bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning disability nurses' experiences of being with clients who may be in pain
Authors: Donovan Jim 
Published: March 2003

Learning disability nurses' experiences of being with clients who may be in pain Aims. This study aims to describe the experiences of Learning Disability Nurses (RNLDs) when they are with clients who may be in pain but who cannot communicate their feelings verbally. Background. Research indicates that general nurses often find it difficult to perceive their patients' pain accurately, but no studies refer to the experiences of RNLDs. For people with severe learning disabilities this could lead not only to unnecessary suffering, but also to long‐term tissue damage and may even prove fatal. Method. A phenomenological approach was adopted, as unrecognized pain is a subject about which little is known and the lived experiences of nurses and the meanings that they attach to them were being explored. Data were collected by unstructured interviews with a snowball sample of eight RNLDs. The participants were asked to describe a situation in which they thought a client was in pain. Analysis was based on Hycner's guidelines for the phenomenological analysis of interviews. Findings. Five central themes emerged: the importance of a caring relationship with the client, recognizing changes in verbal and nonverbal behaviour, searching for a meaning in the client's behaviour, negotiating with other health professionals and sharing in the client's feelings. Conclusions. Nurses valued highly their relationship with a client, which can, in itself, be therapeutic. Clients apparently used a wide range of both conventional and nonconventional forms of nonverbal communication, including aggressive and self‐harming behaviours, as the primary way of expressing pain. Functional speech cannot be taken as an indicator that the clients can self‐care with regard to pain. RNLDs play an important role in negotiating between their clients and other health professionals, but must be careful not to make assumptions about the causes of pain and pass these assumptions on to the General Practitioner as a professional opinion. The use of diagnostic tests should be supported. RNLDs appeared to be sympathetic, rather than empathetic, towards their client's painful experiences.
A controlled trial of music and pre‐operative anxiety in Chinese men undergoing transurethral resection of the prostate
Authors: Yung Paul Man Bun , Chui‐Kam Szeto , French Peter , Chan Tony Moon Fai 
Published: March 2003

Aim of the study.

To test the effects of music intervention on pre‐operative anxiety in Chinese males undergoing transurethral resection of the prostate
. Rationale.  No studies have measured the effects of music intervention in reducing pre‐operative anxiety for patients with transurethral resection of the prostate (TURP). Previous studies have examined the effects of music on pre‐operative anxiety but have not examined the possible effects of the presence of a carer as an independent variable in pre‐operative anxiety levels of patients in addition to the music intervention. The cultural validity of applying a music intervention to the reduction of pre‐operative anxiety was also investigated. Design.  A quasi‐experimental design with three groups: music intervention, nurse presence and control group. Method.

Thirty patients having TURP were randomly assigned (
n  = 10 each group) to one of the three groups. Pre‐ and post‐test measures of systolic and diastolic blood pressure, heart rate and state anxiety using the Chinese State‐Trait Anxiety Inventory (C‐STAI) were obtained for the three groups. Results.  The findings showed that the music intervention significantly reduced all blood pressure levels for the patients. A reduction in state anxiety level was also found for the music intervention group. No significant reductions in blood pressure, heart rate and state anxiety level were found in the nurse presence and control groups. Conclusion.  The results support the cross‐cultural validity of using a music intervention in pre‐operative anxiety reduction, in this case for TURP patients waiting in the theatre holding area.
Edwards, Benner and Wrubel on caring
Authors: Horrocks Stephen 
Published: March 2003

Aims.  To explain the difficult Heideggerian concept of the ontological difference and then use it as a context to explain the misperceptions of Benner and Wrubel's reply to Edwards' criticism of the differences between ontological and intentional care. Background.  Edwards' paper attempts to clarify what Benner and Wrubel actually mean by the category of ontological care. The latter's reply totally bypasses Edwards' criticisms because they have a misunderstanding of Heidegger's philosophy, which they use to support their arguments. Conclusion.  Benner and Wrubel's claims that they are using Heidegger to underpin their arguments is wrong. This has the consequence that their category of ontological caring comes tumbling down and their philosophy is not as radical as they think it is.
Gaining access to the life‐world of women suffering from stroke: methodological issues in empirical phenomenological studies
Authors: Kvigne Kari , Gjengedal Eva , Kirkevold Marit 
Published: March 2003

