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PubMed2001

Development of a theoretical framework describing relatives' involvement in palliative care.

BACKGROUND: The present study is based on four earlier studies in which the authors classified the relative's involvement in palliative care into different categories and described the involvement as "involvement in the light" or "involvement in the dark". AIM: The aim of the study was to develop a theoretical framework concerning the involvement of relatives based on an in-depth analysis of the results of the four earlier studies. METHOD: Walker & Avant's (1995) strategies for theory construction were used for development of the framework. A number of different concepts, assumptions and statements about relatives' involvement were penetrated in an in-depth analysis. RESULTS: From the concepts two theoretical "blocks" of the relatives' involvement were developed and these constitute the foundation for the framework. One is based on concrete descriptions of the concepts "to know", "to be" and "to do". The other describes how the concepts of "involvement in the light" and "involvement in the dark" differ. Factors that promoted involvement in the light were professional care based on humanistic values, a stronger sense of coherence on the part of relatives, an appropriate illness trajectory, and other available resources. The opposite was the case for those who were involved in the dark. Five assumptions successively developed which together form the theoretical framework. CONCLUSIONS: An important conclusion that can be of importance in palliative care is that the manner in which the staff act toward the patient and relatives influence relatives' possibilities for involvement, patients' possibilities for an appropriate death, and the possibilities the staff have to give good care.

Attitude to Death↗
PubMedDate not supplied

Social support and cardiovascular health promotion in families.

This article looks in depth at the concept of social support and the potential it has to influence cardiovascular health promotion in families. The health behaviors that families share influence the health of family members. Exploring these health behaviors can help nurses identify opportunities that can assist families to encourage positive health behaviors and change negative behaviors that may decrease the risk of cardiovascular disease for the entire family.

Attitude to Health↗
PubMed2000

Relationships between nurses and family caregivers: partners in care?

Increasing reliance on family care of elderly people at home calls for a critical analysis of the relationship between formal and informal caregivers. Although much has been written about how health professionals and family caregivers should relate to one another, we know very little about the relationships that develop between them. Using data from a qualitative study, this article illustrates that relationships between community nurses and family members caring for frail elders are complex, dynamic, and multifaceted. Shifting boundaries in caring work leads to changes in nurse-family caregiver relationships, which can be categorized as four distinct, yet interconnected, types: (1) nurse-helper, (2) worker-worker, (3) manager-worker, and (4) nurse-patient. Each type is described, and implications for nursing practice and research are discussed.

Adult↗
PubMedDate not supplied

Advancing nursing theory through theory-guided practice: the emergence of a critical caring perspective.

Critical caring is proposed as a hybrid, midrange theory that builds on nursing science and critical feminist theories. As such, it has the potential to root public health nursing practice in an expanded nursing caring science that reincorporates the social justice agenda characteristic of early public health nursing practice but not featured prominently in contemporary nursing theories. Critical caring transforms the carative processes of Watson's theory into 7 carative health-promoting processes that form the "core" of public health nursing practice and reflect the legacy and reality of public health nursing practice.

Altruism↗
PubMed2006

Psychological approaches for the nursing management of chronic pain: part 2.

AIMS AND OBJECTIVES: The aim of this article was to present the ways that nurses can integrate psychological approaches into their management of chronic pain conditions using a biopsychosocial framework. Communication, the importance of the patient-practitioner interaction, the role of education and provision of information, reassurance and reduction of anxiety and the use of coping strategies training in the management of chronic pain are reviewed alongside the key skills of nursing. BACKGROUND: This is the second part of a two-part article. Part 1 was a discussion of psychosocial factors associated with chronic pain conditions and the psychological approaches used in the management of these conditions. CONCLUSIONS: It is identified that key nursing skills often equate to the requirements of the psychological approaches, therefore specific techniques from a cognitive-behavioural framework can be readily applied, integrated and used by nurses in the management of chronic pain conditions. RELEVANCE TO CLINICAL PRACTICE: Commonly utilized nursing skills are similar to those required for cognitive-behavioural therapy. It is reasonable to assume therefore that nurses can and should be involved in effectively managing the psychological aspects associated with chronic pain conditions.

Activities of Daily Living↗
PubMedDate not supplied

Parent-child interaction and attention regulation in children born prematurely.

ISSUES AND PURPOSE: The goal of this pilot study was to understand attention behaviors in extremely low-birth-weight (ELBW) children within the context of parent-child interactions and their relation to the child's independent performance. DESIGN AND METHODS: Parent-child and child-alone puzzle matching tasks, demographics, and IQ were measured in a sample of 15 4-year-olds who weighed <1000 g at birth and were free from major disability. RESULTS: A self-regulated and efficient strategy during the parent-child puzzle was related to using an efficient strategy when working alone. Attention regulation during the parent-child puzzle was related to accuracy in the child-alone task. Parents appeared to be regulating attention appropriately. PRACTICE IMPLICATIONS: Understanding the mechanisms of attention regulation in ELBW children could lead to specific interventions to support parents in strengthening their children's self-regulatory functioning.

Adult↗
PubMed1977

Altruism and the practice of medicine.

Biological and psychological research into the antecedents of altruism has considerable significance for those involved in the teaching or practice of medicine. The evidence available indicates that altruistic behaviour is a universal phenomenon influenced by intra-individual, interpersonal, situational and sociocultural factors. A central theme which emerges is the strikingly ambivalent nature of the altruistic drive. The factors which may facilitate or inhibit altruism in medical students and doctors are discussed. Some ways of ensuring that medical training does not seriously distort altruism are suggested.

