bluuebunny/crossref_metadata_2025_split huggingface dataset:
A dirty business: caring for people who are a nuisance or a danger
Authors: Godin Paul 
Published: March 2003

A dirty business: caring for people who are a nuisance or a danger This paper argues that developments in chemical, administrative and legal methods of control, once confined to the asylum, now operate over mental patients in the community. Differences between the hospital and the community have thus been eroded. This paper therefore seeks to understand how mid‐twentieth century sociology, that informed an understanding of the asylum prior to its demise, can be usefully revisited to inform an understanding of the contemporary practice of community mental health nursing. It is argued that in their development, community mental health nurses (CMHNs) have endeavoured to associate themselves with the clean work of caring, rather than with the dirty work of coercive control. However, CMHNs now find themselves representing societal and psychiatric demands for the greater control of mental patients in the community to their clients. Issues of control and care (coercion and persuasion) in community mental health care nursing practice are thus considered in relation to theory regarding the imposition of power.
Data collection with adolescents
Authors: Dashiff Carol 
Published: March 2003

Data collection with adolescents Adolescence spans a wide time period during which development and its context influence behaviour and the strategies used for data collection. This article addresses problems that can be anticipated in data collection with adolescents. Problems are presented that are associated with adolescent developmental capacities, adolescent developmental change and stability, gender and ethnicity. Some problems are specific to certain settings or to certain data collection methods.The application of theoretical and empirical knowledge about adolescent development can strengthen data collection instruments and procedures. Strategies to enhance data collection include carefully defining adolescence and tailoring procedures and protocols based on a theoretical understanding of the biological, cognitive and emotional development of adolescents in conjunction with an understanding of the characteristics of the research setting.Adolescent research settings can pose challenges. Investigators must understand clinic routines in evaluating the feasibility of implementing protocols and collecting data where there are distractions and time constraints. In education settings, strategies must be used to collect data in a group context where peer pressure can affect responses. In home settings, ingrained response patterns and family norms can also impede obtaining valid perspectives from adolescents.Ethnicity as well may play an important role that must be addressed when designing and implementing data collection with adolescents. Procedures and instruments selected to collect data need to address variations in ethnicity.
Action research in action: reflections on a project to introduce Clinical Practice Facilitators to an acute hospital setting
Authors: Kelly Daniel , Simpson Susan 
Published: March 2003

Action research in action: reflections on a project to introduce Clinical Practice Facilitators to an acute hospital setting Aims of the paper. The process and philosophical basis of action research are discussed in this article by reviewing the insights that were gained from a study designed to enhance the support available to junior nursing staff in an acute hospital setting. Rationale. It has been well documented that newly qualified nurses require help to develop professional competencies. With this in mind, the role of Clinical Practice Facilitator was established within a National Health Service (NHS) Trust to enhance clinical skill acquisition and the professional development of newly registered nurses and health care assistants. Design. In order to facilitate the inception, development and subsequent evaluation of these new roles, an action research approach was adopted. Strategies used to encourage collaboration and flexibility during the project are also discussed. Results. The primary aims of the project were achieved and the authors suggest that the choice of action research was significant to the successful outcome. However, a number of issues arose which deserve more attention including the importance of the interpersonal skills of the action researcher and the value of action research to facilitate change which is relevant at both an individual and organizational level.
Hope, despair and hopelessness in living with HIV/AIDS: a grounded theory study
Authors: Kylmä Jari , Vehviläinen‐Julkunen Katri , Lähdevirta Juhani 
Published: March 2003

