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Terms modified by In-depth Selected AbstractsImmigrant Parents' Concerns Regarding Their Children's Education in the United StatesFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 4 2009Olena Nesteruk A growing body of research suggests that as immigrant families assimilate into U.S. culture, their children's academic achievements and aspirations decline. This article explores possible reasons for this finding from the perspective of immigrant parents from Eastern European countries whose children attend U.S. schools. In-depth, qualitative interviews are conducted with 50 married mothers and fathers who hold professional-status employment. The data are analyzed using open and axial coding approach and three central, recurring themes emerge: (a) Parental Influences: "Education is a must,. The sky is the limit"; (b) The Educational System: "Parental guidance and resources are required"; and (c) Sociocultural Influences: "Everything here is about making money,. But what about our children'" Supporting, illustrative narratives are presented in connection with each theme to explain the perspectives of these immigrant parents on their children's schooling in the United States, and to add other tentative factors for further research into the decline of the children's academic achievement and aspirations with longer residence in the United States. Implications for family and consumer scientists are presented. [source] Understanding the ,epidemic' of complete tooth loss among older New ZealandersGERODONTOLOGY, Issue 2 2010Philip V. Sussex doi:10.1111/j.1741-2358.2009.00306.x Understanding the ,epidemic' of complete tooth loss among older New Zealanders Objective:, The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand's historic ,epidemic of edentulism' and how they operated. Method:, In-depth, semi-structured interviews with 31 older New Zealanders were analysed using applied grounded theory. Results:, Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a ,sub-optimal' natural dentition; (b) how the predominant patterns of dental care utilisation (symptomatic and extraction-based) were often strongly influenced by economic and social disadvantage; and (c) the way in which lay and professional worldviews relating to ,calcium theory' and dental caries were fundamental in decisions relating to the transition to edentulism. Major influences were rural isolation, the importance of professional authority and how patient-initiated transitions to edentulism were ultimately facilitated by an accommodating profession. Conclusion:, The combined effects of geography, economics, the dental care system and the professional culture of the day, in the context of contemporary (flawed) understandings of oral disease, appear to have been the key drivers. These were supported (in turn) by a widespread acceptance by the profession and society alike of the extraction/denture philosophy in dealing with oral disease. [source] Patients' experiences with partial dentures: a qualitative studyGERODONTOLOGY, Issue 4 2005Patricia A. Smith Objective:, The aim of the study was to gain insight into people's experiences of being given and using partial dentures. Methods:, In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. Results:, The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. Conclusions:, Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers. [source] Experiences of seeking help from health professionals in a sample of women who experienced domestic violenceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2003Loraine Bacchus BSc MA PhD Abstract The present paper describes a qualitative study of women who suffered domestic violence. The aim was to explore their experiences of seeking help from health professionals and assess their psychological health. Purposive sampling was used to select a subsample from a larger sample of women who were screened for domestic violence as part of a study undertaken at Guy's and St Thomas' Hospitals in London, UK. In-depth, semi-structured interviews were conducted with the subsample of women during the postpartum period (up to 14 months). Interviews were conducted in women's homes and general practitioners' (GPs) surgeries. The sample consisted of 10 women who had experienced domestic violence in the past 12 months (including the current pregnancy), and six women who had experienced domestic violence in the past 12 months but not the current pregnancy. The main outcome measures included: women's experiences of seeking help from health professionals; and assessment for postnatal depression, post-traumatic stress disorder (PTSD) and psychological distress. Women scored highly on measures of postnatal depression and PTSD. With regard to seeking help, there was a tendency for women to regard GPs, and accident and emergency staff as less helpful compared with health visitors in responding to domestic violence. Lack of privacy, continuity of care and time constraints were dominant themes which emerged from women's contacts with health professionals. Very few women voluntarily disclosed domestic violence to a health professional and even fewer were asked directly about domestic violence by one. It is important for health professionals to enquire about domestic violence in a sensitive manner and provide a response that takes into accounts the complexity of women's needs. Domestic violence training is necessary to equip health professionals with the knowledge and skills they need to respond to domestic violence more effectively. [source] From rhetoric to reality: including patient voices in supportive cancer care planningHEALTH EXPECTATIONS, Issue 3 