Achievement↗
PubMed1998

Behavioral aspects of homonegativity.

The prevalence of anti-gay violence is a widespread problem calling for thorough study and effective solutions. Hudson and Ricketts (1980) viewed homonegativity as composed of cognitive, affective, and behavioral aspects. Patel (1989) developed the Self Report of Behavior Scale (SBS) to measure respondents' previous negative behaviors toward gay individuals. Other research using this scale has yielded useful information, and further study is needed to refine the now-evolved scale (SBS-R). Participants in the present study were 264 college students who completed the SBS-R, the Crowne-Marlowe Social Desirability Scale (CMSDS) and Hudson and Ricketts' Index of Attitudes Toward Homosexuals (IAH). A factor analysis of the SBS-R yielded two factors: "avoidance behaviors" and "aggressive behaviors" toward gays. High internal consistency as well as construct validity for the SBS-R were found. This reliable and valid measure of self-reported anti-gay behaviors should help advance our understanding of the relationships among the affective, cognitive, and behavioral aspects of homonegativity.

Adult↗
PubMed2000

Adolescent sexuality at the dawn of the 21st century.

Human sexuality can be defined as including the physical characteristics of and capacities for specific sex behaviors, together with psychosocial values, norms, attitudes, and learning processes that influence these behaviors. It also includes a sense of gender identity and related concepts, behaviors, and attitudes about the self and others as women or men in the context of one's society. At the dawn of the new century, adolescent sexuality remains a topic of concern to adults throughout the world. This concern is not unique to this new age. In each era of recorded history, adults have been concerned about adolescent sexual behavior, particularly sexual intercourse and its consequences. Things have not changed all that much in the realm of adolescent sexual behavior. What has changed is our ability to prevent the serious consequences of this behavior and, hopefully, to help adolescents avoid behaviors that put them at risk for the negative consequences of expressing their burgeoning sexuality. This article reviews the major influences on adolescents developing' sexuality, the data on adolescent sexual activity, some tips on caring for adolescents comprehensively, and ends with some predictions of how this issue will be addressed in the new century.

Adolescent↗
PubMedDate not supplied

The effect of megestrol acetate on oral food and fluid intake in nursing home residents: a pilot study.

OBJECTIVES: The objective of this study was to evaluate the effect of megestrol acetate (Megace OS; Bristol-Myers Squibb, Princeton, NJ) on the oral food and fluid intake of nursing home (NH) residents under two conditions: usual NH care and optimal mealtime feeding assistance. DESIGN AND SETTING: We conducted a prospective, preliminary trial in four NHs. PARTICIPANTS: Participants (n = 17) were recruited from a larger study designed to assess nutritional care quality. Eligibility for the Megace OS trial required participants to consistently eat less than 75% of most meals under both usual NH care and optimal feeding assistance conditions at baseline. INTERVENTION: Megace OS, an oral liquid suspension of megestrol acetate, was given daily in a 400-mg dose for 63 days. MEASUREMENTS: Each participant's oral food and fluid intake was monitored weekly for 1 day (three meals) during which research staff conducted direct observations of usual NH care (weeks 1, 3, and 5 and day 63) or provided optimal feeding assistance (weeks 2, 4, and 6). Average total percent intake was compared from baseline across the assessment weeks of the trial under the two mealtime care conditions. RESULTS: Megace OS had a significant effect on oral food and fluid intake only under the optimal mealtime feeding assistance condition, in which average total percent eaten increased from 50% (+/- 15%) at baseline to 63% (+/- 14%) post-63 days of the trial. There was no change in participants' oral food and fluid intake under the usual NH care condition (average total percent intake at baseline 43% +/- 12% vs. 43% +/- 20% post-63 days). CONCLUSION: The results of this preliminary study suggest that Megace OS is not an effective nutritional intervention to increase oral intake under usual NH care conditions, which is often characterized by inadequate feeding assistance. However, Megace OS in combination with optimal mealtime feeding assistance does significantly increase oral intake in a frail NH sample at high risk for weight loss.

Activities of Daily Living↗
PubMed2006

Parents' views of a Family Health Assessment.

This paper reports on a qualitative study that was undertaken to evaluate a structured health needs assessment, the Family Health Assessment (FHA), from the perspective of parents with pre-school children. Nine mothers were involved in two focus group discussions. Some of the mothers reported that using the FHA with a health visitor had been a positive experience because it had enabled them to identify their health needs and access appropriate advice and support. Other mothers, however, did not find the FHA particularly useful as they did not feel that the FHA was relevant to them at the time and they were unclear about why they were being asked some of the questions. The key findings are outlined in relation to the current context of health visiting, which is supporting a family-centred public health role and the limited but contemporary literature exploring the use of structured approaches to health needs assessment. Recommendations for future research and developments are made.

Attitude to Health↗
PubMed2005

A qualitative study of religious practices by chronic mentally ill and their caregivers in South India.

BACKGROUND: Socio-cultural explanatory factors for mental health problems determine help seeking behaviors. The study aimed to understand the reasons mentally ill patients and their families in India choose to seek help from a religious site. MATERIALS AND METHODS: Persons with mental illness and their families were interviewed at religious sites using a guideline questionnaire. Issues such as significant life events, explanations for perceived abnormal behavior and reasons for choosing a specific religious site for 'treatment' were explored. DISCUSSION: Seeking religious help for mental disorders is often a first step in the management of mental disorders as a result of cultural explanations for the illness. This behavior also has social sanctions.

Adult↗