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Biomedical subjects

A McMurray

Publications and source records attributed to A McMurray.

34 records · Page 2Linked to original sources
PubMed1996

Couples' experiences of infertility: a phenomenological study.

If nurses are to work effectively with families in contemporary society, their practice activities must be appropriately informed. Families exposed to new technologies, such as in vitro fertilization (IVF) require care that is sensitive to their particular experience. Infertile couples have been the subject of a substantial body of research, however, most studies to date focus on the physiological effects of infertility and do not take into account the context in which the experience takes place, or the meanings that people assign to this experience. The purpose of this study was to examine in-depth the experience of couples undergoing IVF treatment for infertility. A phenomenological approach was adopted for the study. A purposive sample of six couples was selected for interview. Data were generated from taped interviews and the researcher's observational field notes. Data analysis was in accordance with the procedure outlined by Colaizzi (1978). Interview responses were categorized by examining the participants' transcripts and identifying significant statements and meanings. Themes which emerged from the statements were then identified, and cross-case comparisons were made to confirm or modify these themes. Four key themes emerged from the data: life changes; powerlessness; hope-disappointment cycle; and social isolation. All couples undergoing infertility treatment experienced life changes which included: lifestyle changes, various physical and emotional changes, and changes in their relationships. There was a perceived loss of control over many aspects of their lives. Couples also described a cycle, alternating feelings of hope and disappointment. Most of the couples reported feelings of social isolation associated with being infertile, that were intensified by having to deal with the inappropriate responses of others. Findings from this study will add to the knowledge base on infertility, and contribute to recommendations for improving the way nurses guide, counsel, and support infertile couples.

Adult↗
PubMed1995

Ulcerative skin reaction from subcutaneous infusion of isotonic methotrimeprazine and diamorphine.

We report an ulcerative skin reaction resulting from a subcutaneous infusion of isotonic methotrimeprazine and diamorphine. Skin reactions are a recognized side effect of this treatment, although they are reduced by the use of the isotonic formulation of methotrimeprazine. Frank ulceration has not been previously reported. It occurred in our patient despite low doses of diamorphine and methotrimeprazine, an isotonic formulation, and a short infusion time.

Adult↗
PubMed1994

Filgrastim fails to improve haemopoietic reconstitution following myeloablative chemotherapy and peripheral blood stem cell rescue.

The morbidity of high-dose chemotherapy has been considerably reduced by the use of autologous peripheral blood progenitor cell reinfusion. Most studies have used myeloid colony-stimulating factors after stem cell reinfusion, making it difficult to determine the relative contribution of each of these variables to the early recovery of blood cells. The financial implications of colony-stimulating factor use are an area of concern as dose intensification in chemosensitive malignancies is increasingly employed. We have studied 19 consecutive patients receiving high-dose chemotherapy with and without filgrastim (Amgen, granulocyte colony-stimulating factor, G-CSF) after stem cell infusion to examine its effect on the kinetics of blood cell recovery, the complications of myelosuppression and the associated costs. Analysis of the two treatment groups reveals that administration of filgrastim 10 micrograms kg-1 day-1 following stem cell reinfusion does not further accelerate haemopoietic recovery, fails to reduce the incidence of neutropenic fever or antibiotic usage and significantly increases the cost of the procedure. The results of this study do not support the routine use of filgrastim after high-dose chemotherapy and peripheral blood stem cell reinfusion.

Adolescent↗
PubMed1993

An evaluation of comparative strategies for teaching breast self-examination.

This study compared the effects of three alternative methods of breast self-examination (BSE) instruction (booklet, film and group discussion, individual teaching) on nurses' personal BSE practice. A pre-test and follow-up questionnaire were administered to a convenience sample of 166 nurses from Western Australian hospitals. The results demonstrated that each method of BSE instruction produced a significant improvement in the technique of BSE (P < 0.0001). However, the nurses involved in the film and discussion had the greatest improvement in BSE proficiency. Findings were analysed in terms of the Health Belief Model. The variables 'barriers to action' and 'perceived susceptibility' (in this case, to breast cancer) were found to be predictive of BSE practice; 'perceived barriers' at pre-test and 'perceived susceptibility' at follow-up. The incidence of BSE was significantly higher in the older nurses. A reminder to practise BSE was significantly associated with an effective BSE technique. Implications for nursing practice are discussed.

Adult↗
PubMed1992

Expertise in community health nursing.

This article reports on a study of expertise in community health nursing. The objective of the study was to develop a model of expertise derived from identification of the characteristics and factors influencing clinical expertise in community health nurses (CHNs) practicing in district nursing, school health, and child health. Participant observations, individual interviews, and written retrospective accounts of clinical episodes were analyzed from 37 nurses (10 novices within the first year of community practice and 27 experts identified by peers and colleagues). The data identified the expert as someone in whom the following characteristics operate synchronously: knowledge; empathy; appropriate communication; holistic understanding; an ability to get right to the problem at hand; and self-confidence in her or his perceptions, judgments, and intervention strategies. The findings suggest that there is a combination of factors which influences the development of expertise. These include educational factors, personal factors, and experience. These factors are incorporated into the model of expertise. The data also suggest that, in order to educate for expert levels of practice, the educational process must be designed to stimulate the learner's perceptual as well as analytic abilities. This can best be achieved through clinical practice opportunities and through demonstrations and case studies which stimulate inferential and intuitive thinking in students.

