bluuebunny/crossref_metadata_2025_split huggingface dataset:
Between joy and sorrow: being a parent of a child with developmental disability
Authors: Kearney Penelope M. , Griffin Tim 
Published: March 2003

Between joy and sorrow: being a parent of a child with developmental disabilityAim. This study explored the experiences of parents who have children with significant developmental disability.Background. Prevailing societal and professional assumptions of parental crisis and maladjustment in response to the ‘tragedy’ of having a disabled child did not accord with the authors’ practice experience. Whilst parents confronted numerous difficulties, most of them appeared to manage with optimism and remarkable resourcefulness.Research design. The study, using an interpretive methodology informed by phenomenology, intensively explored the experiences of six parents of children with significant developmental disability.Findings. Although they experienced much anguish and sorrow, the parents also spoke of hope, love, strength and joy. Interpretation of the parents’ experiences revealed the themes of ‘joy and sorrow’, ‘hope and no hope’ and ‘defiance and despair’, mediated by ‘the tensions’.Conclusions. This phenomenological interpretation provides insight and understanding into the parents’ experiences and has implications for practice, education and research in nursing.
Swedish nurses’ attitudes towards research and development within nursing
Authors: Björkström Monica E. , Hamrin Elisabeth K.F. 
Published: March 2003

Swedish nurses’ attitudes towards research and development within nursing Aim of the study. The aim was to develop and test an assessment instrument in order to study attitudes towards research and development within nursing among randomly selected professional nurses, registered nurses (RNs). Background. The investigation was initiated because of the development within nursing and nursing education in Sweden towards better knowledge about research for the last four decades. Methods. A questionnaire was designed, consisting of three parts: (1) demographic data, (2) attitude scale and (3) research awareness. Appropriate psychometric statistics were used such as factor analysis and parametric as well as nonparametric statistics to compare groups. The form was distributed to 407 randomly selected RNs. Results. The response rate was 71% (n=289). The respondents were from four different examination years, representing four different nursing education systems in Sweden. Factor analysis (Maximum Likelihood and Oblimin rotation) gave seven factors with a total variance of 58% and Cronbach’s α between 0·60 and 0·84. The factors were labelled ‘Research language’, ‘Need of research knowledge’, ‘Participation’, ‘The Profession’, ‘Meaningfulness’, ‘Study literature’ and ‘Developing – Resources’. The results indicated that the respondents in general had positive attitudes towards nursing research. There were significant differences between the examined groups. The group examined in 1966 appeared as the least positive group. Forty‐six per cent never or seldom utilized nursing research findings in their daily practice. About half of the respondents never read research reports. Conclusion. The results indicated that the new instrument is sensitive for measuring professional nurses’ attitudes towards research and development in nursing. Even if the respondents had a positive attitude towards research and development, there was a poor application in their daily work. Further, the respondent’s age, the year of RN examination and acquisition of research skills seemed to be of importance for the attitudes.
Patterns of elderly spousal caregiving in dementia care: an observational study
Authors: Jansson Wallis , Nordberg Gunilla , Grafström Margareta 
Published: March 2003

Patterns of elderly spousal caregiving in dementia care: an observational study Aim.  The aim of this study was to escribe which caring activities eight spouses performed when caring for a partner with dementia, and in what way these activities were carried out. Background.  Family caregivers are recognized as being the primary source of care for the community’s older people. The largest group is comprised of spouses, with wives as the predominant caregivers. This informal care seems to be more or less invisible and performed in silence within the family. Despite the wealth of studies, the essence of family caregiving is not well understood. Methods.  Data collection was conducted by observing the dyads in their homes. A qualitative approach inspired by grounded theory was chosen to discover qualities and describe patterns of spousal caregiving in dementia care. Results.  The analysis yielded four broad themes, which included nine categories. Findings from the study shed some light on the invisible aspects besides the traditional hands‐on caregiving. Conclusion.
The elderly carers were engaged in demanding and time‐consuming care ranging from supervision to heavy physical responsibility. They were caring for as well as about their partners. The study also showed that spouses were successful in managing their situation in different ways. The results reported in this article are unique as they come from direct observations in family home settings where a spouse cared for a partner with dementia. Knowledge about family caregiving is valuable for nurses as there is an emphasis on collaboration between family caregivers and professionals.
Nurse‐led intermediate care: an opportunity to develop enhanced roles for nurses?*
Authors: Wiles Rose , Postle Karen , Steiner Andrea , Walsh Bronagh 
Published: March 2003

