Showing papers in "International Journal of Nursing Practice in 2009"
TL;DR: The aim of the article is to demystify the dense language used and present the fundamental beliefs of each philosopher in a format that is accessible to novice phenomenologists.
Abstract: Introduced as an alternative to empirical science, phenomenology offers nursing an insightful means for understanding nursing phenomena specifically in relation to lived experiences. However, not all phenomenologies were created equal, a point which has left many a nursing researcher not only confused. Furthermore, this confusion might result in the choosing of a philosophical framework that is neither cognizant with the research question nor the epistemological lens through which the researcher operates. Drawing on common nursing examples to illustrate concepts, the authors closely examine and debate the disparities between Husserl's transcendental phenomenology and Heidegger's hermeneutic approach to phenomenology. The aim of the article is to demystify the dense language used and present the fundamental beliefs of each philosopher in a format that is accessible to novice phenomenologists.
219 citations
TL;DR: In this article, a systematic review was conducted to answer the question: What is the impact of the primary and community care nurse on patient health outcomes compared with usual doctor-led care in primary care settings?
Abstract: This paper reports on a systematic review that sought to answer the research question: What is the impact of the primary and community care nurse on patient health outcomes compared with usual doctor-led care in primary care settings? A range of pertinent text-words with medical subject headings were combined and electronic databases were searched. Because of the volume of published articles, the search was restricted to studies with high-level evidence. Overall, 31 relevant studies were identified and included in the review. We found modest international evidence that nurses in primary care settings can provide effective care and achieve positive health outcomes for patients similar to that provided by doctors. Nurses are effective in care management and achieve good patient compliance. Nurses are also effective in a more diverse range of roles including chronic disease management, illness prevention and health promotion. Nevertheless, there is insufficient evidence about primary care nurses' roles and impact on patient health outcomes.
132 citations
TL;DR: Qualitative methodology based on action research identified challenges when caring for persons with advanced dementia, as perceived by key professional providers and concluded that the need for a palliative approach to care in advanced dementia should be recognized.
Abstract: Qualitative methodology based on action research identified challenges when caring for persons with advanced dementia, as perceived by key professional providers. Data collection was via five focus groups (total n = 24) and 20 follow-up individual interviews. Participants included palliative care, aged care and dementia specialist nurses, medical specialists from an area health service, residential aged care staff and general medical practitioners. Responses emphasized the need for improved knowledge and skills, and clearer policy. Concerns included accurate assessment, especially of pain, owing to the inability of people with advanced dementia to communicate their symptoms. Assessment, managing physical and behavioural symptoms, and communicating with family presented as further challenges. Conclusions are that the need for a palliative approach to care in advanced dementia should be recognized. Aged care staff can deliver palliative care to people with advanced dementia only if the staff receive relevant education and training beyond their generalist competencies.
95 citations
TL;DR: The underlying philosophical attributes of adherence and the interchangeable concepts of compliance and concordance are explored, with the implications of the meanings attributed to these concepts for nursing practice and research considered.
Abstract: It is well established that pharmacotherapy is fundamental to disease and symptom management. Adherence to medication regimens is therefore essential for improved patient health outcomes. In reality, however, many patients experience difficulty with medication taking resulting in suboptimal adherence. Given the consequences of this pervasive problem, non-adherence is increasingly recognized as one of the leading challenges that professionals face in contemporary health care. As health-care professionals, nurses have an important role in combating this problem. This paper therefore examines the literature surrounding medication adherence for the purposes of enhancing professional knowledge and practice in this area. Specifically, the impact of poor adherence from the patient's, health-care professional and health-care system perspective is detailed to highlight the significance of this issue. The underlying philosophical attributes of adherence and the interchangeable concepts of compliance and concordance are explored, with the implications of the meanings attributed to these concepts for nursing practice and research considered.
80 citations
TL;DR: The Emergency Nurse Practitioner model demonstrates consistent levels of patient satisfaction with patients reporting more favourable satisfaction with the Emergency nurse Practitioners compared with emergency department doctors.
Abstract: The Emergency Nurse Practitioner role was introduced to an Emergency Department, Melbourne in 2004 as an alternative health-care model to provide accessible and efficient patient care. The aim of the study was to explore patient satisfaction using a questionnaire from their emergency department experience comparing Emergency Nurse Practitioners and emergency department doctors. Patients who received care from either Emergency Nurse Practitioners or emergency department doctors were given a self-administered questionnaire to complete. Descriptive statistics and non-parametric tests were used for data analysis. A total of 202 patients completed the survey with 103 seen by the Emergency Nurse Practitioners and 99 seen by emergency department doctors. Significant differences were reported in 12 of the 16 questions comparing patient satisfaction with either Emergency Nurse Practitioners or emergency department doctors with greater patient satisfaction demonstrated with the Emergency Nurse Practitioners. The Emergency Nurse Practitioner model demonstrates consistent levels of patient satisfaction with patients reporting more favourable satisfaction with the Emergency Nurse Practitioners compared with emergency department doctors.
79 citations
TL;DR: The study findings were used to revise the Restorative Care for the Cognitively Impaired Intervention and could direct future implementation of programmes in nursing home settings.
Abstract: Nursing home residents with dementia represent a majority of the most functionally impaired individuals residing in nursing homes. Although many perceive this population as having little restorative potential, maintaining resident functional abilities for as long as possible helps to optimize quality of life and decrease caregiver burden. This study used a qualitative design with a focus group methodology to explore facilitators and barriers to engaging cognitively impaired residents in functional activities and exercise. A purposive sample of seven geriatric nursing assistants who were experts in dementia care participated in the study. Twenty-seven codes were reduced to three themes: (i) knowing what makes them tick and move; (ii) teamwork and utilizing resources; and (iii) barriers to restorative care. The study findings were used to revise the Restorative Care for the Cognitively Impaired Intervention and could direct future implementation of programmes in nursing home settings.
72 citations
TL;DR: If the elderly tend to be passive and resigned, it can be necessary for the community nurses to have a more active problem-solving approach to these patients, in order to help them creating a daily rhythm with which they can feel comfortable.
Abstract: The purpose of this study was to gain a more comprehensive understanding of how the elderly cope with being sick, unhealthy and living alone. Qualitative research interviews using a hermeneutic approach was undertaken to explore how the patients experienced coping with their daily life. Twenty patients with an average age of 82 years having different injuries and diseases were interviewed. The interviews were audiotaped, transcribed and analysed in a hermeneutical tradition of the hermeneutic circle: part-whole, pre-understanding-understanding, and primary, secondary and basic themes. Findings showed that even if physical constraints put limits on their level of activity, the elderly were able to adapt and carry out different activities that did not require any physical strength. The main coping strategy was to accept the situation, but the acceptance was often coloured by a resigned and passive acceptance. If the elderly tend to be passive and resigned, it can be necessary for the community nurses to have a more active problem-solving approach to these patients, in order to help them creating a daily rhythm with which they can feel comfortable.
69 citations
TL;DR: Nursing workforce development needs to focus on strategies that provide role support for nurses as they work with this clinically challenging patient group, showing that workplace education has no independent association with therapeutic attitude and that an effect from education only occurs when nurses have at least a moderate level of role support.
Abstract: This study examines the impact of workplace drug and alcohol education on nurses' therapeutic attitude to patients who use illicit drugs. It builds on a study of the generalist nursing workforce in the Australian Capital Territory in 2003, which showed that the interaction of role support with workplace drug and alcohol education facilitated nurses' therapeutic attitude. This paper explores this interaction in detail, showing that workplace education has no independent association with therapeutic attitude and that an effect from education only occurs when nurses have at least a moderate level of role support. Nursing workforce development needs to focus on strategies that provide role support for nurses as they work with this clinically challenging patient group. Without the ready availability of someone in the nurse's clinical field to advise and assist them, efforts to increase nurses' knowledge and skills are wasted.
62 citations
TL;DR: The results showed that the overall turnover rate among registered nurses in Jordanian hospitals was 36.6%, and there were variations according to geographical region, health sector and place of residence.
