bluuebunny/crossref_metadata_2025_split huggingface dataset:
Denture satisfaction and clinical performance in a paediatric population
Authors: Rodd H.D. , Atkin J.M. 
Published: March 2003

Objectives. The objectives of this study were to investigate the clinical performance of partial upper dentures in children and to assess reported denture satisfaction in this young population. Design. This was a retrospective study using patients’ dental records in conjunction with a postal questionnaire. Setting. The Paediatric Dentistry Clinic, School of Clinical Dentistry, Sheffield. Sample and methods. Fifty‐eight children (aged 7–17 years) who had been provided with a partial upper denture to replace one or more missing permanent incisors were included in the study. The patients’ dental records were examined for the following details: tooth type missing, presence of retained incisor roots, aetiology of tooth absence, age at which the denture was first provided, total time period dentures had been worn, and frequency and type of any denture repairs or replacements. Next a short questionnaire was sent to each child, which sought an evaluation of several parameters of denture satisfaction including: overall attitude towards wearing a denture, denture appearance, ease of eating, comfort and perceived degree of teasing from peers. Visual analogue scales (VAS) were employed to provide a graded response. Results. 70·7% of subjects had a single missing incisor and trauma was the most common cause of tooth loss (77·3%). The mean age at which patients started wearing a denture was 11·6 years and the mean length of time dentures had been worn, at the time of the investigation, was 2·1 years. A ‘T‐shaped’ denture was most commonly employed (77·5% of dentures). Overall, 36·2% of subjects had required at least one denture repair, 28·2% presenting within a year of denture provision. One or more denture replacements had been received by 60·3% of the patients, and 43·6% had required this within a year. Component failure was highest for the denture tooth (40% of repairs) and a change in the patient’s dentition necessitated a denture remake in 66% of cases. VAS scores for parameters of denture satisfaction indicated an overall positive evaluation of the dentures, with the most positive response relating to ease of eating. However, the reported degree of teasing was high and increased with time. The only significant difference for denture satisfaction according to gender was for mastication: girls reportedly found eating easier than did boys. Conclusion. Children are generally accepting of upper partial dentures, but their poor clinical performance is of concern and there is need for improvement.
General anaesthesia for exodontia in children: experience of a dental teaching hospital in relation to changes in national guidance
Authors: Hunter M. L. , Hunter B. , Dhir A. P. , Shah B. 
Published: March 2003

Summary. Objectives. To examine, in relation to changes in national guidance, trends in the provision of general anaesthesia for exodontia in children.Design. Retrospective analysis of hospital records.Setting. University Dental Hospital, Cardiff, UK.Methods. Data were drawn from records of services provided in each of four index months during 1989, 1991, 1997 and 1999 (the years immediately preceding/following the Poswillo Report of 1990 and the General Dental Council's revised guidance of 1998).Results. In the first year after publication of the Poswillo report, there was a 19·6% increase in use of ‘chair case’ general anaesthesia over the four index months. Subsequently, upon the emergence of additional providers, patient flow in 1997 had fallen to 65·8% of that seen at baseline. Following the General Dental Council's revised guidance of 1998, there was a further reduction in the provision of ‘chair case’ general anaesthesia (to 40·8% of that seen at baseline).Conclusions. In this unit, throughput of children receiving general anaesthesia for exodontia has fluctuated in periods marked by changing national guidance. However, it is not possible to attribute such fluctuations in patient flow solely to this factor.
Impacted supernumerary tooth developed under palatal polyp
Authors: Noguchi M. , Tomizawa M. , Suzuki M. , Noda T. 
Published: March 2003

Summary. We present a rare case of an infant's palatal polyp associated with an impacted supernumerary tooth. We have previously reported three cases of palatal polyps in infants [1]. In one case, after surgical removal of the palatal polyp at the age of 1 year and 8 months, the lesion subsequently began swelling. A periapical radiograph at the age of 2 years and 9 months revealed a small calcified mass in the maxillary left incisor region. The swelling was kept under observation, the calcified mass developed gradually and was removed surgically at the age of 5 years and 5 months. The removed calcified mass was clinically diagnosed as an impacted supernumerary tooth and this was confirmed histologically. Histological findings did not indicate any relationship between the palatal polyp and the impacted supernumerary tooth.
Death, portry, psychotherapy and clinical supervision (the contribution of psychodynamic psychotherapy to palliative care nursing)*
Authors: Jones Alun 
Published: March 2003

