bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the correspondence of breastfeeding and bottle‐feeding couples’ infant feeding attitudes
Authors: Shepherd Chew Kim , Power Kevin G. , Carter Harden 
Published: March 2003

Examining the correspondence of breastfeeding and bottle‐feeding couples’ infant feeding attitudes This report focuses on the comparison of infant feeding attitudes within breastfeeding (n = 126) and bottle‐feeding (n = 101) couples and their socio‐demographic details. The findings from this study reinforce the view that socio‐demographic factors are associated with the mothers’ choice of feeding method. However, this study highlights the influence of maternal and of paternal knowledge and attitudes which distinguish between breastfeeding and bottle‐feeding couples. Fathers of bottle‐feeding babies were found to have limited knowledge of health benefits of breastfeeding to both mothers and infants. However, bottle‐feeding mothers, when compared with their partners, were more supportive towards bottle feeding and less negative towards breastfeeding. Fathers of breastfeeding babies, compared with their partners were found to be less aware of the benefits of breastfeeding. Furthermore, breastfeeding mothers when compared with their partners were more supportive towards breastfeeding. Fathers of both bottle and breast feeding babies were also found to be more embarrassed than their partners about mothers in general breastfeeding in front of nonfamily members. It seems that bottle‐feeding mothers and all fathers could be better prepared in many aspects of breastfeeding by the nursing professions to allay the many misconceptions and the social embarrassment associated with breastfeeding, by providing appropriate information and support.
Clinical problem‐solving in nursing: insights from the literature
Authors: Taylor Catherine 
Published: March 2003

Clinical problem‐solving in nursing: insights from the literatureThis paper reviews the literature surrounding the research on how individuals solve problems. The purpose of the review is to heighten awareness amongst nurses in general, and nurse academics in particular about the theories developed, approaches taken and conclusions reached on how clinicians problem‐solve. The nursing process, which is heavily used and frequently described as a problem‐solving approach to nursing care, requires a deductive reasoning process which is not the problem‐solving process in use during care‐giving activities. More knowledge is required on what process is in place as we develop as a profession. The literature highlights the complexities involved in attempting to uncover thinking processes. The main research approaches to discovering problem‐solving strategies in the past three decades have been from a cognitive perspective, with two main theories, decision‐theory and information processing‐theory, underpinning the majority of studies conducted. None of the research approaches used to date has resulted in the identification of a general model of problem‐solving that is consistent across tasks or disciplines. However, early hypothesis activation with subsequent testing of the hypothesis seems to be consistent in clinicians across disciplines.
Situated learning in the practice placement
Authors: Cope Peter , Cuthbertson Philip , Stoddart Bernadette 
Published: March 2003

Situated learning in the practice placement Nurses who had just completed their training in Scotland were interviewed with regard to their experiences on placements. The nurses had either completed a traditional training course or came from the first cohort of the Project 2000 diploma level course. The interviews focused on the way in which the student nurses had learned in their practice placements. The results suggest that the placement is a complex social and cognitive experience in which there are elements of situated learning. Acceptance into the community of practice is important but this can be separated, conceptually at least, into a social acceptance which might be extended to any student and a professional acceptance which relies on the display of appropriate competence. The nurses described the way in which their mentors had interacted with them in terms which suggested that cognitive apprenticeship strategies had been used to further their learning in practice. It is concluded that, in view of the central importance of the placement for training nurses, explicit use of mentoring techniques derived from situated learning and cognitive apprenticeship might be beneficial.
Disposition towards critical thinking: a study of Chinese undergraduate nursing students
Authors: Ip Wan Yim , Lee Diana T.F. , Lee Iris F.K. , Chau Janita P.C. , Wootton Yvonne S.Y. , Chang Anne M. 
Published: March 2003

