bluuebunny/crossref_metadata_2025_split huggingface dataset:
Masterworks of art and chronic illness experiences in the elderly
Authors: Hodges Helen F. , Keeley Ann C. , Grier Elaine C. 
Published: March 2003

Masterworks of art and chronic illness experiences in the elderly Aim. This article presents findings of a qualitative study, conducted between 1997 and 2000, to investigate the plausibility of integrating masterworks of art with care of the chronically ill elderly, and to analyse perceptions about chronic illness among three groups: registered nurses, nursing students, and the elderly. Background and significance. Statistically the incidence of chronic illness increases in the elderly. Although pathophysiology of chronic illness is increasingly understood, few studies explore the experience of living with chronicity from the perspective of the elderly. Understanding and intervening appropriately for the elderly with chronic illness may contribute significantly to improving quality of life for this growing population. Ethical issues and approval. The study was approved through an Institutional Review Board. Facility permission and participant informed consent were obtained. Anonymity and confidentiality were protected. Design. Using hermeneutic phenomenology and masterworks of art as a centre point for dialogue, the investigators explored the perceptions of nurses, students, and the elderly about living with a chronic illness. A purposive sample of 65 participants made up seven focus groups with which group interviews were conducted. Themes were explicated and analysed from audiotaped interviews until data saturation was reached. Findings. Content analysis of focus group interviews revealed themes of social isolation, inevitable role change, and inertia–movement. Only the elderly acknowledged hope and a steadfast refusal to give up, while nurses and students viewed chronicity more negatively. Themes of social isolation and role change are consistent with other studies of the elderly. A paradox of inertia–movement in the chronically ill elderly has not been reported in the nursing literature. Conclusions. Paradoxical tension of inertia–movement in the chronically ill elderly appears to be linked to the broader concept of energy in nursing science, and to Parse’s theory of human becoming. Masterworks of art can generate energy exchange between the elderly and caregivers, providing a plausible catalyst for meaningful interventions that transcend age and practice settings.
Eating as both coping and stressor in overweight control
Authors: Solomon Margot R. 
Published: March 2003

Eating as both coping and stressor in overweight control Aim. The aim of this study was to test a conceptual model proposing that stress evokes eating as coping, that eating then becomes a stressor in itself, and that a coping repertoire specific for overeating is required to moderate its yield of negative mood states. Background. It is known that stressors may evoke eating as a coping response, and that some persons respond to lapses in their dietary regimen with depression and self‐criticism. These two findings are linked within the context of a stress and coping paradigm that has in the past been applied to the study of substance abuse. Method. A survey of 79 women who reported overeating was implemented, including the administration of five instruments and a telephone interview. Findings. Over 43% of the variance in the dependent variable, negative mood states, was explained by hierarchical regression of the independent variables, entered sequentially as exemplars of: social stressors, coping, degree of required calorie consumption, use of overweight control strategies and the interaction between the degree of required weekly calorie consumption and use of overweight control strategies. Significant contributions were made by variables denoting stressors, coping, and the interaction between degree of required calorie consumption and use of overweight control strategies. Of particular interest was the suggestion that for individuals who frequently use strategies to control overeating and overweight, eating may produce negative mood states. Individuals intensively involved in efforts to control their weight may be vulnerable for dysphoria, may require unique nursing interventions, and thus deserve continued study in this context.
The practical, methodological and ethical dilemmas of conducting focus groups with vulnerable clients
Authors: Owen Sara 
Published: March 2003

The practical, methodological and ethical dilemmas of conducting focus groups with vulnerable clients Aim. This paper presents some of the practical, methodological and ethical dilemmas that were encountered in a study that used focus groups to elicit the views of women with serious and enduring mental health problems about the services they were receiving. Findings. The dilemmas identified included the time and effort taken to gain access to the women, the role of the researcher as facilitator, communication and interaction in the focus group, accepting the women’s reality, and the thin divide between research and therapy. Conclusion. The paper concludes with some recommendations for researchers who are planning to use focus groups to elicit the views of vulnerable clients.
From hospital to home care: a randomized controlled trial of a Pain Education Programme for cancer patients with chronic pain
Authors: De Wit Rianne , Van Dam Frits 
Published: March 2003