2005Sara K. Tedford Gold PhD Abstract Objective, To explore the extent and manner of patient participation in the planning of regional supportive care networks throughout the province of Ontario. We consider the disconnect between the rhetoric and reality of patient involvement in network planning and co-ordination. Context, In 1997, the Province of Ontario, Canada, established a new, regionalized cancer care system. By transferring responsibility to the regional level and to networks, the architects of the new provincial system hoped to broaden participation in decision making and to enhance the responsiveness of decisions to communities. Research approach, Through a qualitative, multiple case study approach we evaluated the processes of involving patients in network development. In-depth, semi-structured interviews and document analysis were complemented by observations of provincial meetings, regional council and network meetings. Results, The network development processes in the three case study regions reveal a significant gap between intentions to involve patients in health planning and their actual involvement. This gap can be explained by: (i) a lack of clear direction regarding networks and patient participation in these networks; (ii) the dominance of regional cancer centres in network planning activities; and, (iii) the emergence of competing provincial priorities. Discussion, These three trends expose the complexity of the notion of public participation and how it is embedded in social and political contexts. The failed attempt at involving patients in health planning efforts is the result of benign neglect of public participation intents and the social and political contexts in which public and patient participation is meant to occur. [source] Exploratory analysis of Chinese-American family caregivers' needs and instructional video on dressing stroke survivorsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2010Shu-Hwa LinArticle first published online: 18 AUG 2010 Abstract The aims of this project were to explore the needs of family caregivers in the Chinese-American community and to develop training videos for caregivers on dressing stroke survivors. In-depth, semi-structured, open-ended interviews were used to explore the problems of caregivers of stroke survivors. Forty participants were recruited from Chinese-American communities. Verbatim interview transcripts were coded and analyzed. Four main concerns emerged: the impact and adjustment in lifestyle for family caregivers; lack of social activities and failure to seek community support; physical and mental stress and methods to alleviate stress, such as instruction in heavy lifting and guidance for daily activities, which include dressing. An 18-min video was produced to provide instruction on dressing stroke survivors for those who need this information. Also, this article addresses the lack of social activities and information about community or public services. [source] Power, social exchanges and tourism in Langkawi: rethinking resident perceptionsINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 3 2002K. Kayat Abstract A study was undertaken among the residents on Langkawi Island, Malaysia to explore the utility of a combination of social exchange and power theories to explain residents' attitudes toward tourism and to examine how residents' evaluation of the impact of tourism influences their attitudes. In-depth, semi-structured interviews were conducted with 46 residents. The study concludes that the combination of social exchange and power theories is more useful than social exchange theory alone in understanding residents' attitudes concerning the impact of tourism. However, residents' general values, dependence on tourism, and ability and willingness to adapt moderate the influence of power on residents' evaluation of the impact of tourism. Copyright © 2002 John Wiley & Sons, Ltd. [source] Conceptions of Dementia in a Multiethnic Sample of Family CaregiversJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2005Ladson Hinton MD Understanding variability in conceptions of dementia in multiethnic populations is important to improve care and guide research. The objectives of this study were to describe caregiver conceptions of dementia using a previously developed typology and to examine the correlates of conceptions of dementia in a multiethnic sample. This is a cross-sectional study conducted in Boston and the San Francisco Bay area. Participants were a convenience sample of 92 family dementia caregivers from four ethnic/racial groups: African-American, Anglo European-American, Asian-American, and Latino. In-depth, qualitative interviews explored the caregivers' ideas about the nature and cause of dementia (i.e., explanatory models). Explanatory models of caregivers were categorized as biomedical, folk, or mixed (folk/biomedical). Quantitative analyses examined the association between ethnicity and other caregiver characteristics, and explanatory model type. Overall, 54% of caregivers, including 41% of Anglo European Americans, held explanatory models that combined folk and biomedical elements (i.e., mixed models). For example, many families attributed Alzheimer's disease and related dementias to psychosocial stress or normal aging. Ethnicity, lower education, and sex were associated with explanatory model type in bivariate analyses. In multiple logistic regression analysis, minority caregivers (P<.02) and those with less formal education (P<.02) were more likely to hold mixed or folk models of dementia. Although minority and nonminority caregivers often incorporated folk models into their understanding of dementia, this was more