Aim.  First to give a brief introduction to some dimensions of phenomenology as philosophy, and then to discuss some problems related to empirical research. The objectives of the discussion are: (1) to show what is involved in investigating changes in the life‐world caused by illness and (2) to show what must be taken into consideration to obtain adequate descriptions of the changes. Rationale.  To discuss some of the methodological requirements and challenges that phenomenological studies are expected to meet, particularly focusing on the data collection phase. Methods.  This is primarily a theoretical analysis supplemented by illustrations drawn from an ongoing study of women who have had suffered stroke. Findings.  Openness is essential in the whole research process. It is a precondition for conversation with the informants. In interview‐based investigations two forms of openness are at issue – the informant's openness in describing his/her life‐world, and the sensitivity of the researcher as regards seeing and hearing what is conveyed in the situation. Both forms of openness can be influenced positively or negatively by many factors, including the physical and mental health of the informants, the researcher's theoretical insight, her ability to communicate, and not least the relationship between the informant and the researcher. A relationship of power, for example, might reinforce gender differences, differences in cultural background, education and social status. Conclusion.  Openness on the part of the researcher is a prerequisite in order to gain access to the informant's life‐world.
Effects of prone and supine positions on sleep state and stress responses in mechanically ventilated preterm infants during the first postnatal week
Authors: Chang Ying‐Ju , Anderson Gene Cranston , Lin Chyi‐Her 
Published: March 2003

Background/rationale. Preterm infants in mechanical ventilation are vulnerable and may manifest physiological instability and a disorganized behavioural state when responding to external stimuli. Adequate positioning strategies may play an important role in protecting infants from environmental stressor and assisting quality of sleep. However, no study has examined effects of prone and supine positions on behavioural state and stress signs including startle, tremor, and twitch responses for ventilated preterm infants during the critical first week postbirth.Aim of the study. The purpose of this study was to compare effects of prone and supine positions on behavioural state and stress responses in mechanically ventilated preterm infants.Design/methods. The infants were aged 25–36 weeks of gestation, ≤ 7 days of age, and without sedation or congenital abnormalities. Using a crossover design, 28 infants were randomly assigned to supine/prone or prone/supine position sequence. Infants were placed in each position for 2 hours. A stabilization period of 10 minutes before observation of each position was allowed. During the protocol, care procedures were kept minimal and ventilator settings remained unchanged. Behavioural state and frequencies of stress signs including startle, tremor, and twitch were systemically recorded and analysed with repeated measures analysis of variance.Findings. Infants when prone compared with supine had (a) less crying, less active sleep, and more quiet sleep states, and (b) fewer stress responses of startle, tremor, and twitch.Conclusion. Results indicate that prone positioning improves the quality of sleep and decreases stress for ventilated preterm infants during the first week postbirth. These may conserve energy and assist infants' extrauterine adaptation.
A conceptual model‐based programme of nursing research: retrospective and prospective applications
Authors: Radwin Laurel , Fawcett Jacqueline 
Published: March 2003

Background. A conceptual model implicitly or explicitly guides research. Some researchers identify the conceptual model prior to conducting their studies. Other researchers may eventually come upon a conceptual model that provides a context for the research already completed and direction for future studies.Aim. The purpose of this article is to explain how one researcher, working with a theoretician, found a conceptual model that has provided a frame of reference for her past, present, and future studies and has allowed her to view her heretofore somewhat disparate studies as a more coherent programme of research.Conclusion. Finding an explicit conceptual model provided a meaningful frame of reference for interpreting previous research. Finding an explicit model also had the benefit of uncovering of new possibilities for research. In particular, as the findings from previous research were brought together within the context of the conceptual model, unanticipated areas of future study were identified.
Health‐related quality of life and health service use following total hip replacement surgery
Authors: McMurray Anne , Grant Sheila , Griffiths Susan , Letford Ali 
Published: March 2003

