bluuebunny/crossref_metadata_2025_split huggingface dataset:
One voice, different tunes: issues raised by dual analysis of a segment of qualitative data
Authors: Savage Jan 
Published: March 2003

One voice, different tunes: issues raised by dual analysis of a segment of qualitative data Qualitative data analysis is a complex and contested part of the research process that has received limited theoretical attention. This paper explores the relationship between the way in which data are analysed and the nature of findings that emerge. It does this in response to demands to recognize the multiple voices that inform representations of reality, and debates about whether the interpretation of data reveals or constructs meaning. A small segment of data provided by one informant is subjected to both thematic and narrative analysis and the different perspectives that emerge are discussed with reference to whether different kinds of analysis lead to different kinds of meaning being imputed to the same text. The paper suggests that, rather than provide a unified and ever‐more refined version of ‘reality’, the use of dual or multiple analysis helps to elucidate alternative interpretations of the data which might escape consideration with the use of a single approach.
Experiences of AIDS‐dedicated nurses in alleviating the stress of AIDS caregiving
Authors: Sherman Deborah Witt 
Published: March 2003

Experiences of AIDS‐dedicated nurses in alleviating the stress of AIDS caregiving From the beginning of the AIDS epidemic, there have been individuals dedicated to the care of patients with AIDS. However, there has been little research regarding their perceptions and experiences of AIDS caregiving and the strategies they use to alleviate the stress and promote their willingness to care. Based on the experiences of 12 nurses at one hospital, who had chosen to work on an AIDS‐dedicated unit, this exploratory study, conducted in 1998, explored the following: the physical, emotional or spiritual risks and stresses associated with AIDS caregiving; factors that provide resistance to the stresses of AIDS caregiving and promote a willingness to care; and strategies recommended by AIDS‐dedicated nurses in caring for patients with AIDS. The data reveal important themes related to the physical stress of AIDS caregiving, specifically being aware of risks, but not paralysed by fear, and bombardment of the senses. The coping strategies of nurses included taking the risk in their stride, reframing the risk, and protecting oneself. The emotional stress of AIDS caregiving included witnessing suffering, experiencing unresolved grief, accepting diversity, being emotionally connected, distress from the dismantling of the AIDS unit and work demands, and declining team spirit. Coping strategies included balancing personal and professional life, releasing pain, respecting yet controlling feelings, managing demands, and asking for help. Nurses maintained their spiritual perspective. They experienced through AIDS caregiving a greater sense of shared humanity and a new perspective of life. Findings indicate that AIDS‐dedicated nurses use many coping strategies. The experiences of these nurses can assist clinicians, educators and administrators in supporting nurses’ caregiving and promoting the quality of care offered to patients with AIDS.
End‐of‐life care preferences of Canadian senior citizens with caregiving experience
Authors: Wilson Donna M. 
Published: March 2003

End‐of‐life care preferences of Canadian senior citizens with caregiving experience A grounded theory study of senior citizens’ preferences for end‐of‐life care was conducted in 1998 in Canada. Seniors who had experienced the deaths of others and who had considered their own death and dying were the target population. The sample was 49 seniors who met the study criteria. Participants provided end‐of‐life care in a variety of settings for 1–8 family members or friends. Two concepts identified were expected dependency while dying and appropriate end‐of‐life care. Almost all participants preferred to be cared for at home, yet family caregivers who could provide appropriate end‐of‐life care when dependent were needed for this to occur. The appropriateness of end‐of‐life care was contingent upon the place where end‐of‐life care occurred, as well as the type of care provided. Life prolongation was not desired, 53% even endorsed euthanasia as a way of bringing about the inevitable end to life.
Development and testing of the Family Caregiving Factors Inventory (FCFI) for home health assessment in Taiwan
Authors: Shyu Yea‐Ing Lotus 
Published: March 2003

Development and testing of the Family Caregiving Factors Inventory (FCFI) for home health assessment in Taiwan This paper describes the development and psychometric testing of the Family Caregiving Factors Inventory (FCFI). Data were collected from 97 caregivers of frail elders in Taiwan to examine the validity and reliability of the four FCFI scales: caregiving resources, caregiver self‐expectations, caregiving task difficulty, and knowledge of the care receiver. Acceptable test–retest and internal consistency reliabilities were found, though inter‐rater reliability was unsatisfactory for caregiving task difficulty and knowledge of the care receiver scales. Testing of hypothesized relationships between the FCFI and related variables supported the construct validity of the FCFI. Confirmatory factor analysis with good overall model fits also supported the construct validity of the FCFI scales. In its present form, the FCFI can facilitate home health assessment and problem identification for families with frail elders. Studies with larger samples are needed to further verify the measurement models.
Should service providers be paid for providing pre‐registration clinical placements?
Authors: Jones Myfanwy Lloyd , Akehurst Ron 
Published: March 2003

