bluuebunny/crossref_metadata_2025_split huggingface dataset:
Space and place in the construction and performance of gendered nursing identities
Authors: Halford Susan , Leonard Pauline 
Published: December 2004

Background and aims.  This paper draws on recent research conducted in two contrasting NHS hospitals: one a large District General, the other a small Community hospital; to look at hospitals as organizational spaces. This includes both the physical environment as well as how these spaces are inhabited and used. This paper aims to explore the ways in which hospital spaces impact on the working lives of nurses. Methods.  The research employed two main methods. Two phases of round the clock non‐participant observation were carried out within each hospital, one at the beginning of the research period and one at the end. This generated thick description of the diversity of spaces, as well as individuals' use of space. In addition, more than 50 in‐depth unstructured interviews were conducted with both nurses and doctors. Findings.
Three aspects of the relationship between nurse and hospital spaces are considered. First, the degree of
access that nurses have to the different hospital spaces is limited, and many are confined to the wards in which they work. The high proportion of female nurses working on wards means that there are marked gender differences in access to hospital spaces. There are also marked professional differences when nurses are compared to doctors who have much greater freedom to roam and there are differences in the amount of private space allocated to nurses and doctors. Second, styles of bodily movement in space are also highly differentiated by profession and gender. Third, different spaces have very different meanings attached to them, and this has a strong impact on styles of performance and identity. Attention to space thus offers original insights to nurses working conditions as well as to inter‐professional relations.
How Japanese nurses provide care: a practice based on continuously knowing the patient
Authors: Takemura Yukie , Kanda Katsuya 
Published: December 2004

Aim. Criticisms of the nursing process as a problem‐solving approach have emerged recently. This study aimed to identify and describe a way of nursing based on the clinical practice of selected nurses in Japan. Methods. Data were collected using semi‐structured interviews and observations at one 300‐bed Japanese hospital in 1999. The purposive sample consisted of 24 female nurses. Data analysis occurred simultaneously with data collection, and questioning and constant comparison were used for data analysis. Codes were clustered into categories and relationships among these were identified. In the final stage of the analysis, two group interviews with participants were carried out to enhance credibility. Findings. This study identified a Japanese way of nursing intended to help patients explore and realize meanings and values of their experiences with illness. When nurses first contacted a patient, they quickly formed a patient image, but altered it each time they obtained new patient information. A patient image consisted of the patient's subjective world (the patient's perspective) and the holistic patient (nurses' perspectives of the patient). The nurses sometimes pursued strategies to know the patient's subjective world. The target, direction, conditions and ways of nursing care were decided based on continuously knowing the patient. The nurses related their knowledge and thoughts to the patient, and by talking with the patient promoted the patient's consideration and participation, and empowered the patient. Nurses continued attending to patients even when they could not provide specific nursing interventions. Conclusions. Knowing the patient was found to be especially important in determining nursing care. The model described in this study does not contradict the nursing process as a systematic approach to problem‐solving. Rather, it has some alternatives that might be useful in providing individual care in Japan.
Family and community support to adolescent mothers in Swaziland
Authors: Mngadi Patricia Thuli , Zwane Isabel Thembi , Ahlberg Beth Maina , Ransjö‐Arvidson Anna‐Berit 
Published: December 2004

Background.  Early pregnancy and unplanned childbirth have far‐reaching physical, psychological and social consequences to the adolescent girl and her offspring and is therefore a public health problem for concern. At Mbabane Government Hospital 25% of the deliveries are by women aged 10–19 years. Little has been documented about family and community support for adolescent mothers in Swaziland.Aim.  The aim of this study was to generate more systematic data on support to adolescent mothers and their newborns during the early postpartum period by families, communities and health professionals.Methods.  Thirty‐one adolescent mothers were recruited from Mbabane Obstetric Unit after childbirth and were visited in their homes 7 days after delivery and interviewed about the family, community and health professional support experienced for themselves and their newborns. A semi‐structured interview guide was used to obtain both quantitative and qualitative data.Findings.  Support from families, community and health professionals were generally poor, and pregnancies among adolescents were unplanned. There was poor or no communication, and information from parents and the community on sexuality and reproductive health had been grossly lacking. Peers were the primary source of information about sexuality and reproduction. Communities did not offer services aimed at providing adolescents with information and skills regarding safe sexual behaviour.Conclusions.  Adolescents need contraceptive counselling and services in order to prevent pregnancies at a young age. Communication among parents and their daughters needs to be encouraged in order to monitor postpartum care and also to ensure continuity of maternity care.
Cross‐cultural psychometric testing of the Care Dependency Scale with data
Authors: Dijkstra Ate , Coleman Mick , Tomas Concepcion , Välimäki Maritta , Dassen Theo 
Published: December 2004

