bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dimensions of perioperative nursing for a national specialty nomenclature
Authors: Kleinbeck Susan V.M. 
Published: March 2003

Dimensions of perioperative nursing for a national specialty nomenclature Before nurses can develop a clinical database capable of evaluating quality of care or validating their impact on health or illness, they must describe the basic dimensions of their specialty. The purpose of this study was to define the dimensions of clinical perioperative nursing practice. Experienced perioperative nurses (n=239) were mailed a survey and asked to rank the frequency with which specific patient diagnoses occurred in their daily practice (1=never occurs; 5=occurs almost all the time) and the priority of treatment each diagnosis required (1=never requires attention of the nurse; 5=demands immediate attention of the nurse). Completion of the form indicated consent to participate in the study. Following a principal component analysis and theoretical discussion by perioperative experts, four dimensions of perioperative practice were delineated: (a) patient and family behavioural responses to surgery (26·7% of variance, α=0·92); (b) perioperative patient safety (10·1% of variance, α=0·89); (c) perioperative physiological response to surgery (5·7% of variance, α=0·87); and (d) the health systems required to deliver perioperative care. Dimensions extracted in this analysis served as the domains for the new perioperative nursing nomenclature.
New perspectives on vulnerability using emic and etic approaches
Authors: Spiers Judith 
Published: March 2003

New perspectives on vulnerability using emic and etic approachesThe concept of vulnerability has not been developed theoretically from a nursing perspective. It has been viewed epidemiologically as population‐based relative risk with little consideration of its experiential qualities. The purpose of this paper is to analyse critically the use of the term vulnerability using elements of concept clarification and a critical literature review. A new perspective of vulnerability is offered based on differentiating between the concepts of risk and experience. Risk consists of assumptions from etic or external evaluation of relative danger while lived experience informs an emic or personal interpretation. Assumptions related to the etic view include normative social values, objective harm and endangerment, and social sanction for intervention. An emic view of vulnerability is based on experiential perception of challenge to personal integrity and the universal and mutual nature of the phenomenon. Questions about the evaluation of harm, potential for growth, subjectivity and objectivity, social sanction and capacity for action, can help clarify the range between these two dimensions.
Wound care in the community setting: clinical decision making in context
Authors: Hallett Christine E. , Austin Lynn , Caress Ann , Luker Karen A. 
Published: March 2003

Wound care in the community setting: clinical decision making in context Sixty‐two community nurses in northern England of grades B and D to H were interviewed by a team of four researchers. The interviews were semi‐structured, and were tape‐recorded, fully transcribed and content analysed. They were conducted as part of a larger study, the aim of which was to examine community nurses’ perceptions of quality in nursing care. One of the main themes the work focused on was decision‐making as an element of quality. Data relating to wound care were considered from the perspective of the insights they offered into clinical decision‐making. Data were interpreted in the light of a literature review in which a distinction had been made between theories which represented clinical decision‐making as a linear or staged process and those which represented it as intuitive. Within the former category, three sub‐categories were suggested: theorists could be divided into ‘pragmatists’, ‘systematisers’ and those who advocated ‘diagnostic reasoning’. The interpretation of the data suggested that the clinical decisions made by community nurses in the area of wound care appeared largely intuitive, yet were also closely related to ‘diagnostic reasoning’. They were furthermore based on a range of sources of information and justified by a number of different types of rationale.
Fit for purpose: the relevance of Masters preparation for the professional practice of nursing. A 10‐year follow‐up study of postgraduate nursing courses in the University of Edinburgh
Authors: Whyte Dorothy A. , Lugton Jean , Fawcett Tonks N. 
Published: March 2003

Fit for purpose: the relevance of Masters preparation for the professional practice of nursing. A 10‐year follow‐up study of postgraduate nursing courses in the University of Edinburgh Continuing education is now recognized as essential if nursing is to develop as a profession. United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) consultations are currently seeking to establish appropriate preparation for a ‘higher level of practice’ in the United Kingdom. The relevance of Masters level education to developing professional roles merits examination. To this end the results of a 10‐year follow‐up study of graduates from the Masters programme at the University of Edinburgh are reported. The sample was the entire cohorts of nurses who graduated with a Masters degree in the academic sessions from 1986 to 1996. A postal questionnaire was designed consisting of mainly closed questions to facilitate coding and analysis but also including some open questions to allow for more qualitative data to be elicited. The findings indicated clearly that the possession of an MSc degree opened up job opportunities and where promotion was not identified, the process of study at a higher level was still perceived as relevant to the work environment. This applied as much to the context of clinical practice as to that of management, education or research. The perceived enhancement of clinical practice from a generic Masters programme was considered a significant finding. Also emerging from the data was an associated sense of personal satisfaction and achievement that related to the acquisition of academic skills and the ultimate reward of Masters status. The concept of personal growth, however, emerged as a distinct entity from that of satisfaction and achievement, relating specifically to the concept of intellectual sharing, the broadening of perspectives and the development of advanced powers of reasoning.
Sense of coherence: quality of life before and after coronary artery bypass surgery — a longitudinal study
Authors: Karlsson Ingela , Berglin Eva , Larsson Pär A. 
Published: March 2003

Sense of coherence: quality of life before and after coronary artery bypass surgery — a longitudinal studyThe attention to patient outcome has nowadays extended from morbidity and mortality to an aspect of patients’ benefits in terms of quality of life. One factor crucial for quality of life is coping capacity, in this study represented by the sense of coherence concept. Physical status and emotional state (often measured by comprehensive instruments not always suitable for clinical use) are also additionally used to reflect quality of life. The purpose was therefore to study sense of coherence and emotional state as indirect measures of quality of life in relation to coronary artery bypass grafting surgery. One hundred and eleven patients were studied by a developed questionnaire on five occasions in relation to the surgery: the week before the angiography, the day before surgery and then at 3, 6, and 12 months post‐operatively. The main findings were: (1) The sense of coherence was changed (more than ±10%) from before to 1 year after surgery in 41% of the patients, which is contrary to the theory of sense of coherence as a stable personality characteristic in adults. (2) Experience of depressed mood, stress, and anxiety decreased significantly from before to after surgery. (3) Beneficial outcome with regard to sense of coherence was significantly related to less experience of loneliness, depressed mood, stress and anxiety, and to less experience of chest pain 1 year after surgery. In conclusion, sense of coherence and emotional state variables, are suggested to be valuable as measurements of quality of life in relation to coronary artery bypass grafting surgery.
Nursing, empathy and perception of the moral
Authors: Reynolds  , Scott  , Austin Wendy 
Published: March 2003

Nursing, empathy and perception of the moral Over the last 15–20 years we have witnessed a dramatic interest in the moral domain of clinical practice. There has also been a growing focus on the patient as an individual whose individuality and perspective must be respected. It is argued in this paper that a key to both these concerns is a consideration of the role of empathy in both perceiving the moral aspects and issues of practice, and in providing adequate support for patients. In this paper the meaning and components of empathy are discussed in the context of human receptivity and preconditions of moral performance. However, we also draw attention to empirical studies which suggest that even following adequate educational preparation, if the clinical environment and the structures within which care is delivered are not supportive, the practitioner’s ability to perceive the moral is limited. In such circumstances, patients are in danger of receiving less than appropriate care — from both the moral and professional perspective.
Cognitive therapy supervision as a framework for clinical supervision in nursing: using structure to guide discovery
Authors: Sloan Graham , White Craig A. , Coit Frank 
Published: March 2003

Cognitive therapy supervision as a framework for clinical supervision in nursing: using structure to guide discovery Cognitive therapy has an undisputed evidence base upon which its clinical application flourishes. This approach is now a well‐recognized and widely adopted method used in the treatment of a diversity of psychological problems. More recently, prominent innovators of this psychotherapy have devised a framework to guide the clinical supervision of cognitive therapists. In keeping with its therapeutic application, the cognitive therapy framework for supervision is focused, structured, educational and collaborative. It serves to enhance the therapeutic proficiency of the cognitive therapist. In contrast, the supervision models reported in the recent nursing literature are less precise in their mission and when evaluated their contribution to nursing is shown to be dubious. Following an overview of the supervision models commonly cited in the nursing literature, a more focused comment on the evaluative research concerning Proctor's three‐function interactive model will be offered. It is suggested that the unconvincing research findings may be related to the conceptual muddle surrounding clinical supervision, and the expectation for clinical supervision to deliver more than an opportunity for the progression of our therapeutic integrity. From this, a cognitive therapy supervision framework is described and suggested by the authors as a structure from which supervisors can guide discovery.
Who cares? Offering emotion work as a ‘gift’ in the nursing labour process
Authors: Bolton Sharon C. 
Published: March 2003