Abstract: The aim of this study is to (i) determine the turnover rate among registered nurses in Jordanian hospitals; and (ii) compare the turnover rate between (a) male and female registered nurses; (b) northern, middle and southern regions; (c) public, private and university hospitals; (d) rural and urban hospitals; and (e) general and specialized hospitals. A descriptive, cross-sectional retrospective survey design was used. A structured interview method was utilized to collect data. A proportional random sample of 25% of the total number of Jordanian hospitals was taken. The results showed that the overall turnover rate was 36.6%. There were variations according to geographical region, health sector and place of residence. Turnover among registered nurses in Jordanian hospitals is considered a problem that requires effective strategies to deal with. Further research is required to identify the causes, and to explain the differences in the turnover rates according to the different study variables.
54 citations
TL;DR: Tasks of a medical nature are given priority over health promotion and DNs lack support and no one asked or cared about the results from health promotion activities.
Abstract: Purpose: To investigate district nurses (DN) opinions regarding facilitators and barriers in their work with health promotion. Methods: Qualitative descriptive study. Interviews with a purposeful s ...
54 citations
TL;DR: A quasi-experimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study as mentioned in this paper.
Abstract: Hourly rounding in the acute hospital setting has been proposed as an intervention to increase patient satisfaction and safety, and improve the nursing practice environment, but the innovation has not been adequately tested. A quasi-experimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study. A Patient Satisfaction Survey instrument was developed and used in conjunction with the Practice Environment Scale of the Nursing Work Index. Results on patient satisfaction showed no significant changes. Significant changes were found for three of the five practice environment subscales. Consistent with the aim of a pilot study, this research has provided important information related to design, instruments and process that will inform a larger sufficiently powered study.
TL;DR: In this article, the relevance of normal body temperature as 37°C and its consequences in clinical practice are discussed, and the best approach is to use the same site, and an unadjusted mode without adjustments to other sites.
Abstract: The definition of normal body temperature as 37°C still is considered the norm worldwide, but in practice there is a widespread confusion of the evaluation of body temperature, especially in elderly individuals. In this paper, we discuss the relevance of normal body temperature as 37°C and consequences in clinical practice. Our conclusion is that body temperature should be evaluated in relation to the individual variability and that the best approach is to use the same site, and an unadjusted mode without adjustments to other sites. If the baseline value is not known, it is important to notice that frail elderly individuals are at risk of a low body temperature. In addition, what should be regarded as fever is closely related to what is considered as normal body temperature. That is, as normal body temperature shows individual variations, it is reasonable that the same should hold true for the febrile range.
TL;DR: Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.
Abstract: A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.
TL;DR: Cardiac rehabilitation programmes provided significant improvement in participants' quality of life, exercise capacity, lipid profile, body mass index, body weight, blood pressure, resting heart rate, survival rate, mortality rate and decreased myocardial infarction risk factors, although there was limited participation.
Abstract: Previous Western cardiac rehabilitation (CR) purported to improve patients' quality of life and health-related parameters for cardiovascular diseases (CVD). Nursing's role in CR was minimally identified. The purpose of this integrative literature review was to determine the effectiveness of current CR programmes and to determine if nurses are included in multidisciplinary CR teams. An online search of databases for the National Institutes of Health Library, Medline, CINAHL, Blackwell Synergy and PsychINFO electronic databases, with keywords--cardiac rehabilitation, lifestyle modification, secondary prevention, quality of life, effects of rehabilitation--identified 13 articles published 2001-2006 for inclusion. Cardiac rehabilitation programmes provided significant improvement in participants' quality of life, exercise capacity, lipid profile, body mass index, body weight, blood pressure, resting heart rate, survival rate, mortality rate and decreased myocardial infarction (MI) risk factors, although there was limited participation. They also decreased depression and anxiety. Eight studies included Nurses as CR providers, but without clear descriptions of their role. Nurses in developing countries need to participate in CR programmes to improve patients' participation, and to focus on modalities with lower overhead costs, such as home-based CR, and to clearly articulate their unique contributions.
TL;DR: Taking care of cancer patients at home creates several problems among carers and the acknowledgement and recognition of these problems by health-care professionals might contribute to finding solutions in order to assist the difficult task of these individuals.
