bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial recovery from adult kidney transplantation: a literature review
Authors: WAINWRIGHT STEVEN P. , FALLON MAUREEN , GOULD DINAH 
Published: March 2003

• Kidney transplantation is the preferred treatment for patients with end‐stage chronic renal disease.• There appears to be no recent and extensive review of the literature on psychosocial recovery from adult kidney transplantation.• This comprehensive review considers literature on six aspects of patient recovery and rehabilitation: psychiatric sequelae, functional recovery, stress and coping, the psychological impact of failed kidney transplants, quality of life (QOL), and adherence with medications.• We conclude that although studies have become both more ambitious and rigorous, there is a pressing need to move away from descriptive research toward carefully designed multidisciplinary psychological intervention studies with kidney transplant patients.
An investigation of interprofessional collaboration in stroke rehabilitation team conferences
Authors: GIBBON BERNARD 
Published: March 2003

• The aim of this paper is to report a study examining the team processes occurring in team conferences in a stroke unit.• Team conferences provide an opportunity for all members of the rehabilitation team to report patients' progress and establish patients' rehabilitation goals.• The findings suggest that little discussion or consideration of alternative intervention plans are undertaken and that team conferences serve to disseminate decisions rather than establish patients' rehabilitation goals.• Core members of the rehabilitation team have developed specific roles. The physiotherapist `proposes' decisions which are `seconded' by the occupational therapist. The doctor acts to sanction decisions and the nurses action them.• Team conferences are effective for dissemination of decisions and for giving rise to a sense of team collaboration.
Construct validity of the Nursing Care Dependency Scale
Authors: DIJKSTRA ATE , BUIST GIRBE , MOORER PETER , DASSEN THEO 
Published: March 2003

• This paper describes the results of a study determining construct validity aspects of the Nursing Care Dependency (NCD) Scale.• This 15‐item instrument has been developed recently for the assessment of the care dependency of dementia or learning‐disabled inpatients.• Data was collected for 450 dementia and 203 learning‐disabled patients using the NCD instrument.• Factor analysis of the NCD instrument resulted in one Factor. With Mokken scale analysis an H‐coefficient of 0.75 was found, which implied a strong hierarchical scale.• Cronbach's α coefficients (0.97) were high enough to use the NCD instrument in clinical practice, at both group and individual levels.
‘It’s not the same as him being at home’: creating caring partnerships following nursing home placement
Authors: Nolan Mike , Dellasega Cheryl 
Published: March 2003

• Admission to a nursing home is a major life event for both older people and family carers.• Despite a policy of community care in both the UK and the US, entry to nursing homes will be an increasingly common event.• Family carers are often the key decision makers but little is known about their experience of placement, especially adjustment after the event.• Antagonistic relationships can often develop between staff and relatives, as the former seek to take over care and the latter to develop new roles.• There is a need to create a partnership between staff and family so that the care of the older person is improved and the carers’ need to remain involved is acknowledged.
How people with stroke and healthy older people experience the eating process
Authors: Jacobsson Catrine , Axelsson Karin , Österlind Per Olov , Norberg Astrid 
Published: March 2003

• The aim of this study was to describe the process of eating, experiences of eating and oral functions.• Participants consisted of 30 people with first stroke and localization of the damage verified by computer topography (CT), and 15 healthy older people.• All were observed during test‐meals, interviewed about eating, and oral functions were tested.• The results demonstrated that most (21) people with stroke had some difficulties in eating and expressed feelings of fear and shame about eating and changed physical and social appearance, mainly related to difficulties in preparing and transporting food to the mouth as well as swallowing deficits.
Communicating with people with stroke and aphasia: understanding through sensation without words
Authors: Sundin Karin , Jansson Lilian , Norberg Astrid 
Published: March 2003

• To illuminate the phenomena of ‘communicating with people with stroke and aphasia without words’, 10 care providers particularly successful at communicating with stroke and aphasia patients who were working at a stroke rehabilitation ward narrated their experiences of communicating with such patients.• A phenomenological hermeneutic approach, inspired by Ricoeur’s philosophy, was used in the analysis.• Two main themes were found:facilitating opennessandbeing in wordless communication.• The care providerssensedthe feelings of the patients and experienced similar feelings themselves, thus, the communication is guided by the shared feelings between the care provider and the patient, i.e. communion. For this ‘communication through sensation’ to take place, the following factors were found to be necessary: creative closeness in combination with protective distance; striving for satisfaction and against exhaustion and desperation; meeting the patient halfway to gain understanding; exhibiting attention and accessibility to the patient; and trust and confidence for both care providers and patients.• The findings were interpreted and discussed in the light of works by Levinas, Lögstrup and Stern.
Education and training towards competency for cardiac rehabilitation nurses in the United Kingdom
Authors: Stokes Helen C. 
Published: March 2003