common in minority caregivers and those with less formal education. Further research on cross-ethnic differences in a larger, more-representative sample is needed. [source] Supervising medication administration by undergraduate nursing students: influencing factorsJOURNAL OF CLINICAL NURSING, Issue 5-6 2010Kerry Reid-Searl Background., The administration of medication is an important skill nursing students need to learn in the clinical setting to develop safe practices. Legally within Queensland, registered nurses are required to provide personal supervision for this process. Research undertaken by the authors suggests the supervision students receive frequently falls short of what is legally required. Aims and objectives., The aim of the study was to examine the factors that influence the experiences of final-year undergraduate nursing students when administering medications in the clinical setting. Design., A grounded theory approach was used with constant comparative analysis to identify categories from the data. Methods., The experiences of final-year nursing students were explored using a grounded theory approach. In-depth, semi-structured interviews were conducted with 28 final-year undergraduate nursing students in Queensland, Australia. Results., Supervision was found to be the central issue influencing medication administration for students. Three main factors were identified as influencing the supervision provided by registered nurses: attitudes of the registered nurse, communication from the university, and busyness and having time. Conclusions., The extent to which registered nurses provide direct supervision to nursing students when administering medication is influenced by factors inherent within the clinical environment. Relevance to clinical practice., The factors influencing the supervision provided by registered nurses needs further exploration that effective strategies can be implemented to ensure safe practices in relation to medication administration can be implemented. [source] Micro-analysis of light emission properties of GaN-based laser diodesPHYSICA STATUS SOLIDI (C) - CURRENT TOPICS IN SOLID STATE PHYSICS, Issue 7 2007M. Godlewski Abstract In-depth and in-plane changes of emission intensity from GaN-based laser diode structures were studied using cathodoluminescence, photoluminescence (PL), micro-PL and a Kelvin probe (potential fluctuations). We show that even at high excitation density potential fluctuations are not screened in active layers of laser diode structures. Potential fluctuations are enhanced in p-type doped layers. We also found that dislocations are formed there, which can penetrate to active region of LD devices. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] LEAN, GREEN, AND THE QUEST FOR SUPERIOR ENVIRONMENTAL PERFORMANCEPRODUCTION AND OPERATIONS MANAGEMENT, Issue 3 2001SANDRA ROTHENBERG We examine the relationship between lean manufacturing practices and environmental performance as measured in terms of air emissions and resource use. We draw on two unique surveys of 31 automobile assembly plants in North America and Japan, which contain information on manufacturing practice and environmental performance, as well as in-depth interviews with 156 plant level employees at 17 assembly plants. Our survey results and interviews suggest that lean management and reduction of air emissions of volatile organic compounds (vocs) are associated negatively. Lean manufacturing practices contribute to more efficient use of paints and cleaning solvents, but these in-process changes are not sufficient to meet the most stringent air regulations. We found some evidence to support the link between lean practices and resource efficiency. While our survey results were in hypothesized direction, they were not statistically significant. In-depth semi-structured interviews, however, suggest a more robust relationship, and we use them to describe some mechanisms by which all three aspects of lean management (buffer minimization, work systems, and human resource management) may be related to environmental management practices and performance. [source] Patient delay in oral cancer: a qualitative study of patients' experiencesPSYCHO-ONCOLOGY, Issue 6 2006S.E. Scott Abstract Up to 30% of patients delay seeking the advice of a healthcare professional after self-discovery of symptom(s) of oral cancer. Reasons for this patient delay are poorly understood. The aim of the present study was to explore patients' initial experiences and reactions to developing symptoms of oral cancer, and to identify factors influencing their decision to consult a health care professional. In-depth semi-structured interviews were conducted with 17 consecutive patients who had received a diagnosis of oral squamous cell carcinoma, but had yet to start treatment. Participants were asked about their beliefs about their symptoms over the course of the disease and their decision to seek help. The tape-recorded interviews were transcribed verbatim and analysed using ,Framework analysis'. Oral symptoms were rarely attributed to cancer and were frequently interpreted as minor oral conditions. As a result of these beliefs, patients tended to postpone seeking help or fail to be concerned over their symptoms. Prior to seeking help, patients responded to symptoms by using self-medication, changing the way they ate and disclosing their discovery of symptoms to friends or family. Problems with access to healthcare professionals and patients' social responsibilities acted as barriers to prompt help-seeking. This study has documented that an individual's interpretation of oral cancer symptoms may be misguided and this can adversely affect subsequent help-seeking behaviour. Copyright © 2005 John Wiley & Sons, Ltd. [source] GENDER, STREETLIFE AND CRIMINAL RETALIATION,CRIMINOLOGY, Issue 4 2004CHRISTOPHER W. MULLINS Recent work in criminology has highlighted the central role of retaliation in shaping criminal violence in America's inner cities. Most of this work, however, has been based on male offenders. It has also failed to consider whether and how gender structures payback in real-life settings and circumstances. In this paper, we analyze in-depth, semi-structured interviews with forty men and twelve women who recently engaged in one or more episodes of retaliatory violence to examine the ways in which gender shapes vengeance. We hope to provide an insider's view of how gender frames the context and dynamics of retaliatory events for both men and women. [source] The neurologic manifestations of mitochondrial diseaseDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2010Sumit Parikh Abstract The nervous system contains some of the body's most metabolically demanding cells that are highly dependent on ATP produced via mitochondrial oxidative phosphorylation. Thus, the neurological system is consistently involved in patients with mitochondrial disease. Symptoms differ depending on the part of the nervous system affected. Although almost any neurological symptom can be due to mitochondrial disease, there are select symptoms that are more suggestive of a mitochondrial problem. Certain symptoms that have become sine qua non with underlying mitochondrial cytopathies can serve as diagnostic "red-flags." Here, the typical and atypical presentations of mitochondrial disease in the nervous system are reviewed, focusing on "red flag" neurological symptoms as well as associated symptoms that can occur in, but are not specific to, mitochondrial disease. The multitudes of mitochondrial syndromes are not reviewed in-depth, though a select few are discussed in some detail. © 2010 Wiley-Liss, Inc. Dev Disabil Res Rev 2010;16:120,128. [source] Corruption and Entrepreneurship: How Formal and Informal Institutions Shape Small Firm Behavior in Transition and Mature Market EconomiesENTREPRENEURSHIP THEORY AND PRACTICE, Issue 5 2010Vartuhí Tonoyan This article explores the determinants of corruption in transition economies of the post-Soviet Union, Central-Eastern Europe, and Western industrialized states. We look in-depth at the East,West gap in corruption, and why entrepreneurs and small business owners become engaged in corrupt deals. Part of the answers lie in the country-specific formal and informal institutional make-up. The likelihood of engaging in corruption is influenced by the lower efficiency of financial and legal institutions and the lack of their enforcements. Also, viewing illegal business activities as a widespread business practice provides the rationale for entrepreneurs to justify their own corrupt activities. Moreover, closed social networks with family, friends, and national bureaucrats reduce the opportunism of the contracting party of the corrupt deal, thus providing breeding grounds for corruption. [source] A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process?EUROPEAN JOURNAL OF CANCER CARE, Issue 4 2010L. MCCULLOUGH msc, nurse leader clinical support services MCCULLOUGH L., MCKINLAY E., BARTHOW C., MOSS C. & WISE D. (2010) European Journal of Cancer Care A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process? This qualitative study describes how doctors and nurses report their contribution to treatment decision-making processes when patients have advanced cancer. Thirteen nurses and eight doctors involved in cancer treatment and palliation in one geographical location in New Zealand participated in the study. Data were collected using qualitative in-depth, face-to-face interviews. Content analysis revealed a complex context of decision making influenced by doctors and nurses as well as the patient and other factors. A model of clinician and patient decision making emerged with a distinct and cyclical process as advanced cancer remits and progresses. When patients have advanced cancer, nurses and doctors describe a predictable model of decision making in which they both contribute and that cycles through short- and long-term remissions; often nowadays to the point of the patient dying. In conclusion, the findings suggest doctors and nurses have different but complementary roles in what, when and how treatment choices are negotiated with patients, nevertheless within a distinct model of decision making. [source] Vulvar Pain: A Phenomenological Study of Couples in Search of Effective Diagnosis and TreatmentFAMILY PROCESS, Issue 2 2008JENNIFER J. CONNOR PH.D. Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of, the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships. RESUMEN Dolor vulvar: estudio fenomenológico de parejas que buscan un diagnóstico y tratamiento efectivos El síndrome de vestibulitis vulvar (svv), un trastono de dolor vulvar, continúa dejando perplejos a los profesionales de la salud física y mental debido a su etiología desconocida y a la inexistencia de un tratamiento efectivo. Este estudio utilizó metodología fenomenológica experimental para explorar las experiencias de parejas en que a la mujer se le ha diagnosticado el svv. Se llevaron a cabo dieciséis entrevistas (en profundidad y semiestructuradas) con 13 parejas heterosexuales y 3 mujeres, de las que se obtuvieron cuatro conclusiones esenciales: (1) En busca de , la investigación médica requería una búsqueda más exhaustiva de médicos eruditos y respetuosos que aportasen un tratamiento. (2) El proceso de desarrollar una comprensión personal del trastorno condujo