bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pressure ulcers: validation of two risk assessment scales
Authors: Defloor Tom , Grypdonck Maria FH 
Published: February 2005

Aims and objectives.  To compare the predictive value of two pressure ulcer risk assessment scales (Braden and Norton) and of clinical judgement. To evaluate the impact of effective preventive measures on the predictive validity of the two risk assessment scales.Methods.  Of the 1772 participating older patients, 314 were randomly selected and assigned to the ‘turning’ group; 1458 patients were assigned to the ‘non‐turning’ group. Using the Braden and the Norton scale the pressure ulcer risk was scored twice weekly during a four‐week period. Clinical assessment was monitored daily. The patients at risk in the ‘turning’ group (Braden score <17 or Norton score <12) were randomly assigned to a two‐hour turning schedule or to a four‐hour turning schedule in combination with a pressure‐reducing mattress. The ‘non‐turning’ group received preventive care based on the clinical judgement of the nurses.Results.  The diagnostic accuracy was similar for both scales. If nurses act according to risk assessment scales, 80% of the patients would unnecessarily receive preventive measures. The use of effective preventive measures decreased the predictive value of the risk assessment scales. Nurses predicted pressure ulcer development less well than the Braden and the Norton scale. Only activity, sensory perception, skin condition and existence of old pressure ulcers were significant predictors of pressure ulcer lesions.Relevance to clinical practice.  The effectiveness of the Norton and Braden scales is very low. Much needless work is done and expensive material is wrongly allocated. The use of effective preventive measures decreases the predictive value of the risk assessment scales. Although the performance of the risk assessment scales is poor, using a risk assessment tool seems to be a better alternative than relying on the clinical judgement of the nurses.
Nurses’ concerns about using information systems: analysis of comments on a computerized nursing care plan system in Taiwan
Authors: Lee Ting‐Ting 
Published: February 2005

Aims and objectives.  The purpose of this study was to pursue a deeper understanding of nurses’ perceptions of a computerized nursing care plan as written in comments on a survey.Background.  Studies have examined nurses’ perceptions of computer use, but comments written on surveys of computerized nursing care planning have never been reported and the pattern and meaning of such feedback have not been systematically analysed.Design.  Of 738 nurses in Taiwan who completed a two‐part survey to evaluate a computerized nursing care plan, 202 responded on part II to an open‐ended question about overall perceptions of a nursing information system.Methods.  A sample of 10 questionnaires with comments was subjected to qualitative content analysis. Key words and phrases were identified, then grouped into categories, which were used to code the remaining respondents’ comments. Another 20 were used to pilot test these coding categories. The final coding categories were applied to all 202 questionnaires with comments for data analysis.Results.  Nurses were concerned about inconvenient access to computers; reduced work efficiency; inability to individualize patient care and nursing specialty deficiencies; poor content design, system function, and system integration; using the system as a policy requirement; and privacy and legal issues.Conclusions.  Hardware availability, content design and user training/education programmes are critical issues that affect nurses’ use of computers in their daily practice.Relevance to clinical practice.  These comments can be applied in strategic planning and staff development programmes to further use of information systems in patient care.
HIV nursing consultants: patients’ preferences and experiences about the quality of care
Authors: Hekkink Christine F , Wigersma Lode , Joris Yzermans C , Bindels Patrick JE 
Published: February 2005

Aim and objectives.  We were interested to find out how human immunodeficiency virus (HIV)‐patients judge the quality of care received from their HIV nursing consultants, compared with the care delivered by HIV specialists and general practitioners. Furthermore, we were interested in how the opinions of HIV patients on the HIV nursing consultant compared with the opinions of patients with rheumatic diseases on the care they receive from their specialized nurses.Background.  The role of nurses has changed over the years. For patients with chronic diseases there seems to be an increasing role for nursing consultants in the delivery of care. In evaluating quality of care, patients’ views are considered important especially for the chronically ill who can be seen as experts by experience.Methods.  Between February 1999 and June 2000, 250 patients, receiving care from both general practitioner and specialist, received a questionnaire [Quality of Care Through the Patient's Eyes (QUOTE)‐HIV] to assess HIV‐related quality of care, as perceived by them. Aspects were formulated as ‘importance’ and ‘performance’ statements. Items were scored on 4‐point scales. A ratio score (Rij = Pij/Iij) was calculated by dividing the perceived performance score (P) of an individual patient (i), on a health service (j) by his importance score (I). A comparison was made with patients with rheumatic diseases by using data from the QUOTE‐Rheuma.Results.  Patients judged the quality of care from the HIV nursing consultant as predominantly good. Five aspects showed an unfavourable ratio score (R < 1.0) which indicates room for improvement. On the dimensions ‘professional performance’ and ‘attitude of the professional’ the HIV nursing consultant scores between the general practitioner and the HIV specialist. Patients with rheumatic diseases seemed to be more satisfied than HIV patients with the care from their nurse consultant.Conclusions.  The HIV nursing consultants have an important role in the care of patients infected with HIV. The HIV nursing consultants are judged as good and are ranked in between the general practitioner and the HIV specialist. Given the orientation towards a more integrated care for chronically ill patients, there should be more attention paid to the position of the HIV nursing consultant.Relevance to clinical practice.  In the Netherlands and in the United Kingdom there is a tendency to a greater degree of differentiation of tasks in health care. This study shows that there is room for a position like the nursing consultant and that this is highly valued by patients.
Self‐concept: comparison between school‐aged children with congenital heart disease and normal school‐aged children
Authors: Chen Chi‐Wen , Li Chung‐Yi , Wang Jou‐Kou 
Published: February 2005