Disposition towards critical thinking: a study of Chinese undergraduate nursing students The purpose of this study was to explore empirically whether undergraduate nursing students at a selected university in Hong Kong display a disposition towards critical thinking. The California Critical Thinking Dispositions Inventory (CCTDI) was used to measure the key theoretical aspects of the overall dispositional dimension of critical thinking. A cross‐sectional descriptive design was used to examine 122 Chinese students who were completing their 1st, 2nd and 3rd year of a university baccalaureate nursing programme. In the majority of sub‐scales of CCTDI, students showed a negative disposition towards critical thinking. A one‐way ANOVA indicated that year 3 students scored significantly lower than their junior counterparts (P < 0·001). Pearson product moment correlation coefficient yielded a significant positive relationship between critical thinking dispositions and term grade point average (P < 0·05). Consistent with the findings of western studies, the students scored lowest on the truth‐seeking sub‐scale and highest on the inquisitiveness. Discussion of the findings with regard to nursing education, curriculum and research is delineated.
Factors affecting the administration of analgesia to patients following repair of a fractured hip
Authors: Willson Heather 
Published: March 2003

Factors affecting the administration of analgesia to patients following repair of a fractured hip Fracture of the neck of femur, or hip, has become common in older females and the resulting pain is often a factor in inhibiting early mobilization following surgical repair. Since the administration of analgesia is dependant upon decision‐making of the nurse, this study concentrated on what influences nurses in the administration of analgesia to patients following surgical repair of a fractured hip. A review of the literature identifies the main influencing factors as nurses’ lack of knowledge and the drug prescription, and suggests that education is the key enabler. However, much of this research is limited to controlled situations outside the clinical setting with a focus on the internal processes of decision‐making. This ethnographic multiple‐case study aimed to analyse factors which influence nurses’ decision‐making in the clinical setting and define behaviours in context. Following periods of participant observation and observation of documentation, semi‐structured interviews were conducted to explore further the rationale behind nurses’ decisions. Factors found to influence decision‐making were: time, organization of care, influence of shift worked, impact of the multidisciplinary team (MDT), concerns over the use of opioid analgesia, and information giving and collection. These influences were found to be dependant on location (ward), and shift, with the factor of time providing a tension between all influences. The study findings suggest that education alone will not improve the administration of analgesia. It recommends that the voice of patients is heard more clearly, that the administration of analgesia is separated from the routine drug round, that attention is paid to how decision‐making by nurses is supported in clinical settings, and that education be organized on a multidisciplinary basis. In addition, further research should be carried out in the clinical setting.
Interactions between nurses during handovers in elderly care
Authors: Payne Sheila , Hardey Michael , Coleman Peter 
Published: March 2003

Interactions between nurses during handovers in elderly careThis paper explores the role of nursing interaction within the context of handovers and seeks to identify the clinical discourses used by registered nurses, student nurses and care assistants in acute elderly care wards, to determine their influence on the delivery of patient care. The study design involved an ethnographic approach to data collection which involved: observations of formal nursing end of shift reports (23 handovers) and informal interactions between nurses (146 hours); interviews (n=34) with registered nurses, student nurses and care assistants; and analysis of written nursing records. A grounded theory analysis was undertaken. Data were collected from five acute elderly care wards at a district general hospital in the south of England. Results from this empirical study indicate that handovers were formulaic, partial, cryptic, given at high speed, used abbreviations and jargon, required socialized knowledge to interpret, prioritized biomedical accounts and emphasized physical aspects of care. Patients’ resuscitation status was highly salient to all grades of nurse. Doing ‘paperwork’ was accorded less status and priority than patient care, and was regarded as excessively time consuming. Despite this, there was evidence of repetition in nursing documents. Moreover, the delivery of clinical nursing appeared to be guided by personal records rather than formal records.
Practical considerations in case study research: the relationship between methodology and process
Authors: McDonnell Ann , Jones Myfanwy Lloyd , Read Susan 
Published: March 2003

Practical considerations in case study research: the relationship between methodology and process This paper explores the extent to which the design of a research study is influenced by pragmatic as well as theoretical considerations by describing the authors’ experience of conducting multiple case studies in the context of a policy‐orientated research project. The case studies in question formed part of a collaborative project exploring the development of innovative roles in nursing and the professions allied to medicine. The researchers adopted Yin’s approach to the conduct of multiple case studies to explore issues relating to the effectiveness of new roles, their resource implications and educational issues surrounding their development. They address the fact that methodological decisions have practical implications and also explore the effects of practical and ethical issues on research design. Three purposively selected acute National Health Service Trust hospitals in England formed the case study sites for the work recorded in this paper. In each Trust, three nursing roles were selected, making nine cases for study. A variety of data collection strategies were used including semi‐structured interviews with post‐holders and other stakeholders (n=51), non‐participant observation of meetings, collection of audit, financial and statistical data and review of relevant documentation. This paper describes some of the dilemmas which arose during the course of the study, the rationale for methodological decisions taken to resolve these dilemmas and the steps taken to enhance rigour. In particular, the authors discuss the problems associated with obtaining informed consent in the context of qualitative research and with member validation of transcripts in a context where confidentiality was crucial. The decision to present findings thematically rather than as individual cases is justified both in terms of the nature and purpose of the research and in relation to the particular importance of anonymity and confidentiality in this study. Finally, the degree of reciprocity between researcher and researched is discussed.
Setting the context for research: exploring the philosophy and environment of a cancer clinical trials unit
Authors: Cox Karen 
Published: March 2003