Nurse‐led intermediate care: an opportunity to develop enhanced roles for nurses? Background.  Nurse‐led intermediate care units are being set up across the UK primarily as potential solutions to hospital bed crises. Aims.  This paper draws on data collected as part of a comprehensive evaluation of one 10‐bedded nurse‐led unit (NLU) located in the South of England. It explores the potential for enhanced nursing roles provided by such units by focusing on the views of NLU nursing staff and other professional groups within the Hospital Trust where the unit is located. Methods.  A total of 38 in‐depth audio‐taped qualitative interviews were conducted with NLU nursing staff and with a range of other professional groups (managers, acute ward nurses and doctors). Findings.  These data indicated that models of nurse‐led postacute care do provide opportunities for nurses to develop enhanced nursing roles in which care associated with concepts of therapeutic nursing can be provided. However, even though the nurses derived satisfaction from their work on the NLU this model of care was seen by junior and middle grade nurses and other professional groups as being of low status. In contrast to senior nurses’ views, they did not equate work on the NLU with the continuing professionalization of nursing. Senior nurses viewed the route to developing nursing on the NLU as involving nurses as doctor substitutes (extended roles) rather than as working in separate but complementary therapeutic domains (enhanced roles). Conclusions.  NLUs provide opportunities for nurses to develop enhanced roles in which they can work autonomously in providing elements of therapeutic nursing aimed at improving patient outcomes at discharge. However, education, training and leadership will be needed to ensure that such opportunities are well understood and are optimized to the benefit of nurses and their patients.
Patients’ perceptions of self‐determination as expressed in the context of care
Authors: Nordgren Stina , Fridlund Bengt 
Published: March 2003

Patients’ perceptions of self‐determination as expressed in the context of care Aim. The aim of this study was to describe patients’ perceptions of how self‐determination finds expression in the context of care. Background. Self‐determination is an important concept within health care as well as an important patient right. New legislation on patient rights in Sweden and Europe is aimed at increased patient self‐determination. Design and method. Data were collected through semi‐structured, tape‐recorded interviews with 17 strategically chosen patients within somatic care and analysed using a method inspired by phenomenography. Results. The analysis found three descriptive categories of the informants’ perceptions: trusting, accepting and a feeling of powerlessness. The patients expressed a great sense of trust and confidence in the care provided and they accepted the health care procedures. At the same time, they expressed a feeling of powerlessness because of not being part of decision‐making, as well as lacking knowledge and information about treatment strategies. The patients wished to have the right of more self‐determination but lacked the strength and knowledge to be able to influence their own care. Conclusions. Patients’ perceptions of self‐determination suggest that, in their encounters with the professional care, knowledge is expressed as power. The feeling of a lack of self‐determination can be reduced by help and support from a nurse who allocates time for communication in order to learn the patient’s needs and reach a mutual understanding.
A psychoanalytically informed conversation with a woman and her husband following major surgery for cancer of her neck and torso
Authors: Jones Alun 
Published: March 2003

A psychoanalytically informed conversation with a woman and her husband following major surgery for cancer of her neck and torso Aims of the Paper. This paper explores psychoanalytic ideas of containment as described by Wilfred Bion and applies them understanding the concerns of a woman with serious illness and her husband. A case vignette shows psychoanalytic thinking in context. The paper explores verbatim exchanges that took place in a room just off a hospital ward and offers a psychoanalytically informed analysis. Rationale. This discussion suggests that the impact of physical illness is such that there is potential for the seriously ill to saturate health workers in anxiety and raw feelings. To protect themselves, nurses and other health workers could sometimes unconsciously overlook the emotional care of people in favour of routines, physical aspects of care and other demonstrable methods of treatment. Conclusions. Drawing on the work of Isabel Menzies Lyth, the discussion concludes by recommending that environments are needed in which a person with serious illness or family member can be helped to make sense of his or her experiences and so integrate them into a meaningful life continuum. Similar conditions are perhaps needed for nurses or other health workers. Appropriate methods of work discussions in clinical supervision might conceivably provide these important requirements.
Psychological aspects of breast reconstruction: a review of the literature
Authors: Harcourt Diana , Rumsey Nichola 
Published: March 2003

