Implications For Nursing Practice Research Articles

Growing up with chronic illness: the experience of growing up with cystic fibrosis.

The article describes the experience of growing up with a chronic illness. A hermeneutic-phenomenologic design based on van Manen's technique and set in Watson's theory of human caring was used to explore the meaning of the experience for 10 adults with cystic fibrosis. Themes that emerged included being different, "dont't call me terminal," and will power and faith. Implications for holistic nursing practice are included.

Delivering the future

The third and last White Paper on primary health care has been released by the Department of Health. Barry Blatt reviews the implications for practice nurses.

Attributes of nurses that determine the quality of care for mentally handicapped people in an institution.

This is an ethnographic study that examines, from the relatives' perspective, the attributes of nurses that are considered important in the caring process of mentally handicapped people in an institutional setting in Hong Kong. Twelve interviews were carried out with a family member who had a relative living in a special unit for severely mentally handicapped people. Empirical studies, mainly from the west, have shown that decisions to place a mentally handicapped family member in residential care is a complex process. Family characteristics, the relatives' characteristics as well as the availability of support, have been found to influence decisions about out-of-home placement. Once this decision has been made, a new caring relationship between nurse, family and relative needs to be established. The final categories that emerged from the data show that families have expectations about the nurses' competence and commitment to the job and about their relationships with the client and the family. Consequently quality is judged, not only by the way in which nurses work with the clients, but also by the way in which they work with the family. Implications for practice and education of nurses working with mentally handicapped people and for nursing administration in Hong Kong are discussed.

Patient education resources related to biotherapy and the immune system.

PURPOSE/OBJECTIVES To provide cancer care professionals with insight into available patient education resources related to biotherapy. DATA SOURCES Literature from pharmaceutical companies, national organizations, the National Cancer Institute, and individual cancer centers. DATA SYNTHESIS Comprehensive, but not all-inclusive, list of booklets, videotapes, and fact sheets currently available to inform and instruct patients and families regarding biotherapy, injection techniques, the immune system, and reimbursement strategies. CONCLUSIONS Using available materials eliminates the need to develop new products and standardizes patient instruction. IMPLICATIONS FOR NURSING PRACTICE These products facilitate patient and family education to promote understanding of the disease and treatment plan. Increased understanding can lead to independence and confidence in self-care.

Measuring Outcomes in Nursing Centers

While it is generally recognized that NPs offer affordable, quality health care, few studies have measured outcomes of clients who seek primary care services from NPs. This pilot study describes the outcomes of children with otitis media who received care from NPs employed in an academic nursing center. Outcome measurements included issues related to timing, level of analysis, and attribution. Parents of 27 children participated in a telephone survey consisting of seven questions relating to the care their children received from NPs and their recovery path. Although every respondent reported having a positive visit at the nursing center, concerns for NPs surfaced during the process of measuring outcomes. This study emphasizes the need for measuring outcomes in nursing clinics and demonstrates one way to measures client outcomes, revealing both general health care and specific nursing practice implications.

By accident or design

John Tingle highlights some recent problems in emergency care services and looks at some of the implications for practice nurses of a recently pubished Audit Commission report.

The experiences of patients and their partners 1 month after a heart attack.

The purpose of this study was to explore any patterns that may be evident in the experiences of 20 patients and their partners 1 month after a first heart attack. An interpretive research approach was used to illuminate the illness experience of patients and its impact on their partners. Semi-structured interviews were conducted with the participants, and qualitative analysis of the data revealed six major categories. These were: expectations about advice and information; feelings about the future; reactions of the partner; playing down the significance of the heart attack; wanting to get back to normal; and the effect on the couple's relationship. These findings are discussed in relation to the theoretical literature and other empirical research. The results of this study may provide pointers to the implications for practice of nurses, particularly on ways to improve support for patients and their partners during early convalescence.

The experience of advocacy.