From hospital to home care: a randomized controlled trial of a Pain Education Programme for cancer patients with chronic pain Aim of the study. To investigate the role of district nurses in the care of cancer patients with chronic pain at home, as well as the effects of a Pain Education Programme for patients and their district nurses. The Pain Education Programme consisted of a tailored multi‐method approach in which they were educated about pain, instructed how to report pain, and how to contact health care providers. Background. No educational programs for patients in pain have been studied in outpatients nor integrated with the home care provided. Design and methods. One hundred and four patients and their 115 district nurses were enrolled in a prospective, longitudinal, randomized controlled study. The primary outcome of interest was type of care provided by district nurses, satisfaction with the pain treatment, and agreement in estimating patients’ pain intensity. Results. Results showed that continuity of care was poor as only 36% of the district nurses were informed about patients’ pain by hospital nurses. Pain was rarely the reason for referring the patient to district nursing after discharge. Although pain control was not a main reason for district nurses to visit a patient, pain was a subject for discussion in 76% of visits. Besides discussing the pain problem with patients, district nurses provided only a few pain‐relieving interventions. District nurses randomized to the intervention group significantly better estimated patients’ pain intensity, and were more satisfied about patients’ pain treatment, but no differences were found in their assessment of patients’ pain relief. Conclusions. These findings suggest a significant but moderate effect of the Pain Education Programme, with district nurses only playing a minor role in the treatment of cancer pain.
The concept of self‐management of type 1 diabetes in children and adolescents: an evolutionary concept analysis
Authors: Schilling Lynne S. , Grey Margaret , Knafl Kathleen A. 
Published: March 2003

The concept of self‐management of type 1 diabetes in children and adolescents: an evolutionary concept analysis Aim. An evolutionary concept analysis was undertaken to clarify the concept of self‐management of type 1 diabetes in children and adolescents. Background. Several problems exist in the literature on self‐management of type 1 diabetes in children and adolescents. There is no uniform terminology and there is no uniform definition of the concept. Also, there is no differentiation in the literature between self‐management of diabetes in children and adults. Methods. Ninety‐nine references were reviewed and analysed in the disciplines of nursing, medicine, and psychology. After separate analyses revealed no significant differences across disciplines, the analyses were combined to describe the attributes, antecedents, consequences, and surrogate and related concepts. Results. The three essential attributes of the concept were identified as process, activities, and goals. Self‐management of type 1 diabetes in children and adolescents is an active and proactive process; it is daily, lifelong, and flexible, and it involves shifting and shared responsibility for diabetes care tasks and decision‐making between child and parent. It is a process that involves collaboration with health care providers. Self‐management of type 1 diabetes in children and adolescents also consists of varied and many activities related to giving insulin, monitoring metabolic control, regulating diet and exercise, to name just a few. The concept also involves goals, which may differ from one parent/child dyad to another. A working definition of the concept is suggested. Conclusions. It is hoped that a more uniform definition of the concept will enable researchers to continue investigating antecedents and consequences of the concept in a way that allows for aggregating results.
Barriers and bridges to care: voices of homeless female adolescent youth in Seattle, Washington, USA
Authors: Ensign Josephine , Panke Aileen 
Published: March 2003

Barriers and bridges to care: voices of homeless female adolescent youth in Seattle, Washington, USA Aim. The purpose of this study was to conduct an assessment of reproductive health‐seeking behaviours, sources of advice, and access to care issues among a sample of clinic‐based homeless adolescent women. Background. Adolescent women are among the most vulnerable and medically underserved subgroups within the homeless population in the United States. Homeless youth are rarely invited to participate in research aimed at improving their access to appropriate health care. Also, the culture in which they live and the personal experience of being homeless are often not addressed. Study method. The research was descriptive, using focus groups and individual interviews with a purposeful sample of 20 female youth, aged 14–23 years. Findings. The women said that they seek health advice from other women, including their mothers even while they are homeless. They reported first trying self‐care interventions, and going to clinics when self‐care actions no longer worked. They stated that the main barriers to health care were lack of insurance, confusion over consent, transportation problems, lack of respect (from providers) for their own self‐knowledge, and judgementalism from providers. Conclusion. Using the concept of cultural competency, the results provide insights into how to improve communication and health care services for these women. Recommendations. Health care providers need to recognize and appreciate the lifestyle, beliefs, and adaptive attitudes of homeless youth, rather than labelling them as ‘deviant’. All personnel who interact with and on behalf of homeless youth must be adequately trained in general knowledge regarding the health of homeless youth as well as in an understanding of the role that culture plays in their health‐seeking behaviours.
Psychosocial consequences of falling: the perspective of older Hong Kong Chinese who had experienced recent falls
Authors: Kong Karol Siu‐wai , Lee Fung‐kam , Mackenzie Ann E. , Lee Diana T.F. 
Published: March 2003

Psychosocial consequences of falling: the perspective of older Hong Kong Chinese who had experienced recent falls Aim of the study. The study's aim was to explore the psychosocial consequences of falling with a group of older Chinese who had recently fallen. Background. Older people fall more frequently. Thus, the consequences of these falls and their influence on health outcomes need to be determined. One important outcome, namely the psychosocial consequence of falling, has not been extensively studied. As a result, this study explored the psychosocial consequences of falling with a group of older Chinese who had recently experienced a fall. Research approach. An explorative qualitative approach with semi‐structured interviews was used in this study. Sample. Twenty informants, with recent fall experiences either in the community or hospital setting, were interviewed in two elder care wards in an acute care hospital. Findings. Three major categories of psychosocial consequences of falling emerged from the interview data: powerlessness, fear and seeking care. Powerlessness was also exemplified in three subcategories: lack of control, self‐comforting and lack of emotion. Informants perceived falls as unpredictable and not preventable, expressing fears that falling could result in dependence on others and becoming a care burden. The interview data also showed that there is a need by older Chinese to seek care and advice from relatives and health care professionals. Conclusions. Findings from this study have provided insights into the psychosocial consequences of falling for older Chinese. These insights suggest nursing interventions should promote a sense of mastery in prevention of falls, facilitate supportive social interactions with relatives and give empathetic responses to those who have fallen.
Getting evidence into practice: the role and function of facilitation
Authors: Harvey Gill , Loftus‐Hills Alison , Rycroft‐Malone Jo , Titchen Angie , Kitson Alison , McCormack Brendan , Seers Kate 
Published: March 2003

Getting evidence into practice: the role and function of facilitationAim of paper. This paper presents the findings of a concept analysis of facilitation in relation to successful implementation of evidence into practice.Background. In 1998, we presented a conceptual framework that represented the interplay and interdependence of the many factors influencing the uptake of evidence into practice. One of the three elements of the framework was facilitation, alongside the nature of evidence and context. It was proposed that facilitators had a key role in helping individuals and teams understand what they needed to change and how they needed to change it. As part of the on‐going development and refinement of the framework, the elements within it have undergone a concept analysis in order to provide theoretical and conceptual clarity.Methods. The concept analysis approach was used as a framework to review critically the research literature and seminal texts in order to establish the conceptual clarity and maturity of facilitation in relation to its role in the implementation of evidence‐based practice.Findings. The concept of facilitation is partially developed and in need of delineation and comparison. Here, the purpose, role and skills and attributes of facilitators are explored in order to try and make distinctions between this role and other change agent roles such as educational outreach workers, academic detailers and opinion leaders.Conclusions. We propose that facilitation can be represented as a set of continua, with the purpose of facilitation ranging from a discrete task‐focused activity to a more holistic process of enabling individuals, teams and organizations to change. A number of defining characteristics of facilitation are proposed. However, further research to clarify and evaluate different models of facilitation is required.
The psychological well‐being of renal peer support volunteers
Authors: Brunier Gillian , Graydon Jane , Rothman Barbara , Sherman Charline , Liadsky Roselyn 
Published: March 2003

The psychological well‐being of renal peer support volunteers Aim of the study. The purpose of this study was to describe the characteristics of renal peer support volunteers (PSVs) and explore the effects on their psychological well‐being from helping others. Background. Dialysis patients, transplant patients and family members who become renal PSVs receive special training in empathy, listening, self‐awareness and problem solving. The trained renal PSVs offer a unique service to others struggling to learn to live with renal failure because they have faced the same struggles. Methods. This exploratory study utilized a longitudinal design. The first time for data collection was immediately after the volunteers had completed a Kidney Foundation of Canada training programme. Subsequent interviews were at time intervals of 4, 8 and 12 months after the first interview. Information on the psychological well‐being of the volunteers was collected at each interview in two different ways: the 38‐item Mental Health Inventory (MHI) and open‐ended questions. Findings. Thirty‐one PSVs completed all four interviews. The average age of the volunteers was 45 years and almost half had a university level of education. They identified themselves as belonging to 12 different ethno‐cultural groups. Analysis of the quantitative data from the MHI indicated that the mental health of the PSVs stayed remarkably stable over time. Analysis of the qualitative data from the open‐ended questions revealed four major themes which, taken together, showed notable increases in personal growth and well‐being for the PSVs over time. Conclusion. After participating in a training programme, renal PSVs maintained, and possibly improved, their own well‐being by helping others with chronic renal failure.
The safety and effectiveness of a nurse‐led anticoagulant service
Authors: Connor Carole A. , Wright Chris C. , Fegan Christopher D. 
Published: March 2003

