ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01185.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01186.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The family is the primary source of care for a chronically ill child, and it is the parents who must manage the child's illness on a daily basis. This qualitative study was undertaken to investigate the ways in which 10 two‐parent families of children with juvenile arthritis experience their child's illness. In this paper the theme of coming to terms with the management of the illness and what it entails for the parents is examined. The data provide evidence of how the parents learn, and their efforts and experience of learning to care for the child on a daily basis. This is a complex process and includes the different phases the parents experience as they move through the learning process. The findings suggest that the parents learn the child's care and make adjustments to the demands of managing the child's illness in a way that works best for the

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01187.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The increasing use of ambulatory care settings for children's surgery places more responsibility on parents for psychological preparation of children for surgery and for their post‐operative care. This paper describes the evaluation of a pre‐admission programme to prepare children between the ages of 3 and 15 years and their families psychologically for day surgery. Seventy‐five families comprised the study sample, 23 in the programme group and 53 in the non‐intervention group. The programme focused on familiarizing families with the physical and procedural components of day surgery through a videotape of a family in a naturally occurring day surgery situation, a tour, and hospital play. Fewer children and parents in the programme group reported high anxiety levels awaiting surgery. Children and parents with previous surgical experience reported higher levels of pre‐surgical anxiety than inexperienced families. Families reported the physicians and day surgery nurse as their primary sources of information and rated the day surgery nurse highest in their satisfaction with information received. Implications for practice, particularly for meeting the needs of young children and out‐of‐town families,

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01188.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This paper reports on the results of two studies conducted to further validate the Abu‐Saad Paediatric Pain Assessment Tool, a Dutch‐language questionnaire developed to assess pain in school‐age children. Children of 5 to 15 years of age reported in the first study their post‐operative pain before and after the administration of analgesic medication using word descriptors of pain, the 10‐cm scale, the Oucher, and a visual analogue scale (VAS). Lower mean pain scores at 4‐hourly intervals post‐analgesia supported the construct validity of the tool. Convergent validity was supported in both studies when scores on all concurrently administered measures positively correlated with the pain tool. In the second study, the correlations between pain and fear, a concurrently used measure with the pain instruments, were low, substantiating the discriminant validity of the pain tool. The significance of the results in relation to instrument development and multidimensional pain assessment in children are further discussed a

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01189.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The assessment and control of pain in elderly patients present unique problems. Old people are likely to experience more pain, both chronic and acute, than their younger counterparts. Demographic changes mean that larger numbers of older patients will require effective and efficient control of pain in order to optimize their quality of life. Relatively little research has focused on this potentially huge problem. This paper discusses issues specific to pain in elderly people, and suggests that wide ranging and careful assessments are needed. Benefits can be achieved not only from the appropriate use of analgesic drugs, but also physical and psychological therapies.

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01190.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study is part of a major research project that is concerned with disruptive behaviour among elderly patients and the use of physical restraint in geriatric nursing. The purpose of this study was to describe the use of physical restraint and alternatives as reported by professional nurses. The data were collected by a structured questionnaire. Nursing staff (n=287) from a geriatric unit of a health centre, a nursing home, and the medical and psychiatric clinics of a university hospital in one city in central Finland, volunteered for the study. The clear majority (85%) of the nurses stated that physical restraint had been used on the ward during the week preceding the questionnaire. Reasons cited most often for restraint use were reduced physical and cognitive capacity of demented patients. The most common alternative was to try to understand the reasons for the elderly patient's disruptive behaviour. A major challenge for future research and for field experiments is to provide new alternatives to the use of physical restraint in geriatric nursing.

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01191.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The present study focuses on the characterization and perception of patient aggression by nurses working in a psychiatric hospital in The Netherlands. Data have been collected by interviewing nurses working on open and closed wards. The results have been compared and related to the existing literature on aggression. An expert panel has collaborated in the assessment of part of the research findings. Nurses perceive and describe aggression in different ways. Since the descriptions of aggression varied considerably, it was not possible to formulate a general definition of aggression on the basis of the results of the study. Despite the fact that on the whole the general public have a negative view of aggression, the descriptions nurses gave were not always negative. Most of the nurses acknowledged positive as well as negative aspects of aggressive behaviour by patients. Interventions in cases of aggressive behaviour depend on different factors, e.g. the individual nurse's perception of the situation, the (mostly unwritten) rules, and the type of ward (open or closed). The same interventions are often used both to prevent aggression and to stop it. The difference lies in the moment of execution. Most interventions are aimed at stopping aggressive behaviour by acting in a non‐restrictive way, e.g. by talking to the patient, touching the patient and giving unexpected responses. Nurses express the belief that aggression is mainly caused by a combination of patient‐related, situational and interactional factors. This is not in accordance with the opinion of the North American Nursing Diagnosis Association, who relate aggressive behaviour mainly to patient characteris

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01192.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Despite the shift in recent policy towards people with severe and long‐term mental health problems, there is considerable evidence that mental health nurses tend to prioritize clients with acute, neurotic or short‐term problems and become demoralized when working with people with persistent needs and disabilities. Mental health nurses need to find ways of developing effective relationships with these people in order to offer a service which the client is not only willing to engage in, but takes an active part in, and which allows care providers to derive satisfaction from their work. Through 46 in‐depth interviews with case managers (working specifically with people with long‐term mental health problems) and their clients, this qualitative study provides some guidelines for mental health nurses working in this field. Analysis of the interviews revealed that both clients and case managers focused on the problems and strategies associated with developing and maintaining relationships with one another. Furthermore, the interviews suggested that case managers adopted a philosophy for working that enabled both clients and case managers to feel positive about the work. The principles of this value base, and the way it was used in the process of case management, are explored in this

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01193.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Research with caregivers of cognitively impaired individuals has provided evidence which suggests that most caregivers experience at least some degree of burden. However, it has been postulated that it is the caregiver's subjective interpretation of the situation that is the primary factor responsible for mediating the degree of burden experienced. Caregivers who cope well with this type of stress may possess a high level of self‐efficacy. The purpose of this paper is to analyse the concept of self‐efficacy and its relationship to health care using Walker&Avant's concept analysis methodology. Uses of the concept of self‐efficacy, as well as its defining attributes, antecedents, consequences and empirical referents, are discussed. Also, model, borderline, related, contrary and invented cases are constructed to illustrate the concept further. The relevance of the concept to nursing practice and areas requiring future investigation are

ISSN:0309-2402    

DOI:10.1111/j.1365-2648.1994.tb01194.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY