bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mother, daughter, patient, nurse: women’s emotion work in aged care
Authors: Gattuso Suzy , Bevan Celia 
Published: March 2003

Mother, daughter, patient, nurse: women’s emotion work in aged care This paper examines emotion work within the predominantly female environment of aged‐care nursing, identifying phenomena which must be accounted for in a theory of emotional labour. These phenomena include the blurring of public and private in women’s experiences and maternal models of care. Initial findings demonstrate the high levels of stress experienced by staff, related to emotional labour and to conflicts around the erosion of care standards. Sixteen women, from rural Australia, participated in the first stage of the research. The oldest was in her sixties, the youngest in her thirties. Length of aged‐care experience ranged from 2 to 33 years. Although most of the women expected to still be in aged care in 5 years’ time, they were negative in their attitudes to personal ageing, suggesting an ambivalence in their feelings about working in aged care. Three women nurses are the particular focus of this paper. Their narratives illustrate the intersection of private and public caring in nurses’ lives and the implications of this for emotional labour. Phenomena such as dual caring, conflicts in insider‐outsider roles, and transference are revealed in their narratives. We argue that the welfare of the recipient of gerontic nursing is linked to the well‐being of the nurse‐carer but that a cultural change is needed so as to recognize and value emotion work. However, endorsing Staden, we agree that such a change is dependent on the politicization of ‘caring’. There is also need for further and broader research concerning the nature of emotional labour and the ethics of care.
Managing post‐discharge care at home: an analysis of patients’ and their carers’ perceptions of information received during their stay in hospital
Authors: Driscoll Andrea 
Published: March 2003

Managing post‐discharge care at home: an analysis of patients’ and their carers’ perceptions of information received during their stay in hospital This small‐scale study carried out in a Melbourne metropolitan hospital explored patients’ and their carers’ perceptions of information, adequacy of information, and their utilization of information concerning post‐discharge care received from health professionals during their stay in hospital. The research design consisted of two stages. Stage one involved a qualitative approach using focused interviews of five pairs of patients and their carers, 2 weeks after discharge from hospital. Five main themes emerged from the content analysis of the interview transcripts: information given by health professionals to patients and carers, patients’ and carers’ psychological well‐being, activities of daily living, caring tasks of the patients, and community linkages. A quantitative approach was used for stage two involving two sets of questionnaires, one for the patient and one for the carer, developed from the themes identified in stage one. A pilot study was conducted on three pairs of patients and their carers, 2 weeks after discharge from hospital. The main study consisted of a convenience sample of 40 pairs of patients and their carers who completed the questionnaires 2 weeks post‐discharge. Data analysis of stage two of the study consisted of descriptive statistics and cross‐tabulations. The main findings suggested that carers received very little information from health professionals concerning their patients’ health problems and care at home. The carers’ health and employment states were often not considered in their patients’ discharge plan. Carers who were present with their patients when they received information concerning post‐discharge care experienced a decrease in anxiety during their patients’ convalescence at home, greater satisfaction with the information they received, and their patients experienced fewer medical problems post‐discharge. The implications for nursing practice and research include recommendations for a more effective system of discharge planning, and further research to include a larger population with a more varied group of participants.
Nurses’ experiences of making decisions to call emergency assistance to their patients
Authors: Cioffi Jane 
Published: March 2003

Nurses’ experiences of making decisions to call emergency assistance to their patients Patient survival often depends on decisions by nurses to call emergency assistance. The experiences of nurses calling emergency assistance have not been described. This descriptive study explored the experiences of registered nurses (n=32) using unstructured interviews. The main findings were that nurses questioned whether they were doing the ‘right thing’ calling the emergency team, sometimes collaborated with others prior to calling and most felt nervous and anxious. They recognized patient deterioration from feelings they had that something was wrong. However, they were not able ‘to put their finger on it’. Knowing the patient and past experiences were involved in the recognition of deterioration. This association indicates the importance of experience in the development of clinical decision‐making skills. Further, nurses calling emergency assistance need to be provided with the opportunity to debrief after calling. Their heavy reliance on subjective data before searching for objective data as outlined in the emergency calling criteria suggests that it is essential that nurses do not devalue or ignore concerns they may have about patients.
Reducing distress in first level and student nurses: a review of the applied stress management literature
Authors: Jones Martyn C. , Johnston Derek W. 
Published: March 2003

