bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postnatal depression – biological or cultural? A comparative study of postnatal women in the UK and Taiwan
Authors: Huang Yu‐Chu , Mathers Nigel 
Published: March 2003

Postnatal depression – biological or cultural? A comparative study of postnatal women in the UK and Taiwan Aim.  The aim of the study was to compare the factors which are associated with postnatal depression in the UK (United Kingdom) and Taiwan. Background/Rationale.  A comparative study of postnatal women in the UK and Taiwan was undertaken to investigate postnatal care and the prevalence of postnatal depression. Design/Methods.  The Edinburgh Postnatal Depression Scale (EPDS) was used to determine the prevalence of postnatal depression. A semistructured interview and validated questionnaire were used to collect data on maternal satisfaction with postnatal care and the factors associated with postnatal depression. A one in three random sample of women from two community midwife teams in Sheffield, UK and three public health stations in Keelung, Taiwan took part in the study. Results/Findings.
Fifty (94% response rate) women from Sheffield and 101 (83% response rate) women from Keelung, who were at low risk for maternal or foetal problems during labour and the postnatal period, agreed to participate. The prevalence of postnatal depression in the British and Taiwanese women was almost equal; 18% in the UK and 19% in Taiwan. In Taiwan, the prevalence of postnatal depression had a negative association with relationship with partner (Spearman correlation=–0·34, P < 0·001) and self‐confidence (Spearman correlation=–0·28, P < 0·01, Spearman correlation). In addition Taiwanese women who felt more anxious after birth (10·9 ± 7·9, P < 0·001, t‐test) had a higher chance of postnatal depression. In the UK, there was a significant negative association between adaptation to the new role of motherhood and score on the EPDS (Spearman correlation=–0·47, P < 0·001). The overall scores for maternal satisfaction were 28·1 and 24·3 in the UK and Taiwan, respectively (P < 0·001, t‐test). British women reported a better quality of care during the postnatal period in terms of emotional support and physical care. Conclusions.  The findings of this study suggest that further cross cultural investigation could shed light on the relative balance of biological and cultural factors which may be associated with the onset of postnatal depression. As the prevalence of postnatal depression is similar in both cultures despite large differences in culture and postnatal care systems, some support is given to a hypothesis that postnatal depression has at least some biological determinants as well as cultural/social ones.
A literature review on the concept of intimacy in nursing
Authors: Williams Angela 
Published: March 2003

A literature review on the concept of intimacy in nursing Aim. This paper explores the concept of intimacy in nursing. Rationale. Intimacy is an increasingly important concept in nursing and feature of the nurse–patient relationship, which is perceived to be intrinsic to the proposed therapeutic potential of nursing. The introduction to the paper highlights the theoretical enthusiasm and endorsement of intimacy, the apparent lack of conceptual clarity from a nursing perspective and little published research investigating intimacy in practice. Method. Literature is reviewed from nursing and a variety of health–related disciplines. Findings. The paper traces the historical background of the nurse–patient relationship and intimacy and highlights the change in value from detachment and distancing to intimacy, commitment and involvement. The nature of intimacy is examined and a concept analysis based on literature from psychology and psychiatric medicine is critically analysed. Intimacy is suggested to have psychological, emotional and physical aspects, which are explored. An ethnographic research study on intimacy in nursing is reviewed, which also recognizes physical and emotional dimensions of the concept and the importance of sufficient resources to allow the close relationships advocated. Attention is drawn to the constraints on intimacy imposed by the current market–led health service. Literature and research on the implications and consequences of intimacy for the nurse are discussed. These report practical difficulties of maintaining close relationships with individual patients and the potential for over‐involvement and emotional labour. Conclusion. The paper concludes with the increasing importance attached to intimacy in nursing and its complex, ill‐defined nature. This serves to highlight the importance of research aimed at exploring and clarifying intimacy and further illustrating the therapeutic potential of nursing.
A descriptive study of meaning of illness in chronic renal disease
Authors: Caress Ann‐Louise , Luker Karen A. , Owens R. Glynn 
Published: March 2003