• The development of cardiac rehabilitation in the UK, the evolution of the nursing role as a speciality, and the nursing role within the multidisciplinary team are briefly outlined.• The potential impact of different professional backgrounds on the effectiveness of patient care is discussed, with particular reference to the differences between acute cardiac care and rehabilitation.• Issues of professional competency are discussed, and core competencies for cardiac rehabilitation as specified by various professional associations are described. Current opportunities for preparation for practice in this field in the UK are outlined.• Conclusions point towards the need for clearly specified competencies and an accredited programme of education and training to meet proposed standards for the management and rehabilitation of coronary heart disease (CHD) in the UK.
‘You do know he’s had a stroke, don’t you?’ Preparation for family care‐giving – the neglected dimension
Authors: Brereton Louise , Nolan Mike 
Published: March 2003

• Countries throughout the developed world have introduced a policy of community care for older people to reduce costs to the state and maintain quality of life.• In reality community care is largely family care and recognition of the need to support family carers is being promoted through the notion of partnership with professional carers.• Such a partnership calls for a more complete understanding of how carers’ needs change over time and how professional support can be most effective.• Support is particularly important at the start of care‐giving in order that carers can exercise free choice and be adequately prepared for their role.• This paper provides an overview an ongoing longitudinal study and reports specifically on the findings of data from a preliminary study in which a convenience sample of seven experienced carers of stroke survivors who attended a stroke and carers club were interviewed in their own homes.• Based on initial data from a longitudinal study of stroke victims, this paper outlines four themes: ‘What’s it all about’, ‘Going it alone’, ‘Up to the job’ and ‘What about me?’ These themes highlight the difficulties carers experience in the immediate aftermath of stroke.
Nurses’ perceptions of the nature and frequency of aggression in general ward settings and high dependency areas
Authors: O’Connell Bev , Young Jeanne , Brooks Jeff , Hutchings Joan , Lofthouse Jacqui 
Published: March 2003

• Studies on aggression in healthcare settings have reported increased frequency of this behaviour in both psychiatric and accident and emergency areas; however, to date, very few studies have addressed this issue in general ward settings in Australia.• This descriptive study was conducted to determine nurses’ perceptions of the nature and frequency of aggressive behaviours in general wards and high dependency areas and thereby address the gap in the literature.• Two hundred and nine nurses in one Australian hospital completed a 23‐item questionnaire on aggression in the workplace.• The findings revealed that the majority (89.5%) of nurses defined aggressive behaviour as including verbal aggression, physical aggression and intimidation.• Ninety‐five per cent of respondents had encountered at least several episodes of verbal aggression within the last 12 months.• Patients were found to be the main perpetrators of aggressive acts, followed by relatives. After experiencing either verbal or physical aggression nurses most frequently reported feeling angry or emotionally hurt.• These findings confirm that acts of aggression are experienced frequently in the general medical and surgical ward areas of the study hospital.• Consequently, there is a need to provide staff with education and support in order to deal with this issue and minimize the impact of increasing levels of aggression in the workplace.
Clinical role clarification: using the Delphi method to establish similarities and differences between Nurse Practitioners and Clinical Nurse Specialists
Authors: Roberts‐Davis Marie , Read Susan 
Published: March 2003

•  This article is based on the Department of Health’s (England) funded pluralistic evaluation of Nurse Practitioner preparation, ‘Realizing Specialist & Advanced Nursing Practice: establishing the parameters of and identifying competencies for “Nurse Practitioner” roles and evaluating programmes of preparation’ (RSANP).•  During this 27‐month project, which began in 1996, one of the research methods used, the Delphi study, was aimed at reaching a consensus of views amongst nurses in clinical practice, educators, purchasers, providers and representatives of statutory and professional bodies on the parameters and competencies desirable for the Nurse Practitioner role.•  The agreed competencies were then used as one measure of the appropriateness of various programmes used to prepare Nurse Practitioners.•  Of the competencies required for the role, the majority are ‘nursing’ competencies and are the same as those required for the Clinical Nurse Specialist role. However, for both Clinical Nurse Specialists and Nurse Practitioners, these are practised at a ‘higher level’.•  Other competencies needed for the Nurse Practitioner role relate to the knowledge and skills required to assess, diagnose and determine nursing and medical management of a patient and to evaluate that management. Data indicated, however, that even these competencies were being used by some Clinical Nurse Specialists. Final analysis enabled the identification of the two roles with the use of a ‘Typology of Named Clinical Nursing Roles’.
Works of art: a complement to theoretical knowledge when teaching nursing care
Authors: Wikström Britt‐Maj 
Published: March 2003