This paper explores one facet of a therapeutic relationship with a woman suffering from inoperable cervical cancer. The psychotherapy sessions were conducted in both hospital and the family home and continued on a weekly basis until final termaination immediately prior to the woman's death. Through a ‘suspense structure’ case study narrative, the writer, a nurse psychotherapist, describes the way in which the humanities art and poetry can provide a means through which to understand seemingly incomprehensible feelings related to reviewing past events as a preparation for death.While no explict critique is made of the twin psychoanalytical concept of transference and countertransference, the occurrence is woven into the text. The essential nature of clinical supervision is illustrated in context. The author proposes that engagement in a therapeutic relationship with a dying person presents the worker with parallel struggles manifesting in elementary feelings which require discernment. The central recommendation of this paper is that the rich symbolic language and metaphors, redolent in art and poetry, be harnessed as a potent therapeutic and metaphors, redolent in art and poetry, be harnessed as a potent therapeutic tool. Throughout the discussion, the terms counseling and psychotherapy are used interchangeably.
Safeguarding care gains: a grounded theory study of organizational change
Authors: Ardern Peter 
Published: March 2003

Safeguarding care gains: a grounded theory study of organizational change The orientation towards a community focus of care challenges the need for National Health Service day hospital provision for people with dementia, thus forcing day hospitals to reorganize, relocate or close. Day hospitals were originally opened in the mid‐1970s as cost‐effective alternatives to the traditional in‐patient care for the dementia sufferer. Ironically, day hospitals are now under threat because they are considered an expensive luxury. Advances in dementia care have included the move away from the mechanistic model of care (routines and tasks), to the development of the social psychological model of dementia care. This paper examines the process of changes experienced by a group of staff working in a day hospital for people with dementia. Where the staff experienced a period of prolonged change and loss, their perception of support differed from that of the organization. When threats to the future and low support were encountered, defensiveness and risk containment allowed the mechanistic model of care to predominate. The concept of ‘safeguarding care gains’ was contained in the actions the staff took to prevent further perceived erosion of their care practice.
The meaning of learning in critical care nursing: a hermeneutic study
Authors: Little Christine V. 
Published: March 2003

The meaning of learning in critical care nursing: a hermeneutic studyMany critical care nurses choose to undertake further, specialist education and have an expectation that the curriculum will reflect their common learning requirements. Although previous studies have addressed education‐related issues, few have explored fundamental learning needs as expressed by the students themselves. This paper summarizes a study which aimed to explore the meaning of learning to 10 intensive care/coronary care nurses who had recently undertaken specialist post‐registration study. Utilizing an interpretative human science approach (Heideggerian hermeneutic phenomenology) the study identified three major themes: learning as focusing, learning as questioning and learning as technological mastery. One theme, learning as technological mastery, was revealed to be a particular feature of critical care nursing and was subsequently identified as the constitutive pattern. An alternative view of the relationship between nursing and technology is presented from the perspective of Heideggerian hermeneutic phenomenology. As a phenomenological account, this study does not claim to be representative of the larger population of critical care learners; however, it is suggested that unique human experiences may also be shared by others with similar backgrounds.
The nurse’s role in drug handling within municipal health and medical care
Authors: Kapborg Inez , Svensson Håkan 
Published: March 2003

The nurse’s role in drug handling within municipal health and medical care In Sweden, elderly care has been transferred from the county councils to the municipalities, resulting in changes in the work tasks of nurses. Today, nurses within municipal health and medical care carry sole responsibility for large groups of care receivers, especially during evenings and weekends. A consequence of this heavy work load is that the nurses have to delegate a number of tasks to subordinate staff. Drug administration is a task which is often delegated. Cases of malpractice involving drug administration, reported from the municipal health and medical service to the regional supervisory units of the National Board of Health and Welfare during a 3‐year period, have been analysed in order to gain a deeper understanding of the underlying causes of malpractice. In addition, interviews were conducted with eight nurses, the objective being to find out how they rate their knowledge within this area. The analysis showed that the majority of errors occurred in nursing homes and that the most common errors were administration of the wrong drug, and levels of drugs administered exceeding the prescribed ones. These errors were also common among subordinate staff who had been delegated responsibility for drug administration. Of the nurses interviewed, six out of eight had been close to making errors or had noticed a colleague making an error in conjunction with drug handling. Not all nurses reported errors made to the physician in charge immediately on discovery. It is concluded that through the transformation of elderly care, nurses working within municipal health and medical care have been given a new professional role. This places new demands on their competence, requiring them to make independent judgements and to take their own initiatives.
A longitudinal study into the perceptions of caring among student nurses using multivariate analysis of the Caring Dimensions Inventory
Authors: Watson Roger , Deary Ian J. , Lea Amandah 
Published: March 2003