Abstract: The care of patients suffering from advanced cancer is not limited in the hospital setting. It continues at home where the burden of care is borne by specific individuals. The aim of the present study was to survey and record the various problems faced by those who care for cancer patients at home. The study was conducted in our hospital during the summer of 2007. All participants completed, during a personal interview, a questionnaire which covered pathologic, social, psychological, spiritual/religious and financial problems. Seventy-six carers returned fully completed questionnaires. The most frequent problems reported were: anxiety regarding the patient's future (61.8%), troublesome symptoms such as pain (54%), increased economic burden-financial difficulty (51.3%), problems with patient's feeding (50%), unhappiness or depression (48,7%), emotional upset (47.4%), worsening of the patient's behaviour and personality (38.2%), difficulty of establishing a positive attitude regarding their current status (34.2%), transport to hospital (32.9%), assistance from the wider family circle (25%). Taking care of cancer patients at home creates several problems among carers. Many of them remain undetected. The acknowledgement and recognition of these problems by health-care professionals might contribute to finding solutions in order to assist the difficult task of these individuals.
TL;DR: This exploratory clinical study explored patient dignity within the acute hospital environment through observation of staff-patient interactions and interviews with patients and identified deviations to ideal practice in the maintenance of the physical environment and communication styles of the nursing staff.
Abstract: Patients' rights such as the need for dignity and respect are essential in the provision of quality care. This exploratory clinical study explored patient dignity within the acute hospital environment through observation of staff-patient interactions and interviews with patients. Dignity can be influenced through two major mediums-maintenance of the physical environment and the communication style of the nurse. The findings identified deviations to ideal practice in the maintenance of the physical environment and communication styles of the nursing staff. Maintenance of dignity and privacy were not identified by patients during the interviews as being under threat despite deviations to ideal practice being observed. Patients possibly accept that 'ideal practice' is not always provided to them because nurses are 'busy', or other factors take precedence in this environment. It is possible that a prevailing culture influences patients' perceptions of whether dignity is maintained.
TL;DR: Nursing prioritization of the patient need for care was revealed both as a non-sequential decision-making process throughout unfolding patient situations and as an advanced skill of nursing practice.
Abstract: Every day in clinical settings, nurses practise in complex and dynamic situations. Nurses work to achieve emergent order in these situations through nursing prioritization of the patient need for care. As direct research on nursing prioritization had not been reported, a study, using critical realism as method, was designed to discern the profession's embedded understanding from within the clinical decision-making literature. The research synthesizes a tacit knowledge on nursing prioritization of the patient need for care from key international literature (from 1966 to 2003). Nursing prioritization was discerned in both education and practice literatures; interrelationships between these and theoretical approaches were also identified. Nursing prioritization of the patient need for care was revealed both as a non-sequential decision-making process throughout unfolding patient situations and as an advanced skill of nursing practice. Increasing confidence with this skill is the hallmark of developing expertise.
TL;DR: This Jordanian study indicated high early initiation of breastfeeding, and most mothers gave supplements other than breastfeeding, including water without knowing that this supplementation could affect exclusive breastfeeding or the continuation of breastfeeding.
Abstract: The purpose of the study was to explore Jordanian women's breastfeeding beliefs and practices including exclusive breastfeeding. A descriptive cross-sectional design with a convenience sample of 200 Jordanian mothers was used. The majority of mothers were muliparous and were recruited from primary health-care centres within 6 weeks of a normal vaginal birth or an instrumental delivery. Eligible women, who met the inclusion criteria, were invited to participate in the study. A sociodemographic data form and a 14-item questionnaire concerning different aspects of breastfeeding beliefs and practices were developed for self administration. This study indicated high early initiation of breastfeeding. Most mothers gave supplements other than breastfeeding, including water without knowing that this supplementation could affect exclusive breastfeeding or the continuation of breastfeeding. Finding of this study shed some light on the current breastfeeding practices including exclusive breastfeeding among Jordanian women. Women need to be better educated about breastfeeding. Therefore, more efforts and resources should be put into providing opportunities for education to discuss breastfeeding during antenatal care. This Jordanian study could be relevant to Arabic women in the West, because cultural beliefs and practices are likely to be part of immigrant woman's perceptions about breastfeeding practices.
