bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deliberate self‐harm in adolescence: a systematic review of psychological and psychosocial factors
Authors: Webb Lucy 
Published: March 2003

Deliberate self‐harm in adolescence: a systematic review of psychological and psychosocial factors Aims. This paper is a systematic review of the research literature that identifies psychological and psychosocial factors associated with adolescent deliberate self‐harm (DSH). The aims of this review were to identify the key psychological and psychosocial factors that aid the identification of individuals at risk of DSH, and suggest specific strategies for intervention. Background. Research has highlighted a parallel rise in rates of DSH referrals to general hospitals and rates of successful suicides in the younger age groups and gender groups. It is also highlighted that pressure on services in responding to these increases may be resulting in an inadequate response to both first‐episode DSH and repetition of self‐harm. One cause for concern is the lack of adequate psychosocial assessment for adolescents presenting at hospital following a DSH incident. Research of the literature suggests that there may be a paucity of research into after‐care strategies in self‐harm to prevent repetition and escalation of self‐destructive behaviour. Methods. A systematic review of the literature was conducted to identify the psychological and psychosocial factors relating to DSH. Results. The results found typical psychological and psychosocial factors associated with DSH in adolescents, although psychosocial factors were less consistently measured because of the breadth of tools and methods used. Conclusions. It is discussed whether associated factors are causative of DSH or the accompanying symptoms in DSH. It is suggested that positive psychosocial factors may have a part to play in providing protection against DSH behaviour. Therapeutic responses to DSH are suggested as preventative measures against repeat episodes.
Power dressing and meta‐analysis: incorporating power analysis into meta‐analysis
Authors: Muncer Steven , Taylor Shirley , Craigie Mark 
Published: March 2003

Power dressing and meta‐analysis: incorporating power analysis into meta‐analysis Aims. This paper highlights the lack of consideration that is given to power in the health and social sciences, which is a continuing problem with both single study research and more importantly for meta‐analysis. Background. The power of a study is the probability that it will lead to a statistically significant result. By ignoring power the single study researcher makes it difficult to get negative results published and therefore affects meta‐analysis through publication bias. Researchers using meta‐analysis, who also ignore power, then compound the problem by including studies with low power that are more likely to show significant effects. Method. A simple means of calculating an easily understood measure of effect size from a contingency table is demonstrated in this paper. A computer programme for determining the power of a study is recommended and a method of reflecting the adequacy of the power of the studies in a meta‐analysis is suggested. An example of this calculation from a meta‐analytic study on intravenous magnesium, which produced inaccurate results, is provided. Conclusion. It is demonstrated that incorporating power analysis into this meta‐analysis would have prevented misleading conclusions being reached. Some suggestions are made for changes in the protocol of meta‐analytic studies, which highlight the importance of power analysis.
The beliefs of nurses who were involved in a whistleblowing event
Authors: Ahern Kathryn , McDonald Sally 
Published: March 2003

The beliefs of nurses who were involved in a whistleblowing eventBackground. Nursing codes of ethics bind nurses to the role of patient advocate and compel them to take action when the rights or safety of a patient are jeopardized. Reporting misconduct is known as whistleblowing and studies indicate that there are personal and professional risks involved in blowing the whistle.Aim. The aim of this study was to explore the beliefs of nurses who wrestled with this ethical dilemma.Design. A descriptive survey design was used to examine the beliefs of nurses in Western Australia who reported misconduct (whistleblowers) and of those who did not report misconduct (nonwhistleblowers).Methods. The instrument listed statements from current ethical codes, statements from traditional views on nursing and statements of beliefs related to the participant's whistleblowing experience. Respondents were asked to rate each item on a five‐point Likert format which ranged from strongly agree to strongly disagree. Data were analysed using a Pearson's correlation matrix and one‐wayANOVA. To further explore the data, a factor analysis was run with varimax rotation.Results. Results indicated that whistleblowers supported the beliefs inherent in patient advocacy, while nonwhistleblowers retained a belief in the traditional role of nursing. Participants who reported misconduct (whistleblowers) supported the belief that nurses were primarily responsible to the patient and should protect a patient from incompetent or unethical people. Participants who did not report misconduct (nonwhistleblowers) supported the belief that nurses are obligated to follow a physician's order at all times and that nurses are equally responsible to the patient, the physician and the employer.Conclusion. These findings indicate that nurses may respond to ethical dilemmas based on different belief systems.
Constructions of sexuality for women living with multiple sclerosis
Authors: Koch Tina , Kralik Debbie , Eastwood Sue 
Published: March 2003