A longitudinal study into the perceptions of caring among student nurses using multivariate analysis of the Caring Dimensions Inventory A longitudinal study involving student nurses’ responses to the Caring Dimensions Inventory (CDI) was carried out to investigate the development of perceptions of caring. This study continues previously reported work in which the development of the CDI was described. The current study was designed to see if the CDI could detect changes in perceptions of caring among student nurses as they progressed through their training. Data were collected on the same subjects at three points, each a year apart, throughout the study. A cohort of 168 student nurses entering training was recruited into the present study and data from the CDI was analysed using exploratory factor analysis. A four factor structure for perceptions of caring throughout the study was supported, with some evidence for a five factor structure at 24 months into the programme of nurse education. A professional and technical factor increased in congruence with a similar factor, identified in a previous study, throughout the present study and was used to provide factor scores for individual students. There was a statistically significant and moderately sized correlation between the score on this factor and the age of the student nurses. The five factor solution yielded a factor of accountability. Professional and educational consequences of the study are discussed along with the problem of attrition in longitudinal studies.
Clinical guidelines: promoting clinical effectiveness or a professional minefield?
Authors: Mead Paula 
Published: March 2003

Clinical guidelines: promoting clinical effectiveness or a professional minefield? The development of clinical guidelines as one means of implementing evidence‐based practice is currently a topical issue. The recent Government White Paper, The New NHS. Modern. Dependable, proposes the establishment of a National Institute for Clinical Excellence whose expressed aim will be to produce and disseminate guidelines based upon evidence of clinical effectiveness in health care. There will be an expectation that practitioners adapt these national guidelines for local needs and particularize them to individual patients. There has been considerable debate in the medical press between the critics and advocates of evidence‐based medicine surrounding the relative usefulness of clinical guidelines. However, there has been limited corresponding debate within the nursing literature, which has largely limited itself to descriptions of the implementation of guidelines. This paper examines some of the advantages and limitations of clinical guidelines as a means of operationalizing research evidence to promote effective health care. Finally, some recommendations surrounding the implementation of guidelines will be made.
Responses of family caregivers and family members with Alzheimer’s disease to an activity kit: an ethnographic study
Authors: Hutchinson Sally A. , Marshall Melody 
Published: March 2003

Responses of family caregivers and family members with Alzheimer’s disease to an activity kit: an ethnographic study This qualitative evaluation research focused on individuals with Alzheimer’s disease cared for at home by a family caregiver. It aimed to assess the responses of family caregivers and family members to an activity kit containing 20 therapeutic activities (The BAG or ‘Be Active with Games’ kit). In‐depth interviews with and observations of 21 caregiver/member dyads were analysed according to Spradley’s ethnographic method. Responses to The BAG were contingent upon the family member’s symptoms, prior experience, and time of day. For some caregivers The BAG was useful in filling time, inspiring additional activities, facilitating connections with the family member, and connecting family members with their past; for others it was an additional burden in an already frenetic life. The BAG engaged some family members with AD while it ‘insulted’ others. The value of activities for individuals with AD requires more theoretical and methodological exploration.
The patient’s thoughts and feelings about their transfer from intensive care to the general ward
Authors: Odell Mandy 
Published: March 2003

The patient’s thoughts and feelings about their transfer from intensive care to the general ward This qualitative, phenomenological study was undertaken to find out how patients felt about being transferred from the intensive care unit to the ward. The six patients who took part in the study, had been in intensive care for more than 4 days. Their transfer was planned as part of their recovery from a critical illness. Following transfer to the ward, the patients were interviewed using a semi‐structured approach. The interviews were audio‐taped, and transcriptions from the tapes were analysed for meaning and interpretation.Findings supported the literature that was reviewed, in that transfer from intensive care to the ward was a traumatic experience for the patient, who often found it confusing, stressful and tiring.Improvements to the transfer process can be guided using the information from the literature review and findings of the study.
Adjusting stroke patients’ poor position: an observational study
Authors: Dowswell George , Dowswell Therese , Young John 
Published: March 2003

Adjusting stroke patients’ poor position: an observational study Although nurses’ role in rehabilitation has been generally ill‐defined and consistently undervalued, of all professional groups, nurses working with stroke patients have potentially the greatest contribution to make. Stroke patients are believed to benefit from good posture yet they can spend long periods in inappropriate positions. This study examined the positioning, handling and mobilizing of stroke patients in hospital. Non‐participant observation was used to gather data on stroke patients’ position and nurses’ activities. This paper addresses two basic questions — what causes the adjustment of patients from poor to good position and who is involved in achieving this adjustment. Poor position was observed to end 158 times in 380 ‘patient hours’ of observation. The most frequent causes of positional improvement were activities whose primary intention was unrelated to position correction. The deliberate adjustment of patients’ position by nurses was a rare event which occupied a small part of nurses’ time. The potential for a more considered and consistent nursing approach appears to be great.
Liaison nursing for stroke patients: results of a Dutch evaluation study
Authors: Arts Suzanne E.J. , Francke Anneke L. , Hutten Jack B.F. 
Published: March 2003