This article explores the concept of advocacy and its relationship to the empowerment of service users. Forms of advocacy are described and their potential applications in practice are discussed. The practice implications for nurses and carers of vulnerable client groups are considered. A subsequent article will examine the process and outcomes of self-advocacy from the perspective of a group member with a learning disability.

Childhood violence: a nursing concern.

This article reviews the salient features of juvenile violence as they pertain to the factors contributing to the rise of violence and the impact of violence on public safety and health care. An overview of this pediatric health concern is addressed as well as its implications for pediatric nursing care and practice.

Ethnic identity, role integration, quality of life, and depression in Korean-American women

Little is known about how living between two cultures affects the mental health of immigrant women. This study examined the relationships between ethnic identity, role integration, quality of life, and depression in 76 Korean-American women. Quality of life was positively associated with role integration ( r = .68, p < .01). Role integration and quality of life were negatively and significantly associated with depression ( r = −.59 and r = −.72, p < .01, respectively). An exploratory path analysis was performed to examine the relationships between demographic and conceptual variables. Only quality of life and length of residence in the United States were strongly associated with depression. Findings have implications for psychiatric nursing practice.

Traditional healers and perceptions of the causes and treatment of cancer

The observation that some Nigerian patients use alternative health care services when they perceive that one medical system has failed them provided the impetus for this survey. The purpose of the survey was to understand why some Nigerian patients rely on traditional healers for cure of cancer by exploring the perceptions of Igbo traditional healers from Anambra State of Nigeria about the causes and treatment of cancer. Implications of the different meanings of illness and disease to patients and physicians provided the theoretical framework for understanding the cultural context of the study. Findings have ethical, moral, and cultural implications for professional nursing practice, education, and research.

Measuring nursing outcomes in a psychiatric setting.

Recent developments in health care reform suggest the importance of outcome data regarding the nature, costs, and documented effectiveness of various health care services. While psychiatric nurses believe in the value of the care they provide, the present climate requires that research be conducted to elaborate the outcomes of psychiatric nursing care. This article describes a pilot study conducted on two adult inpatient units of a teaching hospital. On the experimental unit, nurses used North American Nursing Diagnosis Association (NANDA) nursing process documentation that related to specific patient outcome criteria. On the control unit, nurses used a medical systems approach to documentation. Study results and important unanticipated findings are reported with implications for future nursing research and practice.

Understanding Staff Nurse Responses to Change

This paper reviews the literature on the psychological effects of change and discusses the impact of an overarching organizational change on the staff nurses of a large oncology unit in the Midwest. Their reactions are compared with a grief-change framework synthesized from the literature. This framework was useful in explaining staff nurse behaviors and attitudes, and offered interventions specific to each stage of the change process useful to the CNS. Dissemination of this information is discussed, as well as implications for advanced nursing practice.

Geriatric falls: prevention strategies for the staff.

1. Multiple falls and injuries are more prevalent among elderly over the age of 75 and are the second leading cause of accidental death in the elderly. The risk for falling is noted to be significantly greater in the hospitalized elderly. 2. Review of retrospective quality improvement chart audits revealed that peak fall times were associated with the patient's need for toileting, rest, and obtaining nutrition and hydration. 3. The MetroHealth Falls Prevention Program is based on simple proactive measures to prevent falls in the elderly. 4. An effective falls prevention program has several implications for gerontological nursing practice, including less restraint use, increased patient autonomy, and decreased loss of self-esteem. There is also a sense of increased nursing control over patient safety and time management, as well as implications for further nursing research.

Sampling issues in parent-child nursing research: implications for nursing practice.