Reducing distress in first level and student nurses: a review of the applied stress management literature Following recent evidence of continuing high levels of distress in both trained and student nurses, a critical review of the stress reduction and stress management literature targeting both trained and student nurses is presented. Using a systematic approach, some 36 studies dating from 1980 until the present day were identified adopting either pre‐experimental, quasi‐experimental or experimental designs. While many work‐site programmes in this series were successful in terms of adaptive changes in problem‐solving, self‐management skills including relaxation and interpersonal skills, affective well‐being, and work performance, a number of design and evaluation inadequacies were identified. The relative lack of home–work interface or organizational level programmes to reduce work‐related distress, and the scarcity of interventions targeting aspects of the work environment likely to contribute to such outcomes may have contributed to continuing high levels of distress in trained and student nurses. Recommendations regarding the future design, provision and evaluation of such work‐site interventions include the further clarification of the structure of perceived stressors, and development of causal models of the stress process to identify the job characteristics ‘causing’ work‐related distress. Such an approach would inform the design and implementation of evidence‐based organizational level interventions augmenting strategies to target the health behaviour, lifestyle/risk factors and self‐management skills of practitioners and students with attempts to amend problematic elements of the psychosocial work environment.
Exploring reflective thinking in nursing practice
Authors: Teekman Bert 
Published: March 2003

Exploring reflective thinking in nursing practice While it is claimed in the nursing literature that reflective thinking is the approach par excellence for learning and advancing the art and practice of nursing, few empirical studies have been undertaken in this area to date. Sense‐Making, a qualitative research method, was utilized to obtain and analyse data from interviews with 10 registered nurses in order to study reflective thinking in actual nursing practice. Ten non‐routine nursing situations were analysed for the presence of reflective thinking. Time‐line interviews of the events resulted in a total of 59 micro‐moments, each of which was explored in terms of the thinking processes utilized to make sense of the situation as well as the focus of their thought. ‘Pre‐perceptions’ played an important part in how the respondents perceived their situation. Reflective thinking was extensively manifest, especially in moments of doubt and perplexity, and consisted of such cognitive activities as comparing and contrasting phenomena, recognizing patterns, categorizing perceptions, framing, and self‐questioning in order to create meaning and understanding. Self‐questioning was identified as a significant process within reflective thinking. By exploring and analysing the type of questions respondents were asking themselves, the study uncovered three hierarchical levels of reflective thinking. Respondents most often engaged in reflective thinking‐for‐action which centred on the here and now in order to act. Reflective thinking‐for‐evaluation focused on creating wholeness and contributed to the realization of multiple perceptions and multiple responses. Reflective thinking‐for‐critical‐inquiry could not be demonstrated in the study sample. The findings of this study resulted in the development of a model of reflective thinking, which is discussed in terms of the implications for learning in nursing practice.
Asthma and dualism
Authors: Paley John 
Published: March 2003

Asthma and dualism The rejection of Cartesian dualism can be taken to imply that the mind is implicated in health and illness to a greater degree than conventional medicine would suggest. Surprisingly, however, there appears to be a train of thought in antidualist nursing theory which takes the opposite view. This paper looks closely at an interesting example of antidualist thinking — an article in which Benner and her colleagues comment on the ways in which people with asthma make sense of their condition — and concludes that it places unduly stringent and arbitrary limits on the mind’s role. It then asks how antidualism can lead to such a dogmatic rejection of the idea that states of the body are clinically influenced by states of mind. The answer to this question is that Benner assimilates very different philosophical theories into the same ‘tradition’. On this occasion, she has combined Descartes, Kant and the Platonist ascetics into a single package, misleadingly labelled ‘Cartesianism’, and this move accounts for her unexpected views on the relation between mind and body in asthma.
Cognitive ability and functional status
Authors: Knight Margaret M. 
Published: March 2003

Cognitive ability and functional status Significant confusion exists in the literature about functional status. Despite its importance, little attention has focused on developing and substantiating frameworks that detail the underpinnings of functional status, which has resulted in lack of agreement about its definition and dimensions. The purpose of this literature review was to examine the development of functional status and to describe the inclusion of its cognitive dimension. Cognition is one key dimension of functional status. One must ‘know how’ to perform to be successful in an activity. While cognitive capacity is generally considered in relation to functional status, the nature of the cognitive dimension is poorly described and poorly understood. Three databases were selected for review: Citations in Nursing and Allied Health (CINAHL), Psychology Literature (PsychLit), and the Medical data base known as MedLine. Key word searches identified thousands of sources. This analysis includes an extensive sampling of these sources from the 1960s through to 1998. The sources sorted into four primary categories and demonstrate a growing recognition of the cognitive dimension of functional status in the literature. Despite this recognition, the lack of conceptual clarity of both the term functional status and its cognitive dimension limits communication among disciplines and limits comparisons of functional status outcomes across studies. Functional status models are needed that include cognition as a core dimension. Population specific descriptions of the cognitive dimension should be guided by knowledge in the neurosciences.
Psychiatric care as seen by the attempted suicide patient
Authors: Samuelsson Mats , Wiklander Maria , Åsberg Marie , Saveman Britt‐Inger 
Published: March 2003