Aims of the study.  The study investigated health‐related quality of life in relation to demographic and clinical factors, and health service use and satisfaction by older total hip replacement (THR) patients following discharge from one Australian Hospital. Rationale.  Understanding health‐related quality of life and patterns of service use during recovery informs caregiving and patient and family education needs for discharge planning and case management. Background.  Post‐discharge, older THR patients have a high rate of health services use. Few valid measures of outcomes link nursing discharge or case management to patient‐identified health status or service needs. Research methods.  Ward nurses conducted telephone interviews to study self‐perceived health‐related quality of life using Medical Outcomes Study Short‐Form (SF‐36) and responses to an accompanying questionnaire on demographics, service use and satisfaction at 1, 2, 4, 8, and 12 weeks postdischarge. SF‐36 scores were compared with Australian population norms according to age and gender to determine the relative extent of postdischarge recovery. Results.
Psychosocial recovery preceded physical recovery, which steadily improved. Physical component summary scores reached population norms and mental component summary scores exceeded norms by week 1. No differences in quality of life were found by age, but women took longer to recover physically. Those who lived alone did
not have lower scores than those with residential support. General practitioners were seen most often; nursing visits were frequent only in weeks 1 and 2, specialist visits occurred at weeks 8 and 12. Allied health, hospital and pathology services were used less often. Most patients were satisfied or very satisfied with all services used. Discussion/conclusions.  An almost immediate impact on quality of life was evident, probably indicating successful pain alleviation. Service use indicated adequate discharge planning and successful recovery. Having ward nurses as researchers was instrumental to continuity of communication between patients, families and service providers, which suggests increased potential for continuity of care.
Can burdened caregivers be effective facilitators of elder care‐recipient health care?
Authors: Greenberger Haya , Litwin Howard 
Published: March 2003

Background. Caregiving by informal family caregivers of dependent older people in the community may be affected by burden and by the personal and social resources available to the caregiver. Given the increase in the dependent older population, study of factors affecting informal caregiving is necessary.Aim. To examine caregiver resources, burden and competence as predictors of health‐care facilitation on behalf of older patients.Design. Cross‐sectional data were collected by an interview schedule from 240 randomly sampled spousal and filial caregivers in Jerusalem. Study variables included caregiver background variables, general self‐concept and feelings of caregiver competence, informal and formal social support, burden and levels of health‐care facilitation. Path analysis was performed to clarify the direct and indirect predictors of health‐care facilitation.Results. Caregiver facilitation of health‐care was positively related both to the presence of personal and social resources and to burden levels. The results suggest that quality caregiving can coexist with burden, provided that ample caregiver resources are present. The most important resources were caregiver sense of competence and support from the professional health‐care provider.Discussion. Caregiving burden is not readily reducible, given the chronic nature of older people's health problems. However, caregiver resources can be bolstered, particularly by health professionals. Nurses, who are orientated to holistic family centred care, are especially well‐suited for this important intervention.
Theory‐driven guidelines for practical care of older people, based on the theory of gerotranscendence
Authors: Wadensten Barbro , Carlsson Marianne 
Published: March 2003

wadensten b. &
carlsson m. (2003) Journal of Advanced Nursing 41(5), 462–470

Theory‐driven guidelines for practical care of older people, based on the theory of gerotranscendence Introduction. The theory of gerotranscendence states that human development is a process extending into old age. When optimized, this process ends in a new perspective. The developmental process towards gerotranscendence can be obstructed or accelerated by life crises and grief, but elements in the culture can also facilitate or impede the process. Similarly, the caring climate can obstruct or accelerate the process toward gerotranscendence. The view introduced by the theory may have several consequences for staff treatment of and actions towards older people, as it offers a new understanding of living into old age. Aim. The aim of the present study was to derive guidelines for practical use in the care of older people. The guidelines should be used to promote a development toward gerotranscendence and should also be of value for people who already have attained a state of gerotranscendence. Methods. The method of deriving guidelines from the theory was focus group interviews. The theory of gerotranscendence was used as a foundation for stimulating the discussions in the focus groups as well as for organizing the proposals that emerged. Findings. Concrete guidelines at three levels, focusing on the individual, activity and organization, were derived. The guidelines describe different ways to support older people in their process towards gerotranscendence. Conclusion. These guidelines could support staff in their practical care of older people and could be used as a supplement to enrich the present care.
Diurnal and seasonal mass variation in blackbirds Turdus merula: consequences for mass‐dependent predation risk
Authors: Cresswell Will 
Published: March 2003

