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Advanced Nursing (advance + nursing)
Selected AbstractsPart two: The core components of legitimate influence and the conditions that constrain or facilitate advanced nursing practice in adult critical careINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2004Carol Ball RGN MSc PhD This paper describes intervening conditions that might constrain or facilitate the exercise of Legitimate Influence: The Key to Advanced Nursing in Adult Critical Care, the foundation of which is credibility and advanced clinical nursing practice. Constraining conditions are conflict, resistance, gender bias, political awareness and established values. Credibility, advanced clinical nursing practice and strategic activity are required to enhance patient stay in hospital and improve patient outcome. Intervening conditions that facilitate these are overcoming resistance, political awareness and established values. In a previous paper, it was indicated that enhanced patient stay and improved patient outcome were achieved primarily through strategic activity that emphasized restoring patients to a former, or improved, health status. This paper portrays how intervening conditions can impinge upon this and the exercise of legitimate influence. [source] Women's perceptions and experiences of a traumatic birth: a meta-ethnographyJOURNAL OF ADVANCED NURSING, Issue 10 2010Rakime Elmir elmir r., schmied v., wilkes l. & jackson d. (2010) Women's perceptions and experiences of a traumatic birth: a meta-ethnography. Journal of Advanced Nursing,66(10), 2142,2153. Abstract Aim., This study presents the findings a meta-ethnographic study reporting women's perceptions and experiences of traumatic birth. Background., Childbirth is viewed by many as a life transition that can bring a sense of accomplishment. However, for some women, birth is experienced as a traumatic event with a minority experiencing post-traumatic stress. A traumatic birth experience can have a significant impact on the physical and emotional well-being of a woman, her infant and family. Data source., The CINAHL, MEDLINE, Scopus and PubMed databases were searched for the period January 1994 to October 2009 using the keywords birth trauma, traumatic birth, qualitative research, birth narrative and birth stories. Review methods., A meta-ethnographic approach was used. Quality appraisal was carried out. An index paper served as a guide in identifying particular findings and comparing them with other findings. This ,reciprocal translation' process started with a search for common themes, phrases and metaphors. Results., Ten qualitative studies were included in the final sample. Six major themes were identified: ,feeling invisible and out of control', ,to be treated humanely', ,feeling trapped: the reoccurring nightmare of my childbirth experience', ,a rollercoaster of emotions', ,disrupted relationships' and ,strength of purpose: a way to succeed as a mother'. Conclusions., It is evident that a small percentage of women experience a traumatic birth. Although some women who experience a traumatic birth do not necessarily have physical or psychological adverse outcomes, others identify a significant personal impact. Healthcare professionals must recognize women's need to be involved in decision-making and to be fully informed about all aspects of their labour and birth to increase their sense of control. [source] Ginger compress therapy for adults with osteoarthritisJOURNAL OF ADVANCED NURSING, Issue 10 2010Tessa Therkleson therkleson t. (2010) Ginger compress therapy for adults with osteoarthritis. Journal of Advanced Nursing,66(10), 2225,2233. Abstract Aim., This paper is a report of a study to explicate the phenomenon of ginger compresses for people with osteoarthritis. Background., Osteoarthritis is claimed to be the leading cause of musculoskeletal pain and disability in Western society. Management ideally combines non-pharmacological strategies, including complementary therapies and pain-relieving medication. Ginger has been applied externally for over a thousand years in China to manage arthritis symptoms. Method., Husserlian phenomenological methodology was used and the data were collected in 2007. Ten purposively selected adults who had suffered osteoarthritis for at least a year kept daily diaries and made drawings, and follow-up interviews and telephone conversations were conducted. Findings., Seven themes were identified in the data: (1) Meditative-like stillness and relaxation of thoughts; (2) Constant penetrating warmth throughout the body; (3) Positive change in outlook; (4) Increased energy and interest in the world; (5) Deeply relaxed state that progressed to a gradual shift in pain and increased interest in others; (6) Increased suppleness within the body and (7) More comfortable, flexible joint mobility. The essential experience of ginger compresses exposed the unique qualities of heat, stimulation, anti-inflammation and analgesia. Conclusion., Nurses could consider this therapy as part of a holistic treatment for people with osteoarthritis symptoms. Controlled research is needed with larger numbers of older people to explore further the effects of the ginger compress therapy. [source] Case management educational intervention with public health nurses: cluster randomized controlled trialJOURNAL OF ADVANCED NURSING, Issue 10 2010Wen-I. liu w.-i., edwards h. & courtney m. (2010) Case management educational intervention with public health nurses: cluster randomized controlled trial. Journal of Advanced Nursing,66(10), 2234,2244. Abstract Aim., This paper is a report of a study conducted to determine the effectiveness of a community case management collaborative education intervention in terms of satisfaction, learning and performance among public health nurses. Background., Previous evaluation studies of case management continuing professional education often failed to demonstrate effectiveness across a range of outcomes and had methodological weaknesses such as small convenience samples and lack of control groups. Method., A cluster randomized controlled trial was conducted between September 2005 and February 2006. Ten health centre clusters (five control, five intervention) recruited 163 public health nurses in Taiwan to the trial. After pre-tests for baseline measurements, public health nurses in intervention centres received an educational intervention of four half-day workshops. Post-tests for both groups were conducted after the intervention. Two-way repeated measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes. Results., A total of 161 participants completed the pre- and post-intervention measurements. This was almost a 99% response rate. Results revealed that 97% of those in the experimental group were satisfied with the programme. There were statistically significant differences between the two groups in knowledge (P = 0·001), confidence in case management skills (P = 0·001), preparedness for case manager role activities (P = 0·001), self-reported frequency in using skills (P = 0·001) and role activities (P = 0·004). Conclusion., Collaboration between academic and clinical nurses is an effective strategy to prepare nurses for rapidly changing roles. [source] Cigarette dependence questionnaire: development and psychometric testing with male smokersJOURNAL OF ADVANCED NURSING, Issue 10 2010Chih-Ling Huang huang c.-l., lin h.-h. & wang h.-h. (2010) Cigarette dependence questionnaire: development and psychometric testing with male smokers. Journal of Advanced Nursing,66(10), 2341,2349. Abstract Aim., This paper is a report of a study conducted to develop and test a theoretically derived Cigarette Dependence Questionnaire for adult male smokers. Background., Fagerstrom questionnaires have been used worldwide to assess cigarette dependence. However, these assessments lack any theoretical perspective. A theory-based approach is needed to ensure valid assessment. Methods., In 2007, an initial pool of 103 Cigarette Dependence Questionnaire items was distributed to 109 adult smokers in Taiwan. Item analysis was conducted to select items for inclusion in the refined scale. The psychometric properties of the Cigarette Dependence Questionnaire were further evaluated 2007,08, when it was administered to 256 respondents and their saliva was collected and analysed for cotinine levels. Criterion validity was established through the Pearson correlation between the scale and saliva cotinine levels. Exploratory factor analysis was used to test construct validity. Reliability was determined with Cronbach's alpha coefficient and a 2-week test,retest coefficient. Results., The selection of 30 items for seven perspectives was based on item analysis. One factor accounting for 44·9% of the variance emerged from the factor analysis. The factor was named as cigarette dependence. Cigarette Dependence Questionnaire scores were statistically significantly correlated with saliva cotinine levels (r = 0·21, P = 0·01). Cronbach's alpha was 0·95 and test,retest reliability using an intra-class correlation was 0·92. Conclusion., The Cigarette Dependence Questionnaire showed sound reliability and validity and could be used by nurses to set up smoking cessation interventions based on assessment of cigarette dependence. [source] Insomnia Severity Index: psychometric properties with Chinese community-dwelling older peopleJOURNAL OF ADVANCED NURSING, Issue 10 2010Doris S.F. Yu yu d.s.f. (2010) Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people. Journal of Advanced Nursing,66(10), 2350,2359. Abstract Aim., This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Background., Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. Methods., An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Results., Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item-to-total correlations in the range of 0·34,0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. Conclusion., The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. [source] Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 9 2010Dorothy N.S. Chan chan d.n.s., lui l.y.y. & so w.k.w. (2010) Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic review. Journal of Advanced Nursing,66(9), 1902,1914. Abstract Aim., This article is a report of a review of the effectiveness of exercise programmes on shoulder mobility and lymphoedema in postoperative patients with breast cancer having axillary lymph node dissection, as revealed by randomized controlled trials. Background., Breast cancer is the most common malignancy in women. After surgery, the most common postoperative complications are reduced range of motion in the shoulder, muscle weakness in the upper extremities, lymphoedema, pain and numbness. To reduce these impairments, shoulder exercises are usually prescribed. However, conflicting results regarding the effect and timing of such exercises have been reported. Data sources., Studies were retrieved from a systematic search of published works over the period 2000,2009 indexed in the Cumulative Index to Nursing and Allied Health Literature, Ovid Medline, the British Nursing Index, Proquest, Science Direct, Pubmed, Scopus and the Cochrane Library, using the combined search terms ,breast cancer', ,breast cancer surgery', ,exercise', ,lymphoedema', ,shoulder mobility' and ,randomized controlled trials'. Methods., A quantitative review of effectiveness was carried out. Studies were critically appraised by three independent reviewers, and categorized according to levels of evidence defined by the Joanna Briggs Institute. Results., Six studies were included in the review. Early rather than delayed onset of training did not affect the incidence of postoperative lymphoedema, but early introduction of exercises was valuable in avoiding deterioration in range of shoulder motion. Conclusion., Further studies are required to investigate the optimal time for starting arm exercises after this surgery. Nurses have an important role in educating and encouraging patients to practise these exercises to speed up recovery. [source] Anticipatory grieving among parents living with a child with cancerJOURNAL OF ADVANCED NURSING, Issue 9 2010Ekhlas Al-Gamal al-gamal e. & long t. (2010) Anticipatory grieving among parents living with a child with cancer. Journal of Advanced Nursing,66(9), 1980,1990. Abstract Aim., This paper is a report of a comparative study of anticipatory grief of parents of children newly diagnosed with cancer and those whose children were diagnosed 6,12 months earlier. Background., Public perceptions of cancer as a fatal illness persist despite improved prognosis for children. Parents may experience feelings of despair, hopelessness, and worthlessness , the most common psychological expressions of anticipatory grief. With a focus on developing more effective therapeutic intervention, healthcare professionals have developed greater interest in the concept of anticipatory grief. Method., One hundred and forty parents, divided between ,newly diagnosed' and ,6,12 months after diagnosis' groups, were recruited in 2006 from two hospitals representative of the healthcare sector in Jordan. Structured interviews were conducted to assess anticipatory grief, using the Marwit and Meuser Caregiver Inventory: Childhood Cancer. Analysis was performed using t -tests. Results., Fewer than half of the parents in both groups reported being at peace with themselves and their situation in life. Parents of newly diagnosed children reported more severe anticipatory grief responses than those in the second group. No statistically significant differences were found in responses between mothers and fathers. Conclusion., Healthcare professionals should encourage parents to discuss negative feelings related to their child's illness and potential outcome. Hospital policies need to include the provision and promotion of support group services for parents, and nurses should encourage parents to exploit such services. [source] Persistent cognitive decline in older hospitalized patients in TaiwanJOURNAL OF ADVANCED NURSING, Issue 9 2010Cheryl Chia-Hui Chen chen c.c.-h., chang y.-c., huang g.-h., peng j.-h. & tseng c.-n. (2010) Persistent cognitive decline in older hospitalized patients in Taiwan. Journal of Advanced Nursing,66(9), 1991,2001. Abstract Aim., This paper is a report of a study conducted to determine the prevalence and predictors of persistent and transient cognitive decline in older hospitalized patients over 6 months after hospital discharge. Background., Cognitive decline occurs in 16,35·5% of older hospitalized patients, but this decline may be persistent rather than transient. Distinguishing persistent from transient cognitive decline is clinically useful. Methods., For this prospective cohort study, 291 older patients were recruited from five medical and surgical units at a tertiary medical centre in Taiwan between 2004 and 2006. Participants were assessed for cognitive status by scores on the Mini-Mental State Examination at admission, discharge, 3 and 6 months postdischarge. Persistent cognitive decline was defined as continuing score reduction and ,3-point reduction 6 months postdischarge. Transient decline was defined as ,3-point reduction at some stage, with a total decline <3 points 6 months postdischarge. Findings., The cognitive status of the majority of participants (57·4%, n = 167) decreased ,3 points during follow-up. Of these decliners, 59 (35·3%) had persistent cognitive decline, with an average 5·32-point reduction 6 months postdischarge. Forty-six (27·5%) participants experienced transient cognitive decline. After multiple adjustments in logistic regression analysis, persistent decline was predicted by no in-hospital functional decline (OR = 0·16, P = 0·002), more re-admissions after discharge (OR = 2·42, P = 0·020), and older age (OR = 1·09, P = 0·048). Conclusion., A new perspective is needed on discharge