Who cares? Offering emotion work as a ‘gift’ in the nursing labour process The emotional elements of the nursing labour process are being recognized increasingly. Many commentators stress that nurses’‘emotional labour’ is hard and productive work and should be valued in the same way as physical or technical labour. However, the term ‘emotional labour’ fails to conceptualize the many occasions when nurses not only work hard on their emotions in order to present the detached face of a professional carer, but also to offer authentic caring behaviour to patients in their care. Using qualitative data collected from a group of gynaecology nurses in an English National Health Service (NHS) Trust hospital, this paper argues that nursing work is emotionally complex and may be better understood by utilizing a combination of Hochschild's concepts: emotion work as a ‘gift’ in addition to ‘emotional labour’. The gynaecology nurses in this study describe their work as ‘emotionful’ and therefore it could be said that this particular group of nurses represent a distinct example. Nevertheless, though it is impossible to generalize from limited data, the research presented in this paper does highlight the emotional complexity of the nursing labour process, expands the current conceptual analysis, and offers a path for future research. The examination further emphasizes the need to understand and value the motivations behind nurses’ emotion work and their wish to maintain caring as a central value in professional nursing.
Using web‐based discussion as a teaching strategy: bioethics as an exemplar
Authors: Ellenchild Pinch Winifred J. , Graves Janet K. 
Published: March 2003

Using web‐based discussion as a teaching strategy: bioethics as an exemplar Nurses are required to be competent in the area of bioethics based on several accreditation standards. Bioethics courses are one strategy to develop such a competency. Bioethics education itself has various goals including the need to engage in discussion and the ability to debate diverse issues. Providing an educational experience that meets both disciplinary and topic needs can be challenging. On‐line conferencing through WebBoard 3·0, a web‐based discussion software program, within a graduate level bioethics course successfully contributed to meeting these needs. A technical description of the WebBoard is provided in the following discussion along with a description of the integration of this device into a bioethics course. The WebBoard conferencing allowed all students to enter the class discussion and especially facilitated discussion for reticent speakers and distance learners. Evaluations of the bioethics course from both the faculty and students’ perspectives were generally positive. Most students found the technique easy to use and liked the asynchronous format that allowed them to read and contribute at any hour of the day or night. Despite the labour intensive nature of this experience, the strategy ensured participation by every student, a major goal of the project. Developing an interdisciplinary situation would increase the value of such an experience.
The contexts of adherence for African Americans with high blood pressure
Authors: Rose Linda E. , Kim Miyong T. , Dennison Cheryl R. , Hill Martha N. 
Published: March 2003

The contexts of adherence for African Americans with high blood pressureAfrican American men between the ages of 18 and 49 years have the lowest rates of awareness, treatment and control of high blood pressure (HBP) of all age/race/gender groups in the United States. A qualitative study was done to gain an understanding of urban black males’ experiences of living with HBP. In‐depth semi‐structured interviews were conducted with 19 black males. The interviews explored perceptions of health, health problems and priorities, and concerns of daily living that influenced appointment keeping and medication taking. The sample was a subset of 309 men participating in a 3‐year clinical trial to improve HBP control in an inner city African‐American population. Content analysis of transcribed interviews identified the following themes and related concerns: (a) personal contexts: meaning of health, high blood pressure and treatments; (b) social context: living as a young black male in an urban environment; and (c) cultural context of relating: patient–provider relationship can make a difference. Influencing participants’ responses were: interpreting symptoms; adjusting medication taking; protecting personal privacy; allocating limited resources; dealing with addiction; and feeling cared for by a health care provider. Adherence appeared to be multifaceted and changing depending upon: the men's social, economic and personal circumstances; empathetic and non‐judgemental assistance from providers; financial concerns and employment; and drug addiction. Findings are useful in refining high blood pressure interventions.
Personal control in pain relief during labour
Authors: Wright Marion E. , McCrea Hally , Stringer Maurice , Murphy‐Black Tricia 
Published: March 2003

Personal control in pain relief during labour Personal control is a central feature of women’s involvement in their childbirth experiences. To achieve this control tacit rules and guidelines are applied to define how women and the professionals who care for them should behave. This study investigated the extent to which women exercised control in pain relief during the first stage of labour by comparing (a) the rules which they held prior to childbirth (2–3 cm cervical dilatation) with those which they afterwards felt applied to their labour and (b) the rules held by the women before and after childbirth with those held by the midwives. In a quantitative study using a repeated measures design, a questionnaire was administered to 35 midwives and to 100 women prior to and within 24 hours following their delivery. Consistency of the women’s scores before and after childbirth, indicated by few statistically significant differences, tended to confirm their rules on control of pain relief. Some of the rules were held even more strongly following childbirth. A surprising finding was the even stronger agreement by midwives with some of the rules. There was a definite trend for many of the rules held by the women prior to childbirth to increase following birth towards those of the midwives. This could be the result of the experience of childbirth per se but the possibility that it was contributed to by the influence of the midwives cannot be ruled out and warrants further research. An interesting hierarchy in the rules for compliance with professional care has been highlighted.
Psychodynamic sources of resistance among student nurses: some observations in a human relations context
Authors: Gilmartin Jo 
Published: March 2003