Aim.  In this paper we reveal constructions of sexuality that were articulated by 12 women who participated in an inquiry, which aimed to understand the experiences of women who live with multiple sclerosis (MS). The aim of this paper is to consider constructions of sexuality when chronic illness such as MS intervenes. Background.  In previous studies women placed their sexuality on the agenda for discussion, claiming that their concerns had not previously been vocalized nor understood. Design.  This participatory inquiry was framed by the principles of ‘look, think and act’. These principles are operationalized as looking at ourselves, reflecting and questioning aspects of our lives, and then taking action to resolve the issues identified. Twelve women aged between 30 and 60 years who lived with MS joined the three researchers for five group sessions. Each session lasted 3 hours. In addition, several women opted to be interviewed individually. In this paper we describe the way in which women have constructed and articulated their sexuality since acquiring MS. Findings.  Sexuality has multiple meanings that are shaped and influenced by life experiences. When MS intrudes in a woman's life, sexuality is reshaped against a foundation of previous sexual experiences and expectations. Constructions of sexuality encompassed physical sexual responses, perceptions of appearance and attractiveness to self and others, communication and relationships, self‐image and self‐esteem, and the sense of affirmation and acknowledgement that women experienced from others in their everyday lives. Conclusions.  This paper reveals that sexuality was not privileged by women but was regarded as an ordinary part of life. Often sexual activity was placed on hold as other aspects of living with a chronic illness intervene, for instance an exacerbation of MS. Whilst this paper has a focus on constructions of sexuality, there is a close relationship to shifts in self and identity. Health professionals need to reject the myths and stereotypes surrounding disabled women and attempt to understand the possible impact of long‐term illness on women's sexuality.
The lived experience of families of children who are failing to thrive
Authors: Thomlinson Elizabeth H. 
Published: March 2003

Objective.  This study was conducted to explore the experience of families of children who were failing to thrive. The aim of the study was not to generalize the findings but to generate a rich description of the phenomenon of living with children who were not growing as expected. Background.  Although failure to thrive has been found to have long‐term negative implications for children there is little information available on how families experience this phenomenon. Methods.  A purposive sample of 12 families with children who were failing to thrive from multiple known and unknown reasons were interviewed (21 participants: mothers, fathers, and grandmothers). Findings.  Twenty‐seven subthemes emerged from the descriptions provided by the participants and these were then grouped into seven themes. Families spoke of an all‐encompassing fear with which they lived. They were affected by the comparisons of the children made by others and themselves. In the process of seeking care for the children, the families described how their concerns often were not heard by the professionals. They felt blamed for their children's growth failure and this added to a sense of isolation and helplessness. Nurses and doctors who listened and acknowledged that they trusted the family were respected and valued. Families felt they were then valuable members of the care team. Regardless of the difficulties, families described how they adapted and persevered in their attempt to provide as normal a life as possible for the children. They considered themselves the experts who best knew the children and continued to provide the complex care that was needed. Conclusions.  The research suggests that health care professionals need to be more aware of the impact of their words and actions on families.
Relieving discomforts: the help‐seeking experiences of Chinese perimenopausal women in Taiwan
Authors: Tsao Lee‐Ing 
Published: March 2003

Background.  Although studies show that women view perimenopause as a natural process, few studies explore the experiences of Taiwanese mid‐life women who visit clinics for perimenopausal health problems. Research is required to understand the patterns and explanations for the women's behaviours in the process of seeking medical help. Such understanding will help guide teaching and care‐giving approaches. Aims.  To generate a descriptive theoretical framework about the experiences of women who visited traditional Chinese and Western medicine clinics in Taiwan to seek medical help for perimenopausal symptoms. Methods.  A grounded theory research design was used. Thirty Taiwanese women, aged 48–55 years, participated in two face‐to‐face audio‐taped interviews. Trained staff nurses conducted the interviews. Data collection, coding of interviews and field notes, and data analysis occurred simultaneously. Findings.   ‘Relieving the discomforts’ was the core theme for describing and guiding the process of seeking medical help during the perimenopausal period. During the process, ‘Feeling the discomforts’ was identified as the antecedent condition. Analyses showed five dimensions to the women's help‐seeking behaviours: (1) searching for medical help, (2) taking medicine, (3) reassurance of health, (4) desiring to be understood, and (5) emotional swings. Conclusions.  Women in this study expected to relieve their perimenopausal discomforts by finding treatment to match their body constitution. They hoped to find a caring and understanding doctor or staff member who would carefully explain health‐related issues to them. Health care providers need to consider women's individual health values and, based on these values, use different approaches to treat and teach women with perimenopausal symptoms and concerns.
Helpfulness of nursing actions to suddenly bereaved family members in an accident and emergency setting in Hong Kong
Authors: Li Serena P. , Chan Carmen W.H. , Lee Diana T.F. 
Published: March 2003