TL;DR: Examination of the effects of breast-feeding on pain relief during neonatal immunization injections in Jordan concluded that, breast- feeding and skin-to-skin contact significantly reduced crying in infants receiving immunization.
Abstract: Using a quasi-experimental design, this study was conducted in two maternal & child health centres in Jordan to examine the effects of breast-feeding on pain relief during neonatal immunization injections. Inclusion criteria were first year of age, breast-fed and no concurrent illness. Infants were divided into two groups (of 60 infants for each). One is intervention group: mothers were taken to a private room, seated and reclined on a comfortable chair with their infants awake in their arms, without cloth and with clean diapers. The mothers cradled their infants during breast-feeding to maintain full-body skin-to-skin contact during immunization injections. The other is control group: infants were observed during routine immunization in maternal & child health centres. Pain responses of infants during and after immunization were assessed by using Facial Pain Rating Scale and Neonatal/Infant Pain Scale (NIPS), before, during and after the procedure. Infants' heart rates and duration of crying for both groups were calculated. Findings revealed that the crying time was shorter in intervention (breast-fed) group than in the control group with a statistically significant difference in the duration of crying during and after immunization. We concluded that, breast-feeding and skin-to-skin contact significantly reduced crying in infants receiving immunization.
TL;DR: This two-wave study explored the relationship between the coping styles and stressful life events in terms of the occurrence of depression and anxiety among 97 Japanese female nursing students before (Time 1) and after (Time 2) a clinical training.
Abstract: Nursing students face stressful situations during a clinical training. This two-wave (between June and December 2004) study explored the relationship between the coping styles and stressful life events in terms of the occurrence of depression and anxiety among 97 Japanese female nursing students before (Time 1) and after (Time 2) a clinical training. In a structural equation modelling, Time 2 depression was significantly predicted by Time 1 depression and stressful life events whereas Time 2 anxiety was predicted by Time 1 anxiety, stressful life events and emotion-oriented coping. Moreover, Time 1 depression predicted the impact of stressful life events and Time 1 anxiety predicted emotion-oriented coping.
TL;DR: Findings of the study indicated that women had a more painful labour than they expected, they were scared of the experience of labour, they went through different procedures during labour including induction and episiotomy, and perceived that they had an intense childbirth experience.
Abstract: The main aim of this study is to document women's perceptions of the different aspects their childbirth experience including expectations, satisfaction and self-control. Other aspects of the labour process including length of labour, difficulty of labour, effectiveness of pain control, expectations of pain level, perception of level of involvement in decisions among other variables were also explored. A descriptive cross-sectional design was used to achieve the aim of this study. A convenience sample of 177 Jordanian mothers was used. They were recruited from three primary health-care centres located in Irbid, north of Jordan. Findings of the study indicated that women had a more painful labour than they expected, they were scared of the experience of labour, they went through different procedures during labour including induction and episiotomy, and perceived that they had an intense childbirth experience. The majority of participants reported that they were not satisfied with the different aspects of the childbirth experience and perceived that they had little control during childbirth. These findings should be considered by all health-care providers, hospital administrators and policy-makers to plan and implement appropriate strategies that could help women go through the childbirth experience with less fear and anxiety and empowered with coping mechanisms that could reduce their dissatisfaction with their childbirth experience and to help them regain more control during childbirth. Such strategies might include reconsidering staffing in the maternity units and patient nurse or midwife ratio.
TL;DR: Respondents generally reported highly limited physical functioning and slightly limited social functioning, and more attention should be paid to the environment of nursing homes and residents' hobbies and special interests.
Abstract: This study examined the health-related quality of life (HRQOL) of nursing home residents (≥ 65 years) using the Short-Form-36 Health Survey subscales and how these subscale scores are related to residents' sociodemographic and medical conditions. Residents 95–102 years old reported higher HRQOL than younger respondents. Those with more education reported higher HRQOL. Residents who reported hobbies or special interests had a higher HRQOL score on vitality and mental health variables. Finally, respondents with no comorbid illness scored highest on all HRQOL dimensions, and this was statistically significant for physical functioning and bodily pain. In conclusion, respondents generally reported highly limited physical functioning and slightly limited social functioning. To improve the situation of residents, more attention should be paid to the environment of nursing homes and residents' hobbies and special interests.
