bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of restraint in the treatment of paediatric dental patients: old and new insights
Authors: Peretz B. , Gluck G. M. 
Published: March 2003

Summary. Objective. This article reviews aspects of the restraint strategies in paediatric dentistry that have been reviewed in recent years and point out those strategies that remain controversial as well as questionable.Methods. Studies that evaluated demographic and cultural factors that influence dentists’ use of restraint, discussion of the rationale behind the use of restraint, the role of parents, informed consent, use of restraints at the undergraduate and at the postgraduate level, and some ethical questions were selected.Conclusions. Practice location, caries prevalence, and the educational backgrounds of the dentist played a role in the selection of behavioural strategies. Use of these techniques varied depending on the age of the dentist and the dental school from which the dentist had graduated. Parents are one leg of the child/dentist/parent triangle and therefore have a role to play in the determination of treatment strategies. Dentists must select techniques that help to instil a positive dental attitude in the child by performing treatment effectively and efficiently. Dentists must inform parents of all aspects of the applied strategy and must have their approval.
Radiographic assessment of congenitally missing teeth in orthodontic patients
Authors: Silva Meza R. 
Published: March 2003

Summary. Objective. To estimate the prevalence of congenitally missing teeth (CMT) in patients evaluated for orthodontic care. A sample of 668 panoramic radiographs from Mexican population was reviewed from orthodontic healthy patients, 9–20 years old.Method. Statistical tests were used to compare maxillary and mandibular hypodontia in right and left quadrants between males and females.Results. Prevalence was 27% when all teeth were included, and was 2·7% when third molars were excluded. A significant difference was found between maxillary and mandibular symmetrical CMT in third maxillary molars, lateral incisors and second premolars (P < 0·001), and in mandibular third molars and central incisors (P < 0·001).Conclusions. We confirmed that occurrence of CMT in the permanent dentition of a Mexican population most often affects third molars, followed by maxillary lateral incisors and then mandibular second premolars.
An investigation into community psychiatric nurses' use of humour during client interactions
Authors: Struthers John 
Published: March 2003

An investigation into community psychiatric nurses' use of humour during client interactions Community psychiatric nurses' (CPNs') accounts of interactions with clients often reflect benefits of using humour appropriately. This is despite the use of humour as a specific therapeutic form of communication generally being ignored during CPNs' professional development. With the growth in community care, mental health nurses are required to function more autonomously within the client's home environment, thus the contextual nature of the nurse's use of humour may have to be adjusted accordingly. How nurses makes this adjustment of their use of humour appears to be left to their own experiences. Yet inappropriate use of humour may be costly to the nurse–client relationship. The research described in this paper used a descriptive qualitative methodology to explore the perceptions of seven CPNs working in Scotland in relation to their use of humour during client interactions. As this study did not specifically access clients, ethical permission was not required from the local research and ethics committee. This did not excuse the author from recognizing ethical considerations of the subjects in relation to sharing information about being volunteers, their rights of withdrawal and the risks and benefits of the study. Confidentiality and anonymity were also maintained by the use of pseudonyms. Data collected through critical incident analysis and interviews were subjected to content analysis. Findings confirm the paradoxical nature of humour. Humour, when used appropriately, assisted the development of trust and changing the client's restrictive perceptions. Damaging effects were reported, however, if the humour was misinterpreted or perceived by the client as demeaning their experience. Although the CPNs had not received any formal education about the use of humour, recommendations centred on raising student nurses' and CPNs' awareness about their own use of humour.
Career desirability: young people’s perceptions of nursing as a career
Authors: Hemsley‐Brown Jane , Foskett Nicholas H. 
Published: March 2003

Career desirability: young people’s perceptions of nursing as a career The majority of young people make a career choice without regard for salary, and base their decision on interest and enjoyment or a desire to help people. This paper examines students’ perceptions of nursing as a career at a number of key stages in their education decision‐making, and how this information influences their subsequent career decision either to choose or to reject nursing. Factors relating to image and status are also explored and some comparisons are made between nursing and young people’s own choice of career, to highlight a number of significant issues. The findings indicate that although young people expressed admiration for the work of nurses, this was rarely matched by an envy of nurses, or a desire to become a nurse themselves.
Can nurses learn to let go? Issues arising from an intervention designed to improve patients’ involvement in their own care
Authors: Pill Roisin , Rees M.E. , Stott N.C.H. , Rollnick S.R. 
Published: March 2003

