bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children visiting family and friends on adult intensive care units: the nurses’ perspective
Authors: Clarke Clare M. 
Published: March 2003

Children visiting family and friends on adult intensive care units: the nurses’ perspective Recent surveys show that children are still restricted from visiting their critically ill family and friends on many adult intensive care units throughout the country. The purpose of this small‐scale exploratory pilot study was to examine and describe the experiences and perceptions of trained nurses towards children visiting within this setting. The aim of the study was to gain greater insight and understanding into the reason why, despite evidence to support the benefits to children of visiting their critically ill family and friends, they remain discouraged and restricted. It is hoped that the study will act as an initial enquiry to generate themes and further research questions. A qualitative research approach was adopted and in‐depth focused interviews used as a method of data collection. The participants of the study were trained nurses working on an adult intensive care unit in a District General Hospital in England. A total of 12 individual interviews were conducted which were audiotaped in full and analysed using a method of thematic content analysis. The value of the research is to promote family‐centred care within an adult intensive care environment to meet the neglected needs of the well children of the critically ill person. The findings suggest that the participants in the study attempted to offer valuable support to children visiting their critically ill family and friends, but, despite an open visiting policy, children rarely visited within this setting. The desire of the well parent to protect and shield the child from the crisis of critical illness was perceived by the participants to be the main reason why they did not visit. To provide family‐centred care within an adult intensive care setting has many implications for practice and several of these important issues are discussed. These include the educational and training needs of nursing staff and the importance of adopting a collaborative team approach to providing care for the critically ill person and their family. The need to generate research and literature from within the United Kingdom’s health care system has also been identified and recommendations for further studies are proposed.
Sampling for a longitudinal study of the careers of nurses qualifying from the English pre‐registration Project 2000 diploma course
Authors: Marsland Louise , Murrells Trevor 
Published: March 2003

Sampling for a longitudinal study of the careers of nurses qualifying from the English pre‐registration Project 2000 diploma course This paper describes the processes involved in selecting a sample, from the eight English regional health authorities, of nurse qualifiers from all four branches of the Project 2000 pre‐registration diploma course, for a longitudinal study of nurses’ careers. A simple random sample was not feasible since accurate information about the population could not be obtained and the study design involved recruiting participants by personal visit. A multi‐stage approach was therefore adopted in which ‘college of nursing’ was taken as the primary sampling unit. Sampling was further complicated by the fact that adult branch students could generally only be visited in larger groups than was ideal. Information obtained during pilot work about the accuracy of data about the population, course completion rates and the proportion of students who were likely to agree to participate was used to calculate required sampling fractions. The final sample was therefore a function of this information and the practicalities of recruiting nurses into the study.
Interactive model of women’s stressors, personality traits and health problems
Authors: Kenney Janet W. , Bhattacharjee Anu 
Published: March 2003

Interactive model of women’s stressors, personality traits and health problems Theories have linked various stressors with health problems, and some studies have identified personality traits that enhance health. However, few studies have examined the interaction among women’s stressors, personality traits and their health. This retrospective study (1996–1997) analysed the effects of women’s major stressors and personality traits on symptoms of health problems, and developed a model of women’s health based on the interaction among these factors. A convenience sample of 300 women aged between 18 and 66 years completed a questionnaire that measured three types of stressors, eight personality traits and 40 symptoms of health problems. Principle components and factor analyses identified the best items to measure the stressors, traits and problems. New reduced data subsets were constructed for classification tree analyses to identify the effects of stressors and personality traits on women’s health. Women with medium or high stressors and low assertiveness, low hardiness, or the inability to express their feelings, were more likely to report physical symptoms than women who were stronger in these personality traits. Also, women with medium or high stressors and low to medium trust or love relationships were very likely to report high emotional symptoms, as were women with high trust or love, who did not express their feelings. An interactive model of women’s health was supported. The amount of women’s stressors and their personality traits may increase or diminish their stress response and affect their health. Nurses can identify women with high stressors and unhealthy personality traits that increase their risk for stress‐related illnesses, and assist these women to modify their stressors or personality traits to enhance their health.
Minimizing postpartum pain: a review of research pertaining to perineal care in childbearing women
Authors: Calvert Susan , Fleming Valerie 
Published: March 2003