Hope, despair and hopelessness in living with HIV/AIDS: a grounded theory study Background. Hope, despair or hopelessness have been detected in several research reports as important elements of the lives of persons living with human immunodeficiency virus (HIV) (PLWH) or acquired immunodeficiency syndrome (AIDS) (PLWA). However, there is an obvious gap in the literature suggesting a need to study the overall dynamics of hope (including both hope and despair or hopelessness) along the HIV spectrum from PLWHs’ and PLWAs’ perspective. Aim. The purpose of this study was to describe the dynamics of hope in living with HIV/AIDS. Methods. The data were collected through interviewing 10 PLWHs/PLWAs and analysed using a grounded theory method. Findings. The dynamics of hope is a multifaceted and complex combination of ‘hope’, ‘despair’ and ‘hopelessness’. It comprises balancing between ‘believing life to be worth living at the present and in the future’, ‘losing one’s grip and sinking into narrowing existence vs. fighting against sinking’ and ‘giving up in the face of belief in nonexisting future’. A dynamic alternation between hope, despair and hopelessness takes place in the presence of factors that contribute to the ‘folding’ and ‘unfolding’ possibilities in everyday life. Factors contributing to the folding possibilities include ‘losing’, ‘fear’, ‘uncertainty’, ‘problems in care’, ‘HIV/AIDS in close ones’, ‘difficulties in relationships’ and ‘negative public images and attitudes concerning HIV’. Factors contributing to the unfolding possibilities are ‘constructive life experiences’, ‘wishing not to have HIV while uncertain’, ‘constructive relationships’, ‘ability to control one’s life’, ‘finding the meaning of life and zest for life’, ‘caring’, ‘noticing one’s improved health and the continuance of life’, ‘increasingly positive attitudes concerning HIV‐positive people’ and ‘protection by law’. Conclusions. The dynamics of hope discovered in this study present new conceptualization, where hope, despair and hopelessness are viewed in relation to each other. The emerged definitions may be used in clinical practice to identify these phenomena in individuals with HIV/AIDS. The discovered factors contributing to the folding and unfolding possibilities can be used in clinical practice to help the individuals along the dynamics of hope.
The importance of conducting and reporting pilot studies: the example of the Scottish Births Survey
Authors: Van Teijlingen Edwin R. , Rennie Anne‐Marie , Hundley Vanora , Graham Wendy 
Published: March 2003

The importance of conducting and reporting pilot studies: the example of the Scottish Births Survey Background.  In many research papers, pilot studies are only reported as a means of justifying the methods. This justification might refer to the overall research design, or simply to the validity and reliability of the research tools. It is unusual for reports of pilot studies to include practical problems faced by the researcher(s). Pilot studies are relevant to best practice in research, but their potential for other researchers appears to be ignored. Objective.  The primary aim of this study was to identify the most appropriate method for conducting a national survey of maternity care. Methods.  Pilot studies were conducted in five hospitals to establish the best of four possible methods of approaching women, distributing questionnaires and encouraging the return of these questionnaires. Variations in the pilot studies included (a) whether or not the questionnaires were anonymous, (b) the staff involved in distributing the questionnaires and (c) whether questionnaires were distributed via central or local processes. For this purpose, five maternity hospitals of different sizes in Scotland were included. Results.  Problems in contacting women as a result of changes in the Data Protection Act (1998) required us to rely heavily on service providers. However, this resulted in a number of difficulties. These included poor distribution rates in areas where distribution relied upon service providers, unauthorized changes to the study protocol and limited or inaccurate information regarding the numbers of questionnaires distributed. Conclusions.  The pilot raised a number of fundamental issues related to the process of conducting a large‐scale survey, including the method of distributing the questionnaire, gaining access to patients, and reliance on ‘gatekeepers’. This paper highlights the lessons learned as well as the balancing act of using research methods in the most optimal way under the combined pressure of time, ethical considerations and the influences of stakeholders. Reporting the kinds of practical issues that occur during pilot studies might help others avoid similar pitfalls and mistakes.
Psychometrics of a Chinese translation of the swallowing questionnaire
Authors: Lin Li‐Chan , Chen Miao‐Yen , Chen Yi‐Ching , Portwood Michael J. 
Published: March 2003

Psychometrics of a Chinese translation of the swallowing questionnaire Aims of the study.  The purpose of this study was to determine the psychometric properties of a Chinese version of a swallowing questionnaire. Background/Rationale.  Impaired swallowing may lead to serious complications if health care professionals do not accurately assess the problem and promptly intervene. The recognition of symptoms indicative of a swallowing problem is essential for nurses. The swallowing questionnaire could provide nurses with a valid instrument to assess patients’ impaired swallowing. Designs/Methods.  Phase I consisted of experts doing the initial translation into Chinese and back‐translations of the questionnaire. Five experts then determined content validity of the Chinese version, and 35 bilingual subjects determined equivalence of the Chinese translation and English version. Phase II determined concurrent validity and internal consistency using 113 screened medical patients as subjects. Phase III used 105 screened long‐term care subjects to determine construct validity. Results/Findings.
In Phase I, rating on the appropriateness of items on the Chinese version yielding a content validity index of 0·988. The coefficient of equivalence between the Chinese and English versions of the instrument was 0·81, while per cent agreement for all items on the two versions ranged from 0·80–1·00. Phase II established internal consistency with a K‐R20 of 0·74, and concurrent validity yielded a correlation between the swallowing questionnaire and the neurological swallowing exam of 0·675 (P < 0·01). Phase III determined construct validity with significant positive correlations found between the swallowing questionnaire and stroke history and masticatory ability. Significant negative correlations were found between swallowing and cognitive status, functional status and albumin. Conclusions.  Although useful as a tool for nursing assessment and intervention, further work on the swallowing questionnaire such as conducting video fluoroscopy and a swallowing speed test, are recommended to further validate its accuracy.
Burnout in psychiatric nursing
Authors: Kilfedder Catherine J. , Power Kevin G. , Wells Tony J. 
Published: March 2003