Background.  The importance of the present study lies in addressing whether it is justified to compare the care dependency status of older patients from different settings and cultures using the same instrument.Aim.  The aim of this international study was to compare the psychometric properties of the Care Dependency Scale (CDS) by analysing data gathered in Finland, Spain and the United Kingdom (UK).Method.  The Finnish, Spanish and UK research instruments were translations of the original Dutch CDS. Psychometric evaluations of this were carried out for each country separately as well as for the three countries combined, based on a convenience sample of 378 older patients.Results.  High alpha coefficients between 0·94 and 0·97 were obtained. Subsequent test–retest and interrater reliability revealed moderate to almost perfect kappa values.Conclusion.  One of the main outcomes of the international comparison was that the findings between the three countries showed more similarities than differences in psychometric assessment, indicating that the CDS can be used for care dependency assessment in different countries.
Organization of nursing care and stressful work characteristics
Authors: Mäkinen Arja , Kivimäki Mika , Elovainio Marko , Virtanen Marianna 
Published: December 2004

Background.Occupational stress is assumed to arise from social arrangements that are partially determined by the modes of organization of work. However, there is little systematic research on the extent to which modes of organizing nursing work are related to stressful characteristics of work.Objectives.This study explored the relationship between modes of organizing nursing and stress.Methods.Survey responses on modes of organization of nursing were collected from 27 ward sisters and those on stressful work characteristics from 568 nurses working in 27 wards with different nursing modes.Results.Four different nursing modes (primary, modular, team and functional nursing) were not consistently associated with stress. Statistically significant associations involved only certain features of these modes and specific components of stress. After the effects of demographic and ward characteristics were controlled for, hierarchical regression analyses showed that opportunity to write nursing notes decreased the likelihood of nurses’ stress because of problems in interpersonal relationships. Writing nursing notes is common in patient‐focused nursing modes (primary and modular nursing). Other features of nursing modes were not associated with stress.Discussion.In general, nursing mode is not associated with stressful job characteristics. However, certain aspects of patient‐focused nursing reduce the likelihood of interpersonal problems among staff.
The description and evaluation of a longitudinal pilot study of a smoking relapse/reduction intervention for perinatal women
Authors: Chalmers Karen , Gupton Annette , Katz Alan , Hack Tom , Hildes‐Ripstein Elske , Brown Judy , McMillan Diana , Labossiere Diane , Mackay Maria , Pickerl Cathie , Savard‐Preston Yvette , Vincent Jo‐Anne St , Morris Heather M. , Cann Beverley 
Published: December 2004

Background.  Up to 70% of women who quit smoking while pregnant will relapse during the first postnatal year. In this study, a community‐based, ecological approach guided the development and implementation of a smoking cessation intervention for perinatal women.Aims.  The aims of this pilot project were to: (1) develop and implement a community‐based intervention to assist women to stop smoking or prevent smoking relapse during the pre‐ and postnatal periods, (2) provide feedback on participants’ perceptions of the helpfulness of the intervention, (3) compare perceptions of the helpfulness of the intervention between women who received the intervention during the prenatal vs. postnatal periods, and (4) identify additional components of the intervention which need to be included in future research.Design/methods.  Using a participative process and a detailed review of the literature, researchers, health care professionals and women (pregnant or postnatal) developed a multifaceted intervention. The intervention included four core components, which all women received: home visit by the intervention nurse, follow‐up telephone call(s), resource package, and letter of congratulations. Additional optional components included: telephone help line, support groups, referrals and other services. Forty‐two women who were pregnant or had recently delivered participated. Descriptive and evaluation data were collected from participants using questionnaires and telephone interviews. The research was approved by the university Research Ethics Board.Findings.  Participants found the core components of the intervention to be helpful in their smoking cessation goals, particularly the home visit and resource material. The support groups and smoking help line were not used. There were no differences in how helpful the components of the intervention were perceived to be between women who received it in the prenatal or postnatal periods.Conclusions.  Future research is needed to evaluate the effectiveness of the intervention.
The effectiveness of public health nursing: the problems and solutions in carrying out a review of systematic reviews
Authors: Elliott Lawrie , Crombie Iain K. , Irvine Linda , Cantrell Jane , Taylor Julie 
Published: December 2004