planning on patients at risk for persistent cognitive decline. Nurses can oversee the delivery of care, identify cognitive decline, refer patients, and educate families on strategies to enhance cognitive functioning for their aging relatives. [source] HIV disclosure among HIV positive individuals: a concept analysisJOURNAL OF ADVANCED NURSING, Issue 9 2010Rosemary W. Eustace eustace r.w. & ilagan p.r. (2010) HIV disclosure among HIV positive individuals: a concept analysis. Journal of Advanced Nursing,66(9), 2094,2103. Abstract Aim., This paper is a report of an analysis of the concept of HIV disclosure. Background., There is a growing interest among healthcare providers and researchers in HIV disclosure as an effective HIV prevention and early disease management initiative. However, the concept still remains unclear. Conceptual clarity is important for providing an expanded theoretical definition and understanding of attributes of HIV disclosure. This information is useful in constructing better HIV disclosure measures in HIV/AIDS nursing practice and research. Data sources., A computer search of the following databases was conducted to capture the meaning and processes of HIV disclosure among HIV-positive individuals: PubMed, CINAHL and PSYCINFO. Only English language journals were used. Publication dates of the literature review ranged from 1999 to 2009. The following key words were used: HIV disclosure, self-disclosure, disclosure and serostatus disclosure. Methods., The Walker and Avant (2005) concept analysis model (Strategies for Theory Construction in Nursing, Pearson Prentice Hall, River, NJ, 2005) was used to guide the analysis process, which was completed in 2009. Results., The concept analysis revealed that HIV disclosure is a complex process characterized by the following attributes: experiencing an event, communicating something, timing, and contextual environment, protecting someone, relationship status and improving something or being therapeutic. In addition, the process of HIV disclosure varies across time. Conclusion., The proposed HIV disclosure attributes provide nursing scholars and researchers with new directions on how to reframe research questions, develop measurement tools to reflect better the diversity and fluidity of the process of HIV disclosure among HIV-positive individuals. Policy implications include the need to develop approaches that protect individual and public rights. [source] Maternal distress: a concept analysisJOURNAL OF ADVANCED NURSING, Issue 9 2010Elizabeth Emmanuel emmanuel e. & st john w. (2010) Maternal distress: concept analysis. Journal of Advanced Nursing,66(9), 2104,2115. Abstract Aim., This paper is a report of an analysis of the concept of maternal distress. Background., Although not well-developed, the concept of maternal distress has offered an important viewpoint in nursing and midwifery practice since the mid-1990s. Traditionally, understanding of maternal distress has been based on the medical model and dysfunction. The concept of maternal distress needs development so that it describes responses ranging from normal stress responses to those indicating mental health problem/s. Data sources., The SCOPUS, CINAHL and Medline databases were searched for the period from 1995 to 2009 using the keywords ,psychological distress', ,emotional distress' and ,maternal distress'. Review methods., Steps from Rodgers' evolutionary concept analysis guided the conduct of this concept analysis. Results., Four attributes of maternal distress were identified as responses to the transition to motherhood, with the level of each response occurring along a continuum: stress, adapting, functioning and control, and connecting. Antecedents to maternal distress include becoming a mother, role changes, body changes and functioning, increased demands and challenges, losses and gains, birth experiences, and changes to relationships and social context. The consequences of maternal distress are compromised mental health status, maternal role development, quality of life, ability to function, quality of relationships and social engagement. The extent of the impact depends on the level of maternal distress. Conclusion., Clearer interpretation of maternal distress offers a comprehensive approach to understanding maternal emotional health during the transition to motherhood. Acknowledging women's experiences and providing more appropriate support could alleviate some of the struggles and hardships experienced by mothers. [source] Vulnerability related to oral health in early childhood: a concept analysisJOURNAL OF ADVANCED NURSING, Issue 9 2010Deborah J. Mattheus mattheus d.j. (2010) Vulnerability related to oral health in early childhood: concept analysis. Journal of Advanced Nursing,66(9), 2116,2125. Abstract Aim., This article is a report of the analysis of the concept of vulnerability and its relationship to oral health in early childhood. Background., Poor oral health is a continued problem for children worldwide. Vulnerability increases the probability of poor oral health outcomes. The lack of clarity of the concept of vulnerability creates difficulty in understanding this multi-factoral condition. Data sources., Data source included 34 articles covering the period 2000,2009 from a variety of disciplines, including