The safety and effectiveness of a nurse‐led anticoagulant service Aim. The aim of this study was to compare the safety and effectiveness of anticoagulant nurses and a consultant haematologist in managing anticoagulant patients in a hospital outpatient setting. Background. Nurses are increasingly developing roles traditionally undertaken by medical staff. As a result nurse‐led practice has expanded in many areas including anticoagulant services. Previous studies have attempted to demonstrate the effectiveness of using other professionals to manage anticoagulant clinics over short periods of time. This research evaluates the safety and effectiveness of a consultant‐led and a nurse‐led service over two sequential 18‐month periods. Research methods. A nonexperimental design was adopted. Data were collected retrospectively, from a random sample of 197 patients, who had been managed by both the consultant‐led and nurse‐led service. Two main outcome measures were selected: anticoagulant control between professional groups and interval between outpatient clinic appointments. Results. No statistically significant difference in anticoagulant control was found between professional groups (P=0·137). There was evidence that patients attended anticoagulant clinics on significantly fewer occasions with nurse‐led management (P < 0·0005). Conclusion. At the department within which this research was conducted, anticoagulant nurses were found to be at least as safe and effective as the consultant haematologist in managing outpatient anticoagulant patients over the study period. These findings are of importance in both shaping the future provision of anticoagulant care and also contributing to the wider area in evaluating the impact of nurse‐led practice within health care.
Two theories/a sharper lens: the staff nurse voice in the workplace
Authors: DeMarco Rosanna 
Published: March 2003

Aim of the paper.  This paper (1) introduces the two theoretical frameworks, Silencing the Self and the Framework of Systemic Organization (2) describes the design and findings briefly of a study exploring spillover in nurses utilizing the frameworks, and (3) discusses the process and value of theory triangulation when conducting research in the context of complex nursing systems phenomena where gender, professional work, and gender identity merge. Background/rationale.  A research study was designed to analyse the actual workplace behaviours of nurses in the context of their lives at work and outside work. An exploration of theoretical frameworks that could direct the measurement of the phenomena in question led to the use of two frameworks, the Framework of Systemic Organization (Friedemann 1995) and the Silencing the Self Theory (Jack 1991), and the creation of a valid and reliable summative rating instrument (the Staff Nurse Workplace Behaviours Scale, SNWBS). Design/Methods.  A descriptive correlational design was used to measure behaviours between work and home. Results/findings.  There were statistically significant relationships found between workplace behaviours, family behaviours, and silencing behaviours as measured by the two separate scales measuring framework concepts. Conclusions.  Although both theories had different origins and philosophical tenets, the findings of a research study created an opportunity to integrate the concepts of each and unexpectedly increase and broaden the understanding of spillover for women who are often nurses.
Nurse practitioner knowledge of complementary alternative health care: foundation for practice
Authors: Sohn Patricia M. , Loveland Cook Cynthia A. 
Published: March 2003

Aim.  With the increasing use of complementary alternative treatments by the general public in the United States of America (USA), it is critical that nurse practitioners have the most up‐to‐date information about the use and safety of these modalities. A strong knowledge base is crucial in delivering competent and culturally sensitive care, yet the level and source of nurse practitioner knowledge in this area is largely unknown. The purpose of this study was to investigate the level and source of nurse practitioner knowledge of complementary alternative health care practices, as well as their referral practices involving these treatments. Methods.  Using a cross‐sectional descriptive research design, a sample of 151 nurse practitioners from Missouri and Oregon completed an adapted version of Sapp's self‐administered survey that explored these issues. Evaluation of the psychometric properties of the adapted instrument demonstrated good face validity, test–retest reliability (kappa = 0·81) and internal consistency reliability were 0·90 and 0·92 for two subscales with continuous response categories. Findings.  Eighty‐three percent of the nurse practitioners recommended complementary alternative treatments to their patients with the most frequent being massage therapy, chiropractic care, acupuncture or acupressure, nutritional therapy and herbal treatment. However, only 24% reported that formal nurse practitioner education was a source of knowledge about these treatments. Instead, over 60% relied on their personal experiences for this knowledge, as well as lay and professional journals. Conclusion.  Nearly 9 out of 10 nurse practitioners recommend the use of complementary alternative therapies to patients, but their source of knowledge is not derived from professional education. Attention needs to be given to increasing content about complementary alternative therapies in formal academic programs, professional conferences and in‐service education opportunities.