Aims and objectives.  The aim of this study was to evaluate and compare the self‐concept of school‐aged children with congenital heart disease to those of normal school‐aged children. The primary objective was to analyse results of the Self‐Concept Scale questionnaire administered to children with congenital heart disease aged 9–12 years. Sixty‐four children with congenital heart disease (study group), and 71 without congenital heart disease (control group), completed the questionnaire.Background.  Little attention has focused on school‐aged children with congenital heart disease who are in the important stages of developing self‐concept.Results.  The mean score on the Physical self‐concept of the Self‐Concept Scale was significantly lower for the study group than the control group (P < 0.05). No significant differences were observed between children with congenital heart disease and normal children in terms of family self‐concept, school self‐concept, appearance self‐concept, emotional self‐concept and general self‐concept for the Self‐Concept Scale.Conclusions.  Nurses should use the study findings to encourage positive self‐concept development and improve their patient education about physical activity before the child is discharged. Thus, children with congenital heart disease could leave the hospital with a clear understanding of their body and condition, and how it affects daily life.Relevance to clinical practice.  The results of this study may provide more holistic views on self‐concept for clinical nurses working with children who have congenital heart disease and their families and for school nurses working with elementary school children.
Nursing observations during the first 24 hours after a surgical procedure: what do we do?
Authors: Zeitz Kathryn 
Published: February 2005

Aims and objectives.  The purpose of the study was to describe what constitutes postoperative nursing monitoring during the initial 24 hours on the ward including the components of observation, frequency and time spent with patients.Background.  The literature provides little guidance as to the best practice of postoperative surveillance. To understand the practice of monitoring patients after returning to the ward from a surgical procedure it is important to describe the current practice.Design.  The study involved a non‐participant observation of nursing practice.Method.  Data were generated via observation of postoperative patients in the first 24 hours after returning to the ward. This occurred in the general surgical units of two different South Australian hospitals over an 8‐week period.Results.  A total of 81 patients were observed for 282 patient hours. Vital sign collection generally reflected a traditional pattern of hourly for the first four hours, reducing to four hourly across the 12‐ to 24‐hour period. The frequency and duration of patient–nurse interactions, observations recorded and the collection of other clinical data such as pain, oxygen saturations and nausea are also discussed.Relevance to clinical practice.  The findings presented here depict the current nursing practice of postoperative monitoring in two different settings, providing insight into what constitutes contemporary postoperative surveillance.Conclusion.  Before inroads can be made to identify the best practice of postoperative patient surveillance a clear cognisance of practice needs to be identified.
Survival of intimate partner violence as experienced by women
Authors: Flinck Aune , Paavilainen Eija , Åstedt‐Kurki Päivi 
Published: February 2005

Aims and objectives.  The study set out to describe women's experiences of intimate partner violence, the consequences of such violence, the help they received and women's experiences of their survival.Background.  Social and health professionals do not have sufficient ability to identify and help families who suffer from intimate partner violence. Methods for identifying and treating partner violence not have been developed adequately.Method.  The study was conducted in Finland by loosely formulated open‐ended interviews with seven battered women. The data were analysed by inductive qualitative content analysis.Findings.  Women had past experience of maltreatment and a distressing climate at their parental home. Women experienced both themselves and their spouse as having weak identities; their ideals, patterns of marriage and sexuality were different. Violence occurred in situations of disagreement. Women tried to strike a balance between independence and dependence in the relationship. The different forms of couple violence were interlinked. The women sought help when their health and social relationships got worse. An awareness of the problem, taking action, counselling and social relationships helped them survive. Religiousness was a factor that involved commitment to the couple relationship, made religious demands on women and promoted the recovery of integrity.Conclusions.  Intimate partner violence was associated with the family model, childhood experience of maltreatment, the partners’ weak identity and conflicts between individualism and familism. Social and healthcare professionals need competence in early intervention and skills to discuss moral principles, sexuality, and violence in a way that is free of prejudice and condemning attitudes. Spiritual approaches in the context of interventions should be taken into consideration.Relevance to clinical practice.  In a clinical context, nurses should be aware of the symptoms of violence, and they should have skills in dealing with intimate moral and spiritual issues.
Graduate nurses’ communication with health professionals when managing patients’ medications
Authors: Manias Elizabeth , Aitken Robyn , Dunning Trisha 
Published: February 2005