Can nurses learn to let go? Issues arising from an intervention designed to improve patients’ involvement in their own careThe aim of the paper was to explore the reasons behind a perplexing observation that an intervention designed to alter professional behaviour in general practice consultations in South Wales was poorly sustained despite initial enthusiasm among the nurses. Nurses’ baseline and continuing responses to the new approach with patients with non‐insulin dependent diabetes are described, drawing on observations and interviews with the 18 practice nurses in the 15 experimental practices.The nurses fell into two groups: those showing greater understanding of the principles underlying the approach and a more reflective attitude to their work; and those who adapted the simple technology provided to their usual consultation style. This variation was related to their perception of their role and their attitudes to diabetic care, especially the challenge posed by the ‘difficult patient’. They were noticeably less willing to allow the patient freedom to decide what to do once diabetic control was deteriorating according to biochemical measures. It is concluded that the failure of the nurses to sustain behaviour change over time stems from a basic dilemma, namely, what is the extent of my responsibility and how ought I to discharge it? There is scope for more research into professional perspectives on chronic care, the strategies they use to manage patients and to cope with their own feelings, and the implications of these strategies for patients.
Quantitative measurement of caring
Authors: Beck Cheryl Tatano 
Published: March 2003

Quantitative measurement of caring Caring is a difficult, elusive concept not only to define but also to measure. Eleven different quantitative instruments designed to measure caring are reviewed. Out of these 11 caring instruments, seven are Likert scales, two are visual analogue scales, one is a checklist, and one is a Q‐sort. For each of these instruments the following information is provided: description of the tool, such as number of items and length of time to administer; conceptual definition of caring upon which it is based; reported reliability and validity; and the instrument’s use in research studies. Comparison of these instruments revealed that different aspects of caring are measured by these tools such as caring behaviours, satisfaction with caring behaviours, ability to care, and response to caring behaviours. Some caring instruments are designed to be completed by patients only, by nurses only, or by either patients or nurses. Multiple factors need to be taken into consideration by nurse researchers in deciding which instrument to use to measure caring.
Incompatible skills and ideologies: the impediment of gender attributions on nursing research
Authors: Hicks Carolyn 
Published: March 2003

Incompatible skills and ideologies: the impediment of gender attributions on nursing research The evidence‐based care culture requires that ritualistic treatment interventions are subjected to scientific scrutiny, with the ultimate intention that clinical practice should have empirical rather than historical justification. Despite initiatives to increase research output, there is evidence for a continued research/practice rift. One explanation for this that has relevance for the present paper is the perceived conflict between the skills and ideologies associated with clinical nursing and research. More specifically, it would seem that the characteristics demanded by high quality nursing are diametrically opposed to those required by research, such that research activities may be perceived to be inappropriate within the traditional nursing role. Formal gender‐role schemata may also contribute to the theory–practice gap, insofar as nursing embodies qualities that are essentially female‐associated, while research requires attributes associated with masculinity. These conceptualizations are derived from two studies based on central trait theory, which involved participants in making assumptions about a range of qualities of hypothetical candidates for a nursing post, who were described either as a good researcher or a good clinician. The hypothetical candidates in the first study were female, but in the second were male; in both cases the participant raters were female. It is, however, conceivable that rater‐gender impacts upon assumptions of personal and professional attributes of clinical and research nurses. In order to investigate this contention, the present paper manipulated the gender of the raters, whilst replicating the previous studies in every other way. Analysis of the data using a series of 3‐way ANOVAS suggested that there were some significant effects of rater and candidate gender, as well as of clinical/research descriptors, especially in terms of ascribed kindness, compassion, ambition and success. The results are discussed in relation to gender role stereotypes and nursing research.
Professional nurse autonomy: concept analysis and application to nursing education
Authors: Wade Gail Holland 
Published: March 2003