a varias parejas a plantearse su papel en la causa y la prolongación del svv. (3) Desarrollar estrategias para afrontar un coito doloroso condujo a tres estrategias: prescindir del sexo, optar por alternativas al sexo vaginal y modificar o soportar el coito doloroso. (4) Se experimentaron sensaciones de aislamiento, pues el proceso de adaptación a este síndrome de dolor crónico resultó, a menudo, un proceso solitario. Entre los consejos clínicos se incluyen tratar a la pareja, y no sólo a la mujer con svv; animar a las parejas a ampliar las definiciones de la importancia y preferencia por el coito vaginal, así como sugerir actividades sexuales con menor riesgo de causar dolor vulvar; desarrollar un significado común como pareja; y ayudar a las parejas a encontrar médicos y recursos. Palabras clave: síndrome de vestibulitis vulvar; dolor vulvar; terapia de pareja. [source] Strategies for Success: Profiling the Effective Learner of GermanFOREIGN LANGUAGE ANNALS, Issue 3 2001Jennifer Bruen The primary objective of this study is to identify the language-learning strategies associated with the achievement of higher levels of oral proficiency in German for 100 Irish students about to complete their second year at Dublin City University. It also investigates the way in which these strategies are used by those with higher and lower levels of proficiency. The methodology combines quantitative assessment (using questionnaires)with in-depth, qualitative interviews. The article begins by explaining key concepts in the field of language learning strategy research and then reviews a selection of relevant studies. An experiment designed to achieve the above objectives is then described. The results indicate that more-proficient students use more language-learning strategies, in particular more cognitive and metacognitive strategies. Furthermore, ten. strategies correlate with higher levels of oral proficiency at a significant level. These provide a tentative strategic profile of the more effective learner of German. Finally, the qualitative findings suggest that more-proficient students use language-learning strategies in a more structured and purposeful manner and apply them to a wider range of situations and tasks. Finally, implications for future research and for the language classroom are discussed. [source] Narrative 360° assessment and stakeholder analysis: How a powerful tool drives executive coaching engagementsGLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 6 2010Richard Koonce A process of in-depth targeted interviews and analysis goes where a traditional 360° assessment cannot, revealing cultural, political, and other subtle organizational and performance factors that can make or break an executive. Rich, real-time contextual feedback helps leaders and their coaches to focus on those areas most critical to performance in a particular role and organization. The author describes the process and instrument and illustrates its use and value through two case studies. He also examines the benefits of pairing the process with the concepts of social economics and social theater and with a number of other coaching tools. © 2010 Wiley Periodicals, Inc. [source] Being ,fat' in today's world: a qualitative study of the lived experiences of people with obesity in AustraliaHEALTH EXPECTATIONS, Issue 4 2008Samantha L. Thomas PhD Abstract Objective, To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity. Design, Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index ,30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included. Results, Seventy-six individuals (aged 16,72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ,blame' against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight. Discussion and Conclusion, There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities. [source] An exploratory study of nurses suffering from severe acute respiratory syndrome (SARS)INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2005Esther Mok RN PhD In 2003, severe acute respiratory syndrome (SARS) came to be recognized as a newly emergent form of disease that is highly contagious. The aim of this study was to describe the perceptions of nurses with SARS in Hong Kong, as the perceptions of nurses who have suffered from SARS have not been studied. Ten nurses who had suffered from SARS were interviewed, either face-to-face or by telephone, about their subjective experiences. These interviews provided in-depth, descriptive data, which were analysed using content analysis. Nine broad categories were identified: uncertainty, information control, feelings of anger and guilt, lack of preparation and fear of death, feelings of isolation and loneliness, physical effects, support, change of perspective of life, and change of perspective of nursing. Although the dreaded disease affected the nurses tremendously, both physically and psychologically, it has also had its positive side. As a result of experiencing the illness, the participants came to treasure relationships, health and everyday life more. In caring for patients, they came to see the world more from the perspective of the patients. They found that they need to take the time to reassure patients and families and to seriously listen to all of their concerns. [source] Caring for abused women: impact on nurses' professional and personal life experiencesJOURNAL OF ADVANCED NURSING, Issue 8 2009Hadass Goldblatt Abstract Title.,Caring for abused women: impact on nurses' professional and personal lifeexperiences. Aim., This article is a report of a study of the impact of caring for abused women on nurses' professional and personal life experiences. Background., Encountering abused women can have emotional, cognitive and behavioural influences on nurses, known as vicarious traumatization. They may feel incompetent to deal with such an overwhelming problem and may avoid screening survivors of abuse. Thus, nurses treating these survivors need to be aware of their attitudes, emotions and differential responses during these interactions. Method., A phenomenological study was carried out in 2005 in Israel. The data were collected using in-depth, interviews with 22 female Israeli nurses in hospitals and community healthcare clinics. Findings., Data analysis revealed one main theme, ,Struggling on work and home fronts', based on two subthemes: ,Encounter with domestic violence: a challenge to nurses' professional role perception' and ,Between work and home'. Nurses experience perplexity regarding abused women and their professional care. Encounters with these women challenge nurses' personal and professional attitudes, as well as influencing their personal lives (intimate relationships, parenthood and gender attitudes). These encounters induce empathy and compassion, but also anger and criticism towards abused women, creating emotional labour for the nurses. Conclusion., The dissonance between personal values, attitudes and emotions and the desirable professional intervention procedures might impede nurses' performance in caring for abused women. Implementing training programmes for screening and intervening with abused women might reduce the emotional labour required, enhance nurses' responses to domestic violence, and enable personal growth. [source] Decision-making for acutely ill nursing home residents: nurses in the middleJOURNAL OF ADVANCED NURSING, Issue 5 2009Ruth Palan Lopez Abstract Title.,Decision-making for acutely ill nursing home residents: nurses in the middle. Aim., This paper is a report of a study to generate a model of nursing behaviours and social processes inherent in decision-making for acutely ill nursing home residents. Background., Most research concerning clinical decision-making in nursing homes focuses on the perspectives of doctors. Much less is known about the perspectives and actions of nurses with regard to decision-making, despite the centrality of their roles in nursing homes. Method., Grounded theory was used. Data were collected in 2004 in four nursing homes in the United States of America using in-depth, semi-structured interviews, 74 hours of non-participant observation and informal conversational interviews with key nursing staff involved in decision-making. Findings., Nurses strive to create a plan of care acceptable to family members and doctors, consistent with wishes of residents and most comfortable for residents. A unifying theme of satisfying all sides emerged as representative of the negotiation strategies used by nurses to address these competing points of view. Four phases in this negotiation occurred: weighing the significance; notifying the family; feeling it out; and playing the middleman. The outcome was either a decision for life-prolongation or for palliative care. Conclusion., Decisions for nursing home residents are complex and involve weighing and balancing the interests and preferences of many concerned participants, including residents, families and doctors. This process requires skill in clinical judgment, communication and collaboration. [source] Healing through self-reflectionJOURNAL OF ADVANCED NURSING, Issue 5 2001Karran Thorpe PhD RN Healing through self-reflection Background.,Today, women have an enlightened view towards their life cycles, which is evidence of their healing potential. Women need to share their insights about their healing potential gained through self-reflective processes. Their voices must be heard so that we can benefit from their collective wisdom. The process of healing through self-reflection has begun as a group of nurses share their insights. Documenting the perspectives of these nurses provides the opportunity for other women to learn from and apply this knowledge to their lives. Method.,Through purposive sampling, eight registered nurses, all women, were selected to participate in in-depth, personal, semi-structured interviews. The purposes in this paper are to describe a three-stage (i.e. awareness, critical analysis, and new perspective) reflective-thinking model and discuss the application of this model to women's expressed inner knowledge and wisdom across personal and professional life cycles. Results.,Three themes, signifying their ability to heal themselves, were labelled: Spirituality, Be-ing Versus Do-ing, and Eustress Versus Distress. Conclusions.,Essentially, self-reflection results from both personal and professional stimuli and signifies the need for change so that healing can begin. Recommendations are offered for nurse educators and researchers. [source] After Adoption: Sustaining the Innovation A Case Study of Disseminating the Hospital Elder Life ProgramJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005Elizabeth H. Bradley PhD Objectives: To examine key factors that influence sustainability in the diffusion of the Hospital Elder Life Program (HELP) as an example of an evidence-based, multifaceted, innovative program to improve care for hospitalized older adults. Design: Longitudinal, qualitative study between November 2000 and November 2003 based on 102 in-depth interviews every 6 months during HELP implementation. Setting: Thirteen hospitals implementing HELP. Participants: Forty-two hospital staff members (physician, nursing, volunteer, and administrative staff) implementing HELP, conducted 102 interviews. Measurements: Staff experiences sustaining the program, including challenges and strategies that they viewed as successful in addressing these challenges. Results: Of the 13 hospitals studied, 10 were sustaining HELP at the end of the study period; three terminated the program (after 24 months, 12 months, and 6 months). Critical factors were identified as influencing whether the program was sustained: the presence of clinical leadership, the ability and willingness to adapt the original HELP protocols to local hospital circumstances and constraints, and the ability to obtain longer-term resources and funding for HELP. Conclusion: Recognizing the need for sustained clinical leadership and funding as well as the inevitable modifications required to sustain innovative programs can promote more-realistic goals and expectations for health services researchers, clinicians, and policy makers in their laudable efforts to translate research into practice. [source] Translating Research into Clinical Practice: Making Change HappenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2004Elizabeth H. Bradley PhD Objectives: To describe the process of adoption of an evidence-based, multifaceted, innovative program into the hospital setting, with particular attention to issues that promoted or impeded its implementation. This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges. Design: Qualitative study design based on in-depth, open-ended telephone interviews. Setting: Nine hospitals implementing HELP throughout the United States. Participants: Thirty-two key staff members (physician, nursing, volunteer, and administrative staff) who were directly involved with the HELP implementation. Measurements: Staff experiences implementing the program, including challenges and strategies they viewed as successful in overcoming challenges of implementation. Results: Six common challenges faced hospital staff: (1) gaining internal support for the program despite differing requirements and goals of administration and clinical staff, (2) ensuring effective clinician leadership, (3) integrating with existing geriatric programs, (4) balancing program fidelity with hospital-specific circumstances, (5) documenting positive outcomes of the program despite limited resources for data collection and analysis, and (6) maintaining the momentum of implementation in the face of unrealistic time frames and limited resources. Strategies perceived to be successful in addressing each challenge are described. Conclusion: Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations. [source] A novel direct aerodynamically assisted threading methodology for generating biologically viable microthreads encapsulating living primary cellsJOURNAL OF APPLIED POLYMER SCIENCE, Issue 2 2008Sumathy Arumuganathar Abstract In a recent discovery, coaxial electrospinning was explored to encapsulate living organisms within a continuous bio-polymeric microthread from which active biological scaffolds were fabricated (Townsend-Nicholson and Jayasinghe, Biomacromolecules 2006, 7, 3364). The cells were demonstrated to have gone through all expected cellular activity without their viability being compromised. These biologically active threads and scaffolds have direct and tremendous applicability from regenerative to therapeutic medicine. Currently these post-processed cells as composite threads and scaffolds are being investigated in-depth at a cellular level to establish if the processing methodology has any affect on the cellular make-up. We now demonstrate a competing non-electric field driven approach for fabricating composite threads and scaffolds influenced only by a differential pressure. We refer to this novel composite thread to scaffold fabrication methodology as coaxial aerodynamically assisted bio-threading (CAABT). Our investigations firstly, demonstrate that this technique can process handle living organisms without biologically perturbing them in anyway. Secondly the process is elucidated as possessing the ability to form composite active threads from which biologically viable scaffolds are formed. Finally our study employs florescent activated cell sorting (FACScan), a method by which the cellular dynamics and viability are quantified on control and threaded cellular samples at two prescribed time points. In parallel with FACScan, optical comparison of cellular morphology at three time points within a period of three weeks is carried out to photographically observe any changes in the post-processed cellular phenotype. Our developmental investigations into this novel aerodynamically assisted threading methodology has unearthed a unique biomicrofabrication approach, which joins cell electrospinning in the cell threading to scaffold fabrication endeavor. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008 [source] Nursing students' experiences of their first encounter with death during clinical practice in TaiwanJOURNAL OF CLINICAL NURSING, Issue 15-16 2010Xuan-Yi Huang Aims and objectives., The aim of this study was to elucidate the experiences of first encountering death by nursing students during clinical practice. The objective is to assist nursing educational and clinical professionals to provide essential assistance for nursing students who encounter patient death. Background., Increasingly, deaths are occurring in hospitals. However, there has been little qualitative research in Taiwan on the experiences of nursing students who encounter patient death for the first time. Design., A descriptive qualitative method was employed to explore nursing students' first experience with death during clinical practice in Taiwan. Methods., Purposive sampling, one-on-one, in-depth with semi-structured interviews were conducted to collect data. Participants were selected from an acute haematological ward in a major teaching hospital in Central Taiwan. Narratives were analysed using Colaizzi's seven-step method. Results., Data saturation was achieved after interviewing 12 nursing students. The average age of the students was 20, and seven and half days was the average time spent attending dying patients. Three themes and eleven sub-themes were identified: Providing Care During the Dying Period (feelings of dread and terror, hardship of experiencing patient's life fading away, devotion to patient care and self-affirmation); Facing the Moment of Patient Death (state of being scared or trapped, emotional breakdown); Adjustment after Patient Death (acceptance or avoidance, growth or escape). Conclusions., Findings demonstrate the importance of understanding such first experiences, and the results are beneficial to clinical instructors and nursing personnel in understanding the students' pressure and difficulties experienced before, during and after the patients' death. Relevance to clinical practice., Several recommendations have been made, including teaching and support not only in the period of dying, but at the moment of patient death and postmortality. Avoiding topics about death in local culture have been noted. [source] Parents' experiences of a Family Support Program when a parent has incurable cancerJOURNAL OF CLINICAL NURSING, Issue 24 2009Kari E Bugge Aims and objectives., The Family Support Program was created to support children and parenting when one of the parents has incurable cancer. We chose a family-based approach to support parent's coping and to help families pull together, identify strengths in the family and learn how to seek help. Background., Cancer is usually a new experience for young families. In most cases, parents do not have the necessary knowledge about their children's need for information and support about their parent's serious illness and impending death. Design., A qualitative evaluation study based on data collected through in-depth interviews focusing on parent's experiences with the Family Support Program. Methods., Participants were patients with incurable cancer and their partners and ex-partners with children aged between 5,18 years. Thirteen parents were in-depth interviewed. Results., Parents described how the Family Support Program helped them gain greater insight into their children's thoughts and reactions and into how the situation affected their daily living. Parents reported that conflicts were reduced, they could talk more openly about the situation in the family and that they were shown how to support their children's coping. Conclusion., The Family Support Program met the parents in the study's needs for more information and support about how to cope with their children during the patient's terminal illness. Relevance to clinical practice., The Family Support Program is described in detail in a manual that makes it easy for other health workers to use the same programme. The Family Support program was in use in outpatient clinics, oncology wards and palliative care units and was provided both from nurses and social workers trained in cancer care. Parent's in the study would like the Family Support Program to be available to all patients who receive the poor prognosis that their cancer cannot be cured. [source] Embodiment of discrimination and overseas nurses' career progressionJOURNAL OF CLINICAL NURSING, Issue 12 2007John Aggergaard Larsen PhD Aim and objectives., To examine empirically and in-depth how discriminatory attitudes and practices are experienced by overseas nurses and how the discrimination may affect their well-being and career progression and, furthermore, to apply the theoretical perspective of embodiment in understanding these processes. Background., The UK healthcare sector has, in recent years, relied on overseas-trained professionals to fill up vacancies in nursing and other professions. Research shows that overseas nurses claim that their UK colleagues, managers and patients express discriminatory, racist and xenophobic attitudes. Design and method., The paper provides an existential phenomenological analysis of in-depth interviews with two overseas nurses. The data are drawn from a study of overseas-trained healthcare workers' experiences working and living in the UK. The two cases have been purposively selected to provide an illumination and discussion of personal experiences with discrimination, how individuals may respond to these and how their professional career is affected. Findings., Discrimination towards migrant workers may, at times, be experienced as ,blatant racism' or, in more subtle forms, as ,aversive racism'. It is demonstrated how such discrimination may impact on the afflicted person's sense of self, suggesting a theoretical model of the embodiment of discrimination. Discrimination not only works at an interpersonal and institutional level, but is a form of ,symbolic violence' that may be internalized to affect the person's ,habitus'; it can be resisted through meaning-making activity that explains and hence objectifies and embodies the experience in a way that allows individuals to positively influence their situation through agency. Conclusion., This article details how social and institutionalized discrimination in the UK healthcare sector may be internalized by overseas workers and affects their professional careers. Relevance to clinical practice., The study allows a theoretical reflection on the damage inflicted by discrimination, and it may contribute to the eradication of discriminatory practices and the development of necessary support and monitoring mechanisms. [source] |