nursing, dentistry, medicine and public health. Methods., The concept analysis was conducted using Rodgers' evolutionary method. The literature was analysed and a social ecology model was used to frame the discussion, recognizing family and community influences on children's oral health. Results., The context of oral health in early childhood contributes to the changes in the concept vulnerability. The attributes are closely related to family and community factors and identified as limited parental income, parental education, community-based services and fluoride; and exposure to poor parental habits, parental neglect and harmful toxins. The primary antecedent is identified as a form of limited protection from exposure to various circumstances. Conclusion., Children with limited protection have increased vulnerability and greater probability of poor health outcomes. Nurses who understand the concept of vulnerability related to oral health and can identify factors that create protection and are capable of decreasing vulnerability through parent education, community awareness and policy changes that support children and families. [source] Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature reviewJOURNAL OF ADVANCED NURSING, Issue 8 2010Claire RashidArticle first published online: 2 JUL 2010 rashid c. (2010) Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing,66(8), 1658,1670. Abstract Aim., This paper presents an integrative literature review of studies exploring the benefits and limitations of the recent expansion of the clinical role of nurses working in general practice in the United Kingdom. Background., Similar clinical outcomes and high levels of satisfaction with consultations undertaken by nurse practitioners compared to general practitioners in primary care have been reported in a Cochrane review [Cochrane Database of Systematic Reviews (2004) vol. 5, p. CD001271]. Since then, nurse consultations have increased considerably as general practitioners have delegated part of their clinical workload to other general practice nurses. However, whether all general practice nurses can fulfil this extended role remains open to question. Method., An integrative review was performed. Nine electronic databases were searched. UK studies were included if they were published after the previous Cochrane review, i.e. between 2004 and 2009. Results., Eight studies were identified, most using qualitative methodology. The evidence suggested that the changes in nurses' role have been predominantly driven by the perceived increase in workload arising from the new general practitioner contract. Delegating work to nurses provided a means of organizing workload within a practice without necessarily allowing patient choice. Patients generally thought that all general practice nurses would be able to deal with simple conditions, but they would prefer to consult with a general practitioner if they thought it necessary. There were concerns about nurses' knowledge base, particularly in diagnostics and therapeutics, and their levels of training and competence in roles formerly undertaken by general practitioners. Conclusion., There have been few studies in this key area of healthcare policy. There is a need for better training and support for nurses undertaking roles in consultation and for patients' views to be better represented. [source] Inpatient falls in adult acute care settings: influence of patients' mental statusJOURNAL OF ADVANCED NURSING, Issue 8 2010Huey-Ming Tzeng tzeng h.-m. (2010) Inpatient falls in adult acute care settings: influence of patients' mental status. Journal of Advanced Nursing,66(8), 1741,1746. Abstract Title.,Inpatient falls in adult acute care settings: influence of patients' mental status. Aim., This paper is a report of a study of fallers' mental status as one of the patient-related intrinsic risk factors for falls. Background., Whether confusion is one of the most important risk factors associated with risk of falling in hospital settings is unclear. Literature reviews have not identified consistent evidence for effective preventive interventions for patients with mental status deficits. Methods., This retrospective research was conducted in six adult acute care units in a community hospital in the United States of America. The data source was the 1017 fall incidents occurring between 1 July 2005 and 30 April 2009. Descriptive statistics and Pearson chi-square tests were used to analyse the data. Results., The presence of mental status deficits was identified as the dominant issue in 346 (34%) falls. The group of fallers with mental status deficits (32·1%, n = 111) seemed to have fewer toileting-related falls than those without mental status deficits (46·7%, n = 314). Fallers with mental status deficits tended to have more severe fall injuries than those without mental status deficits (,2 = 10·08, d.f. = 3, P = 0·018). Conclusion., Risk assessment and targeted surveillance should be used as part of falls prevention policy. Involving nursing staff and family members in assessing a patient's mental status may help to prevent falls caused by mental status deficits. [source] Recovery after coronary artery bypass surgery: effect of an audiotape information programmeJOURNAL OF ADVANCED NURSING, Issue 8 2010Ketsarin Utriyaprasit utriyaprasit k., moore