Aim and objectives.  The aim was to examine how graduate nurses communicated with other health professionals about their medication management activities in the acute care context. The objectives were to determine the types of information communicated about patients’ medications and the communication processes used during interactions with other nurses, doctors and pharmacists.Background.  Graduate nurses are challenged with enormous responsibilities and their competence is constantly tested in an ever‐changing arena. One of their responsibilities involves communicating with other health professionals about patients’ medications.Design.  A qualitative exploratory research design was used for this study.Methods.  Participant observation and semi‐structured interviews were conducted to elicit information from 12 graduate nurses with university degrees employed in a metropolitan public hospital, in Melbourne, Australia. Graduate nurses were observed once for two hours and interviewed on the same day of the observation at a mutually convenient time. The purpose of these interviews was to clarify activities observed and to obtain further information.Results.  The results highlighted how work dynamics of the clinical setting had an impact on the ability of graduate nurses to communicate effectively with other nurses, doctors and pharmacists. These work dynamics included the availability of doctors and the structure of ward rounds. The results also demonstrated the value graduate nurses placed on communicating particular information such as evaluating the effect of medication changes and organizing discharge medication.Conclusions.  Graduate nurses were effective in communicating about medication management activities when they initiated or were prepared for such interactions. When graduate nurses were not prepared, such as during impromptu ward rounds, they did not participate effectively and important information was not communicated.Relevance to clinical practice.  It is important to understand how collegial communication facilitates accurate exchange of information and effective decision‐making to achieve optimal health care outcomes for patients.
Jasmonate‐regulated Arabidopsis stress signalling network
Authors: Devoto Alessandra , Turner John G. 
Published: February 2005

Plants respond to biotic and abiotic factors in the external environment. These include wounding, pathogen and pest attack, and changes in light and temperature. They also respond to internal signals produced during development, such as during the formation of flowers. These responses generally involve the re‐programming of gene expression. Biotic and abiotic stress signal perception responses have commonly been represented as three pathways, which can be distinguished by the production of jasmonates, ethylene or salicylic acid. Each of these pathways therefore involves the perception of the stress, the synthesis of the signal molecule, the perception of the signal molecule and the ensuing response. An added complication is that these signalling pathways act both locally, at the point of the stress, and systemically. Much of what we know about these signalling pathways has come from studies of responses to the signal molecules, and of mutants altered in the production of, or sensitivity to, these signal molecules. This has provided clear indications that the pathways interact significantly. Because biotic and abiotic stresses induce the production of all three of these signal molecules, albeit in differing amounts, it is more appropriate to view the response output as the integration of a signalling network that involves the production of jasmonates, salicylic acid and ethylene. In this review, we provide an update on the regulation of jasmonic acid biosynthesis and the suggested roles for different biologically active intermediates in this pathway in Arabidopsis, and describe the jasmonate signalling mutants identified so far. We also examine how outputs from the jasmonate, salicylic acid and ethylene signalling pathways are integrated in the regulation of stress response and plant development. We use Boolean gates as a tool to represent the molecular networks and provide a qualitative description of the transmission of the signals. Finally, we illustrate how protein degradation, a common mechanism regulating many plant processes, may act as the ultimate level of integration between signalling pathways.
Incidence of adrenal involvement and assessing adrenal function in patients with renal cell carcinoma: Is ipsilateral adrenalectomy indispensable during radical nephrectomy?
Authors: Yokoyama Hiroshi , Tanaka Masatoshi 
Published: February 2005

OBJECTIVETo determine the value of ipsilateral adrenalectomy with radical nephrectomy, by investigating the clinical aspects of adrenal involvement and adrenocortical function in patients with renal cell carcinoma (RCC).PATIENTS AND METHODSThe demographic, clinical and pathological data of adrenal involvement were reviewed in 247 patients with RCC. To evaluate adrenocortical function, 14 patients (adrenalectomy in eight, adrenal‐sparing in six) had a rapid adrenocorticotropic hormone (ACTH) stimulation test before and 2 weeks after surgery.RESULTSThere was adrenal involvement with RCC in seven of the 247 (2.8%) patients (a solitary adrenal metastatic tumour in four and direct extension into the adrenal gland in three). All adrenal involvement was detectable on abdominal computed tomography before surgery, and these patients had a large primary renal tumour of > pT2 and/or distant metastasis. Plasma cortisol levels declined significantly more in response to the rapid ACTH stimulation test in those treated by adrenalectomy than in those with spared adrenal glands at 2 weeks after surgery (P < 0.05), while there was no significant difference between the groups before surgery.CONCLUSIONSThese results suggest that unconditional ipsilateral adrenalectomy with radical nephrectomy for RCC should be avoidable, and thus preserve the reserve of adrenocortical function, as preoperative imaging, especially thin‐slice multidetector helical computed tomography, can detect adrenal involvement with RCC in most cases. Unilateral adrenalectomy might cause an irreversible impairment of the reserve of adrenocortical function.
An investigation of dose titration with darifenacin, an M3‐selective receptor antagonist
Authors: Steers William , Corcos Jacques , Foote Jenelle , Kralidis Georg 
Published: February 2005