Liaison nursing for stroke patients: results of a Dutch evaluation study Liaison nurses, employed by a home care organization, were introduced into two Dutch hospitals to improve discharge planning for stroke patients. The main aim of the study presented was to gain insight into the effects of liaison nursing on the quality of the discharge process and related outcomes. After the introduction of liaison nursing, hospital nurses completed a questionnaire on satisfaction with the liaison nurse. In addition, both before and after the introduction of liaison nursing, two groups of discharged stroke patients were interviewed by telephone. The records of these patients were also studied with respect to background characteristics and duration of hospital stays. The hospital nurses were, generally, positive about the liaison nurse and the job she did (e.g. they found that home care was better organized). Further, after the introduction of liaison nursing, more patients stated that their post‐discharge needs had been discussed not later than 48 hours prior to discharge, and more patients said their aftercare had been discussed with community nurses. However, the number of patients whose medication had arrived at home on time had decreased. The results also indicated that there was no significant difference in the duration of stay between the before and after group. The overall conclusion is that the liaison nurses have been moderately successful in their jobs. However, since the study was conducted in only two Dutch hospitals, findings may not be representative of other settings. Future research on liaison nursing is therefore recommended.
Suicide and self‐harm in inpatient psychiatric units: a national survey of observation policies
Authors: Bowers Len , Gournay Kevin , Duffy David 
Published: March 2003

Suicide and self‐harm in inpatient psychiatric units: a national survey of observation policies There is little empirical literature on observation as a psychiatric nursing procedure to prevent patients from harming themselves or others. National guidelines for this practice do not exist, with a consequence that local policies might be variable in content and quality. This paper reports a national survey of observation policies and usage based upon a stratified random sample of 27 psychiatric inpatient service providers in England and Wales. Extreme variation in terminology and practice was encountered. The terminological confusion is likely to reduce nurses’ clarity about their responsibilities and increase risks to patients. Further variation exists from place to place as to whether, and to what extent, student nurses and family members should be entrusted with the responsibility to observe patients. More than one in 10 services of the sample still have no written observation policy, and four in 10 have no clinical recording system of the procedure in place. Nurses commonly amend the procedure and terminology on an ad hoc basis. The results of this survey confirm that the Department of Health should set national standards for the policies and procedures for patient observation and that as an interim step practice guidance should be issued to all nurses (and other mental health workers) involved in this procedure.
Protecting children: intuition and awareness in the work of health visitors
Authors: Ling Margaret S. , Luker Karen A. 
Published: March 2003

Protecting children: intuition and awareness in the work of health visitorsThis paper is based upon an ethnographic study of a group of health visitors engaged in child protection work. The purpose of this paper is to explore the meanings individual health visitors attach to events concerned with identifying children who may be at risk of harm from child abuse, and also the idiosyncratic nature of health visiting in this complex but everyday social situation. The paper focuses on understanding the importance of a particular form of knowledge which the health visitors referred to as ‘intuitive awareness’.
Primary health care in Saudi Arabia: applying global aspects of health for all, locally
Authors: Littlewood Jenny , Yousuf Shadia 
Published: March 2003

Primary health care in Saudi Arabia: applying global aspects of health for all, locallyThis paper describes the application of primary health care principles in the Islamic Kingdom of Saudi Arabia. It arose from a doctoral supervisory experience on a joint programme for women students, operating between a British and Saudi Arabian University. The research looked at nutritional advice given by diploma‐level nurses to pregnant women attending primary health care centres in Saudi Arabia. The supervisor supported research that drew on internationally recognized trends in nursing research (the reflexive learner) whilst attending to local requirements and conventions of the culture. The student was encouraged explicitly to site the research within the framework of Islamic teaching and Saudi culture. The Qur’an was used as an overarching framework within which the tenets of primary health care were explored. This was seen to be crucial in addressing World Health Organisation and the International Council of Nurses’ views on contextualizing nursing for the greatest benefit of the population. This was of particular relevance in Saudi Arabia where research carried out in the community by women is novel, and as yet there are no nurse theorists from within Saudi culture.