s.m. & chaiseri p. (2010) Recovery after coronary artery bypass surgery: effect of an audiotape information programme. Journal of Advanced Nursing,66(8), 1747,1759. Abstract Title.,Recovery after coronary artery bypass surgery: effect of an audiotape information programme. Aim., The aim of the study was to test the effect of an audiotape giving concrete objective information and strategies to reduce symptoms, psychological distress and enhance physical functioning in patients having coronary artery bypass grafts. Background., The period following hospital discharge is stressful for patients having coronary artery bypass grafts. Evident-based interventions are needed to improve outcomes in Thai populations following coronary artery bypass graft surgery. Methods., A randomized controlled trial was conducted during 2004,2005. A sample of 120 Thai patients having coronary artery bypass grafts was randomly assigned to an intervention group or a control group. The intervention group was given an information audiotape the day prior to hospital discharge, and encouraged to listen to it as many times as necessary. Participants were interviewed using validated instruments predischarge and at 2 weeks and 4 weeks after discharge. Findings., Participants in the intervention group had statistically significantly fewer symptoms of shoulder, back or neck pain and lack of appetite, and increased physical activity after discharge, compared to the control group. This effect remained statistically significant after controlling for age, gender, co-morbidity and presurgical cardiac functional status. However, no statistically significant difference in psychological distress was observed. Conclusion., Nurses can use an audiotape containing preparatory information to improve outcomes for patients having coronary artery bypass grafts during the few weeks after discharge from hospital. Further studies are recommended to improve its effect on psychological distress. [source] Effectiveness of the implementation of an evidence-based nursing model using participatory action research in oncohematology: research protocolJOURNAL OF ADVANCED NURSING, Issue 8 2010Eva Abad-Corpa abad-corpa e., meseguer-liza c., martínez-corbalán j.t., zárate-riscal l., caravaca-hernández a., paredes-sidrach de cardona a., carrillo-alcaraz a., delgado-hito p. & cabrero-garcía j. (2010) Effectiveness of the implementation of an evidence-based nursing model using participatory action research in oncohematology: research protocol. Journal of Advanced Nursing,66(8), 1845,1851. Abstract Title.,Effectiveness of the implementation of an evidence-based nursing model using participatory action research in oncohematology: research protocol. Aim., To generate changes in nursing practice introducing an evidence-based clinical practice (EBCP) model through a participatory process. To evaluate the effectiveness of the changes in terms of nurse-sensitive outcome (NSO). Background., For international nursing science, it is necessary to explore the reasons for supporting EBCP and evaluate the real repercussions and effectiveness. Methods., A mixed methods study with a sequential transformative design will be conducted in the bone marrow transplant unit of a tertiary-level Spanish hospital, in two time periods >12 months (date of approval of the protocol: 2006). To evaluate the effectiveness of the intervention, we will use a prospective quasi-experimental design with two non-equivalent and non-concurrent groups. NSO and patient health data will be collected: (a) impact of psycho-social adjustment; (b) patient satisfaction; (c) symptom control; (d) adverse effects. All patients admitted during the period of time will be included, and all staff working on the unit during a participatory action research (PAR). The PAR design will be adopted from a constructivist paradigm perspective, following Checkland's "Soft Systems" theoretical model. Qualitative techniques will be used: 2-hour group meetings with nursing professionals, to be recorded and transcribed. Field diaries (participants and researchers) will be drawn up and data analysis will be carried out by content analysis. Discussion., PAR is a rigorous research method for introducing changes into practice to improve NSO. [source] The Pregnant Women with HIV Attitude Scale: development and initial psychometric evaluationJOURNAL OF ADVANCED NURSING, Issue 8 2010Lynda A. Tyer-Viola tyer-viola l.a. & duffy m.e. (2010) The Pregnant Women with HIV Attitude Scale: development and initial psychometric evaluation. Journal of Advanced Nursing,66(8), 1852,1863. Abstract Title.,The Pregnant Women with HIV Attitude Scale: development and initial psychometric evaluation. Aim., This paper is a report of the development and initial psychometric evaluation of the Pregnant Women with HIV Attitude Scale. Background., Previous research has identified that attitudes toward persons with HIV/AIDS have been judgmental and could affect clinical care and outcomes. Stigma towards persons with HIV has persisted as a barrier to nursing care globally. Women are more vulnerable during pregnancy. An instrument to specifically measure obstetric care provider's attitudes toward this population is needed to target identified gaps in providing respectful care. Methods., Existing literature and instruments