Australia↗
PubMed1986

Preceptoring.

Explore the source record for details and available documents.

Education, Nursing↗
PubMed1984

Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation.

The classical criteria for the evaluation of clinical trials in cancer reflect alterations in physical well-being, but are insensitive to other important factors, such as psychosocial state, sociability, and somatic sensation that may play a critical role in determining the patients' functional response to their illness and its treatment. The Functional Living Index-Cancer is designed for easy, repeated patient self-administration. It is a 22-item questionnaire that has been validated on 837 patients in two cities over a three-year period. Criteria for validity include stability of factor analysis, concurrent validation studies against the Karnofsky, Beck Depression, Spielberger State and Trait Anxiety, and Katz Activities of Daily Living scales, as well as the scaled version of The General Health Questionnaire and The McGill/ Melzack Pain Index. The index is uncontaminated by social desirability issues. The validation studies demonstrate the lack of correlation between traditional measures of patient response and other significant functional factors such as depression and anxiety (r = 0.33), sociability and family interaction, and nausea. These findings elucidate the frequently observed discrepancies between traditional assessments of clinical response and overall functional patient outcome. The index is proposed as an adjunct to clinical trials assessment and may provide additional patient functional information on which to analyse the outcome of clinical trials or offer specific advice to individual patients.

Canada↗
PubMedDate not supplied

Violence against ex-wives: anger and advocacy.

Researchers on violence against women have failed to reveal any studies that provide definitive explanations for the violent behaviors of certain males. However, violence against women has been known to occur as a result of unusually potent situational stressors, regardless of the male's propensity toward violence. Some of these situational stressors occur during the process of marital separation and divorce, particularly in relation to disputes over child custody, support, and access. In this paper I report on a second-level analysis of a set of studies in Australia aimed at examining the experience of separating parents who did not gain custody of their children. One of the dominant themes that emerged in the initial analysis from the male cohort was the real or vicarious violence that pervaded the men's interactions with their ex-spouses. These men, from a range of socioeconomic backgrounds and age groups, freely discussed episodes in which they had either planned, executed, or fantasized about violence against their spouses in retaliation for real or perceived injustices related to child custody, support, and/or access. In many cases, these thoughts and actions were reinforced by the encouragement of other males. To a lesser extent, women also reported violent inclinations induced by the situation. The implications for those advocating for women and families are clear. There is a need to understand the experience of marital separation from the perspective of both spouses as a basis for family counseling. We must also heighten awareness of the need to educate young people away from an "ownership" model of marriage and relationships, which is counterproductive to the personal development of both partners. Equally important is the need for all health professionals to advocate for changes that would help to correct injustices in the family court system, many of which are related to gender issues.

Adult↗
PubMedDate not supplied

Advocacy for community self-empowerment.

At the heart of the movement toward health care for all by the year 2000 lies an important central theme: community self-empowerment. When a community is able to choose strategies for health based on appropriate information, local resources, accessible support and institutional, organizational and social approval, it can be described as empowered. Such a community's health care is then considered to be self-determined, an enviable state of affairs, and one which is in accord with the goals of primary health care.

Community Health Nursing↗
PubMedDate not supplied

Time to extend the 'process'?

During the past two decades, nurses and nursing students have been encouraged to organize care planning via the 'nursing process'. Although it is helpful to adopt a systematic approach to planning nursing care, it may be time to evaluate our use of the process; to consider whether strict adherence to it has shifted nursing's perspective from holism to an unduly mechanistic approach to care giving. Several research studies support the notion that intuitive processes are an important aspect of clinical judgement. In order to educate future generations of nurses for expertise in practice rather than mediocrity, these processes must be acknowledged and taken account of in curriculum planning; the nursing process should be recognized as merely a fraction of the equation for practice.

Clinical Competence↗
PubMedDate not supplied

Domestic violence: are we listening? Do we see?

This article reports on a study of female victims of abuse who had been hospitalised for treatment of injuries inflicted by their spouses. A phenomenological approach was adopted wherein four women were interviewed to elicit their perceptions of their last hospital experience. Four major themes emerged from analysis of the interview data, these were that the women consistently experienced: disengagement and loss of status; disempowerment and lack of control; stigma and social isolation and a sense of being misunderstood. The results of the study are discussed in relation to women's expectations of nurses' attitudes and nursing interventions.

Attitude to Health↗
PubMedDate not supplied

Caring for the dying: nurses' experiences in hospice care.

This article reports on a phenomenological study of nurses' experiences of caring for dying patients in a Western Australian hospice. Data obtained from indepth interviews with nine experienced hospice nurses were analysed using Colaizzi's method. The five major themes that emerged from the data indicated that: nurses were transformed by the experience of caring for dying patients; the hospice context influenced caring; caring was embodied in nurse-patient interactions; caring extended to patients' families and nurses developed strategies to cope with their experience. The implications of the findings are that awareness of the effects of their caring activities on patients, their families and themselves is essential to nurses' maintenance of self and to their ability to enable patients to make choices. Suggestions are made for future research of the importance of caring contexts in both comforting patients and in preparing them for death.

Adaptation, Psychological↗