TL;DR: The findings in this article present the perspective of the mothers who opted for elective Caesarean, and the importance of understanding and taking into consideration the mothers' psychosocial perspective on birth choices as a key to providing counsel and support is emphasized.
Abstract: As the rate of primary and repeat Caesareans around the world increases, obstetricians, midwives and primary care providers are being expected to provide counsel to women seeking information regarding birth choices for delivery after a prior emergency Caesarean. This article seeks to contribute to the knowledge on this topic by presenting research findings from a qualitative study designed to explore, from the mothers' perspective, the decision-making experience with regards to subsequent birth choice for women who have previously delivered by Caesarean section. Specifically, the findings in this article present the perspective of the mothers who opted for elective Caesarean. Eighty per cent of mothers in this study chose elective Caesarean for reasons of fear and the desire to retain some control over the birthing process. For many, this decision is made prior to or early in pregnancy without any openness to consider other possibilities. Thus, the findings strongly emphasize the importance of understanding and taking into consideration the mothers' psychosocial perspective on birth choices as a key to providing counsel and support.
TL;DR: A significant problem with the knowledge surrounding CPR was identified and the lack of professional responsibility in dealing with this inadequacy was more concerning than the inability to recall essential CPR knowledge.
Abstract: There is a public expectation that registered nurses are competent in their skills. Nurses need to know cardiopulmonary resuscitation (CPR) to enable them to safely and effectively provide appropriate CPR measures. The objectives of this descriptive study were (i) to investigate nurses' knowledge regarding CPR; and (ii) to identify barriers to appropriate CPR evaluation. One hundred questionnaires were distributed to nurses working in a public government hospital in Bahrain; 82 of these were returned. The results indicated that cognitive knowledge was not adequately retained. Fifty-eight per cent of respondents perceived recalling CPR information as easy or extremely easy. Only 7% of respondents passed the knowledge test. In general, those who had less education and experience did not recall essential CPR knowledge. This study identified a significant problem with the knowledge surrounding CPR. More concerning was the lack of professional responsibility in dealing with this inadequacy.
TL;DR: Good patients were rewarded with tender loving care although difficult patients were ignored or needed interventions deliberately delayed, and nurses found to violate health-care consumers were counselled, disciplined and/or dismissed.
Abstract: The paper is part of a large-scale study exploring violence in nursing conducted between 2005 and 2006. There were various objectives for each aspect of the study. Qualitative descriptive survey was selected. The population were all nurses licensed with the South African Nursing Council. Non-probability sampling technique was utilized to distribute confidential questionnaires to nurses employed in the eight public hospitals during 2006. Good patients were rewarded with tender loving care although difficult patients were ignored or needed interventions deliberately delayed. Because of the severe shortage of qualified staff, nurses had to rationale care in order to meet needs of all their patients. However, nurses found to violate health-care consumers were counselled, disciplined and/or dismissed.
TL;DR: Because of the increased level of post-traumatic stress disorder reported post disaster work, it is imperative that governmental and non-governmental agencies consider predisaster training of volunteers in not only clinical skills, but also communication and team building.
Abstract: Because of the increased level of post-traumatic stress disorder (PTSD) reported post disaster work, it is imperative that governmental and non-governmental agencies consider predisaster training of volunteers in not only clinical skills, but also communication and team building When these concepts are combined with ongoing support post disaster, a decrease in the frequency and severity of PTSD has been reported A review of 12 studies examined responses of relief workers to various disaster situations Experiences were extracted, categorized, and a data reduction model was developed to illustrate the characteristics of the experiences and subsequent interventions that were reported Three interventions that positively affected the responses of relief workers to disaster experiences emerged: debriefing, team building and preparation
TL;DR: 12 clinical practice guidelines that were developed from the findings of a literature review into non-pharmacological measures that are thought to facilitate patient comfort are presented.