Professional nurse autonomy: concept analysis and application to nursing education Professional nurse autonomy, an essential attribute of a discipline striving for full professional status, is often confused with personal autonomy, work autonomy or aggregate professional autonomy. Using Walker & Avant’s (1995) model for concept analysis, this paper presents an analysis of professional nurse autonomy. Professional nurse autonomy is defined as belief in the centrality of the client when making responsible discretionary decisions, both independently and interdependently, that reflect advocacy for the client. Critical attributes include caring, affiliative relationships with clients, responsible discretionary decision making, collegial interdependence, and proactive advocacy for clients. Antecedents include educational and personal qualities that promote professional nurse autonomy. Accountability is the primary consequence of professional nurse autonomy. Associated feelings of empowerment link work autonomy and professional autonomy and lead to job satisfaction, commitment to the profession, and the professionalization of nursing. A student‐centred, process‐orientated curricular design provides an environment for learning professional nurse autonomy. To support the development of professional nurse autonomy, the curriculum must emphasize knowledge development, understanding, and clinical decision making.
Experiences of violence in HIV seropositive women in the south‐eastern United States of America
Authors: Sowell Richard , Seals Brenda , Moneyham Linda , Guillory Joyce , Mizuno Yuko 
Published: March 2003

Experiences of violence in HIV seropositive women in the south‐eastern United States of AmericaWomen represent one of the fastest growing groups being diagnosed with HIV infection. Because of the circumstances under which they live, women at the highest risk for HIV infection may also be at risk for verbal, physical and sexual violence. The purpose of this study was to examine the frequency and type of violence experienced by women infected with HIV, and describe associations between reported violence, self‐esteem and sense of competence. The study used a descriptive design and was conducted in the south‐eastern United States. The sample consisted of 194 women infected with HIV. Women were primarily single, African‐Americans residing in urban areas with an annual household income of less than $10 000 per year. Participants completed face‐to‐face interviews using a structured questionnaire which included a frequency of violence scale, Rosenberg’s self‐esteem scale, and Pearlin and Schooler’s mastery scale. Approximately 15% of women reported at least one event of physical abuse and 55% at least one event of verbal abuse in the past 6 months. Verbal abuse experienced by women was the strongest net negative predictor of self‐esteem and competence. These findings indicate that HIV‐infected women are at risk for experiencing physical abuse and verbal abuse, and the experience of violence is associated with lower self‐esteem and competence.
Violence in mental health care: the experiences of mental health nurses and psychiatrists
Authors: Nolan Peter , Dallender Janie , Soares Joaquim , Thomsen Sarah , Arnetz Bengt 
Published: March 2003

Violence in mental health care: the experiences of mental health nurses and psychiatrists Violence against mental health service personnel is a serious workplace problem and one that appears to be increasing. This study aimed to ascertain the extent and nature of violence against mental health nurses and psychiatrists, and to identify what support, if any, they received following exposure to violence. Mental health staff working within five West Midlands Trusts in the United Kingdom were surveyed using a postal questionnaire to investigate the extent and nature of violence they encountered in their daily work. There was an overall response rate of 47%, which included a response rate for psychiatrists of 60% (n=74) and for mental health nurses of 45% (n=301). Though both groups experienced violence at work, nurses were found: to have been exposed to violence significantly more during their career; to have been a victim of violence within the previous 12 months of the survey; and to have suffered a violent incident involving physical contact. Whilst a higher proportion of nurses than psychiatrists received some support following a violent incident, a large proportion of both groups did not receive any, although most felt in need of it. The implications of this study for training and management are discussed.
Intensified primary cancer care: a randomized study of home care nurse contacts
Authors: Johansson Birgitta , Berglund Gunilla , Glimelius Bengt , Holmberg Lars , Sjödén Per‐Olow 
Published: March 2003

Intensified primary cancer care: a randomized study of home care nurse contacts Newly diagnosed cancer patients (n=527) were randomised to intensified primary care or a control group. Intensified primary care comprised routines to improve general practitioners’ and home care nurses’ possibilities to support and monitor patients, i.e. increased information from specialist care, education and supervision in cancer care. The aims of this paper are to evaluate the effects of intensified primary care on cancer patients’ home care nurse contacts, and to study if patients’ use of home care services 6 months after diagnosis can be predicted. The intervention resulted in a marked increase of follow‐up contacts. About 90% of intensified primary care patients reported such contacts, compared to 26% of control patients. The results indicate that standard care does not routinely include follow‐up contacts, not even for the oldest (80+ years) or those with advanced disease. Only 27% and 36% of these groups of control patients reported follow‐ups. Logistic regression analysis identified intensified primary care as the strongest predictor for reporting a continuing contact 6 months after diagnosis. Intensified primary care patients were 14 times more likely than controls to report a such contact. The strongest predictor of a continuing contact in the intensified primary care group was high age. Patients with advanced disease were more likely than patients with non‐advanced disease to report a continuing contact, and living in a rural district was positively associated with reporting a contact. A majority of the patients (70%) assessed the time for the first contact as the ‘right time’ and estimated that the nurse gave expected support to a very large or large extent (67%). The results suggest that routines like those implemented through intensified primary care may be an effective strategy to increase the accessibility and continuity of care, especially for elderly people and for patients with a need for long‐term contacts.
Initiating research with doubly vulnerable populations
Authors: Moore Linda Weaver , Miller Margaret 
Published: March 2003