Psychological aspects of breast reconstruction: a review of the literature Aim. This paper critically examines the research literature relating to the psychological aspects of breast reconstruction. Particular attention is given to the role of specialist breast care nurses in supporting women faced with the decision of whether or not to opt for reconstructive surgery. Background. Breast reconstruction is intended to offer psychological benefits (e.g. improvements to quality of life, body image, anxiety and depression) to women treated by mastectomy following diagnosis of breast cancer. Methods. A literature search was carried out on the PSYCHINFO, MEDLINE and CINAHL databases using the terms ‘breast reconstruction’, ‘mastectomy’, ‘reconstructive surgery’, ‘breast surgery’, ‘breast implants’, ‘transverse rectus adominis myocutaneous (TRAM) flap’ and ‘Lat‐dorsi’. Further relevant articles were identified from the reference lists of papers detected by this literature search. Finally, proceedings of recent psychological and surgical meetings were scrutinized to identify any conference papers on this topic. Findings. A thorough search of the existing literature revealed a lack of theoretically based studies examining breast reconstruction in terms of relevant psychological constructs, especially in relation to coping and decision‐making. This review highlights the methodological flaws with much of the existing research in this area, in particular the reliance upon retrospective designs and the inappropriate use of randomised controlled trials. Suggestions are given for further research in this topical area. Conclusions. Existing research into the psychological aspects of breast reconstruction is limited and not sufficiently conclusive to inform changes to policy and the provision of care. More methodologically rigorous research is needed.
The implementation of a Pain Monitoring Programme for nurses in daily clinical practice: results of a follow‐up study in five hospitals
Authors: De Rond Marlies , De Wit Rianne , Van Dam Frits 
Published: March 2003

The implementation of a Pain Monitoring Programme for nurses in daily clinical practice: results of a follow‐up study in five hospitals Aims of the study. To study the effects of the implementation of a Pain Monitoring Programme (PMP) for nurses in daily clinical practice. In addition, nurses’ and physicians’ pain knowledge and attitudes were studied, as well as change in nurses’ pain knowledge after implementation of the programme. Rationale. The rationale for the study was that many hospitalized patients suffer from pain and treatment of pain is often inadequate. Background. Reasons for inadequate treatment of pain are the failure of nurses to assess pain on a daily basis and insufficient knowledge about pain and pain management in both nurses and physicians. The PMP tried to overcome these barriers by implementing daily pain assessment and educating nurses about pain and pain management. Research methods. This follow‐up study was conducted in five hospitals. In total, 277 nurses and 115 physicians participated. The implementation and long‐term effects of the programme were measured with a pretest–post‐test design without a control group. Results. Results showed that nurses carried out daily pain assessment in at least 75% of patients during the first 5 months of the intervention period, but in the remaining 2 months professional compliance gradually decreased. Both nurses and physicians are positive about daily pain assessment and want to continue with it. The level of nurses’ and physicians’ knowledge about pain and pain management is moderate. The programme increased nurses’ knowledge and satisfaction regarding the quality of pain treatment. Discussion. Because professional compliance decreased after 5 months, incentives are needed to motivate nurses to continue with daily pain assessment. Continuous Quality Improvement may be a useful method to guide the implementation process. Conclusions. Based on these results it can be concluded that it is possible to implement the PMP in daily clinical practice. Moreover, the beneficial effects of our programme on nurses’ knowledge and attitudes have been demonstrated. Therefore, participating hospitals were advised to continue and extend the programme and other hospitals are encouraged to implement it.
Leadership, organizational stress, and emotional exhaustion among hospital nursing staff
Authors: Stordeur Sabine , D'Hoore William , Vandenberghe Christian 
Published: March 2003

Leadership, organizational stress, and emotional exhaustion among hospital nursing staff Study’s rationale and objectives. We examined the effect of work stressors and head nurses’ transactional and transformational leadership on the levels of emotional exhaustion experienced among their staff. Methodological design and research methods. A questionnaire was sent to all nurses of a university hospital. Usable returns were received from 625 nurses, giving a response rate of 39·2%. Data were treated using correlational analyses and multiple regression. The latter modelled stressors and leadership as predictors of nurses’ reported emotional exhaustion. Measures. Work stressors were assessed using the Nursing Stress Scale (NSS) which comprises 34 items divided into three subscales (referring to stress from the physical, psychological, and social environment), and the role ambiguity (three items) and conflict (three items) scales. Leadership was measured with the Multifactor Leadership Questionnaire. Results. In regression analyses, work stressors as a whole were found to explain 22% of the variance in emotional exhaustion whereas leadership dimensions explained 9% of the variance in that outcome measure. Stress emanating from the physical and social environment, role ambiguity, and active management‐by‐exception leadership were significantly associated with increased levels of emotional exhaustion. Transformational and contingent reward leadership did not influence emotional exhaustion. Limitations. A limitation of this study is that it considered only the emotional exhaustion dimension of burnout. Also, as data were cross‐sectional in nature, conclusions regarding the direction of causality among variables cannot be drawn. Conclusions. This study provided, for the first time, a test of the influence of leadership on burnout among nurses, taking into account the role of work stressors. Future research is needed to examine if the effects reported herein can be replicated using the two other dimensions of burnout (depersonalization and reduced personal accomplishment).
The development of an alternative method in the assessment of critical thinking as an outcome of nursing education
Authors: Daly William M. 
Published: March 2003