Background.  The sudden death of a family member is always traumatic to the family. Nursing actions such as providing comfort measures and providing an opportunity to view the deceased were consistently perceived as helpful by the suddenly bereaved. Little is known about the perception of bereaved family members in Hong Kong concerning the care they received in accident and emergency (A & E) departments. This study serves to identify actions, which were perceived as helpful in A & E setting in Hong Kong. Aim.  To gain knowledge about what nursing actions bereaved family members in Hong Kong perceived as helpful. Method.  This study was exploratory and descriptive in nature, and used a quantitative approach. Data were collected through structured telephone interviews using a modified Tye's questionnaire. Results.
Seventy‐six bereaved subjects were recruited in an A & E department in Hong Kong. The subjects perceived written information, opportunity to view the deceased, and respecting individual customs and religious procedures as most helpful and conversely, offering sedation, discouraging viewing of the body, and providing comfort measures as most unhelpful. No statistically significant differences among the overall mean of helpful nursing actions according to the subjects' age, gender, education level, family income and religions were found while using Mann–Whitney's
U and Kruskal–Wallis' tests. Significant correlations between some actions and the respondents' age, family income and educational level were found. Conclusion.  Accident and emergency nurses have unique role in offering helpful actions to support suddenly bereaved family members.
Cautious caregivers: gender stereotypes and the sexualization of men nurses' touch
Authors: Evans Joan A. 
Published: March 2003

Aim. The aim of this research was to explore the experience of men nurses and the ways in which gender relations structure different work experiences for women and men in the same profession.Background. Men are now entering the nursing profession in record numbers and challenging the notion that men are inappropriate in caregiver roles or incapable of providing compassionate and sensitive care. A limitation of the current state of knowledge regarding caring and men nurses is that it is primarily focused on men nursing students, not practising nurses. Little is known about men nurses' practices of caring and how such practices reflect the gendered nature of nursing and nurses' caring work.Methods. The theme of men nurses as cautious caregivers emerged from data that were collected in two rounds of semi‐structured interviews with eight men nurses practising in Nova Scotia, Canada. Thematic analysis, informed by feminist theory and masculinity theory, was used as the method for analysing the data.Findings. For men nurses, the stereotype of men as sexual aggressors is compounded by the stereotype that men nurses are gay. These stereotypes sexualize men nurses' touch and create complex and contradictory situations of acceptance, rejection and suspicion of men as nurturers and caregivers. They also situate men nurses in highly stigmatized roles in which they are subject to accusations of inappropriate behaviour. For men nurses, this situation is lived as a heightened sense of vulnerability and the continual need to be cautious while touching and caring for patients. Ultimately, this situation impacts on the ability of men nurses to do the caring work they came into nursing to do.
Knowledge, confidence and attitudes towards mental health of nurses working in NHS Direct and the effects of training
Authors: Payne Fiona , Harvey Kate , Jessopp Lynda , Plummer Sue , Tylee Andre , Gournay Kevin 
Published: March 2003

Background.  NHS Direct, the United Kingdom's 24‐hour nurse‐led telephone advice service, was announced in December 1997. By November 2000 the service was available throughout England and Wales. Initial research had shown that people with mental health problems used the service and that, prior to its going live, this was one area about which nurses felt least confident. Aims.  The aim of the study was to measure confidence in dealing with mental health calls, knowledge of mental health issues, and attitudes to mental health before and after training. Methods.  A postal questionnaire was sent to all nurse advisers working in 17 NHS Direct sites in England before and after mental health training had been received. The questionnaire was designed to measure confidence, knowledge and attitudes. This was done through scenarios of real calls to NHS Direct, questions from the World Health Organization guide to Mental Health in Primary Care and the Depression Attitude Questionnaire. Results.  Confidence increased in nurses who received mental health training. Although there was no statistically significant increase in knowledge scores after training, those who had received training increased by on average one point. After training, attitudes towards depression had shifted in that nurses now felt more positive towards their role in treating depressed patients. Conclusions.  Training in mental health can lead to increases in confidence and a change in attitudes and would be beneficial for all nurses working in NHS Direct and in other primary care fields. It would also be beneficial to repeat the study with a larger number of nurses and after a longer period of time to assess the long‐term effects of training.
Methodological issues in male caregiver research: an integrative review of the literature
Authors: Houde Susan Crocker 
Published: March 2003