Initiating research with doubly vulnerable populations Some research questions can only be answered by members of a vulnerable group. Frequently members of these groups are doubly vulnerable as they experience more than one factor that diminishes their autonomy. Initiating research with doubly vulnerable persons presents unique and often difficult challenges. Because of these challenges, many researchers purposefully exclude doubly vulnerable groups from research endeavours. Thus, the health care needs and concerns of individuals considered doubly vulnerable are often not addressed in the scientific literature. This article presents two challenges frequently encountered when initiating research with doubly vulnerable populations: resolving pre‐investigation issues and gaining access to vulnerable populations. Ethically sound strategies for confronting these challenges are discussed. Researchers’ experiences with doubly vulnerable populations are also incorporated. Only when doubly vulnerable groups receive the appropriate research attention are the standards of their care and their quality of life enhanced.
Practitioner‐centred research: an evaluation of the implementation of the bedside hand‐over
Authors: Webster Jonathan 
Published: March 2003

Practitioner‐centred research: an evaluation of the implementation of the bedside hand‐over A practitioner‐based enquiry (PBE) or ‘practitioner‐centred‐research’ ( Rolfe 1998), was undertaken using action research to examine the concept of ‘nursing hand‐over’. The move away from the traditional style of hand‐over (which involved either one or two people verbally relaying ‘all’ information to those nurses coming onto duty) to a hand‐over that is based at the bedside with the patient and involves the patient and only those nurses accountable for that individual’s care, was the focus of the study reported here. The study was carried out on a medical ward for people aged 65 and over and aimed to identify whether after 6 months (post‐implementation of the new style of hand‐over) all staff felt that key issues identified in a 3‐month evaluation based primarily on quantitive data collection, had been addressed by using an action research methodology. Although reference will be made to the 3‐month evaluation as it formed a vital part of the process of assessing the change to practice, the focus of the analysis will be the evaluation that took place after 6 months. The key objective was to assess the effectiveness of the planned implementation of hand‐over at the bedside and the subsequent change to current nursing practice.
‘Having a say’: negotiation in fourth‐ generation evaluation
Authors: Koch Tina 
Published: March 2003

‘Having a say’: negotiation in fourth‐generation evaluation In this paper, research guided by the principles of fourth‐generation evaluation, which has negotiation as its centre, will be scrutinized. The role of stakeholders will be discussed with reference to negotiation issues. Throughout this discussion, observations will be based on the actual process of conducting three project evaluations in this tradition. Attention will be drawn to the consequences of negotiating at an uneven table.
Are patients who self‐administer their medicines in hospital more satisfied with their care?
Authors: Deeks Philip A. , Byatt Kay 
Published: March 2003

Are patients who self‐administer their medicines in hospital more satisfied with their care? Patient self‐administration of medicines in hospital prior to discharge is being seen increasingly as good practice by health professionals. Previous studies have looked for increased compliance and knowledge or asked whether patients liked self‐administration and have not clearly demonstrated the benefits. This study surveys patients’ views on self‐administration and on their care. In particular it looks at the discharge process and the way information was given to the patient on discharge. Questionnaires were distributed to 309 patients being discharged from general medical wards of a teaching hospital in Central England to be completed by the patients after their discharge from hospital. Of these, 202 were returned to a separate university department for analysis. Although this study has been undertaken on only two wards, the survey has potential for large scale use. Findings which were consistent with previous work were that a great majority of patients who had self‐administered their medicines would like to again, whilst those who had not had that opportunity were less likely to choose to self‐administer in the future. However, this study found that a majority of patients under 60‐years‐old would choose to self‐administer their medicines in hospital even if they had not been given the opportunity to do so recently. It was also found that patients who had administered their own medicines in hospital were more likely to report their overall care as excellent and were more satisfied with the discharge process than patients who had not.