A S NURSES ARE increasingly expected to read and incorporate research findings into their practice, emphasis on the evaluation of such research becomes critical. Several critical and integrative reviews of nursing research have been published over the past decade (Beal & Betz, in press; Betz & Beal, in press; Brown, Kelen, & Moser, 1985; Cronenwett, 1982; Diers & Molde, 1979; Jacobsen & Meininger, 1985; Moody et al., 1988; Perlmutter, 1985; Selby et al., 1990; Silva, 1986; Strehle, 1981; Uman & Urman, 1990; Werley & Fitzpatrick, 1984, 1985, 1986). Only a few reviews have evaluated the research published in the subspecialty of parentchild health nursing (Beal & Betz, in press; Betz & Beal, in press) or specifically the sampling methodology used (Selby et al., 1990). Because the sampling method used during the conduct of the research so directly impacts on the reader’s ability to use the research findings in clinical practice, we chose to evaluate the sampling methods used in the parentchild research published during the past decade. The purpose of this article is to describe our review and the implications of our findings for the clinical practice of parent-child health nurses. Few studies have scientifically reviewed sampling methodology. Moody and colleagues (1988) in a review of the nursing research published from 1977 to 1988, found that most of these studies reported using small nonrandomized samples. Also, Jacobsen and Meininger (1985) reported that sample sizes were small and that sampling methods were not clearly described. Selby et al. (1990) in a more recent review of 30 randomly selected research reports published in 1986, found that nearly 97% contained at least one major deficiency in sampling methodology. Some of the deficiencies were as follows: (a) failure to describe the sampling frame, sample size, number of refusals, withdrawals and /or cases lost, and sampling methods used; (b) inappro-

Human energy fields and birth: implications for research and practice.

This article reviews nursing and related theories of human energy fields and their relevance for care of women in pregnancy and birth. Alternative nursing activities based on human and environmental energy field concepts are presented and implications for future nursing and midwifery research and practice are discussed.

The tendency for temperament to be "temperamental": conceptual and methodological considerations.

Temperament seems to be a concept that stimulates a great deal of enthusiasm among nurses and professionals who "discover" it. Yet "knowing" that you have captured something of value does not necessarily imply full knowledge and understanding of the object. On the contrary temperament enthusiasts guarantee no consensus of opinion about what it is or how to best measure it. And so the conceptual and methodological issues for debate and discussion continue spilling over into both its research and clinical use. Sorting out the issues and the implications for use when there has been so much discussion and debate can be difficult. This article attempts to identify the main issues surrounding temperament, where we stand on some of the issues, and the practical implications for nurses who are interested in incorporating the measurement of temperament into clinical practice and research.

Characteristics of caregivers that promote children's development in day care.

Most available evidence on day care suggests that characteristics of the caregiver are the key components of high-quality child care. Yet, this fact is rarely appreciated by parents or policy makers. As primary health care providers, nurses can educate parents, caregivers, and policy-makers concerning the broad array of day-care features, including caregiver characteristics that should be considered. This article provides a review of the research on characteristics of caregivers that are found in high-quality day care and describes how these factors facilitate optimal development in young children. From the research findings, implications for nursing practice at the family, community, and national levels are identified.

Women's experiences of miscarriage in early pregnancy

The purpose of this qualitative study was to identify women's perceptions of their miscarriage experiences. Ten women who had miscarried within the first 15 weeks of their first desired pregnancies were interviewed two to four months after their miscarriages. Taped interviews were examined, using content analysis to delineate categories and themes. Themes were grouped into the following categories: the miscarriage event, dealing with the loss, interacting with outsiders, and facing the future. Critical findings included the following: the hush surrounding miscarriage contributed to the inadequate support women perceived; women benefited from unconditional acceptance of their feelings; women felt responsible for their miscarriages; several women experienced pain and bleeding that they perceived as life-threatening; several women grieved their losses as they would mourn the deaths of other family members; and women emerged from their experiences with changed perspectives. Implications for advanced nursing practice and topics for future research are discussed.

Intuition and nursing practice implications for nurse educators: a review of the literature.

Intuitive knowledge is an essential component of the art of nursing and of the nursing process. This article provides an analysis and review of the literature on intuition. The author addresses the use of intuition in nursing science, characteristics of intuitive nurses, receptivity of intuitive knowledge, and the importance of expanding nursing's utilization of the intuitive process. Strategies are provided for promoting intuitive skills in continuing education/staff development settings.