Abstract: Nurses often use non-pharmacological measures to facilitate comfort for patients within the hospital setting. However, guidelines for use of these measures are commonly inadequate or absent. This paper presents 12 clinical practice guidelines that were developed from the findings of a literature review into non-pharmacological measures that are thought to facilitate patient comfort. The non-pharmacological measures addressed in these guidelines are: Aromotherapy, Distraction, Guided Imagery, Laughter, Massage, Music, Reiki, Heat or Cold, Meditation, Reflexology, Reposition and Transcutaneous Electrical Nerve Stimulation. These are preliminary guidelines for the use of non-pharmacological measures and further research and development of such guidelines is recommended.
TL;DR: CIT was successfully used to foster European and Canadian undergraduate students' cultural reflections resulting in considerations and suggestions for future endeavours to enhance cultural competence in nursing education.
Abstract: This paper describes the enhancement of cultural competence through trans-Atlantic rural community experiences of European and Canadian nursing students using critical incident technique (CIT) as the students' reflective writing method. The data generated from 48 students' recordings about 134 critical incidents over a 2-year project were analysed by qualitative content analysis. Five main learning categories were identified as: cross-cultural ethical issues; cultural and social differences; health-care inequalities; population health concerns; and personal and professional awareness. Four emergent cultural perspectives for the health sector that became apparent from the reflections were: health promotion realm; sensitivity to social and cultural aspects of people's lives; channels between the health sector and society; cultural language and stories of local people. CIT was successfully used to foster European and Canadian undergraduate students' cultural reflections resulting in considerations and suggestions for future endeavours to enhance cultural competence in nursing education.
TL;DR: Cancers and related treatments have devastating effects on psychosexual life of patients, but cultural beliefs of Asians pose as barriers to providing and receiving psychosexual affection between women diagnosed with cancer and their spouse serve as protective factors in their mutual acceptance of change in psychosexual activities.
Abstract: Cancers and related treatments have devastating effects on psychosexual life of patients. This study helps us to understand the cultural perspectives of 50 Asian women diagnosed with cancer. Median age was 50+ years. Median duration of time from diagnosis to interview was 23 months. Thirty-eight per cent stopped sex before illness, 36% stopped sex completely whereas 18% stopped gradually after diagnosis; 8% continued to have sex till time of interview. Overall, 70% were living with spouse but not engaged in sexual intercourse; 31.4% slept in different room, 48.6% slept in the same room but without any form of sexual contact. Thirty-eight per cent believed sexual activity could cause cancer recurrence, and 30% believed cancer could be sexually transmitted. Eighty-two per cent reported acceptance of changes to physical appearance. Approximately 70-86% did not discuss sexuality with their doctor or spouse; 90% agreed doctors should ask about psychosexual issues on a routine basis. Approximately 74.4% reported good cooperation from spouse. Cultural beliefs of Asians pose as barriers to providing and receiving psychosexual affection between women diagnosed with cancer and their spouse. However, these beliefs also serve as protective factors in their mutual acceptance of change in psychosexual activities. Health-care professionals need to be sensitive to the vast cultural differences in psychosexual expressions and needs of women diagnosed with cancer.
TL;DR: This model provides a framework for coordinating efforts in providing fertility preservation options to patients undergoing treatment for cancer and ensures that not only a cancer survivor, but one whose quality of life might be enhanced by being able to have a child of his or her own in the future is saved.
Abstract: Cancer treatment and the field of reproductive technology have each made impressive advancements in the last decade. Improved cancer treatment and survival rates have increased the number of cancer survivors, who might benefit from an array of fertility preservation strategies provided by emerging and advanced assisted conception technology. The challenge becomes bridging the gap between these two separate disciplines to ultimately improve the quality of life for cancer survivors. This paper discusses the issues and process involved with bringing these two teams of health-care professionals together. This model provides a framework for coordinating efforts in providing fertility preservation options to patients undergoing treatment for cancer. Effective multidisciplinary teams that include: oncologists, nurses in the specialties of oncology and infertility, social workers, reproductive endocrinology and infertility specialists, andrologists, and embryologists are required to work together in order to achieve success. The result of this unique team approach is not only a cancer survivor, but one whose quality of life might be enhanced by being able to have a child of his or her own in the future.