Setting the context for research: exploring the philosophy and environment of a cancer clinical trials unit This paper describes a process of context setting that was undertaken prior to designing a study to assess the psychosocial impact of participation in phase I and II anticancer drug trials from the patient’s perspective. The paper outlines how and why this context setting was undertaken and highlights important aspects of the culture and organization of cancer clinical trials that may influence patients’ experiences in trial recruitment and participation. In this way, the context setting proved to be an invaluable tool for providing an orientation to the environment where patients received their care and treatment as well as identifying issues that would need to be taken into consideration later in the research study design.
Fatigue in persons with renal failure who require maintenance haemodialysis
Authors: McCann Kathleen , Boore Jennifer R.P. 
Published: March 2003

Fatigue in persons with renal failure who require maintenance haemodialysis Fatigue is a highly prevalent symptom experienced by persons who live with chronic illness, including those with renal failure who require maintenance haemodialysis. Fatigue, however, is a non‐specific and invisible symptom and is a phenomenon that is poorly understood by health care professionals. This study examined the symptom of fatigue as experienced by a group of 39 adult haemodialysis patients. The theory of unpleasant symptoms formed the conceptual framework for the study. A descriptive correlational design was utilized to examine fatigue from an inductive approach, considering relevant physiological, psychological and situational variables based on a review of the literature. Data were collected using a structured self‐report questionnaire and biochemical data from retrospective monthly blood tests. The results of the study indicated that high levels of fatigue are experienced, with correspondingly low levels of vitality, in all the areas measured – general fatigue, physical fatigue, reduced motivation, reduced activity and mental fatigue, by adult haemodialysis patients. Individual variation was noted in the dimensions of fatigue predominantly expressed. Fatigue was significantly associated with the presence of symptoms such as sleep problems, poor physical health status and depression. No associations between fatigue and the biochemical and situational variables measured were noted. Further examination of the data revealed complex relationships between the physiological and psychological factors examined. Depression was significantly associated with physical health status, sleep problems, symptoms and anxiety. Correlations were also noted between symptoms and poor physical functioning, sleep problems and depression. Based on the results, a revised version of the theory of unpleasant symptoms relating to fatigue is presented.
The health‐related quality of life in a Swedish sample of HIV‐infected persons
Authors: Eriksson Lars E. , Nordström Gun , Berglund Torsten , Sandström Eric 
Published: March 2003

The health‐related quality of life in a Swedish sample of HIV‐infected persons The purposes of the present study are (1) to assess the health‐related quality of life (HRQOL) and the subjective health status in a sample of human immunodeficiency virus (HIV)‐infected persons (2) to relate the results to different population groups and (3) to investigate the relationship of medical and demographic variables with HRQOL. A total of 72 HIV‐infected men were included. They answered the Swedish health‐related quality of life questionnaire and the health index. Demographic and medical data were obtained from the medical records. The data collection took place before entering a therapeutic HIV vaccine trial. The results showed a more negative impact on the HRQOL and subjective health status in the HIV‐positive subjects, compared with male population groups. The dimensions of emotional well‐being were most affected. When comparisons were made according to the medical and demographic variables for different subgroups within the HIV sample, differences in the physical‐dimension scales were most prominent. Symptomatic HIV infection or acquired immunodeficiency syndrome (AIDS), anti‐retroviral treatment, sick leave or disability pension, low income and basic education were associated with worse HRQOL and health status. In conclusion, it is of utmost importance to take into account, aspects of the patients’ emotional well‐being in nursing, as well as in medical care and interventions. Moreover, individualized caring programs are needed because the disruptions in HRQOL fluctuated within the HIV sample.
Evaluating educational preparation for a health education role in practice: the case of medication education
Authors: Latter Sue , Rycroft‐Malone Jo , Yerrell Paul , Shaw David 
Published: March 2003

