bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of nursing home placement and home nursing services utilization by elderly patients after hospital discharge in Taiwan
Authors: Shyu Yea‐Ing Lotus , Lee Hsiao‐Chin 
Published: March 2003

Predictors of nursing home placement and home nursing services utilization by elderly patients after hospital discharge in Taiwan Background. Providing appropriate follow‐up health/long‐term care services after hospital discharge for elderly persons is important to enhance health and quality of life. Therefore, identifying factors that affect follow‐up service utilization has become an important concern. Most studies of predictors of follow‐up service utilization for elderly persons after discharge were conducted in the United States of America (USA). Taiwan differs substantially from the USA in health care system, clinical practice, case‐mix, culture, and social organization; thus the findings from the USA need to be validated in Taiwan to ensure appropriate discharge referrals. Aim. To investigate pre‐discharge predictors of follow‐up care including home nursing services and nursing home placement for elderly patients, discharged from hospitals in Taiwan. Methods. A prospective study with a case‐control design was used. Findings. The strongest predictors of institutionalization in a nursing home at 1, 3 and 6 months after discharge were the elderly person's pre‐admission institutionalization (0·33 to 0·48) and the caregiver's preference for institutional displacement (0·23 to 0·85). The strongest predictors of use of home nursing services were the elder's self‐care ability (0·69 to 0·76), conscious level (0·51 to 0·73), and tubes remaining before discharge (0·58 to 0·79). These predictors were stable at 1, 3 and 6 months after discharge and could correctly classify 60–89% of sample. Conclusions. When taking nursing home and home nursing utilization into considerations at the same time, the elderly person's pre‐admission institutionalization and the caregiver's preference for institutional displacement strongly predicted nursing home utilization after hospital discharge. The elder's self‐care ability, conscious level, and tubes remaining before discharge strongly predicted the use of home nursing services after discharge.
Measuring the outputs of Australian nursing research published 1995–2000
Authors: Borbasi Sally , Hawes Cathy , Wilkes Lesley , Stewart Michel , May Donna 
Published: March 2003

Measuring the outputs of Australian nursing research published 1995–2000 Aims. To analyse the research published in refereed nursing journals by Australian authors from 1995 to 2000. Background. Analysis of the research topics and types of methodologies used by Australian nurse researchers has not been recently undertaken. The study was similar to an analysis of United Kingdom (UK) nursing research between 1988 and 1995 to allow comparison between the two countries. Design. A quantitative approach analysed the research abstracts for the topic researched, source of data, location of data collection, paradigm and methodology used and funding source. Results. A total of 509 articles from 11 generalist Australian and UK nursing journals were analysed. The highest numbers of articles were published in Australian Journal of Advanced Nursing and Journal of Advanced Nursing. The most popular topics were education of nurses (18·7%, n=95) and practice issues relating to patient care (15·3%, n=78). However, scant attention was paid to major Australian health issues. Most research was undertaken in the hospital setting (55·8%, n=247). Data were most often drawn from nurses themselves (40·7%, n=206), followed by patients (25·5%, n=129). Both quantitative (41%, n=203) and qualitative approaches (47%, n=230) were employed. A minority of studies acknowledged any funding (14·9%, n=76). Conclusions. Research findings need to be applied in practice to improve patient care. Nurse researchers need to publish their findings and align their research interests to meet national health priorities. They need to be involved in setting these health priorities to ensure that nursing has a place in health research.
Application of a computerized nursing care plan system in one hospital: experiences of ICU nurses in Taiwan
Authors: Lee Ting Ting , Yeh Chao‐Hsing , Ho Lun‐Hui 
Published: March 2003

Aim of the study.  The purpose of this paper is to present ICU nurses' experiences with a computerized nursing care plan system at a medical centre in Taiwan. Background.  Computerized nursing care plans have been implemented in recent years, but users' perceptions of this technology have not been comprehensively explored. It is believed that by taking into consideration users' experiences with computer use, strategies and programs can be developed to help users adapt to new systems. Methods.  A qualitative study, involving one‐to‐one interviews, was conducted with 12 Registered Nurses. Data were analysed according to Miles and Huberman's data reduction, data display and conclusion verification process. Findings.  Themes related to the clinical impact of system use were: ‘saves paper/time’, ‘time‐consuming for print‐outs’, ‘de‐individualization of care plan’, ‘routine/paperwork requirement’, ‘no consensus for nursing diagnoses’, and ‘guidelines for the novice’. Conclusions.  Nurses prefer tools that can help them save time with paperwork and focus on targeting patient problems. With careful assessment and evaluation of nurses' experiences in the use of clinical computer systems, the success of computer implementation can be enhanced.
Parents' experiences of midwife‐managed care following the loss of a baby in a previous pregnancy
Authors: Caelli Kate , Downie Jill , Letendre Angeline 
Published: March 2003

Aims of the study. This article reports on research that explored the impact of the Special Delivery Service, a midwife‐managed intervention, developed as an addition to routine care to support and educate high‐risk pregnant women and their partners subsequent to the death of a baby in a previous pregnancy.Background. Approximately 40 000 families suffer the trauma of a neonatal death*annually in the USA, while statistics for Canada and Australia give similar numbers relative to population. Since many more babies die than those accounted for in these statistics, through stillbirth, miscarriage and Sudden Infant Death Syndrome, more than the above‐cited 2% of childbearing couples will face the trauma of the loss of a baby.Rationale. The resultant threat that this situation may pose to the health of the mother has been extensively documented in the literature. However, despite the recent growth in knowledge about the impact of perinatal loss and bereavement, few interventions are specifically designed to support Australian and Canadian women and their partners during a pregnancy following the loss of a baby.Methodology. This phenomenological study explored women's and their partners' experiences of grief and loss and the support offered to them through the Special Delivery Service programme.Results & Discussion. In the face of funding and organizational changes to both the Australian and Canadian health care systems that have eliminated or reduced some services, this research reinforced the need for individualized, compassionate midwifery care and the urgent need for genuinely empathic and supportive health care services for these women and their partners. It also emphasized the need for couples to be informed and supported so that gender differences in grieving do not become a divisive element in the relationship.Conclusions. The findings have implications for both nurses and midwives in their practice in countries where optimum care of this vulnerable population is not routinely available. The research supports midwife‐managed models of care to ensure women and their families are appropriately supported in crisis. The findings provide insight also into the diverse grief response among couples and the difficulties experienced in a pregnancy following the loss of a baby.
Foucault could have been an operating room nurse
Authors: Riley Robin , Manias Elizabeth 
Published: March 2003

Background.  Operating room nursing is an under‐researched area of nursing practice. The stereotypical image of operating room nursing is one of task‐ and technically‐orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Aim.  Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in‐depth analysis of this specialty area of practice. Content.  The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the ‘surgical conscience’. Conclusion.  This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.
Discrepancies between patients and professionals in the assessment of patient needs: a quantitative study of Norwegian mental health care
Authors: Hansen Thomas , Hatling Trond , Lidal Eli , Ruud Torleif 
Published: March 2003

Background.  Sensitivity to and respect for the user perspective are important facets of user‐centred services and empowerment in contemporary mental health care. Little is known about the extent to which new policies influence mental health work in practice. Aims.  To investigate discrepancy between patients and professionals in the assessment of patient needs. Analyses could indicate emphasis on user orientation in Norwegian mental health care. Methods.

Patients and their respective health professionals (
n  = 1080) completed separate questionnaires regarding patient characteristics and needs. Identifiers were removed from the data locally and then entered into a national database. Descriptive statistics and multiple regression analysis were used to explore mean levels of discrepancy and predictors of discrepancy. Results.  Mean discrepancy was low, as, on average, 30 of the listed 40 needs were considered absent by both the patients and their respective professional. However, the parties showed distinct disagreement as to the amount and type of needs that were present. Specifically, professionals identified more needs than patients (9·3 vs. 4·3, respectively) and this difference was characterized by a strong professional emphasis on needs regarding professional monitoring and follow‐up. Results showed that symptoms of severe cognitive disability were over‐represented in the group of patients with the highest level of discrepancy, however, the majority of high‐discrepancy patients were not severely disabled on cognitive functions. A multiple regression analysis revealed 10 predictors of high discrepancy. Discussion.  A low professional emphasis on user‐orientation may be indicated in some cases. Results are discussed with relation to the tension between autonomy and beneficence. Suggestions for practice and further research conclude the paper.
Exploring nurse learner wastage/persistence using a discursive approach: towards a theoretical understanding of the subject
Authors: Kotecha Mehul 
Published: March 2003

Rationale and aims of the study.  This article summarizes the findings of an exploratory study of nurse learner wastage/persistence conducted in England between 1996 and 2000. Given the lack of theorizing in much of the literature on nurse learner wastage/persistence, this study sought to generate a theoretical standpoint from which to explore voluntary nurse learner wastage. Design/Methods.  The theoretical standpoint developed drew together the theme of integration, derived from the work of Tinto, with the themes of identity and discourses, as conceptualized by Foucault. Accordingly, integration was defined in terms of how well the learner was able to subscribe to the subjectivities made available by the institutional discourses. One of the chief strengths of this approach was that it facilitated an understanding of the interaction between the individual and the institution in relation to wastage/persistence. A multiple case study strategy was used which focused on learners in the first year of a Project 2000 course. The case study strategy utilized a range of qualitative research methods. Findings and conclusion.  The findings indicated that the institution was constituted by two major discourses: the ‘apprentice’ discourse and the ‘autonomous’ discourse. It was found that the stayers were much more integrated into the institution, hence they were able to persist on the course, by virtue of being able to manage the contradictions in their identity as a nurse and a learner that these two discourses engendered.
Establishing methodological rigour in international qualitative nursing research: a case study from Ghana
Authors: Mill Judy E. , Ogilvie Linda D. 
Published: March 2003

Background.  Attention to rigour, from the identification of the problem to the dissemination of the findings, is essential in all qualitative research. In this paper, research carried out in Ghana in 1999 is used to highlight methodological issues in relation to rigour in international qualitative nursing research. Aim.  The purpose of this paper is to review the literature in relation to rigour in qualitative research, highlight the methodological decisions enhancing rigour during this research project, and describe the criteria used to assess rigour during the research process. Design.  A participatory action research design was used to explore the cultural, social, economic, and political factors that influenced Ghanaian women's vulnerability to HIV infection. Collaboration with participants and partnerships with key professionals were integral to the design of the study. Findings.  Participatory action research provided a flexible, socially, and culturally adaptable framework to guide this international research project. Prior to the initiation of international research it was essential to establish the relevance and feasibility of the proposed project. This international research project posed additional methodological challenges to the establishment of rigour. Patience, flexibility and sensitivity were required of the researcher to overcome these challenges. Conclusion.  Collaboration with participants and with culture‐specific ‘experts’ may be key to culturally competent scholarship, particularly in unfamiliar settings.
Acute pain teams and the management of postoperative pain: a systematic review and meta‐analysis
Authors: McDonnell A. , Nicholl J. , Read S.M. 
Published: March 2003

Background.  The introduction of acute pain teams (APTs) in every hospital performing surgery in the UK has been recommended in order to reduce postoperative pain. However, recent evidence suggests that many APTs are under‐resourced. Purchasers may be more prepared to invest in these services if they are persuaded that they result in measurable improvements in patient outcomes. Aim.  A systematic review of the literature and meta‐analysis were performed to determine the effectiveness of APTs in improving the quality of analgesia and other postoperative outcomes of adult patients undergoing surgery. Methods.  A broad search strategy using the terms ‘pain team’ and ‘pain service’ was adapted for a variety of databases. Key journals were hand‐searched and reference lists of selected reports were reviewed. Subject experts and study authors were contacted. Studies describing the impact of the APT/acute pain service (APS) on postoperative pain relief, other postoperative outcomes or the processes of postoperative pain were included. Study quality was assessed using a multidimensional instrument. A broad qualitative overview of the included studies was conducted. Continuous outcome data for pain in the first 24 hours postoperatively (in one case worst pain at 24–48 hours) were pooled. Results.  Fifteen studies were included in the review. There were considerable differences in study design and quality, the nature of the APT and the outcomes measured. Of the nine studies measuring pain, it was possible to present data as Standardized Mean Differences for only four studies. Quantitative synthesis indicates a statistically significant overall estimate of effect using a fixed effects model only. Limitations.  Only published studies in English were included. Study inclusion decisions and data extraction were performed by one reviewer only. Conclusion.  There is insufficient robust research to assess the impact of APTs on postoperative outcomes of adult patients or on the processes of postoperative pain relief.
Constructing experience in individual interviews, autobiographies and on‐line accounts: a poststructuralist approach
Authors: Hardin Pamela K. 
Published: March 2003