Burnout in psychiatric nursing Introduction.  Burnout in nursing is of both individual and organizational concern with ramifications for well‐being, job performance, absenteeism and turnover. Burnout is rarely assessed as part of a comprehensive model of occupational stress, a short‐coming which this paper attempts to redress. Method.  A randomly selected sample of 510 psychiatric nurses from one Scottish Trust completed a questionnaire based on a psychological model of occupational stress which included the Maslach Burnout Inventory (MBI) as the dependent variable. Findings.  The respondents reported average, low and average levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. The study sample had significantly lower scores on emotional exhaustion and depersonalization than normative data but also significantly lower levels of personal accomplishment than a normative group of physicians and nurses. Only 2·0% of the study sample could be categorized as having high burnout overall (i.e. high emotional exhaustion, high depersonalization, low personal accomplishment) and they differed significantly from the rest only in terms of males being over‐represented. Hierarchical regression analysis revealed that selected explanatory variables accounted for 41·9% of emotional exhaustion, 16·4% of depersonalization and 25·6% of personal accomplishment in the study sample. Implications.  The paper discusses the implications of the findings in terms of a comprehensive approach to intervention aimed at minimizing the risk of burnout in psychiatric nurses. Such an approach will involve interventions at the organizational and individual level.
The primary and secondary care interface: the educational needs of nursing staff for the provision of seamless care
Authors: Werrett Julie A. , Helm Ruth H. , Carnwell Ros 
Published: March 2003

The primary and secondary care interface: the educational needs of nursing staff for the provision of seamless care Aim. To identify nurses’ perceived deficits in the knowledge and skills required to provide effective seamless care, so that appropriate training could be provided. Background. A clear understanding of nursing staff roles, skills and resources is paramount to work at the primary/secondary care interface. Nursing staff require an educational model that will provide a clear understanding of how their roles coalesce with other healthcare professionals. There is little evidence that examines the educational needs of nurses related to changing care boundaries. Design/Methods. The study used methodological triangulation to explore these issues within current practice. Focus groups were used to generate items for inclusion in the questionnaire. Questionnaire design was based on an importance‐performance analysis. This procedure has been effective in developing health care marketing strategies. A stratified random sample of nursing staff (n=722) from the participating trusts received the questionnaire, eliciting a response rate of 172 (23·8%). Results. Factor analysis provided a list of seven training categories in order of training need priority: information technology, awareness of roles, communications within seamless care, working across boundaries, professional issues, practice‐related issues, delivery of patient/client care issues. There were no differences in nurses’ training needs across NHS trusts. However, differences were highlighted for staff located in primary or secondary settings or working across the interface. Conclusions. Despite there being a vast range of training issues the majority of nurses appear to have a clear idea of their training needs for the provision of seamless care. A training programme required which targets the specific needs of nursing staff working at different positions across the primary/secondary care interface.
Communication skills of nurses during interactions with simulated cancer patients
Authors: Kruijver Irma P.M. , Kerkstra Ada , Bensing Jozien M. , Van De Wiel Harry B.M. 
Published: March 2003

Communication skills of nurses during interactions with simulated cancer patients Aim.  In this paper the balance of affective and instrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. Rationale.
The balance of affective and instrumental communication employed by nurses appears to be important, especially during the admission interview with cancer patients. Methods. For this purpose, admission interviews between 53 ward nurses and simulated cancer patients were videotaped and analysed using the Roter Interaction Analysis system, in which a distinction is made between instrumental and affective communication. Results.  The results reveal that more than 60% of nurses’ utterances were of an instrumental nature. Affective communication occurred, but was more related to global affect ratings like giving agreements and paraphrases than to discussing and exploring actively patients feelings by showing empathy, showing concern and optimism. Conclusion.  In future, nurses should be systematically provided with (continuing) training programmes, in which they learn how to communicate effectively in relation to patients’ emotions and feelings, and how to integrate emotional care with practical and medical tasks.
Are auditory warnings in the intensive care unit properly adjusted?
Authors: Solsona José F. , Altaba Carmen , Maúll Elena , Rodríguez Luisa , Bosqué Carmen , Mulero Ana 
Published: March 2003

Are auditory warnings in the intensive care unit properly adjusted? The purpose of this study was to determine whether auditory warnings in the intensive care unit (ICU) were properly adjusted. An intervention study (before‐ and‐after assessment) was conducted in a 12‐bed medical‐surgical ICU of an acute‐care teaching hospital in Barcelona, Spain. A total of 100 patients with stable haemodynamic and respiratory parameters were included. In the first 3‐month phase of the study, minimum and maximum alarm parameters of breathing rate, expired volume/min, airway pressure, SaO2, arterial blood pressure and heart rate were recorded. In the second 12‐month phase of the study, the same alarm parameters were recorded every 4 hours in the patient’s medical record. In the third 3‐month phase of the study, alarm readings were recorded again as in the first phase. The change throughout coefficient of variation (CV) and the 95% confidence interval (CI) for each alarm were calculated. Following the intervention, there was a statistically significant improvement in alarm readings for expired volume, heart rate and systolic blood pressure, so that alarms had been more properly adjusted to the patient’s real value. Nursing staff should be aware that auditory warnings in ICU stable patients are frequently set very far from suitable values. Recording of alarm parameters in the patient’s medical record as a routine daily activity was an effective intervention for improving adjustment of auditory warnings.
Cultural discovery in nursing practice with Vietnamese clients
Authors: Labun Evelyn 
Published: March 2003

Cultural discovery in nursing practice with Vietnamese clientsBackground. Although there is a developing body of literature dealing with cultural care issues there is a continuing need for research based knowledge of how nurses work within a multicultural population in providing culturally competent care. Nurses’ experiences with Vietnamese clients can contribute to the knowledge of how to provide cultural care.Purpose. The purpose of this 1997 study was to investigate what North American nurses learned from their work with Vietnamese clients.Method. A grounded theory approach was employed. A purposive sample of 27 Registered Nurses, who work with Vietnamese clients in North America, in acute care, community, and clinic settings were interviewed using a semi‐structured format. Following ethical approval, an explanation of the study, and data collection, data were analysed using dimensional analysis. Verifiability, adequacy of the findings, and empirical grounding of the theory was established through use of the constant comparative method as well as review of the research method and the study results by selected participants in the study and a nursing expert.Findings. The action process of cultural discovery was found as the most fruitful explanation of nurses’ experiences. Properties of cultural discovery were learning to see them, seeing a common humanity, and learning to see how they see health. The condition of cultural discovery was making a connection with the consequences of learning how to provide sensitive care and a changed nurse.Conclusions. Nurses can learn to become more culturally competent in their care for Vietnamese clients. Nurses learned to be more aware of the differences among people of different cultures as well as recognizing common elements among different groups. They learned to broaden and redevelop their concept of health and to respect the social adjustments that the Vietnamese were making.
Daughters‐in‐law in Korean caregiving families
Authors: Kim Jin‐Sun 
Published: March 2003

Daughters‐in‐law in Korean caregiving families Aim. The aim of this study was to examine the emotional and physical health and experiences of daughter‐in‐law (DIL) caregivers compared with daughter caregivers who care for cognitively and/or functionally impaired older people in Korea. Background. In Korea, DILs are the predominant caregivers of impaired older people, but little is known about DIL caregivers. A study which explores the emotional and physical health outcomes of DIL caregivers who care for impaired parents‐in‐law in the sociocultural context of Korea is necessary. Method. A cross‐sectional descriptive correlational study was conducted to examine the emotional and physical health of 93 DIL caregivers compared with 27 daughter caregivers who care for the cognitively and/or functionally impaired older people in Korea. This study hypothesized that DIL caregivers would have poorer emotional and physical health than daughter caregivers and that the type of relationship with the care‐recipient is an important predictor of caregivers’ health outcomes. t‐tests, chi‐square and hierarchical regression analyses were used for hypotheses testing. Results. Contrary to expectations, this study found that caregivers’ health outcomes were very similar for DILs and daughters in Korean families. The type of relationship was not an important predictor of caregivers’ health outcomes, and neither was the quality of intergenerational relationship. However, Korean DIL and daughter caregivers reported relatively poor emotional and physical health compared to those of Western caregivers in previous studies. Conclusions. Daughter‐in‐laws caregivers were not at greater risk group of negative health outcomes than daughter caregivers. However, DIL and daughter caregivers in Korea were a vulnerable group regardless of their relationship with the care‐recipient. The cultural norms and social expectations regarding family‐centred caregiving in Korea may cause negative health outcomes for Korean caregivers. Further family caregiving studies in the Korean context are recommended.