Videothoracoscopy for diagnosis and treatment of respiratory tract diseases

Orthopaedic nurses often are well-educated in dealing with patients' physical and psychologic needs but lack education in caring for the spiritual needs of man. Nurses must realize they, themselves, have spiritual needs and must invest in clarifying their own values and beliefs as well as their patients. To perform a complete spiritual assessment, nurses need to become familiar with the concept of spirituality and what it means in the care of patients. Providing spiritual care is individualized and often complex. The nursing process enables the nurse to plan patient care. Providing spiritual care is a challenge orthopaedic nurses must recognize and assume responsibility for.     

Predictors of patient outcomes following interactions with nurses

A research and theory-based model was used to identify outcome predictors of hospitalized patients' perceptions of caring and support by nurses. The model tested the effects of cogent personal characteristics of patients (general level of self-esteem and need for control while hospitalized) on their perceptions of humanistic caring and support from nurses and, in turn, considered the effect of these variables on situational appraisal, coping strategies, psychological distress, and coping effectiveness. The 120 hospitalized adult patients indicated that the moderate amount of humanistic caring they received was beneficial. Several factors influenced caring ratings. Higher positive ratings were received from younger patients; however, people with low self-esteem and those desiring more control over their care or reporting a high degree of pain tended to perceive more threat and psychological distress as a results of their encounters with nurses. Following positive caring experiences with nurses, patients with higher self-esteem levels reported effective coping. Overall, positive caring experiences, along with coping strategies and decreased psychological distress levels, explained 40% of the variance of hospitalized patients' ability to cope effectively following their encounters with nurses.     

Technology and care in a bone marrow transplant unit: creating and assuaging vulnerability

The article describes the experience of technologically induced vulnerability and the inherent uncertainty of patients undergoing bone marrow transplantation. Examples of care by nurses, as perceived by patients and their family members, are offered. The relationship between the iatrogenic vulnerability and suffering of patients and the nursing response of care is explored. The claim is made that a caring response by nurses enables patients to make meaning of their choice to undergo simultaneously life-saving and life-threatening bone marrow transplantation.     

The meaning and impact of empathic relationships in hospice nursing

This naturalistic field study was designed to explore the patient's perspective of the nature, meaning, and impact of empathic relationships with hospice nurses. The findings are part of a larger study, focused on the meaning and impact of empathic relationships that develop between hospice nurses and their patients. Data were generated through in-depth interviews with 14 terminally ill adults receiving home-based hospice care. According to the hospice patient, an empathic relationship developed through a process of reciprocal sharing and revealing of personhood within a context of caring and acceptance. The experience of an empathic relationship meant being acknowledged as an individual, a person of value. The outcome of the empathic relationships between hospice nurses and their patients was the improvement and maintenance of patients' physical and emotional well-being. Understanding the patient's perspective is critical for effective nursing interventions and meaningful outcomes. Future research needs to explore empathic relationships between the nurse and family caregivers in various settings.     

Family caregiving of hospitalized patients. Caregiver and nurse perceptions at admission and discharge

To ensure patients will be discharged to stable, health-promoting home environments, nurses must understand family caregivers' perceptions of the patients' needs and problems in caring for them. At the time patients were admitted to and discharged from the hospital, there was little agreement between family caregivers and nurses about the kinds of things caregivers needed to care for older patients or about problems that might prevent the continuation of caregiving. There was slightly more overall agreement between family care-givers and admission nurses than discharge nurses, despite the fact that discharge nurses reported spending more time with patients and being more knowledgeable about them. Future discharge planning models should build opportunities for nurses to communicate with other health care colleagues who can contribute to a more accurate and complete picture of patients' and family caregivers' needs and problems in the transition from hospital to home.     

Schizophrenic patients in the psychiatric interview: An experimental study of their effectiveness at manipulation.

This study attempted to examine whether chronic schizophrenic patients could effectively engage in the manipulative strategy of impression management in an evaluative interview situation. The data supported the expectation that schizophrenic mental patients can effectively present themselves as "sick" or "healthy," whichever is more suited to their needs and goals. Thus, when the patients' open ward status was questioned, they convincingly presented themselves in the interview as "healthy" and eligible for open ward living; when their residency status was questioned, they convincingly presented themselves as "sick" and ineligible for discharge. These findings were interpreted as supporting assumptions of patient effectiveness in implementing goals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diminished hyperaemic response of the hepatic artery to portal venous occlusion (the buffer response) in Asian hybrid minipigs: a comparison of the response to that observed in dogs

This study is part of a larger study of the effect of integrity-promoting care in a Swedish nursing home ward. Compared with assessments on a control ward, improvements were found in the patients' behaviour and in the quality of care after a three-month intervention period. This paper reports on parts of a questionnaire survey on the nursing staff's opinions of their working conditions and demented patients. Most staff members on both the intervention ward and the control ward found their jobs meaningful, engaging and stimulating, but they also felt that they had a heavy work-load. Most of the staff members experienced mental strain because of the patients' disturbed behaviour. Many did not think that the care on their ward would have been good enough for their own close relatives, if they had been suffering from dementia. Only slight changes were found in the staff members opinions after the intervention.     

Fractional clearances of low molecular weight proteins in lead workers

The phenomenon of wanting to help another is a universal human experience. Individuals reach out to others in order to fulfill personal commitments, to assist loved ones, or to meet professional obligations. The purpose of this research using Parse's method was to generate the structure of this experience as lived by nurses. Findings indicate that the lived experience of wanting to help another is directing nurturing intentions amidst uplifting affirmations with others while dissonant constraints unfold new possibilities. Findings are discussed in light of Parse's theory in order to expand the knowledge base of nursing. Similarities and differences with research findings on the experiences of nurturance and caring are presented. Implications for practice and further research are specified for nurses encountering persons who express their desire to help another.     