Aims. A poststructuralist orientation to language contends that individuals inherit the language they present to others – and in the context of research, stories and accounts are understood because researchers and research participants share such inheritances. Nurse theorists have foregrounded the constructive aspects of language yet few scholars have focused on how context and different narrative structures affect story construction. Story presentations are always sculpted by the context in which they are told. Thus, the construction of individual experience is neither a‐historical nor a‐contextual. Methods. This work emanates from a larger study that focused on the social construction of anorexia nervosa and in which data were collected from 12 individual interviews, autobiographical accounts and postings from a public Internet group. A poststructuralist orientation to how data are theorized and analysed was used for the study. This article focuses on the differences of account presentation between the three different types of data. Conclusions. Individuals inherit not only shared language, but the customs in which language is exchanged, for example, how interviews are performed, memoirs are written, and on‐line conversations are constructed. Focusing on context foregrounds the notion that stories have different functions and outcomes, depending on the purpose of the telling. Hence, the social and cultural frameworks in which stories are communicated are not incidental, but instrumental to what can be articulated in the production of individual experience.
A field study of size–fitness relationships in the parasitoid Asobara tabida
Authors: Ellers Jacintha , Van Alphen Jacques J.M. , Sevenster Jan G. 
Published: March 2003

1.  Many evolutionary models of parasitoid behaviour assume a positive correlation between size and fitness. In this paper we study the size–fitness relationship in the laboratory and in the field using females of the solitary parasitoid Asobara tabida (Hymenoptera: Braconidae). 2.  In the laboratory, fecundity, fat reserves and longevity without food were positively correlated with size. 3.  Release–recapture experiments in the field showed that dispersal diminishes fat reserves. Dispersal ability is size‐dependent: larger females, with larger fat reserves, disperse over larger distances than smaller females. 4.  The form of the relationship between size and fitness in the field was estimated in two ways: one based on a comparison of the size distribution of released and recaptured females; the other based on the egg load and fat reserves of wild‐caught females. Both showed an accelerating increase of fitness with size. 5.  The majority of females appeared to be time‐limited. Therefore, the increase in fitness with size is predominantly due to a larger dispersal ability and not to a higher egg load.
Plumage dichromatism of birds predicts introduction success in New Zealand
Authors: Sorci Gabriele , Møller Anders Pape , Clobert Jean 
Published: March 2003

1.  Reintroduction of plants and animals has become a common practice in the attempt to establish, re‐establish or augment endangered populations. The fate of these translocation programmes is likely to depend, on the one hand, on several ecological attributes of the introduced species, on the other hand on introduction effort. 2.  In a recent paper, Veltman, Nee & Crawley (1996) reported the correlates of introduction success of exotic birds released by humans in New Zealand before 1907: introduction effort (minimum number of release events and minimum number of released propagules) accounted for most of the variance in introduction success. 3.  One of the factors potentially affecting the establishment of new populations concerns the intensity of sexual selection. Sexually selected species may be more vulnerable to extinction risks for several reasons (they may be more sensitive to both environmental and demographic stochasticity) and therefore have lower introduction success when compared to nonsexually selected species. 4.  In the present study the data set reported by Veltman et al. (1996) was used to address the particular issue concerning sexual selection and introduction success. Each bird species was scored as monochromatic or dichromatic; plumage dichromatism is supposed to have evolved under sexual selection pressures. These scores were then correlated to the fate of introduction. 5.  Plumage dichromatism was found to be, as expected, a significant predictor of introduction success, after removing the potential confounding effect of introduction effort. Dichromatic species had lower introduction success than monochromatic species. This pattern holds true for nonpasserines and passerines, although the correlation between plumage dichromatism and introduction success was not significant for the latter. 6.  These results indicate that dichromatic species may experience reduced chances of establishing new populations when compared to monochromatic species. The presumed mechanisms involved in this phenomenon range from a reduced ability to adapt to a novel environment, to an increase in the risks of extinction through environmental and demographic stochasticity.
Costs of ant attendance for aphids
Authors: STADLER  , DIXON  
Published: March 2003

1.  Interactions between aphids and ants are considered to be mutualistic, with both partners benefiting. Costs associated with such interactions are likely to be less obvious, although they can be expected, especially if these associations are facultative. 2.  It is demonstrated here that there are costs in several life‐history parameters to individual aphids resulting from ant attendance. Over several generations Aphis fabae cirsiiacanthoides feeding on Cirsium arvense, at a range of developmental stages, suffered significant costs when tended by Lasius niger, e.g. in terms of a prolonged developmental time, delayed offspring production, proportionally smaller gonads, fewer well developed embryos and a reduced mean relative growth rate. These effects are similar to those observed when aphids feed on poor quality plants. 3.  This is the first indication that there is a cost for aphids associated with ant attendance. The significance of this for the evolution of ant attendance in aphids is discussed.