A descriptive study of meaning of illness in chronic renal disease Aim. To explore the subjective meaning of illness in a sample of renal patients. Background. Patients’ illness representations, such as the meaning they attach to illness, may affect their coping and adaptation. Improved understanding in this area may therefore benefit patient care. Meaning of illness has not previously been explored in renal disease. Design and methods. Cross‐sectional survey (n=405) in a single regional renal unit in the North of England. Ethical approval was obtained and patients gave written consent. The instrument used was an eight‐item schema, based on the work of Lipowski (1970, Psychiatry in Medicine1, 91–102). Field notes regarding rationale for choice were recorded concurrently, then content analysed to enable identification of themes. The chi‐square test (significance level P < 0·05) was used to analyse differences in selected meaning in older and younger patients; males and females; and patient groups (predialysis, haemodialysis and transplant). Findings. ‘Challenge’ was selected by most patients (n=253, 62·5%), with similar results in all three patient groups. Slightly more older than younger patients selected ‘challenge’, although the difference was not statistically significant and older patients more commonly had a fatalistic interpretation of the option. More men selected ‘challenge’ than women. Those selecting ‘challenge’ and ‘value’ appeared to have a more positive outlook than other patients. Conclusions. Patients had identifiable meanings for their illness, and these may be associated with their response to renal disease. The schema appeared to be comprehensive, but is in need of further refinement. Consideration of the possible influence of social desirability is necessary.
A need to try everything: patient participation in phase I trials
Authors: Moore Sally 
Published: March 2003

A need to try everything: patient participation in phase I trials Rationale. The area of phase I trials is fraught with ethical dilemmas and controversy. Most existing research focuses on issues of human rights and the informed consent procedure. Little attention has been given to patients’ perceptions of participating in such trials. Design. This paper describes a study using qualitative interviews and open‐stem questionnaires to begin to explore patients’ own perceptions of any benefits from participating in phase I trials. Results. Findings suggest that for some patients, phase I trials fulfil a need to try everything in their fight against cancer. The study also suggests that being on treatment allows some patients to construct their lives meaningfully by providing a supportive structure and enabling hope. Implications for nursing practice and further research are discussed.
Living and coping with excessive infantile crying
Authors: Long Tony , Johnson Martin 
Published: March 2003

Living and coping with excessive infantile crying Aim. The aim of the study was to elicit from parents how they lived and coped with a baby who cries excessively. It sought to identify factors which made coping more difficult, as well as interventions perceived by parents to be effective in improving the situation. Background. The excessive crying of a baby can be one of the most trying aspects of parenthood. Although there have been many studies into the cause and treatment of the problem, these have produced little convincing evidence and even less agreement among investigators. In the light of this an alternative approach is to provide effective support to enhance coping until the crying abates. Design. This study was based in pragmatic ethnography and followed an adapted grounded theory approach. A total of 25 adults from 14 families participated, recounting their experiences with 20 babies who either were currently crying excessively or had done so previously while less than 1 year old. Data was collected by a factual questionnaire and tape‐recorded focused interviews conducted in the family home augmented by periods of participant observation. Outcomes. Almost every aspect of family life was disrupted, resulting in strained relationships, feelings of guilt, and concerns about losing control. Repeated attempts had to be made to establish a diagnosis and to find a cure. Such attempts failed, leading to a repeated cycle of hope and disappointment. The greatest potential to effect a positive impact lay in the supportive role of health visitors. They needed to visit frequently; stay for a prolonged period; demonstrate engagement with the family and its difficulties; and impart specific messages with conviction and sincerity. Conclusion. A specific, vital role was found for the health visitor in supporting parents through this problem, and aspects of the role were identified in which further study is indicated.
Emotions and illness
Authors: Bowman Gerald S. 
Published: March 2003

Emotions and illnessAim. This paper discusses issues central to emotional expression in illness. Its aim is to challenge the psychopathological paradigm currently utilized within healthcare and propose an alternative model based on healthy emotions.Background. Emotions are important to human survival. It is argued that most patients will have an emotional response to their illness but anxiety and depression are unlikely to be representative of most patients experience. The paper focuses on two important negative emotions, fear and sadness, and their psychopathological associates, anxiety and depression. Problems of diagnosing anxiety and depression in practice are highlighted. It is contended that emotional reaction to illness is normal and that emotions expressed are likely to hold clues to individual adaptation. It is argued that in health care, emotions should be assessed as healthy reactions to a survival threat and merit study from this perspective if we wish to understand individual patient illness reaction and adaptation better. Literature from cardiology is used to illustrate clinical problems.Rationale. Given the present knowledge of emotions, it should be possible to utilize emotion theory as a paradigm for studying human reaction to illness. This in turn could help shape studies on adherence and adaptation.Conclusion. The reaction and experience of patient illness is unlikely to be understood through the psychopathology paradigm. A better understanding of patient reaction to their illness is more likely to emerge through the study of basic emotions during acute life‐threatening episodes.
Corporate working in health visiting: a concept analysis
Authors: Houston Anna M. , Clifton Jeanette 
Published: March 2003