The properties of simian coronavirus

OBJECTIVE: To determine the effect of a unique educational program in critical care medicine on the attitudes, knowledge, and skills of general internists who care for critically ill patients. DESIGN: Comparison of objective assessments and self-assessments obtained before and after the one-year educational program. SETTING/PARTICIPANTS: Eighteen general internists practicing in a 350-bed university-affiliated community teaching hospital. RESULTS: After the program, the internists felt significantly more competent in, knowledgeable about, comfortable with, and satisfied with caring for critically ill patients than they did when completing the precourse self-assessments (p < 0.05). Participants felt particularly more comfortable with managing ventilator patients and leading the advanced cardiac life-support team (p < 0.05). Comfort levels for other commonly performed critical care procedures did not vary. No significant change in knowledge test scores was noted from before to after the one-year program (61% vs 60%). Residents and nurses rated the internists' overall ability in critical care medicine to be the same as that of senior medical residents. They also favorably rated the internists on humanism, teaching skills, and interpersonal interactions. Residents also appreciated the decrease in their night call because of the program. CONCLUSIONS: This unique educational program increased comfort and satisfaction of general internists caring for critically ill patients. The program was well accepted by residents and nurses because of favorable interaction with the internists and a decrease in resident night-call responsibility. This curriculum is recommended to other teaching hospitals.     

"Codependency". A disease or the root of nursing excellence?

A hermeneutic phenomenological study was conducted to explore how eight professionally competent nurses experienced and evaluated the relation between their childhood adaptation to dysfunctional families and their nursing careers. From the participants' discussion of this topic, the following themes emerged: escaping difficulties by becoming a nurse, coping roles guide nursing career, sensitivity to the untold, transforming dysfunctional responses, and wounded healers. The study did not support the view that children of alcoholics seek careers in nursing to meet their codependent needs for self-esteem, control, or belonging. Instead, its findings indicate that some children of alcoholics become competent nurses by finding positive application for the coping skills they learn in their families. This indicates that, when working with individuals from dysfunctional families, nurses could support them to create new avenues for their coping skills instead of trying to "exterminate" them because of their "codependent" nature.     

A phenomenologic study of the interface of caring and technology in intermediate care: toward a reflexive ethics for clinical practice

A phenomenologic research study of nurse caring was conducted in an intermediate care unit of a hospital. Three narratives from the data are presented as examples to illuminate the meaning of the experience of caring for technologically dependent patients. Results revealed that vulnerability, suffering, and the ethical situations of moral blurring and moral blindness were the dynamics of caring for these patients. Identification of these phenomena cells for a new reflexive ethics in health care to increase understanding of how deep values in relation to the status of vulnerable human beings, and how moral interactions among patients, families, and caregivers, shape ethical decisions.     

The everyday experience of psychiatric hospitalization: the users' viewpoint

Using 38 focussed accounts the author reports on the hospitalization experiences of patients 18 to 38 years old in the psychiatric ward. The sample comes from the psychiatric wards of two general hospitals in the Montréal area (Canada). The data were analyzed using a qualitative method. Empirical categories were inferred from the respondents' discourse based on the broad themes which make up the psychiatric experience: admission; hospital environment and rules; daily life; medication; relations with the staff and leaving the hospital. The results shed light on the suffering, dissatisfaction and ambivalent feelings surrounding the patients' hospital experience. Based on the experience of psychiatric patients, the author identified five processes at work during psychiatric hospitalization.     

Ward sisters' views of the effect of NHS changes

The role of the ward sister or charge nurse has long been acknowledged as being central to the provision of high-quality patient care. Health service reforms since the 1980s have led to greater managerial responsibility for ward sisters and charge nurses, who are often now known as ward managers. This paper reports on a study carried out in one hospital which described how 15 charge nurses and ward sisters saw their roles in the light of recent changes. While the informants spoke of areas of their jobs with which they were satisfied, such as control over financial resources, there were also areas of concern. These included the pace of change and the sense of isolation that they experienced. The ward sister's responses are described and recommendations for practice outlined.     

Sublethal effects of an organophosphate insecticide on the European eel, Anguilla anguilla

Recent research has found that family caregivers do not discuss their caregiving in terms of tasks but instead describe their care as shaped by concerns, commitments and goals. The purpose of this paper is to challenge the ways in which nurses approach the family caregiving process and to explore possibilities for evolving nursing knowledge by questioning existing practice in the light of developing insight into the ways in which being a family caregiver is meaningful. A critique of the philosophical orientations of rationalism and empiricism provides a platform to discuss the merits of a Heideggerian phenomenological approach in assisting nurses to better understand family caring experience. Such critique serves to support the notion of displacing the traditional scientific view as the prime means of disclosing truth, acknowledging alternative ways of knowing.     

Infusional therapy with alkylating agents

Newborns with chronic problems needing continuous and special care even after discharge are not very frequent but represent a challenge for the caring team. The discharge program of the Neonatal Care ward of Trento hospital includes several steps: discharge meetings of teh neonatologist and the nurse responsible for the child, the head nurse, the psychologist and, when possible, the social worker; a training program for the parents; the coordination of communications and interventions of the home-care nurses and a detailed post-discharge planning. From 1995 a home-hospital program, as an alternative to the hospital admission was started. To describe how the team functions and stress the need of a close integration among the team members, the case of Ahmed is presented. This case faced the team with several challenges, because of the lack of parent's knowledge of the italian language and of the severity of the child's problems. Every care plan is developed building on newborn's needs and patients' resources. Data on the patients-problems dealt with from 1991 to 1995 and the interventions and resources needed are presented.