bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expanding conceptualizations of culturally competent care
Authors: Canales Mary K. , Bowers Barbara J. 
Published: March 2003

Expanding conceptualizations of culturally competent care Aim. The aim of the study was to gain an understanding of cultural competence from the perspectives of non‐mainstream nurse educators, specifically those of Latin heritage. Background/Rationale. Although the theoretical concepts of ‘cultural diversity’ and ‘culturally competent care’ have been supported and promoted by the largest professional nursing organizations, the practical application of these concepts has often created difficulties for nurse researchers, educators, and clinicians. The lack of progress in teaching and evaluating cultural competence suggested the need to ‘center the margins’ and explore cultural competence from the margins of one particular non‐mainstream nursing group, Latina nurse educators. Design/Methods. A grounded theory research design was employed. A group of 10 doctoral, prepared, self‐identified, Latina nurse educators participated in face‐ to‐face audiotaped interviews. Data collection, analysis, and theoretical sampling decisions occurred concurrently, strengthening theory generation. Institutional review board approval was received for all steps of the study. The major limitation of the study was the omission of student voices. Results/Findings. The analysis suggests that the Latina participants shared the common purpose of teaching students how to think about difference. The teaching practices of this group of Latina educators was based on a belief that ‘difference’ is not solely about specific cultural groups. For example, content about ‘Hmongs’ or ‘Latinos’. Rather, Latina faculty focused on teaching students how to directly connect with anyone perceived as different from oneself. Conclusions: Latina faculty did not distinguish between competent care and culturally competent care; for them, competence necessarily includes cultural competence. They conceptualize the provision of competent care to all persons who are perceived as different, rather than focusing only on those who are perceived as ‘culturally’ different. These conceptualizations have the potential to shed new light on how nurses and nurse educators think about, develop, and integrate cultural competence into nursing education, practice, and research.
Obesity in adults and children: a call for action
Authors: Holm Karyn , Li Suling , Spector Nancy , Hicks Frank , Carlson Elizabeth , Lanuza Dorothy 
Published: March 2003

Obesity in adults and children: a call for action Obesity/overweight in adults and children is a worldwide health problem associated with substantial economic burden as measured by paid sick leave, life and disability insurance rates, and obesity‐related physician visits and hospital stays. Overweight/obese people experience hypertension, elevated cholesterol, and type 2 diabetes and suffer more joint and mobility problems than people within the normal weight for height range. While there is need to understand individual behaviors that can be modified to promote weight loss and weight maintenance, there is as great a need to consider contextual factors at the societal level that can impede or even sabotage weight control efforts. In every country with improved living standards people will continue to eat too much and engage in too little physical activity. The call for action is for all modernized societies to alter environments and attitudes to support, rather than hinder, healthy dietary intake and being physically active.
Research information in nurses’ clinical decision‐making: what is useful?
Authors: Thompson Carl , McCaughan Dorothy , Cullum Nicky , Sheldon Trevor A. , Mulhall Anne , Thompson David R. 
Published: March 2003

Research information in nurses’ clinical decision‐making: what is useful? Aim. To examine those sources of information which nurses find useful for reducing the uncertainty associated with their clinical decisions. Background. Nursing research has concentrated almost exclusively on the concept of research implementation. Few, if any, papers examine the use of research knowledge in the context of clinical decision‐making. There is a need to establish how useful nurses perceive information sources are, for reducing the uncertainties they face when making clinical decisions. Design. Cross‐case analysis involving qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England, United Kingdom. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 hours and 122 nurses were involved in the Q modelling exercise. Results. Text‐based and electronic sources of research‐based information yielded only small amounts of utility for practising clinicians. Despite isolating four significantly different perspectives on what sources were useful for clinical decision‐making, it was human sources of information for practice that were overwhelmingly perceived as the most useful in reducing the clinical uncertainties of nurse decision‐makers. Conclusions. It is not research knowledge per se that carries little weight in the clinical decisions of nurses, but rather the medium through which it is delivered. Specifically, text‐based and electronic resources are not viewed as useful by nurses engaged in making decisions in real time, in real practice, but those individuals who represent a trusted and clinically credible source are. More research needs to be carried out on the qualities of people regarded as clinically important information agents (specifically, those in clinical nurse specialist and associated roles) whose messages for practice appear so useful for clinicians.
Socio‐psychological stressors as risk factors for low back pain in Chinese middle‐aged women
Authors: Yip Yin‐bing , Ho Suzanne C. , Chan Sieu‐gaen 
Published: March 2003

Socio‐psychological stressors as risk factors for low back pain in Chinese middle‐aged women Aim(s) of the study. This study aims to explore the relationship between socio‐psychological stress and low back pain (LBP) prevalence among Chinese middle‐aged women. Background. Women in mid‐life experience increasing socio‐psychological stress because of midlife transitions, stressful life events and housework or work factors. Encountering socio‐psychological stress itself may result in the manifestation of LBP. Design. A case–control study of Hong Kong community‐based middle‐aged women was conducted. The study subjects were either from the University Family Medicine Clinic or from a previous population‐based cross‐sectional study of middle‐aged women conducted by Department of Community and Family Medicine. Among the 928 potential eligible subjects from both sources, a total of 182 cases and 235 controls participated in this study. Data were collected from face‐to‐face interviews and included demographic factors, menopausal status, socio‐psychological stress and occurrence of LBP. Socio‐psychological stress covered social factors, self‐reported nature of housework/work, housework/work stress and stressful life events. Results. Among the 182 cases who entered this study, 83 women (45·6%) had experienced 1–<14 days of LBP, and 99 women (54·4%) had at least 14 days of LBP in the previous 12 months. Those who reported that ‘their family members, relatives or friends were very sick, died, needed her to take care of them or who they worried about in the past 12 months’ had an increased risk of LBP of 67% (95% confidence interval (CI) 1·09–2·55). In addition women with a bad or ordinary relationship with cohabitants had an increased risk of LBP of 70% (95% CI 1·00–3·04). Lastly, women with a high housework or work stress had an increased risk of suffering both types of LBP of nearly two‐ and half‐fold (95% CI 1·61–3·85). Conclusions. The results indicate that an association exists between high socio‐psychological stress and LBP prevalence. Alleviating the impact of housework or work related factors would, however, involve improving both the work and home environment.
The effects of postpartum stress and social support on postpartum women’s health status
Authors: Hung Chich‐Hsiu , Chung Hsin‐Hsin 
Published: March 2003

The effects of postpartum stress and social support on postpartum women’s health status Background. Eastern sociocultural systems differ in many ways from Western ones, and these differences influence many aspects of the postpartum period. Aim. The purpose of this study was to determine postpartum women’s health status in the wider social context of the Taiwanese family after women return home from the hospital or clinic. Method. A longitudinal study was conducted with data collected at the first, the third, and the fifth weeks of the postpartum period. Five hundred and twenty‐six postpartum women were included in the study using stratified sampling from clinics and hospitals in Kaohsiung City in the southern part of Taiwan. The Hung Postpartum Stress Scale (HPSS), Smilkstein’s Social Support Scale, and the Chinese Health Questionnaire were used to obtain information about the women’s postpartum stress, social support, and health status at each time point. Data were analysed with factor analysis, repeated measures MANOVA, and multiple logistic regression. Results. Three factors associated with postpartum stress were identified by factor analysis: (1) maternity role attainment, (2) lack of social support, and (3) body changes. Furthermore, the level of postpartum stress at the third and the fifth postnatal weeks was higher than at the first. Social support scores at this postnatal week were the highest among the three points in time. In addition, 29%, 41% and 41% of the women at the first, third, and fifth weeks, respectively, had minor psychiatric morbidity. Conclusions. Because the postpartum women’s self‐reported stress is relatively low whereas the social support is relatively high, especially from the family, this confirms Pillsbury’s conclusion regarding the significance of social support during the Chinese women’s postpartum period. The study also showed that the three factors associated with postpartum stress were important predictors of postpartum women’s health status. Future studies should compare the level of postpartum stress, social support, and women’s health status in both Western and Eastern cultures.
The effectiveness of music as an intervention for hospital patients: a systematic review
Authors: Evans David 
Published: March 2003