Minimizing postpartum pain: a review of research pertaining to perineal care in childbearing women This paper provides a review of literature that relates to perineal pain and care. Articles evaluated include systematic reviews and research papers from the disciplines of midwifery, physiotherapy and obstetrics. The major themes to emerge from the literature and be reviewed are the need for episiotomy, suturing methods and materials, assessment of perineal trauma, treatment of perineum in the postpartum period, and postpartum recovery. Research has highlighted that many practices relating to perineal care remain un‐researched and therefore the need for evaluation is urgent. Further postpartum morbidity has been seen to affect many women, but is often unrecognized by practitioners. It is also a topic that requires further evaluation through well‐designed and implemented research.
Woodlands therapy: an ethnographic analysis of a small‐group therapeutic activity for people with moderate or severe dementia
Authors: Pulsford David , Rushforth David , Connor Irene 
Published: March 2003

Woodlands therapy: an ethnographic analysis of a small‐group therapeutic activity for people with moderate or severe dementia This paper reports on an analysis of Woodlands therapy (WT), a sensory‐motor therapeutic activity that aims to encourage interaction with people with moderate or severe dementia. The aims of the study were to examine: the responses of patients to the sensory experiences and play‐based activities that make up a WT session; the factors that influenced their responses; and the verbal interventions employed by the staff who facilitated WT sessions. Methods derived from ethnography were used. The data comprised videotapes of five WT sessions, notes of other sessions, and discussions with staff involved with the approach. Thematic groups of patients’ responses were formulated. WT mainly appears to engender the responses of attention, participation and comment. Factors that influence patients’ responses are discussed. The findings indicate that staff facilitation strategies strongly influence patients’ responses to WT. Verbal interventions made by staff are grouped in terms of their relative helpfulness for promoting positive responses to WT. Suggestions for practice are made for professional carers undertaking sensory‐motor therapeutic activities for people with dementia.
Successful breast‐feeding as a result of a health education programme for mothers
Authors: Hoyer Silvestra , Horvat Ludvik 
Published: March 2003

Successful breast‐feeding as a result of a health education programme for mothers The present study aims to prove an improvement in breast‐feeding practices in mothers who received written instructions for successful breast‐feeding and had individual counselling at the time of taking this questionnaire. The instructions were based on the results of a study carried out in Slovenia in 1993 and published in the Journal of Advanced Nursing (1998), 27, 1250–1256 (Hoyer & Pokorn 1998). The variables that were then found statistically significant in the initial and continued breast‐feeding became the basis of written instructions for breast‐feeding. The results obtained in the new current study were compared with that basic study which included 881 mothers. This was possible because the conditions of breast‐feeding between 1993 and 1995 (when the new study was launched) had not changed. The idea of baby‐friendly hospital initiative (BFHI) had not yet come into force in Slovenia. The current study comprised 203 pregnant women who were first visited during their 8th month of pregnancy. In order to collect data on breast‐feeding and deliver instructions, a field nurse visited each mother eight times until the completion of first year and continued to visit them every third month and for all those who were still breast‐feeding after that time, until the end of the lactation period. Statistical analysis was carried out by means of SPSS statistical package and survival analysis. All mothers in the study started breast‐feeding. By the end of the first month 84·7% of them were still breast‐feeding, while by the end of the third month it dropped to 74·9%, and by the end of the sixth month to 45·8%. Among these, breast‐feeding alone was practised in the first week by 25·7%, by the end of the first month by 16·4%, and by the end of the third month by 9·5%. All the observed parameters were better than in the basic study. The mean duration of breast‐feeding was 217 days, while the longest duration was 852 days. The survival analysis showed a statistically significant difference in the duration of breast‐feeding. In the current study group, mothers weaned their infants at a slower rate than in the group from the year 1993. It has been found that the written instructions as well as personal encouragement by the field nurse exerted a favourable influence on breast‐feeding practices, which was taken as a guideline for our further professional work and change of standards in the field of breast‐feeding promotion.
The relation between quality of co‐ordination of nursing care and quality of life in Dutch nursing homes
Authors: Holtkamp Chantal C.M. , Kerkstra Ada , Ribbe Miel W. , Van Campen Crétien , Ooms Marcel E. 
Published: March 2003