Should service providers be paid for providing pre‐registration clinical placements? The authors have argued elsewhere that second‐ and third‐year student nurses and midwives on ward‐based clinical placements make a service contribution which is of significant value to the service provider. The value of the service contribution made by students in community‐based clinical placements is lower, not least because such placements cannot free staff time in the same way as on the wards, and thus the presence of students appears to form a cost to the service provider. It is clear that there is no case for introducing a system of payments for ward‐based placements, but in community‐based placements the position is less obvious. The argument hinges upon the perceived value to the service provider of the qualitative benefits associated with the presence of students on placement. Other studies have suggested that these benefits are such as to outweigh the associated costs. Because the presence of students on clinical placement is associated with both costs and benefits, efforts should be made to ensure that both ward‐based and community‐based placements are distributed as fairly as possible between locations so that no one location is unduly advantaged or disadvantaged by the number of students which it receives.
Family and staff perceptions of the role of families in nursing homes
Authors: Ryan Assumpta Ann , Scullion Hugh F. 
Published: March 2003

Family and staff perceptions of the role of families in nursing homes Admission to a nursing home is generally regarded as the termination of family care and the commencement of institutional care. Research suggests that following placement families are often expected to relinquish their dependent older relative to the bureaucracy of the institution. The aim of this study was to investigate family and nursing home staff perceptions of the role of families caring for residents in nursing homes. A convenience sample of 44 family carers and 78 nursing home staff completed questionnaires, and interviews were conducted with 10 family carers and 10 nursing home staff. The results suggest that family carers perceived themselves to have a greater role in caring for relatives than that perceived by the nursing home staff. Either families overestimated their involvement, or staff underestimated family involvement in caring for residents in nursing homes. Families were mostly satisfied with their role and with the care provided in nursing homes. They perceived nurses as providers of technical care and they perceived themselves as having an important role in providing social and emotional care. Families trusted the clinical judgement of the staff but the staff were reluctant to trust family carers, especially in situations where care involved an element of risk. Family roles were limited by members’ own ability to care and the dependency of the resident, while professional responsibility and accountability discouraged nurses from sharing some caring roles. The results indicate that families in this study were more willing to help in nursing home care and were perhaps under‐valued as a resource within the nursing home setting.
Correlates of safer sex communication among college students
Authors: DiIorio Colleen , Dudley William N. , Lehr Sally , Soet Johanna E. 
Published: March 2003

Correlates of safer sex communication among college students The purpose of this study was to examine factors that are thought to promote communication about safer sex and HIV among college students in the United States of America and to determine the extent to which communication about safer sex is important in the use of condoms. A better understanding of factors associated with safer sex communication can be helpful in developing HIV and STD prevention programmes for college students. Following approval from the institutional review boards of the six participating colleges and universities, researchers collected data from a random sample of students. The study included participant responses if participants were 18–25 years of age, single and sexually active. For the sample of 1349 participants, the mean age was 20·6 years. Sixty‐three per cent of the sample was female, 50·5% white, 42·3% African‐American, and the remainder of other ethnic groups. Over 50% of respondents reported frequent condom use, with 28% noting that they used a condom every time and 30·6% reporting condom use almost every time they had sex. Only 9·6% indicated that they never used a condom. The results of hierarchical multiple regression analysis revealed that the perception of quality of general communication with parents, the perception of a partner's attitude towards communication, communication self‐efficacy, and communication outcome expectancies, were associated with safer sex communication. However, the association between safer sex communication and condom use was weak, suggesting that other factors excluded from this study are important in determining condom use for this sample of respondents. The findings provide some implications for HIV interventions. Interventions that enhance self‐efficacy and positive outcome expectancies related to communication about safer sex are likely to foster discussion with a sexual partner. However, they might not lead to actual condom use.
Intolerable human suffering and the role of the ancestor: literary criticism as a means of analysis
Authors: Harrison Elizabeth 
Published: March 2003