Psychiatric care as seen by the attempted suicide patientThis study highlights the experiences of patients during in‐patient psychiatric care in Sweden following a suicide attempt. Eighteen patients were interviewed as close to being discharged as possible. Each respondent was asked to narrate his/her experiences of the care received. An interview guide concerned the following areas: admission to the hospital, feelings and reactions, and positive as well as negative experiences during the hospital stay. The interviews were transcribed verbatim and a qualitative content analysis concerning the meanings, intuitions, consequences and the context of the data was performed. Three central categories were identified: being a psychiatric patient, patients’ perceptions of the caregivers and the care provided, as well as important aspects of the psychiatric care received. The importance of being well cared for and receiving understanding and confirmation was emphasized. Lack of confirmation may have contributed in some cases to a feeling of being burdensome, demands for discharge or even another suicide attempt. Verbal contacts with the staff were seen as essential for the process of healing and for the desire to go on living.
Korean nurses’ adjustment to hospitals in the United States of America
Authors: Yi Myungsun , Jezewski Mary Ann 
Published: March 2003

Korean nurses’ adjustment to hospitals in the United States of America Due to shortage of nurses, more nurses from other countries are employed in health care settings in the United States of America (USA). Little attention has been paid to understanding how culturally different international nurses adjust to USA hospitals. The purpose of this study was to investigate how Korean nurses adjust to USA hospital settings. Grounded theory method was used for sampling procedure, data collection and analysis in order to describe Korean nurses’ experiences from their perspective and to develop a substantive theory that explains their process of adjustment. Data were collected using semi‐structured formal interviews with a purposive sample of 12 Korean nurses. The interviews were audio‐taped and transcribed. Analysis of data, using the constant comparative method, revealed ‘adjustment to USA hospitals’ as the basic social psychological process. Five categories composed the process: (1) relieving psychological stress; (2) overcoming the language barrier; (3) accepting USA nursing practice; (4) adopting the styles of USA problem‐solving strategies; and (5) adopting the styles of USA interpersonal relationships. These five categories capture the essential aspects of the adjustment process and each category contains a set of sub‐categories that describe Korean nurses’ day‐to‐day experiences that are critical and also problematic to their adjustment. The process evolves in two stages. In the initial stage, the first three of the five categories greatly influenced the nurses’ adjustment. From the perspective of the nurses in the study, the initial stage lasts about 2 to 3 years. The remaining two categories are principal components of the later stage. It takes an additional 5 to 10 years to complete this stage. This model highlights both distress and accomplishments of Korean nurses during their adjustment to USA hospitals. The results of the study may help USA nurses gain insight in designing and implementing orientation programmes to facilitate and support Korean nurses’ adjustment to USA hospitals.
Quality in health care and ethical principles
Authors: Huycke LaRae , All Anita C. 
Published: March 2003

Quality in health care and ethical principles The last three decades have seen rapid changes in the way United States of America (USA) health care has been delivered, financed and regulated. Four major stakeholders have emerged in the health care debate: patients, providers, payers and public regulatory agencies. These groups do not agree on a definition of quality health care. This paper suggests five ethical principles — autonomy, justice, beneficence, non‐maleficence, and prudence — be included in the framework of quality health care. A framework that outlines possible relationships among these ethical attributes and four major stakeholders is presented.
Developing and testing an instrument for the measurement of individual care
Authors: Suhonen Riitta , Välimäki Maritta , Katajisto Jouko 
Published: March 2003

Developing and testing an instrument for the measurement of individual care This paper describes a preliminary study in which an instrument was developed for the measurement of individual care in adult patients and in which the reliability and validity of the instrument were evaluated. Individual care was defined in terms of how patient individuality was taken into account and how patient participation in decision‐making was facilitated. The purpose here is to describe the process by which the individual care instrument (IC) was developed, the preliminary testing of the instrument and psychometric evaluation of the instrument in a sample of adult patients discharged from a Finnish general Hospital (n=203). Item analyses showed an acceptable level of internal consistency reliability and homogeneity in each scale of the IC, and Cronbach α values were high in every measurement. Exploratory factor analysis supported a three‐factor solution. The psychometric evaluations suggested that the instrument is worthy of further development.
Experiences of coercion in psychiatric care as narrated by patients, nurses and physicians
Authors: Olofsson Britta , Norberg Astrid 
Published: March 2003