The effectiveness of music as an intervention for hospital patients: a systematic review Introduction. Over the past few decades there has been a growing interest in the use of music, which has seen it used to achieve a diverse range of outcomes. While music as an intervention for hospital patients has subject to considerable evaluation, many of these studies are small and findings are therefore often contradictory. This systematic review was conducted to investigate the effectiveness of music as an intervention for hospital patients. Method. A comprehensive search was undertaken involving all major health care databases. For studies to be included in the review they must have investigated the effect of music, involved adult hospital patients and used a randomized controlled trial design. These studies must also have used outcome measures such as anxiety, satisfaction, pain, mood and vital signs. Identified studies were critically appraised, and then categorized according to whether music was evaluated during normal care delivery or during invasive and unpleasant procedures. When appropriate, studies were combined in a meta‐analysis. Results. A total of 29 studies were identified that fulfilled the inclusion criteria, of which 10 were subsequently excluded following critical appraisal. Music played via headphones reduces anxiety of patients during normal care deliver, but it has no impact on the anxiety of patients undergoing procedures such as bronchoscopy, sigmoidoscopy or surgery with a spinal anaesthetic. Music produces a small reduction in respiratory rate during normal care delivery, but appears to have little effect on other vital sign parameters. It has no impact on the vital signs of patients undergoing procedures. Although the evidence is limited, music also appears improve the mood and tolerance of patients. Conclusion. This review demonstrates the effectiveness of music for the reduction of anxiety during normal care deliver. Given the inexpensive nature of this intervention, and the lack of adverse events, it is recommended as an adjunct to normal care practices. This review also highlights the need for further research into many aspect of this intervention.
Minimizing side‐effects: the clinical impact of nurse‐administered ‘side‐effect’ checklists
Authors: Jordan Sue , Tunnicliffe Carol , Sykes Alan 
Published: March 2003

Minimizing side‐effects: the clinical impact of nurse‐administered ‘side‐effect’ checklists Background. For those with chronic illness, the adverse effects of medication are important causes of morbidity and distress which may not always receive due attention. Guidelines and checklists may be one strategy to focus professionals’ attention on long‐term problems. Therefore, client‐centred ‘side‐effect’ evaluation checklists were developed to be administered and actioned by nurses. Aim. The purpose of this study was to explore the clinical impact of these checklists on long‐term users of antipsychotic medication. Methods. This study was undertaken with clients with enduring mental illness, in Community Mental Health Teams. In the first phase, 40 nurse–client interactions were observed. Following introduction of the evaluation checklists, 20 nurse–client interactions were observed with the checklists and 20 nurse–client interactions were observed for comparison. In addition, the views of professionals, service users and user groups on the value of the checklists were sought. Findings. Amongst the 20 clients in the intervention group, the checklists highlighted several problems, two of which were urgent. In the intervention group, the mean number of problems actioned per client increased from 0·35 (range=0–4) with no checklists to 3 (range=0–6) with the checklists. The majority (51 of 59) of actions taken to alleviate adverse effects of medication concerned physical health problems. Nurses offered appropriate advice or encouraged clients to contact the relevant agencies. No such changes were observed in the comparator group. There were no differences between groups in the number of referrals to prescribers. Implications. The usefulness of the evaluation checklists for detecting unattended problems, in conjunction with the responses of service users, suggests that it may be clinically effective to establish procedures to systematically monitor people with serious mental illness for adverse drug reactions (ADRs). However, larger studies are needed to confirm this.
The lived experience of waiting‐to‐know: Ebola at Mbarara, Uganda – hoping for life, anticipating death
Authors: Locsin Rozzano C. , Matua Amandu Gerald 
Published: March 2003

The lived experience of waiting‐to‐know: Ebola at Mbarara, Uganda – hoping for life, anticipating death Purpose of the study. The purpose of the study was to describe the phenomenon of ‘waiting to know’. It is a phenomenon uniquely experienced by persons who had been exposed to patients with Ebola Hemorrhagic Fever (Ebola) but who have not yet exhibited signs and symptoms of the disease. Research method/analysis. The phenomenological human science approach was used using the four life worlds as guides for reflection. These are spatiality, corporeality, temporality, and relationality. Participants. Seven health care personnel were selected through professional networking. They were preferred because of their exposure to patients with Ebola during the epidemic at Mbarara, Uganda. Results/findings. Written descriptions of the experience of ‘waiting to know’ whether exposure to patients with Ebola causes these participants to be infected, were obtained and analysed. Through immersion with the written descriptions, the following themes emerged: helplessness in anticipation and fear of dying or premature death; agonizing and languishing over losing relatives, friends, and loved ones; trusting no one, and; helplessness and hopelessness with the persistence of time.
A critical review of the arguments debating the role of the nurse advocate
Authors: Hewitt Jeanette 
Published: March 2003