The relation between quality of co‐ordination of nursing care and quality of life in Dutch nursing homes Quality of life of nursing home residents is a critical consideration in international health care policies and health care decisions. Yet, there is little relevant research to support decisions about client‐tailored and effective nursing care for this population. Because of the permanency of their stay, the care received affects the quality of daily life. This study investigated the quality of co‐ordination of care and the way it is related to gaps between needs and care supply, the quality of life and health status of residents living in Dutch nursing homes. To assess the perceived quality of life and experienced discrepancies between needs and care supply, 337 residents of 10 different nursing homes were interviewed. The quality of co‐ordination of nursing care was assessed by judgements of the residents and nurses and by analysing the care documents. The results showed a relation between the co‐ordination of care and care discrepancies; the higher the quality of co‐ordination of care, the fewer the gaps between residents’ needs and the care they received. The psycho‐social aspects in particular showed a gap between the needs and care supply. As regards the relation between co‐ordination of care and quality of life, the strongest positive relations were found between taking case histories, patient allocation and dimensions of quality of life. No direct relations were found between the co‐ordination of care and care discrepancies on the one hand and the health status of the residents on the other. In conclusion, this study showed that the quality of co‐ordination of care can affect the perceived quality of life of nursing home residents. To meet the residents’ needs it is important to assess their physical and psycho‐social needs accurately. More research focusing on this assessment is needed in order to improve the quality of life of nursing home residents.
Relatives of hospitalized stroke patients: their needs for information, counselling and accessibility
Authors: Van Der Smagt‐Duijnstee Miebet E. , Hamers Jan P.H. , Abu‐Saad Huda Huijer , Zuidhof Arjan 
Published: March 2003

Relatives of hospitalized stroke patients: their needs for information, counselling and accessibility Aim of the study.  The purpose of this study is to explore the needs of stroke patients’ relatives during the hospitalization period. Background.  In the Netherlands, the consequences of a stroke, and the needs of stroke patients and their relatives are becoming increasingly important. In hospital, however, nursing care is still focused on the patients. A previous qualitative study on the needs of relatives of stroke patients identified four categories of needs. This present study aims to test the results of the previous study in a larger setting and to identify the factors that influence the needs of the relatives. Design/methods.  This study uses a cross‐sectional design. A questionnaire was designed for the purpose of data collection. This questionnaire was completed by 106 relatives of stroke patients admitted to the neurology wards of 19 Dutch hospitals (response rate 64%). The data were analysed using descriptive and multivariate analyses. Results/findings.  The findings of the study indicate that the needs of the relatives of stroke patients are best divided into three categories. These are the need for information, counselling (a combination of communication and support) and accessibility. In all cases, the most important need of the relatives of stroke patients is that their questions are answered honestly. The findings show a discrepancy between the importance of the needs and the degree to which these needs are met. Multivariate data analyses show that female relatives requested most information, whereas highly educated relatives needed less counselling. Satisfaction about the care provided is positively influenced by the period of hospitalization and negatively influenced by prior experiences of hospitalization.
Sources of support for older people after discharge from hospital: 10 years on
Authors: Waters Karen , Allsopp David , Davidson Ian , Dennis Alex 
Published: March 2003

Sources of support for older people after discharge from hospital: 10 years on Aims of the study. The aim of this research was to find out who supports older people at home after discharge from hospital and if sources of support have changed between the 1980s and the 1990s. Background. More and more older people are being discharged from hospital earlier and this creates additional pressures on families, community health and social services and the independent care sector. The research was concerned with how sources of support may have changed in a 10‐year period. Methods. A comparison is made of two separate nonrandom samples, taken 10 years apart, of older people following discharge from hospital. Interviews were conducted in participants’ homes to establish levels of dependence and the source of support given in response to the need for help with personal and domestic activities of daily living. Results. Although limited by the use of relatively small, nonrandom samples, the research found that proportions needing help with domestic activities were higher than those needing help with personal activities of daily living. Although dependence for help with bathing had declined between the 1980s and 1990s, help was still needed with bathing and dressing. Unmet need for help with bathing remained a problem in the 1990s. A growing role for home helps was identified, especially in personal care (bathing and dressing), where support from district nurses had declined. By the 1990s, home helps were doing less cooking and housework, including heavy laundry. Relatives were doing more of most domestic activities except shopping, which was being carried out by home helps. Conclusions. The paper concludes by arguing that hospitals should consider if pressures to discharge older people more quickly might hinder the discharge planning process and communication between hospital and community sectors.
Fragmented sleep and tiredness in males and females one year after percutaneous transluminal coronary angioplasty (PTCA)*
Authors: Edéll‐Gustafsson Ulla M. , Hetta Jerker E. 
Published: March 2003