Background.  In 1999 the Scottish Office, United Kingdom, intimated that the Chief Nursing Officer would undertake a policy review of nurses’ contribution to improving the public's health. The importance of reviewing the scientific literature on the effectiveness of public health nursing was recognized as a crucial part of the policy review. A final report was expected within a 6‐month period. The reason for the short time period was to fit the policy‐making schedule. This paper discusses our literature review for this work.Aims.  The aim was to conduct a review of the international scientific literature that gave the greatest coverage of the role and potential role of nurses in improving the public's health in relation to 14 major health topics. This paper describes the methods used, outlines the rationale underpinning the methods, discusses the problems encountered and offers solutions to some of these problems.Methods.  The initial search for relevant scientific literature revealed 709 suitable primary papers. Reviewing this number was beyond the time limit set by the funding organization. Therefore, a decision was made to concentrate on the evidence contained in systematic reviews. Reviewing systematic reviews raises a number of methodological problems to which there are often no predetermined solutions, such as ensuring that important interventions are included, assessing the relevance and quality of the reviews, and grading the strength of the evidence.Discussion.  Reviewing systematic reviews provides the scope to increase the number of topics that might be covered. However, it is possible that a number of interventions may be missed, particularly those that are not subject to review or those assessed using qualitative techniques. The definition of public health nursing used in the present study was also restrictive, and could be widened to include community interventions. Finally, assessing the quality of reviews and grading the evidence proved difficult and there is lack of consensus on how these tasks should be achieved. Nevertheless, the review presented policy makers with accessible information on a large number of relevant international studies.
Teamworking in nursing homes
Authors: Wicke Dorothy , Coppin Richard , Payne Sheila 
Published: December 2004

Background.  Nursing homes have an important role in the care of frail older people, but concerns have been raised about the quality of care. High standards of care appear to be facilitated when nurses work in effective teams. Greater understanding of teamworking in nursing homes could have implications for training and policy‐making.Aim.  The aim of the study was to explore the experiences and perceptions of teamworking with qualified nurses working in nursing homes.Method.  This was a small, exploratory focus group study. The sample was 12 qualified nurses working in nursing homes in the south of England. Transcriptions of the focus groups were coded by the research team and agreement was achieved by discussion.Findings.  Teams described were constructed in ‘vertical’, hierarchical terms rather than as ‘flat’, collaborative structures. The achievement of good teamworking was hindered by inadequate communication, particularly as many staff worked part‐time and on shifts. Management was perceived as remote, and lines of authority were ambiguous and unfocused.Conclusions.  This group of nurses were aware of the difficulties of working in a hierarchical, profit‐making culture. Individually, they tried to provide good quality care for patients and aspired to teamworking, but seldom succeeded to their satisfaction. There may be considerable potential to improve the working lives of staff and quality of patient care by effective teamworking. However, significant barriers, particularly concerning organizational culture, need to be overcome.
Pain assessment in intellectually disabled people: non‐verbal indicators
Authors: Zwakhalen Sandra M.G. , Van Dongen Katinka A.J. , Hamers Jan P.H. , Abu‐Saad Huda Huijer 
Published: December 2004