Psychodynamic sources of resistance among student nurses: some observations in a human relations context The nurse–patient relationship is considered to be a crucial part of the daily routine for many nurses; however, little evidence is available regarding how student nurses cope with learning human skills. Few researchers have considered how students engage with or resist the learning process. The aim of this study is to examine interpersonal matters and explore psychodynamic sources of resistance encountered among student nurses in an interpersonal skills context. A qualitative approach was adopted with a focus on individual case studies, using the in‐depth interview as the major mode of data collection combined with observation. The four types of student that emerged from the data are emphasized, ranging from type 1 who were extremely reluctant to self‐disclose, to type 4 who were more confident and free‐flowing. The major characteristics pertaining to each type of student are outlined. While some characteristics seem to be related to childhood struggles and years of over‐adaptation, others relate to factors that influence the learning climate. Particular attention is given to the psychological understanding of their predicament, including accounts of childhood and self‐image. The implications for nurse education and limitations of this study are also considered.
Comparison of integrated and consultation‐liaison models for providing mental health care in general practice in New South Wales, Australia
Authors: Harmon Karen , Carr Vaughan J. , Lewin Terry J. 
Published: March 2003

Comparison of integrated and consultation‐liaison models for providing mental health care in general practice in New South Wales, Australia The characteristics of a new service providing integrated mental health care in general practice are described and comparisons made with an earlier consultation‐liaison (C‐L) psychiatry service in general practice, including the range and severity of psychiatric problems, levels of general practitioner (GP) and psychiatrist involvement, and patterns of care. Clinical audit checklists were completed by two experienced mental health nurses for the first 100 patients referred to the service, which was conducted in conjunction with 8 general practices in the Port Stephens region of New South Wales, Australia. The mean age of the first 100 referrals was 38·05 years, 63·0% were female, and 55·0% were referred from GPs. Outcome measures included: referral information, patients’ demographic and diagnostic characteristics, psychosocial functioning, psychotropic medication, management, and number of contacts with the mental health nurses. Relative to the earlier C‐L psychiatry service in general practice, the integrated service treated a broader range of diagnostic groups with higher levels of disability. There were higher rates of mood (48·0%) and psychotic (20·0%) disorders and lower rates of adjustment (2·0%) disorders. One‐third of patients were seen by an additional agency, other than the mental health nurses or GPs. Patients averaged 4·95 contacts with the mental health nurses, with marked variations according to diagnostic group. To date, the new service has been well received. It is highly accessible, acceptable to GPs and patients, caters for a broad range of psychopathology, including severe mental illness, and appears to be sufficiently versatile to be adaptable to a variety of treatment settings.
Women recovering from first‐time myocardial infarction (MI): a feminist qualitative study
Authors: Jackson Debra , Daly John , Davidson Patricia , Elliott Doug , Cameron‐Traub Elizabeth , Wade Vicki , Chin Christine , Salamonson Yenna 
Published: March 2003

Women recovering from first‐time myocardial infarction (MI): a feminist qualitative studyAlthough myocardial infarction (MI) is a leading cause of death and disablement for women internationally, little is known about women’s recovery. This paper describes an exploratory descriptive study that was informed by feminist principles, and which aimed to explore the recovery experiences of a group of women survivors of first‐time MI in the initial period following discharge from hospital. A total of 10 female survivors were interviewed using an open‐ended semi‐structured interview schedule administered at 7, 14 and 21 days post‐hospital discharge. Findings revealed that recovery was experienced as a complex process, initially characterized by fear and uncertainty. Over the duration of the study these feelings were replaced with a more positive outlook, a return of energy, and a sense of confidence in the future. Participants identified an unmet need for reliable information which persisted over the duration of the study. The findings of this study have implications for nursing practice and research. Chief among these is the issue of effective provision of information to women following an acute MI. The importance of providing relevant information to be understood and retained by people experiencing crisis cannot be overstated. Equally important are the provision of opportunities for patients to have regular contact with health professionals to question and seek clarifying information. These findings should now be tested on larger populations.