A critical review of the arguments debating the role of the nurse advocate Aims of the paper. This paper critically reviews the arguments for and against undertaking the role of nurse advocate. Background. Advocacy has become a popular concept in nursing literature over the past two decades. By addressing issues of power and accountability, conclusions are drawn about the risks facing nurses who would practice patient advocacy. Methods. Review and analysis of theoretical debate. Results. Empirical evidence is sparse and philosophical arguments predominate in the field of patient advocacy. Humanistic arguments that promote advocacy as a moral imperative are compelling. However, in reality nurses appear to lack the power base to comply except by covert means. Informed consent with a knowledge of the consequences of undertaking such an intervention is as relevant to the nurse as it is to the patient. Conclusion. Nurses need to be empowered first, if they are to empower their patients. There may however, be more suitable candidates for the role of patient advocate and nurses should recognize that they do not have a monopoly on ethical decision making.
Synergy towards health: a nursing intervention model for women living with fibromyalgia, and their spouses
Authors: Sylvain Hélène , Talbot Lise R. 
Published: March 2003

Synergy towards health: a nursing intervention model for women living with fibromyalgia, and their spouses Aim. The purpose of this study was to develop a consensus‐based nursing intervention model for women living with fibromyalgia, their spouses and nurses working in a community health centre in Québec, Canada. Background. Fibromyalgia syndrome, a rheumatic disorder associated with severe chronic pain and fatigue, has a major impact on the lives of individuals and their family. To date, research results on effective interventions are somewhat limited and inconclusive. Few studies take into account the perspective of those who live with this health problem on a day‐to‐day basis. Methods. Data were collected mainly in 1999, through in‐depth interviews and through group meetings using a qualitative research design, along the lines of the constructivist paradigm. The analysis plan aims for movement between the global and the specific: synthesis and thematic analysis. Analysed data were submitted to all participants throughout the data‐collection process, thus allowing for shared constructions. Findings. Results present the general consensus stemming from shared construction in all three groups. The nature of the intervention involves two major elements, support and teaching along with the fundamental importance of believing in the person. The timing of the intervention and the health and social context in which the intervention occurs also emerge as integral parts of the model. Synergy towards health in fibromyalgia emerges as the constitutive pattern composed of the following three elements: personal growth, spousal and professional support. The discussion addresses the model's components and uses an ecological perspective, in order to consider all the contexts that greatly influence the intervention. Empowerment is embedded in this intervention model. Conclusions. This study shows that research based on partnership allows the integration of perspectives and skills of various actors so as to develop meaningful interventions for both those seeking care and health professionals.
Acute care nurses' perceptions of barriers to using research information in clinical decision‐making
Authors: McCaughan Dorothy , Thompson Carl , Cullum Nicky , Sheldon Trevor A. , Thompson David R. 
Published: March 2003

Aim.  To examine the barriers that nurses feel prevent them from using research in the decisions they make. Background.  A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self‐reported utilization behaviour; poor response rates and small, nonrandom sampling strategies. Design.  Cross‐case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). Results.  Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the individual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, ‘academic’ and overly statistical; (2) Nurses who felt confident with research‐based information perceived a lack of organizational support as a significant block; (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction; (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These individuals liked research messages passed on to them by a third party and sought to foster others' involvement in research‐based practice, rather than becoming directly involved themselves. Conclusions.  Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy‐makers and the research community.
How prevalent is violence towards nurses working in general hospitals in the UK?
Authors: Wells John , Bowers Len 
Published: March 2003

Background.  Violence in nursing is not a new phenomenon but in recent years much greater emphasis has been placed on the problem in the United Kingdom (UK). A number of official reports, media stories and national initiatives have focused attention on the problem in this country. However, it is not clear whether violence and abuse have in fact become more prevalent. At present little is known about the scale of the problem for general nurses working in general hospitals in the UK. Aim of the study.  A realistic assessment of the scale of this problem should facilitate a meaningful debate about the interventions needed to counter it and support the requests for funding that will be required. This study aimed to establish the utility of existing research findings, to include relevant but previously unused sources and to synthesize the results. Method.  A systematic search of the literature pertinent to the aim of the study was followed by a critical review. The focus was on research originating in the UK, including some general research on occupational violence which included data on nurses. Findings.  Overall, the research findings are limited. The best available evidence suggests nurses as a whole do face a high level of risk compared with all workers and this excess risk holds for general nurses. The data support a figure of more than 9·5% of general nurses working in general hospitals assaulted (with or without injury) in any 1 year. Trends over time are impossible to identify at present. Conclusions.  Efforts to combat the problem should include greater emphasis on the problem outside accident and emergency departments, prioritizing preregistration training in the management of aggression, and further research. Better reporting should also be a priority.