Fragmented sleep and tiredness in males and females one year after percutaneous transluminal coronary angioplasty (PTCA)Aim. Reported sleep quality was examined in relation to anxiety, depression, selected psycho‐physiological sleep disturbing symptoms, daytime dysfunctions according to poor sleep, and quality of life 1 year after percutaneous transluminal coronary angioplasty (PTCA). Furthermore, females were compared with age‐matched males to examine any differences in sleep quality, psycho‐physiological symptoms and quality of life.Study design. A descriptive comparative study.Sample. Twenty‐two females, mean age 62·7 (SD5·7) and 70 men, mean age 60·4 (SD6·7), were consecutively recruited.Method. A mailed questionnaire was distributed, including the Uppsala Sleep Inventory, Spielberger State Anxiety scale, Zung's Self‐rating Depression Scale and the Nottingham Health Profile instrument.Results. Forty‐six per cent of the patients had a history of myocardial infarction and 40·2% hypertension. Seventy‐two per cent of the patients were anxious and 30·4% depressed. Difficulty in getting to sleep was related to intrusive thoughts with increased feelings of anxiety and sensitivity. Difficulty in maintaining sleep was the most common sleep complaint (42·4%) and physical tiredness/fatigue was the greatest consequence of disturbed sleep (51·1%). Those with pain, palpitations or respiratory nocturnal sleep‐disturbing symptoms were characterised by shorter sleep duration, emotional distress, cognitive dysfunction, tiredness and reduced quality of life. Greater difficulties initiating sleep and worse health related quality of life were revealed in females compared with aged‐matched males.Conclusion. fragmented sleep is a problem partly because of psycho‐physiological symptoms 1 year after PTCA, with reduced resilience to stress, increasing vulnerability or diminished coping ability and poorer quality of life.
The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia
Authors: Atsalos Christine , Greenwood Jennifer 
Published: March 2003

The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia Background. A network of nine Clinical Development Units (Nursing) (CDU(N)) were recently created in the Western Sydney Area Health Service. These units are designed to develop patient‐focused nursing practice through group process and action research, based on principles of transformational leadership. Aims of the study. Although there is documented evidence from Australia and the United Kingdom (UK) that CDUs and Nursing Development Units (NDUs) are very successful in improving both patient and staff satisfaction, there is also growing evidence that the stressors experienced by nurse leaders are threatening the survival of some of these units. This study set out to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership when these stressors were likely to impinge. Study design.  Hermeneutic phenomenology was employed in order to identify how these experiences changed over time. Two rounds of interviews were conducted: approximately 4–6 months after the launch and, again, 12 months later. Findings.  The Clinical Development Unit (Nursing) philosophy provided a framework on which these very motivated leaders began to enhance nursing accountability in their units through reflective practice and participatory governance. While reinforcing many previously published positive and negative aspects of Clinical Development Units and Nursing Development Units, this paper also highlights how the expectations and experiences of these leaders changed over time with␣unanticipated pressures of work, a high turnover of clinical leaders, a perceived diminution of management support and unrealistic self‐expectations. A significant theme that emerged as these stressors began to impinge was the leaders’ own need for leadership in order to sustain their confidence and motivation. Implications for nursing.  Insights harvested from this study have since been incorporated into a revised leadership preparation programme and support mechanisms for the leaders of eight new Clinical Development Units (Nursing) in the Western Sydney Area Health Service.
Reflection as a transforming process: student advanced nurse practitioners’ experiences of developing reflective skills as part of an MSc programme
Authors: Glaze Jane E. 
Published: March 2003

Reflection as a transforming process: student advanced nurse practitioners’ experiences of developing reflective skills as part of an MSc programme Aim of the study. The aim of this study was to explore student advanced nurse practitioners’ (ANPs) experiences of reflection. Background. The implementation of a National Health Service (NHS) Executive initiative to develop a Master’s Course in advanced nursing practice at Wolverhampton University provided the background to the study. The course was designed to enable experienced nurses to take on activities previously considered the province of physicians. The aim was to extend practice within a holistic nursing framework. Reflection was perceived as central to this process. A pre‐entry degree level reflective practice module and a reflective component for the level 4 (Master’s level) Practice Module were devised to enhance practitioners’ reflective skills. Rationale. The rationale for the study was that it should explore student ANPs’ perceptions of reflection following completion of these modules, to evaluate their experiences and inform curriculum development. Design/Methods. A qualitative methodology was used. The sample comprised 14 ANP students. Interviews and reflective learning contracts were used to collect the data. Colaizzi’s (1978) seven‐stage model guided data analysis. Findings. The findings indicated that all but one of the students described the development of their reflective skills positively. Changes are described in students’ thinking and behaviour. Conclusions. The conclusions have implications for ANPs, for patient care, and for others seeking to develop the ANP role.