Background. Although important progress has been made during the past decade, research on pain in people with intellectual disabilities is still scarce. Pain assessment in people with intellectual disabilities is a frequent and difficult problem, especially for nurses working with people with intellectual disabilities on a daily basis. Gathering more information about pain in people with intellectual disabilities is of major importance and relevance for nursing, and adds to the developing body of knowledge.Objective. To investigate the nature and relative importance of non‐verbal indicators used by nurses to assess pain in people with a severe or profound intellectual disability.Methods. A questionnaire consisting of 158 indicators of pain was used. A total of 135 nurses from nine institutions specializing in the care of people with intellectual disability were asked to rate each indicator on a scale of 1–10 to show which non‐verbal expressions they considered important in diagnosing pain.Results. A total of 109 nurses responded. All 158 indicators were mentioned as being important to indicate pain. All except four had a range of 9. Seven (moaning during manipulation, crying during manipulation, painful facial expression during manipulation, swelling, screaming during manipulation, not using (affected) body part, and moving the body in a specific way of behaving) were reported as ‘very important’ by more than 50% of nurses. The lowest score (median 5·5; minimum 1, maximum 10) was given to the indicator ‘waving arm movements’. The pain of people with severe intellectual disability appeared to be assessed differently from that of people with profound intellectual disability. Indicators belonging to the ‘physiological’ category scored relatively higher in the group of nurses specializing in profound disability. In contrast, indicators belonging to the ‘social‐emotional’ category were scored relatively higher by nurses specializing in severe disability.Conclusion. Nurses used a wide range of indicators to assess pain in people with intellectual disability. Functional abilities and level of disability seem to influence the indicators used.
Use of physical restraints with cognitively impaired nursing home residents
Authors: Hamers Jan P.H. , Gulpers Math J.M. , Strik Willem 
Published: December 2004

Aim.  The aim of the study was to examine the prevalence of physical restraint use in cognitively impaired nursing home residents, the manner in which restraints are used, reasons for using them, and relationships between residents’ characteristics and use of physical restraints.Methods.  A point prevalence study was conducted on the use of physical restraints among all residents cared for in two Dutch nursing homes and one nursing home unit (n = 265). Data about the nursing home residents and the use of restraints were collected by means of a questionnaire, which was filled in by the nurses. The response rate was 98%. The mean age of residents was 81 years (sd = 8·6), 74% of whom were female.Results.  One or more restraints were used with 49% of the residents. The most frequently used physical restraints were bed rails, a waist belt, and a chair with a table. In almost all situations (90%), residents were continuously restrained and restraints were used for longer than 3 months. The most common reason (90%) for use of restraints was to prevent falls. Logistic regression analysis revealed that use of restraints was highly associated with poor mobility, care dependency and risk of falling in the opinion of nursing staff.Conclusions.  The results of this study are comparable with those of other studies. However, since recent studies have reported that physical restraints are inadequate to prevent falls, recommendations are made to re‐evaluate critically the use of restraints and to conduct future research into a responsible and safe way of decreasing the use of physical restraints.
Nurses’ views of using computerized decision support software in NHS Direct
Authors: O'Cathain Alicia , Sampson Fiona C. , Munro James F. , Thomas Kate J. , Nicholl Jon P. 
Published: December 2004

Background.  Nurses working in NHS Direct, the 24‐hour telephone advice line in England, use computerized decision support software to recommend to callers the most appropriate service to contact, or to advise on self‐care.Aims.  To explore nurses’ views of their roles and the computerized decision support software in NHS Direct.Methods.  Qualitative analysis of semi‐structured interviews with 24 NHS Direct nurses in 12 sites.Findings.  Nurses described both the software and themselves as essential to the clinical decision‐making process. The software acted as safety net, provider of consistency, and provider of script, and was relied upon more when nurses did not have clinical knowledge relevant to the call. The nurse handled problems not covered by the software, probed patients for the appropriate information to enter into the software, and interpreted software recommendations in the light of contextual information which the software was unable to use. Nurses described a dual process of decision‐making, with the nurse as active decision maker looking for consensus with the software recommendation and ready to override recommendations made by the software if necessary. However, nurses’ accounts of the software as a guide, prompt or support did not fully acknowledge the power of the software, which they are required to use, and the recommendation of which they are required to follow under some management policies. Over time, the influence of nurse and software merges as nurses internalize the software script as their own knowledge, and navigate the software to produce recommendations that they feel are most appropriate.Conclusions.  The nurse and the software have distinct roles in NHS Direct, although the effect of each on the clinical decision‐making process may be difficult to determine in practice.
Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self‐regulated learning theory
Authors: Kuiper Ruth Anne , Pesut Daniel J. 
Published: December 2004

Background.  Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills. While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development. Self‐regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts.Aims.  This paper reports on a study to explore the impact of self‐regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills.Methods.  Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases. The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self‐regulation and thinking.Findings.  Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition. This skill acquisition is best accomplished through teaching–learning attention to self‐regulation learning theory. A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self‐regulated learning theory. It is apparent that single‐minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development. Likewise, single‐minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development. While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self‐regulated learning prompts.Conclusions.  Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self‐regulated learning strategies. The self‐regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts.