for patients with a long and persistent mental illness like schizophrenia. Design. The study is a 18‐month follow‐up study. Structured interviews were used to interview 120 patients with a diagnosis of schizophrenia or a schizoaffective disorder. Pearlin’s mastery scale, Rosenberg’s self‐esteem scale, the Interview Schedule for Social Interactions (ISSI) and the Brief Psychiatric Rating Scale (BPRS) were used as construct validity measures of the SOC scale. Health related measures such as quality of life, global well‐being, satisfaction with health assessed by the Lancashire Quality of Life Profile (LQOLP) and global psychosocial functioning (GAF) were used in calculations of the predictive validity of SOC. Results. The SOC was positively related to mastery, self‐esteem and social support but negatively associated to psychopathology. In total, mastery, self‐esteem and adequacy of social integration explained 61·1% of the variance in SOC, and mastery contributed with the greatest part of the variance, 46·3% SOC was positively associated to all health related measures and changes in SOC during an 18‐month follow‐up was positively correlated to changes in overall subjective quality of life, general health, global well‐being and global psychosocial functioning. Conclusion. The results gave support to the construct and predictive validity of the SOC measure in individuals suffering from a diagnosis of schizophrenia.
Forced externalization of control in people with diabetes: a qualitative exploratory study
Authors: Gillibrand Warren , Flynn Maria 
Published: March 2003

Forced externalization of control in people with diabetes: a qualitative exploratory study Aim. The purpose of this study was to explore and describe the patients’ perceptions of the Diabetic Disease State and its complications using an ethnographic method. Background. Diabetes mellitus is an extensively researched and studied disease, however, relatively little attention has been given to the lived experience of chronic illness. Methods. A purposive sample of 18 people with diabetes was derived from a diabetes register database. Data were collected by semistructured interviews, which were tape‐recorded and transcribed. The transcripts were analysed together with the researchers’ observational notes, using open coding procedures to identify main categories. Discussion of the results is made in the theoretical context of the locus of control (LOC) framework. Findings. Three main categories emerged from the data: information‐knowledge of illness; the psychological burden of diabetes; rationalizing. A further subcategory, reality avoidance, was identified. The findings showed that these people with diabetes experience and describe complex psychological effects and coping mechanisms in having a chronic illness. Conclusions. The findings also suggested that participants in this study might have felt that the control of their chronic condition had been externalized to the health care professionals responsible for their care.
The concept of care in male nurse work: an ontological hermeneutic study in acute hospitals
Authors: Milligan Frank 
Published: March 2003

The concept of care in male nurse work: an ontological hermeneutic study in acute hospitals Aims. The aims of the study were to facilitate reflection upon an aspect of practice chosen by the participants, to explore and analyse these experiences and compare them with current literature on the concept of care in nursing practice. Background. The concept of care is commonly used in the attempt to define what is unique about the role of the nurse, and both nursing and the concept of care are frequently associated with womanhood. Little research has been undertaken in relation to male nurse experiences and views on the concept. Methods. The study used ontological hermeneutics to explore the concept of care in male nurse work in the acute general hospital setting. Eight male voluntary subjects from acute general hospital areas participated in the study and were asked to complete a summary of an experience from their practice that they felt exemplified care. Data for the study included the participants choice of practice experience, their subsequent reflections, the interview itself, the field journal and relevant literature and research. Results. Six of the participants selected positive experiences in which they felt that their performance was satisfactory even though the events chosen for reflection were difficult and/or sad. The remaining two participants chose to reflect further on the difficulties they had within the experience. A conceptual model was constructed showing that the meeting of needs, effective communication and information giving were central to these nurses’ explanations of care within their practice. All but two of the participants broadened their gaze to include the significant others of the patient. Conclusions. The reflections of these participants emaphsise the emotional load of practice and a sensitivity on their part to the male stereotype of being able to cope with such pressures. It is suggested therefore that those providing and managing clinical supervision take into account the possible reluctance of male nurses to seek such support. Issues of gender should be emphasized in nurse education, as these nurses were sensitive to the impact of gender on their practice, both with patient/clients and their significant others, and with colleagues.
Methodological issues in interviewing families in family nursing research
Authors: Åstedt‐Kurki Päivi , Paavilainen Eija , Lehti Kristiina 
Published: March 2003

Methodological issues in interviewing families in family nursing research Aim of the study. The aim of this study is to discuss what methodological problems can be met in family research with one family member as an interviewee speaking on behalf of the whole family and, vice versa, what is the meaning of having multiple family members or the whole family unit as informants. Background. Family nursing research is part of multidisciplinary research with families. It is a basis for family nursing and contributes to research, especially from the perspective of family welfare and its promotion. Family nursing research generates knowledge concerning families’ and family members’ wellbeing and experiences and expectations of nursing and health care. Methods. The examination of methodological problems while pursuing family research is based on two studies conducted in Finland. Findings. Quantitative methods add to the general knowledge of families. Qualitative methods are well suited to the study of family experiences. Family interviews performed for research purposes differ from interviews aiming at caring for families. They aim at obtaining knowledge of families on a general level so as to improve family nursing. Family research has to be looked at as a whole. It faces many challenges such as the definition of the family, gaining access, methods of data collection and data management. Conclusions. A family is a complex system and research with families need flexible, sensitive and practical methods. Family research should also aim at developing new methods for data collection and analysis.