Corporate working in health visiting: a concept analysis Aim of the paper.  The aim of this paper is to examine individualized health visiting care and compare it to corporate working within a consensual management style. Corporate working has been discussed and used in many different ways since the idea first came to light at the end of the 1980s. Resource management makes it an appealing model, however, analysing how corporate working functions in the practice setting reveals the complexity of this method of service provision. Background.  This paper is based on a method of practice developed by health visitors in Haywards Heath, West Sussex, who implemented the process. The article examines individualized health visiting care and compares it to corporate working within a consensual management style. Important in this analysis are the elements of reflexivity, active listening, reflection and the application of ‘praxis’ within the corporate caseload approach. Methods.  Rogers’ evolutionary concept model was used to illuminate and explain the different ways of delivering the health visiting service. Findings.  There are benefits in working corporately: shared workload, increased professional support and improved accountability. Alongside the integrated supervision of this model is the opportunity offered to practitioners to innovate. This offsets any initial difficulty experienced in setting up this method and makes it a worthwhile change of style in health visiting practice. Improved service delivery, enhanced professional growth and increased opportunity for public health work can be demonstrated as outcomes of this model. For professionals this method may prevent ‘burn‐out’, enhance practice and increase innovation in health visiting practice. Using this method as a blueprint, practitioners can develop their own style of corporate working that offers a service that is equitable, proactive, efficient and accessible to clients.
Technology and humane nursing care: (ir)reconcilable or invented difference?
Authors: Barnard Alan , Sandelowski Margarete 
Published: March 2003

Technology and humane nursing care: (ir)reconcilable or invented difference? Aim(s) of the paper.  This paper questions the validity of a boundary presumed to exist between technology and humane care. It argues the need for reconciliation of presumed tension(s) between technology and person focused care and the need to reconsider our ways of understanding the relations between technology and nursing. Background/rationale.
Recent scholarship in the social sciences related to reproductive and imaging technologies and emergency resuscitation are examined and arguments are presented that question the appropriateness of a humanist view that emphasizes technology on the nonhuman and nonnatural side of a human/nonhuman, nature/artifice divide. It is argued that what determines experiences such as dehumanization is not technology per se but how individual technologies are used and operate in specific user contexts, the meanings that are attributed to them, how individuals or cultural groups define what is human, and the organizational, human, political and economic technological system (technique) that creates rationale and efficient order within nursing, health care and society. Conclusion.  The paper concludes by asking whether the commonplace appeal to resolve tensions between humane care and technology has erroneously highlighted technology as the reason for impersonal care, and encourages re‐examination of the relationship(s) between technology, humane care and nursing practice.
Negotiating lay and professional roles in the care of children with complex health care needs
Authors: Kirk Susan 
Published: March 2003