Evaluating educational preparation for a health education role in practice: the case of medication educationCurrent health care policy and practice contexts in the UK point to the importance of nurses’ ability to make an effective contribution to educating patients about medication, as part of their role in health education and health promotion. Nurses’ potential contribution to this important activity will inevitably be dependent on knowledge and skills acquired during preregistration and postregistration programmes of education. Against this backdrop, changes in pre and postregistration nurse education in the UK in the past decade highlight the importance and timeliness of evaluating the adequacy of educational preparation for a medication role. This paper reports on the findings from an evaluation of UK educational preparation for a medication education role in practice. A case study design was used to investigate current educational preparation at three education institutions. Multiple methods of data collection at each site involved focus group discussions with lecturers and practitioners, individual interviews with key personnel, nonparticipant observation of teaching sessions, postobservation interviews with students and curriculum analysis. Findings highlighted the importance of a number of dimensions of preparation for practice of such a role: the need for sufficient taught pharmacology; opportunities for application and integration of prerequisite knowledge and skills; the importance of practice‐based learning; the need for an evidence‐based curriculum, and the importance of clarifying outcomes and competencies required for a medication education role within pre and postregistration curricula. The paper concludes with a discussion and implications of the findings.
From practice to theory: tightening the link via three fieldwork strategies
Authors: Schwartz‐Barcott Donna , Patterson Barbara J. , Lusardi Paula , Farmer Bonnie Cashin 
Published: March 2003

Background.  Theory that is directly linked with clinical experience has far greater relevance for nursing practice; however, problems continue to persist with the establishment of that linkage. The use of fieldwork as a strategy for developing and linking theory has enormous potential for enhancing the number of theories that truly fit the clinical practice realities of nursing. Traditionally, fieldwork has been conducted in contexts that are unfamiliar to the researcher. However, nurses have a wealth of clinical understanding in their areas of practice. Conduct of inquiry in a familiar practice area may facilitate identification of significant, clinically relevant concepts and expedite theory development that is closely linked to nursing practice. Aim of paper.   A two‐step fieldwork approach and three specific strategies are presented that have been found useful for developing theory that is tightly aligned with nursing practice. The strategies of theoretical selectivity, theoretical integration, and theory creation are described and an example of each presented. The strategies are an extension of the Hybrid Model of Concept Development. These strategies identify alternative paths for concept clarification and theoretical congruence through fieldwork in clinical settings. The focus of theoretical selectivity is elaboration of concept definition with selection among theories. In contrast, the focus of theoretical integration is the linking of a central concept with an existing theory or perspective in the prefieldwork phase and then using the full fieldwork to evaluate its usefulness. Lastly, the theory creation strategy emphasizes describing a phenomenon of interest, identifying influencing factors, and beginning to create relational statements. It is closest to standard inductive theory development.
Problem‐based learning in a new Canadian curriculum
Authors: Morales‐Mann Erlinda T. , Kaitell Christabel A. 
Published: March 2003

Problem‐based learning in a new Canadian curriculum Problem‐based learning (PBL) is a method of group learning that uses true‐to‐life problems as a stimulus for students to learn problem‐solving skills and acquire knowledge about the basic and clinical sciences. This article documents the design and implementation of PBL in a second year course in the new curriculum of the University of Ottawa School of Nursing’s Generic Program. The learning and teaching experiences of students and facilitators in this PBL course are described. As a way to determine students’ perception of their learning using PBL, they were asked to respond to four questions. The most frequently described thinking processes were problem solving, nursing process and group process. When asked to describe the learning they derived from PBL, as differentiated from other instructional methods, students identified group process and problem solving most often. The most frequently identified factors that influenced performance and learning in PBL were positive attitude and group effort. The factors that affected the facilitators’ performance of their role were large group size, insufficient practice of facilitator skills and PBL preparation. To enhance group process, facilitators modelled and shared roles. They fostered student motivation and development through formative evaluation. PBL produced clear benefits for students, such as increased autonomous learning, critical thinking, problem solving and communication. For facilitators, PBL was a liberation from the traditional role of ‘content expert and super consultant’.