•  Visual art dialogues were used in student nurses’ education as a teaching and learning complement to theoretical knowledge of nursing care.•  An intervention group as well as a control group discussed what was characteristic of good nursing care. The control group was used to control for the effects of visual art dialogues in the intervention group.•  The study was undertaken at two university colleges of health sciences in Sweden. Data were collected from student nurses (n=267) during their first year of study.•  The Wheel Questionnaire was used in the intervention group and control group. It measured three aspects of student nurses’ perception of nursing situations: structure, the extent of emotional involvement, and motivation.•  The results showed statistical differences (one wayANOVA) between the intervention group in which visual art dialogues were implemented and the control group.•  Students in the intervention group, compared to the control group, were more structured, motivated and emotionally balanced when they expressed the elements most typical of good nursing care. They showed personal readiness in caring situations.
Placing a spouse in a care home: the importance of keeping
Authors: Sandberg  , Lundh  , Nolan  
Published: March 2003

• Despite a universal policy of community care, the number of frail older people entering care homes is likely to increase in the future.• There have been relatively few studies exploring the experience of spouses who have placed a partner in care.• Due to a lack of preparation, the placement process is often ad hoc, with little attention being given to spouses’ emotional reactions or their efforts to maintain their relationship with their partner.• The relationship between care home staff and families is often superficial and strained.• There is a need for more proactive efforts to facilitate a partnership between care home staff and families.
Screening swallowing function of patients with acute stroke. Part one: identification, implementation and initial evaluation of a screening tool for use by nurses
Authors: Perry Lin 
Published: March 2003

• Stroke is a major cause of acute and chronic disability in the developed world, producing a wide range of impairments, including dysphagia, which impact upon eating.• Dysphagia affects between one and two thirds of patients with acute stroke, with the potential for life‐threatening airway obstruction, aspiration pneumonia and malnutrition.• Whilst associated with increased impairment, dysphagia may present in isolation or accompanied by minimal disability; universal screening of swallowing function is recommended.• This study describes the process undertaken to review the evidence for dysphagia screening methods in patients with acute stroke. It also identifies, implements and establishes sensitivity and specificity of a screening tool (the Standardized Swallowing Assessment, SSA) for use by nurses.• Not all ward staff had completed training to use the SSA by conclusion of the patient audit. Nonetheless 123 out of 165 assessable patients (74.5%) had their swallow function screened, 64 by SSA (52%). Based on 68 completed screening episodes by independently competent nurses, a comparison with summative clinical judgement of swallow function revealed a sensitivity of 0.97 and specificity of 0.9 for detection of dysphagia, with positive and negative predictive values of 0.92 and 0.96. This was significantly better than gag reflex performance, supporting the use of the SSA by competent ward nurses.
A phenomenological study of pain following fractured shaft of femur
Authors: Santy Julie , Mackintosh Carolyn 
Published: March 2003

• There is very little work that discusses the pain experience following fractured shaft of femur. Therefore, an exploratory phenomenological study of the individual experience of pain following a traumatic fracture of the shaft of femur was conducted.• Two key themes emerged: the injury experience and the pain experience, both linked to the need to maintain physical integrity.• The findings underline the highly complex nature of the pain experience and illustrate the range of experiences that individuals with traumatic fractures are exposed to.• The findings have implications for the nursing and medical management of patients following long bone fracture.
Systematic reviews: gatekeepers of nursing knowledge
Authors: Evans David , Pearson Alan 
Published: March 2003

• The past few decades have seen a considerable increase in the number of available health care products and interventions. This growth has been matched by a similar expansion in the health care literature. As a result of these factors, the demand for evidence to support practice is growing, but finding the best evidence is becoming increasingly difficult.• In response, the use of systematic reviews is increasing and they are starting to replace the primary research as the basis for health care decisions.• To date, these reviews have focused predominantly on effectiveness and so have been limited to randomized controlled trials. As a result of this, the interpretive, observational and descriptive research methods that are utilized by nursing have commonly been either excluded from the review or are classified as ‘low level’ evidence.• To address this, nursing must participate in the development of systematic review methods that better answer the questions posed by the profession.
Nurses’ competence in advising and supporting clients to cease smoking: a survey among Finnish nurses
Authors: Pelkonen Marjaana , Kankkunen Päivi 
Published: March 2003