OBJECTIVESTo evaluate the efficacy, tolerability and safety of a flexible‐dosing strategy with darifenacin, an M3‐selective receptor antagonist, in patients with symptoms of overactive bladder (OAB).PATIENTS AND METHODSIn this multicentre double‐blind 12‐week study, 395 patients (aged 22–89 years; 84% female) with OAB symptoms for >6 months were randomized (2 : 1) and received once‐daily treatment with darifenacin controlled‐release tablets 7.5 mg (268 patients) or matching placebo (127). After 2 weeks of treatment, the efficacy, safety and tolerability were assessed and the dose increased to 15 mg once daily (pseudo‐increase for placebo recipients) if additional efficacy was required by both the patient and physician. In the week before clinic visits (at 2 and 12 weeks), patients recorded incontinence episodes (primary efficacy endpoint) and several secondary efficacy variables in an electronic daily diary. Safety and tolerability were evaluated from withdrawal rates and adverse‐event reports.RESULTSThe treatment groups had comparable baseline characteristics. Similar proportions of darifenacin (59%) and placebo (68%) recipients increased the dose at 2 weeks; at 12 weeks patients on darifenacin (overall group) had a significantly greater reduction in the median number of incontinence episodes per week than had those on placebo, at − 8.2 (−62.9%) and − 6.0 (−48.1%), respectively (P = 0.035). There were also significant improvements in voiding frequency (P = 0.001), bladder capacity (volume voided; P= 0.036), frequency of urgency (P < 0.001), severity of urgency (P = 0.013) and number of significant leaks/week (i.e. incontinence episodes needing a change of clothing or pads, per week; P = 0.010) for darifenacin over placebo. Subset analysis suggested that some patients (those remaining on darifenacin 7.5 mg) were more sensitive to darifenacin than those who increased the dose, based on both efficacy and adverse events. Continued treatment with 7.5 mg for ‘sensitive’ patients, and an increased dose (to 15 mg) for remaining patients, resulted in comparable outcomes by 12 weeks. The most common treatment‐related adverse events were mild‐to‐moderate dry mouth and constipation, which led to discontinuation in < 3.0% of darifenacin‐treated patients and <1.0% of the placebo group. Central nervous system and cardiovascular adverse events were comparable to those with placebo.CONCLUSIONSDarifenacin appears to be an effective, well‐tolerated and flexible treatment for patients with OAB, allowing individualized dosing according to patient needs.
Validation of the Urgency Perception Scale
Authors: Cardozo Linda , Coyne Karin S. , Versi Eboo 
Published: February 2005

OBJECTIVETo ascertain the validity and responsiveness of the Urgency Perception Scale (UPS) as an indicator of perceived urinary urgency.PATIENTS AND METHODSThe UPS was developed to assess perceived urinary urgency in clinical studies evaluating the efficacy of the antimuscarinic drug, tolterodine, for treating the overactive bladder (OAB) syndrome. Secondary analyses of clinical and patient assessment data from three clinical studies of tolterodine were conducted to evaluate the UPS. Construct validity was assessed by correlations between the UPS and patient voiding diary variables and other patient assessments, including: perception of bladder condition; perception of treatment benefit; the Medical Outcomes Study Short‐Form 36 health survey; the King's Health Questionnaire; the OAB Questionnaire; and the Overall Treatment Effect scale.RESULTSThe UPS correlated well with the patients’ perception of bladder condition (correlation coefficients − 0.29 to − 0.46; all P < 0.001) and with the voiding diary variables, especially incontinence episodes (−0.30 to − 0.41) and pad usage (−0.25 to − 0.38; all P < 0.001). An improvement in UPS score at the end of treatment was consistently reflected by significant improvements among all voiding variables.CONCLUSIONUrinary urgency is a central symptom of OAB and is particularly bothersome because of its unpredictability and consequent impact on daily life. The UPS is a valid scale by which urinary urgency can be assessed subjectively, and provides a useful tool for research into urinary urgency.