Experiences of coercion in psychiatric care as narrated by patients, nurses and physiciansAim. The aim of the study was to increase understanding of psychiatric patients’, nurses’ and physicians’ experience of coercion, in relation to their own and the other parties’ experiences.Methods. Seven triads of patient, nurse and physician narrated their experiences of the same coercive event. The 21 interviews were analysed focusing on narrative elements.Results. The nurse and physician narratives revealed that they felt unable to connect with the patients, while the patients told us that they wanted more human contact with nurses and physicians. All three parties expressed the belief that interpersonal relationships and the human contact were important. The nurses and physicians stated that knowing the patient made them feel easier about using coercion and that their actions were less violating for the patient. The patients stated that human contact alleviated their feeling of discomfort and made them feel more secure when subjected to coercion.Conclusion. The salient aspect described by all three parts was the importance of human contact and having a mutual relationship. These findings indicate a need for more dialogue between patients and staff. The dialogue should aim at making staff understand patients’ feelings better regarding coercion and at informing the patients about the coercive measures.
Harm reduction theories and strategies for control of human immunodeficiency virus: a review of the literature
Authors: Hilton B. Ann , Thompson Ray , Moore‐Dempsey Laura , Janzen Randy G. 
Published: March 2003

Harm reduction theories and strategies for control of human immunodeficiency virus: a review of the literatureAim. To provide a comprehensive review of the literature on harm reduction theories and strategies related primarily to licit and illicit drug use.Background. Although human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) disease transmission is well understood, it continues to spread, particularly among injection drug users (IDUs). Despite early indications that HIV would be contained within the IDU community, it is spreading to non‐IDU sexual partners and to children of IDUs, threatening a more widespread epidemic.Methods. An examination of research studies and theoretical writings including reviews and policy papers published in English between 1990 and 2000.Results. Harm reduction does not seek to eliminate drug use; it focuses on minimizing the personal and social harms and costs associated with drug use and spread of HIV. It seeks to ameliorate conditions surrounding drug use responsible for the spread of HIV in the IDU community: unequal access to health services; sharing of infected needles; racial and social discrimination; poverty; exposure to street violence; inadequate housing; lack of employment; poor general or mental health and other demographic and social determinants. Some controversial harm reduction strategies are described: methadone maintenance programmes, illegal drugs dispensing under controlled conditions, needle exchanges, HIV testing, vein maintenance, safe‐sex and would‐care programmes.Conclusion. The main challenge is to get IDUs to protect themselves against HIV when suffering physical and social privations and addiction needs. Diverse perspectives on harm reduction are problematic with consequences for success of drug use initiatives. Practical, ethical and theoretical complexities exist but further research is needed to build support for a harm‐reduction orientation in practice and policy formulation.
The meaning of preceptorship: nurses’ lived experience of being a preceptor
Authors: Öhrling Kerstin , Hallberg Ingalill R. 
Published: March 2003

The meaning of preceptorship: nurses’ lived experience of being a preceptor Aim of the study. This phenomenological study is aimed at illuminating nurses’ lived experience of the process of preceptoring and the meaning of preceptorship in a Swedish context. Methods. Seventeen nurses from the North of Sweden with varied previous experience of preceptorship volunteered to participate. Their narratives, describing their experience of being a personal preceptor for a student nurse during practical training on a hospital ward in the third year of a 3‐year diploma programme within a university college of nursing in Sweden, were transcribed verbatim. A phenomenological‐hermeneutic interpretation disclosed the themes ‘sheltering the students when learning’ and ‘facilitating the students’ learning’, together with eight sub‐themes, which created an understanding of the meaning of preceptorship. Findings and discussion. The meaning of preceptorship was understood as reducing the risk of the students learning helplessness and empowering the students when learning in practice. The meaning of preceptorship highlighted the need for further preceptor support and development of the role of the preceptor. On the basis of the findings, suggestions were made to increase the preceptors’ awareness of values in nursing practice and use of pedagogical strategies in the process of preceptoring. Through such strategies a reciprocal development of the preceptors’ and the faculty’s knowledge may take place, to the best advantage of the students’ learning and the development of the profession.