• The article describes the results of a survey of Finnish nurses (n=882).• The purpose of the study was to describe how nurses’ education, working experience and their own smoking habits relate to their self‐reported competence in advising and supporting clients to cease smoking.• Nurses evaluated their skills fairly highly, but did not believe that advice alone was helpful to clients who wished to cease smoking.• Nurses had minimal knowledge of smoking substitutes.• Lower general education, a fairly short time from graduation and a history of smoking were positively related to nurses’ competence to guide clients.• Nurses who smoked daily were found to have better skills in giving advice and support than their non‐smoking colleagues.• The results have implications for the design of smoking cessation programmes.• More education and guidance is required for nurses, so that they can develop their understanding and a positive view as to the effectiveness of smoking cessation programmes.
Nutritional status, symptoms experienced and general state of health in HIV‐infected patients
Authors: Karlsson Anette , Nordström Gun 
Published: March 2003

• The aim of the study was to describe HIV‐infected patients with respect to nutritional status, symptoms experienced, general state of health, and relevant medical and laboratory data. An additional aim was to study the relationships between some of these variables.• On admission to an acute care hospital in Sweden, 25 HIV‐positive men were consecutively included in the study. Medical data, anthropometric variables such as weight, height, body mass index (BMI) and percentage weight loss were studied.• The following instruments were used: the subjective global assessment (SGA) was used to determine nutritional status; the oral assessment guide (OAG) was used for subjective assessment of the oral cavity; and the numeric rating scale (NRS) was used to assess the symptoms experienced. The Health Index (HI) was used to evaluate general state of health.• The results showed that more than half of the patients had suspected/severe malnutrition; between 48% and 72% complained of moderate to severe symptoms of various kinds. Two thirds felt their general state of health was rather poor or very poor.• Correlations showed that the lower the BMI, the worse the nutritional status (SGA); the greater the weight loss in percent, the worse the nutritional status (SGA); and the worse the general state of health (HI), the worse the nutritional status (SGA).• In conclusion, it is important that nurses have good knowledge concerning nutritional problems in order to be able to detect these conditions at an early stage and/or to endeavour to prevent them.
Background pain in fibromyalgia patients affecting clinical examination of the skin
Authors: RAAK RAGNHILD , WAHREN LIS KARIN 
Published: March 2003

• The purpose of this study was to investigate the relationship between on‐going pain and acute thermal pain in patients suffering from chronic pain.• This experimental study in cold and heat sensitivity was performed in order to test the following hypothesis: that fibromyalgia patients scoring high in current background pain tolerate less experimental thermal pain in the skin than patients with low scores.• Ethical aspects of the study are discussed.• The level of tolerable experimental thermal stimuli was tested and compared between the `low‐score' and the `high‐score' patients.• Background pain seemed to affect the intensity of experimental cold pain.• Clinical routine examinations and bodily care of the skin that might interfere with background pain in the fibromyalgia patients are discussed.• Clinical practice should be carefully planned in order to assist fibromyalgia patients in understanding and coping with thermal conditions that might influence background pain.
A study of parenteral use of methotrexate in rheumatic conditions
Authors: ARTHUR VALERIE , JUBB RONALD , HOMER DAWN 
Published: March 2003

• This paper reports the findings of a small pragmatic study to compare the safety and efficacy of methotrexate administered by intramuscular and subcutaneous injection, and to teach patients to self‐administer methotrexate by the subcutaneous route.• Eight patients with rheumatic conditions, already receiving a stable weekly dose of methotrexate by intramuscular injection, were entered into this 13‐week study.• Serum levels of methotrexate were measured on six consecutive occasions: three whilst patients received intramuscular methotrexate and then three after switching to the subcutaneous route.• Patients were taught to self‐administer their methotrexate subcutaneously and were then discharged to perform this task at home.• Levels of disease activity and psychological scores were measured at the start and end of the study. Satisfaction with self‐administration and teaching of injection techniques were assessed at 13 weeks.• Serum methotrexate levels were not significantly affected by the route of administration. All patients were able to perform self‐injection safely and seven out of eight preferred self‐administration at home.• This small study demonstrates that there is no difference in the safety and efficacy of methotrexate given by either parenteral route. Patients were able to administer safely methotrexate subcutaneously. Self‐administration reduced hospital visits, was more convenient for patients and improved patient satisfaction.