1.  A bird’s mass in winter should reflect the trade‐off between the benefits of an increased energy store to reduce starvation risk, and its costs in terms of increasing mass‐dependent predation risk. State‐dependent models of this trade‐off predict that as starvation risk increases then energy reserves should (i), increase, and (ii) be acquired earlier in the day. 2.  Blackbirds increased their minimum weight by 25. ±. 1·5% in midwinter; adults weighed significantly more than juveniles in midwinter, but weighed less in late winter. Weight for both sexes, and particularly adults, decreased with increasing daylength, but weight increases with respect to temperature decreases were most pronounced in males. Female blackbirds showed relatively small seasonal weight changes so that their midwinter mass‐dependent predation risk relative to males was independent of diurnal weight changes. 3.  Blackbirds lost at least 1–9% of their body weight overnight depending on temperature. Over 60% of the weight lost was then regained in the first 3 hours after dawn, with only 5% being regained after 12.00 h. The pattern of early morning weight gain was maintained throughout the winter, with the ratio of weight gain rates in the first 4. h of dawn compared to the rest of the day being c.. 3:1 in midwinter (when individuals maintained high weights) and in early spring (when individuals were losing weight seasonally). 4.  The results agree with the theoretical prediction that energy reserves should increase as risk of starvation increased (as measured by seasonal factors such as cold, short midwinter days). There was, however, little change in the seasonal pattern of diurnal weight gain, with weight always being gained early in the day. In the likely absence of foraging constraints within the study system, this result fits the predictions of state‐dependent foraging models where animals can escape from predation after achieving weight gains, by either using refuges or adopting low‐risk foraging options.
Further perspectives on the breeding distribution of migratory birds: South American austral migrant flycatchers
Authors: Chesser R. Terry 
Published: March 2003

1.  Patterns of distribution of breeding austral migrant tyrant‐flycatchers in temperate South America were quantified and analysed in conjunction with a variety of ecological, biogeographical and climatic variables. 2.  The pattern of proportion of migratory to total breeding tyrannids was most strongly associated with latitude and two temperature variables, mean temperature of the coldest month and relative annual range of temperature. 3.  The strong associations of latitude and temperature with percentage of migrants are consistent with the results of most similar investigations of the breeding distributions of migratory birds, both for migrants breeding in North America and in Europe, but contradict the hypothesis that habitat complexity plays a major role in structuring the proportion of migrants in communities of breeding birds. 4.  The consistency of results among studies of migrants on different continents suggests that temperature and latitude, presumably a surrogate for one or more climatic variables, are globally significant factors in the breeding distributions of migratory birds. 5.  The results for austral migrant flycatchers are consistent with the hypothesis that the prevalence of migration at any particular locality is ultimately dependent on the abundance of resources in the breeding season and the severity of the winter season, or on the difference in resource levels between summer and winter.
Effects of habitat fragmentation on carabid beetles: experimental evidence
Authors: DAVIES KENDI F. , MARGULES CHRIS R. 
Published: March 2003

1.  We tested for effects of habitat fragmentation in a controlled, replicated, field experiment, in south‐eastern Australia. Our experimental subjects were eight carabid beetle species, and the carabid assemblage (45 species). Monitoring was by pitfall trapping in forest remnants and in adjacent continuous‐forest controls. Remnants were of three sizes (0·25, 0·875, 3·062 ha.). Monitoring commenced 2 years prior to habitat fragmentation. Here we present results for 6 years after habitat fragmentation (4 years for species richness). 2.  We tested four hypotheses. Hypothesis one: habitat fragmentation reduces species richness in the remaining remnants. Carabid species richness was not different in habitat remnants compared to continuous forest, neither was carabid richness different for remnants of different sizes, or at monitoring sites close to remnant edges compared to sites in remnant interiors. 3.  Hypothesis two: populations decline as a result of habitat fragmentation. Two species of eight were completely isolated on remnants and both declined in abundance on remnants compared to control plots in continuous forest. The other six species responded in various ways, which included relative increases and decreases in abundance and no change, but as they were not completely isolated on remnants, their responses could not be explained by isolation. 4.  Hypothesis three: remaining subpopulations decline further on smaller habitat remnants than on larger remnants. Three species responded to remnant size; one was most abundant in small remnants, the second was most abundant in large remnants, and the third was equally abundant in small and large remnants and less abundant in medium‐sized remnants. 5.  Hypothesis four: populations near to remnant edges decline further than populations in remnant interiors. Two species were more likely to occur in remnant interiors than at edges, whereas three species were equally likely to occur in remnant interiors and at edges. 6.  The effects of habitat fragmentation may be the consequence of: (i) isolation; and (ii) habitat modification. In this study, we were able to consider effects of isolation for two carabid species. We tested only one aspect of the habitat modification hypothesis, edge effects. We discuss the possibility that other aspects of habitat modification in remnants may explain some of our results and suggest that this is where future research be directed.