Negotiating lay and professional roles in the care of children with complex health care needs Background. Children with complex health care needs are now being cared for at home as a result of medical advances and government policies emphasizing community‐based care. The parents of these children are involved in providing care of a highly technical and intensive nature that in the past would have been the domain of professionals (particularly nurses). Aims of the paper. To assess how the transfer of responsibility from professionals to parents was negotiated, the tensions and contradictions that can ensue, and the implications for professional nursing roles and relationships with parents. Design. Using a Grounded Theory methodology, in‐depth interviews were conducted with 23 mothers, 10 fathers and 44 professionals to gain insight into the experience of caring for children and supporting families in the community. Findings. From the parents’ perspective, their initial assumption of responsibility for the care of their child was not subject to negotiation with professionals. Prior to discharge, parents’ feelings of obligations, their strong desire for their child to come home, and the absence of alternatives to parental care in the community, were the key motivating factors in their acceptance of responsibility for care‐giving from professionals. The professionals participating in the study had concerns over whether this group of parents was given a choice in accepting responsibility and the degree of choice they could exercise in the face of professional power. However, it was following the initial discharge, as parents gained experience in caring for their child and in interacting with professionals, that role negotiation appeared to occur. Conclusion. This study supports other research that has found that professionals’ expectations of parental involvement in the care of sick children role can act as a barrier to negotiation of roles. In this study, parental choice was also constrained initially by parents’ feelings of obligation and by the lack of community services. Nurses are ideally placed to play the central role not only in ensuring that role negotiation and discussion actually occurs in practice, but also by asserting the need for appropriate community support services for families. Being on home territory, and in possession of expertise in care‐giving and in managing encounters with professionals, provided parents with a sense of control with which to enter negotiations with professionals. It is important that changes in the balance of power does not lead to the development of parent–professional relationships that are characterized by conflict rather than partnership.
From tall poppies to squashed weeds*: why don’t nurses pull together more?
Authors: Farrell Gerald A. 
Published: March 2003

From tall poppies to squashed weeds: why don’t nurses pull together more? Aims. To develop a conceptual framework to account for interpersonal conflict in nursing. To extend the boundaries of debate on the causes of interpersonal conflict in nursing. Background/Rationale. In nursing, attempts to offer an explanation for staff conflict or, as it is traditionally referred to, horizontal violence, have, nearly always, been influenced by oppression and feminist theories. Such macrolevel analyses avoid discussing the details of individual acts of aggression in favour of considering nurses’ alleged disempowerment in relation to other perceived dominant groups, especially male doctors, and the violence these groups inflict in terms of the denial of power, control, and access to rewards – material or otherwise. Methodology. A critical analysis of an extended literature review adapted from a doctoral dissertation. Discussion. While the oppression and feminist perspectives can be insightful they are also limiting in that they omit the finer grained‐analysis necessary for a fuller understanding of staff conflict. At least three levels of explanation can be offered to account for poor staff relationships – a macrolevel, which focuses on nurses’ relationships vis‐à‐vis dominant groups, a mesolevel analysis, which concentrates on organizational structures, including workplace practices – many of which are controlled by nurses themselves, and a microlevel analysis, which emphasizes the interactional nature of interpersonal conflict. Conclusions. It is contented that it is not only the alleged misogyny intrinsic to oppression theory that shackles and impedes nurses, but nurses themselves, who in their everyday work and interpersonal interactions, act as insidious gatekeepers to an iniquitous status quo.
An examination of the role and function of psychiatric nurses in clinical practice in Ireland
Authors: Cowman Seamus , Farrelly Mary , Gilheany Patricia 
Published: March 2003

An examination of the role and function of psychiatric nurses in clinical practice in Ireland Aim of the study.  The aim of the study was to describe the role and function of all grades of psychiatric nurse in clinical practice so as to clarify the nature and scope of psychiatric nursing services. Background and rationale.  The psychiatric nursing role in Ireland and the United Kingdom (UK) in recent years has undergone a period of great change. There is a new emphasis on health promotion, early intervention, community development, with nursing being provided closer to where people live and work as well as making access to services easier for vulnerable groups of the population. Role ambiguity and the difficulty with defining psychiatric nursing work is a constant theme in the psychiatric nursing literature and this leaves the profession of psychiatric nursing rather vulnerable during this period of intense change. Design and methods.  A descriptive qualitative research design with a multimethods approach to data collection was utilized involving three disparate but complimentary methods. Results and findings.  Following data analysis, nine categories of nursing role were identified; these included both independent and interdependent roles. Clearly psychiatric nursing occupied a pivotal role in all mental health care settings. A major proportion of psychiatric nursing related to caring interactions and this appears to be a central nursing element. The assessment and maintenance of patient’s safety was also important as mental health problems may place the patient or others in a position where their physical safety is threatened. Conclusion.  It is concluded that Irish psychiatric nurses have been innovative and initiated many new services in response to emerging needs. Our understanding of psychiatric nursing is far from complete and the immediate challenge is to determine the knowledge and skills base required for independent therapeutic roles in response to changing mental health care needs.