Purpose of the paper. The purpose of this integrative review of the literature is to identify sampling and analysis issues related to gender in caregiver research in the nursing and health literature.Background. Men provide approximately 28% of the care in the home to functionally impaired elders in the United States of America (USA), and because of demographic predictions are expected to provide more in the future. Social science research related to male caregivers has been criticized as having many limitations. A critical review of the nursing and health literature would be helpful to nursing researchers and clinicians by identifying limitations in caregiving research related to gender and providing direction for future research.Methods. A literature search using the CINAHL database and the terms ‘family caregiver’, ‘dementia’, and ‘male’ was conducted. Thirty‐six articles were retrieved, reviewed, and abstracted.Findings. Thirteen articles were qualitative studies, 22 were quantitative, and one had both qualitative and quantitative components. Many of the studies used small samples, and no analysis was included by gender. Most of the samples were convenience samples, with many being self‐selected. There was also a lack of analysis of data by family relationship. No qualitative studies and only nine of the quantitative studies included analysis of the data by gender. Studies that reported by gender were all cross‐sectional.Conclusions. There is a need for caregiver research that has larger samples of males, and includes analysis by gender and family relationship. There is also a need for more intervention studies that are well controlled, and evaluate the effect of the intervention on both male and female caregivers.
Predictors of maternal competence by first‐time mothers when the child is 8 months old
Authors: Tarkka Marja‐Terttu 
Published: March 2003

Background.  Maternal role attainment is largely a cognitive and social process that is influenced by the cultural and family context and the mother's and child's traits and characteristics. Feedback from a social network is important to validate competent performance. Aim.  To ascertain factors that contributed to the maternal competence of first‐time mothers when the child was 8 months old. Methods.  Data collection was by structured questionnaires. The sample consisted of 248 first‐time mothers who completed the questionnaires when their child was 8 months old. The data were analysed using stepwise regression analysis. Results.  According to the multivariate analysis, nine predictors remained in the model to explain maternal competence. The more balanced the mother's state of mind, the better she felt about succeeding in child care, and the more easy going the child was, the greater was the mother's competence. The more the mother felt isolation from society, the less was her maternal competence. Younger and healthier mothers, and those who readily accepted their child showed better competence. Also, if the mother still breast‐fed her child, the more concrete support she received from the support network, the better was her maternal competence. Conclusion.  The findings suggest important factors that contribute to the maternal competence of first‐time mothers include mothers' resources, ease of caring for the child, breast‐feeding and social support received from those close to them.
The Delphi technique: myths and realities
Authors: Powell Catherine 
Published: March 2003

Aim. To outline the key concepts and principles of the Delphi technique. Methods. Reference is made to a selection of studies that illustrate a variety of methodological interpretations. Drawing on Heshusius's concept of ‘goodness criteria’, particular emphasis is given to the question of scientific merit and means of evaluation. Conclusion. Although the technique should be used with caution, it appears to be an established method of harnessing the opinions of an often diverse group of experts on practice‐related problems.
Host‐specificity of folivorous insects in a moist tropical forest
Authors: BARONE JOHN A. 
Published: March 2003

1.  To assess the degree of herbivore host‐specificity in the moist tropical forest on Barro Colourado Island, Panama, I conducted an extensive series of feeding trials on the common insect herbivores from 10 tree species. 2.  The herbivores were offered leaves from both congeneric and confamilial plant species to their known host species, as well as leaves from the most abundant tree species in the forest. 3.  The amount of damage caused by these herbivores to young, expanding leaves was also measured on nine of the tree species. 4.  Of 46 herbivores species (seven Coleoptera, one Orthoptera, 38 Lepidoptera), 26% were specialized to a single plant species, 22% were limited to feeding on a single genus and 37% were able to feed on several genera within a single family. The remaining 15% were generalists, able to feed from several different plant families. 5.  The causes of leaf damage varied extensively across the tree species. On average, specialist herbivores caused 58% of the damage to young leaves, generalists herbivores 8% and fungal pathogens 34%. For four of the tree species, pathogens were the most important cause of leaf damage. 6.  In this forest, most chewing herbivores appear to have fairly narrow diets, and these specialists are responsible for most of the insect herbivory.