The development of an alternative method in the assessment of critical thinking as an outcome of nursing education Rationale. Critical thinking is currently a highly valued educational outcome throughout the educational spectrum, but particularly so in relation to higher and professional education. Nursing education worldwide is also embracing the construct critical thinking as a desirable educational outcome, to the extent that some commentators refer to the importance of critical thinking in nursing as a given. The body of evidence relating to the impact that nursing education has upon the development of critical thinking is currently inconclusive. Many commentators claim that this may be because the instruments used in many studies are not sufficiently domain‐specific. Study aims. The primary purpose of this descriptive‐illuminative study was to explore and develop an alternative domain‐specific method for identifying critical thinking in student nurses’ reasoning processes. Design. A longitudinal multimethod design incorporating across‐method triangulation has been utilized for this purpose. Data collection from a group of student nurses involved the combination of the Watson and Glaser (1991) critical thinking appraisal test and a researcher developed think aloud technique incorporating a videotaped client simulation, a cognitive task and stimulated recall strategy. Findings. Findings indicate no significant differences in pre and postprogramme Watson–Glaser mean scores. With regard to the think aloud evidence the sample consistently displayed evidence of reasoning that reflected an absolutist epistemology portraying limited evidence of critical thinking. In instances where more complex reasoning was demonstrated there was evidence to suggest that metacognitive strategies may contribute to this phenomenon. Conclusions. The findings make a further contribution to the assessment of critical thinking and raise interesting challenges to future curriculum development in nursing education, assessment of learning and nursing practice.
Chinese values, health and nursing
Authors: Chen Yu‐chih 
Published: March 2003

Chinese values, health and nursing Purpose. To describe the roots of Chinese values, beliefs and the concept of health, and to illustrate how these ways have influenced the development of health care and nursing among Chinese in the Republic of China (ROC) and the People’s Republic of China (PRC). Scope. Based on the literature and direct observation in the PRC and ROC, this is an introduction to Chinese philosophies, religion, basic beliefs, and values with a special meaning for health and nursing. Chinese philosophies and religion include Confucian principles, Taoism, theory of ‘Yin’ and ‘Yang’, and Buddhism. Beliefs and values include the way of education, practice of acupuncture, herbal treatments and diet therapy. How people value traditional Chinese medicine in combination with western science, and the future direction of nursing and nursing inquiry are also briefly addressed. Conclusion. Chinese philosophies and religions strongly influence the Chinese way of living and thinking about health and health care. Nurses must combine information about culture with clinical assessment of the patient to provide cultural sensitive care. A better way may be to combine both western and Chinese values into the Chinese health care system by negotiating between the traditional values while at the same time, respecting an individual’s choice. The foundation of China’s philosophical and aesthetic tradition, in combination with western science is important to the future advancement of nursing research that will be beneficial to the Republics, Asia, and the world.
Nurses’ communication skills: an evaluation of the impact of solution‐focused communication training
Authors: Bowles Nick , Mackintosh Carolyn , Torn Alison 
Published: March 2003

Nurses’ communication skills: an evaluation of the impact of solution‐focused communication training Aims. This paper describes the evaluation of a short training course in solution‐focused brief therapy (SFBT) skills. This evaluation examined the relevance of SFBT skills to nursing and the extent to which a short training course affected nurses’ communication skills. Background. Nurses’ communication skills have been criticized for many years, as has the training in communication skills that nurses receive. The absence of a coherent theoretical or practical framework for communication skills training led us to consider the utility of SFBT as a framework for a short training course for qualified nurses, the majority of them are registered nurses working with adults. Design and methods. Quantitative and qualitative data were collected: the former using pre‐ and post‐training scales, the latter using a focus group conducted 6 months after the training. Data were analysed using the Wilcoxon signed‐rank test and content analysis. Results and findings. Quantitative data indicated positive changes in nurses’ practice following the training on four dimensions, and changes in nurses’ willingness to communicate with people who are troubled reached levels of significance. Qualitative data uncovered changes to practice, centred on the rejection of problem‐orientated discourses and reduced feelings of inadequacy and emotional stress in the nurses. Conclusions. There are indications that SFBT techniques may be relevant to nursing and a useful, cost‐effective approach to the training of communication skills. Solution focused brief therapy provides a framework and easily understood tool‐kit that are harmonious with nursing values.