Intolerable human suffering and the role of the ancestor: literary criticism as a means of analysis This essay explores the experience of intolerable human suffering in Toni Cade Bambara's novel, The Salt Eaters. The method of analysis is literary criticism, a technique that shares many of the same goals as other types of inquiry. It employs close reading to illuminate the novel's meaning(s), thereby revealing information about the nature of intolerable human suffering. Morrison's characteristics of black art is the literary and cultural framework that guides the analysis of Bambara's novel. The paradigm has broad application for nursing. The purpose of this analysis was to describe the role of the ancestral system as a predictor of the trajectory of suffering. The results extend Morrison's paradigm and her notion of ancestor to include traditions and other non‐corporeal factors that are essential for well‐being and survival. The protagonist in Bambara's novel, Velma Henry, is the patient and exemplar who does not succumb to intolerable suffering because of its cumulative weight, but because she has lost touch with the traditions of her people, an essential component of her ancestral system. The ancestral system is a rich and complex network of individuals, groups, customs and beliefs that are instructive, protective and benevolent. Ancestors are also timeless and provide wisdom, but when the ancestral system is weak or absent, the trajectory of suffering is not favourable. Nurses must learn to recognize intolerable human suffering, to identify the patient's ancestral system, and to work within that system to keep suffering patients from harm.
Pattern recognition as a caring partnership in families with cancer
Authors: Endo Emiko , Nitta Natsuko , Inayoshi Mitsuko , Saito Ryoko , Takemura Kaori , Minegishi Hideko , Kubo Satsuki , Kondo Mayumi 
Published: March 2003

Pattern recognition as a caring partnership in families with cancer The purpose of this study was to address the process of a caring partnership by elaborating pattern recognition as nursing intervention with families with cancer. It is based on Newman's theory of health as expanding consciousness within the unitary‐transformative paradigm and is an extension of a previous study of Japanese women with ovarian cancer. A hermeneutic, dialectic method was used to engage 10 Japanese families in which the wife‐mothers were hospitalized because of cancer diagnosis. The family included at least the woman with cancer and her primary caregiver. Each of four nurse‐researchers entered into partnership with a different family and conducted three interviews with each family. The participants were asked to describe the meaningful persons and events in their family history. The family's story was transmuted into a diagram of sequential patterns of interactional configurations and shared with the family at the second meeting. Evidence of pattern recognition and insight into the meaning of the family pattern were identified further in the remaining meetings. The data revealed five dimensions of a transformative process. Most families found meaning in their patterns and made a shift from separated individuals within the family to trustful caring relationships. One‐third of them went through this process within two interviews. The families showed increasing openness, connectedness and trustfulness in caring relationships. In partnership with the family, each nurse‐researcher grasped the pattern of the family as a whole and experienced the meaning of caring. Pattern recognition as nursing intervention was a meaning‐making transforming process in the family–nurse partnership.
Health promotion and the role of the school nurse: a systematic review
Authors: Wainwright Paul , Thomas Jane , Jones Melanie 
Published: March 2003

Health promotion and the role of the school nurse: a systematic review This paper describes findings from a systematic review of the literature on the effectiveness of school nurses in promoting the health of school children. The paper gives a brief account of the background to the study and the search strategy adopted. Some key findings are presented and discussed. The brief for the review was to seek evidence of effectiveness in the practice of school nurses. The results of the review were disappointing, in that little research of acceptable quality was found and little could be said about effectiveness. The result is therefore a more diffuse review that gives a summary of descriptive research and current views and opinions, although it does also present some pointers for future research. The study was funded by Health Promotion Wales.
Clinical supervision as an emancipatory process: avoiding inappropriate intent
Authors: Heath Helen , Freshwater Dawn 
Published: March 2003

Clinical supervision as an emancipatory process: avoiding inappropriate intent As clinical supervision becomes more widely implemented in the United Kingdom with concerns and resistances being eroded as practitioners discover its benefits, it is important that potential limitations and perhaps failures are avoided. This paper utilizes Johns’ (1996) intent‐emphasis axis to explore how a technical interest, misunderstanding of expert practice, and confusion of self awareness with counselling, can detract from the supervisory process. Several of the criticisms of reflective practice will be examined to demonstrate where concerns are valid and where they may be based on misunderstandings and the need to control clinical supervision. Greater awareness of inappropriate emphasis and intent should enable even relatively inexperienced supervisors to help their supervisees move towards independence, emancipation and evolving expertise.
The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year
Authors: Duke Sue , Appleton Jane 
Published: March 2003

The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year Reflection has gained a reputation for encouraging the integration between theory and practice within professional education. However, this reputation is based on an evidence base that mostly consists of theoretical debate. The aim of this study was to test our experience that the ability to reflect is developmental and that some reflective skills are harder to achieve than others. The research was undertaken by assessing the degree to which registered nurses achieved reflective criteria within assignments submitted for a variety of palliative care undergraduate modules. A total of 160 assignments were analysed using a marking grid constructed from a literature review and the results were compared between students and across academic terms. The results suggest that students are able to describe their practice but find it harder to analyse knowledge, the context of care and to action plan. Nevertheless, reflective abilities developed over time with significant developments made between each term. However, the development of skills indicative of critical reflection was less evident and confined to the ability to raise implications for future learning. The lack of multivariate analysis limits the study. However, the findings build on previous research and prompt questions for future work, particularly with respect to the process of reflection and how this can be supported in order to encourage the development of critical reflective skills.
Enhancing hope in people with a first recurrence of cancer
Authors: Herth Kaye 
Published: March 2003

Enhancing hope in people with a first recurrence of cancer Researchers and clinicians have identified the need for well‐defined intervention studies to test the efficacy of interventions designed to strengthen hope. This quasi‐experimental study sought to determine if a specific nursing intervention program designed to enhance hope would positively influence levels of hope and quality‐of‐life (QOL) in a convenience sample of 115 people with a first recurrence of cancer who were randomly assigned to one of three groups: treatment group (hope), attention control group (informational), or control group (usual treatment). The Herth Hope Index (HHI) and the Cancer Rehabilitation and Evaluation Systems, Short Form (CARES‐SF) were administered prior to intervention, immediately after intervention and at 3, 6, and 9‐month intervals. Treatment and control groups differed significantly with regard to level of hope (P=0·02) and QOL (P=0·03). Both the level of hope and QOL were significantly increased (P=0·03) immediately after intervention and across time (3, 6 and 9 months). This study was a preliminary attempt to design, implement, and evaluate a theory‐driven hope intervention program. Knowledge about the effectiveness of specific interventions designed to enhance hope is vital if nurses are to significantly influence hope in those whom are in their care.
A qualitative study of stress factors in the early stage of acute traumatic hand injury
Authors: Gustafsson Margareta , Persson Lars‐Olof , Amilon Anders 
Published: March 2003

A qualitative study of stress factors in the early stage of acute traumatic hand injury The aim of the study reported in this paper was to identify stress factors in the early stage of acute traumatic hand injury. Stress factors were defined as circumstances which the hand‐injured patients experienced as problems in the actual situation. A total of 20 patients, treated as inpatients at the Department of Hand Surgery in Örebro Medical Centre Hospital, Sweden, were interviewed 8–20 days after the day of the accident. The analyses of the interviews followed the first step in the analytical process described in a modified model of grounded theory. The trauma experience was one of the stress factors in the early stage. Single acute traumatic stress symptoms, mostly involuntary recollection and re‐experience of the trauma, were found in a fourth of the hand‐injured patients. All patients reported impaired functioning caused by their hand, irrespective of injury. Practical problems with daily activities and being dependent on help from others for solving practical problems were stress factors caused by functional impairment. Before the accident most of the hand‐injured had been very active, also working a lot with their hands in their leisure‐time. Involuntary inactivity was a big problem for some of them. Other stress factors in the early stage were uncertainty about function in the future and pain. The appearance of the hand was a minor problem before the first follow‐up visit. Probably because the hand was hidden in a bandage. However, some hand‐injured felt discomfort in seeing the hand when the dressing was changed at the first follow‐up visit.
Nurse education in Mbarara, Uganda
Authors: Kemp Joan , Tindiweegi Jocelyn 
Published: March 2003

Nurse education in Mbarara, Uganda Aim. To describe the establishment of a professional development programme for qualified nurses at Mbarara University Teaching Hospital, Uganda. Background. Between 1997 and 1999, a group of hospital‐based nurses and university lecturers in Hull, United Kingdom, planned and delivered a series of modules to set the Ugandan nurses on course for continuing professional development. Approach. A descriptive account of the delivery of the programme. Findings. Evaluation of the programme indicates that the nurses’ morale was raised by satisfactory completion of the modules and that there were visible improvements in the organization of patient care in the hospital. Conclusions. This professional development programme was a learning experience for all the parties involved. Support from Hull for the education of nurses in Mbarara will continue.