were analysed and two existing measures, the Attitudes about People with HIV Scale and the Attitudes toward Women with HIV Scale, were combined to create an initial item pool to address attitudes toward HIV-positive pregnant women. The data were collected in 2003 with obstetric nurses attending a national conference in the United States of America (N = 210). Content validity was used for item pool development and principal component analysis and analysis of variance were used to determine construct validity. Reliability was analysed using Cronbach's Alpha. Results., The new measure demonstrated high internal consistency (alpha estimates = 0·89). Principal component analysis yielded a two-component structure that accounted for 45% of the total variance: Mothering-Choice (alpha estimates = 0·89) and Sympathy-Rights (alpha estimates = 0·72). Conclusion., These data provided initial evidence of the psychometric properties of the Pregnant Women with HIV Attitude Scale. Further analysis is required of the validity of the constructs of this scale and its reliability with various obstetric care providers. [source] Nurses' intention to leave the profession: integrative reviewJOURNAL OF ADVANCED NURSING, Issue 7 2010Mervi Flinkman flinkman m., leino-kilpi h. & salanterä s. (2010) Nurses' intention to leave the profession: integrative review. Journal of Advanced Nursing,66(7), 1422,1434. Abstract Title.,Nurses' intention to leave the profession: integrative review. Aim., This paper is a report of a study conducted to (1) review and critique the published empirical research on nurses' intention to leave the profession and (2) synthesize the findings across studies. Background., Lack of nurses and nurse turnover represent problems for the healthcare system in terms of cost, the ability to care for patients and the quality of care. At a time of current nursing shortage, it is important to understand the reasons why nurses intend to leave the profession. Data sources., A review was conducted through an initial search of MEDLINE, CINAHL and PsycINFO computerized databases for the period from 1995 to July 2009. The keywords for the search were: Nurs* AND (Personnel turnover OR Career Mobility). Research on nurses' organizational turnover was excluded. Review methods., An integrative literature review was carried out using Cooper's five-stage methodology provided a framework for data collection, analysis and synthesis. Results., A total of 31 studies matching the inclusion criteria were identified. Variety in samples, measurement instruments and measures of intention to leave led to difficulties when attempting to compare or generalize study findings. A number of variables influencing nurses' intention to leave the profession were identified, including demographic, work-related and individual-related variables. Conclusions., Further research is needed using sound measurement instruments, consistent measures of leaving intention and more rigorous sampling. More in-depth research is needed to give nurses opportunities to explain in their own words the reasons for their intentions to leave. [source] Perceived support from healthcare practitioners among adults with type 2 diabetesJOURNAL OF ADVANCED NURSING, Issue 7 2010Bjørg Oftedal oftedal b., karlsen b. & bru e. (2010) Perceived support from healthcare practitioners among adults with type 2 diabetes. Journal of Advanced Nursing,66(7), 1500,1509. Abstract Title.,Perceived support from healthcare practitioners among adults with type 2 diabetes. Aim., This paper is a report of a study of how adults with type 2 diabetes perceive different attributes of support provided by healthcare practitioners and how various attributes of support can influence people's motivation to self-manage their disease. Background., Motivational problems seem to be a major reason for poor diabetes management. According to well-known theories of motivation, expectations of being able to perform certain behaviours are a key element. Different attributes of support from healthcare practitioners are likely to influence such expectations. To date, no researchers have specifically examined how people with type 2 diabetes perceive different attributes of support from healthcare practitioners and how these may influence their motivation to manage their disease themselves. Methods., A descriptive/explorative qualitative design and focus groups were used to collect data. The sample consisted of 19 adults with type 2 diabetes, and the data were collected in 2007 and analysed using qualitative content analysis. Findings., Five themes were identified, reflecting perceived attributes of support from healthcare practitioners: (1) an empathetic approach, (2) practical advice and information, (3) involvement in decision-making, (4) accurate and individualized information and (5) ongoing group-based support. Conclusion., Healthcare practitioners may strengthen the self-management motivation among adults with type 2 diabetes by enhancing expectations of being able to perform the necessary diabetes care, and through the provision of empathetic, individualized, practical and ongoing group-based support. [source] Healthcare professionals' perceptions of existential distress in patients with advanced cancerJOURNAL OF ADVANCED NURSING, Issue 7 2010Esther Mok mok e., lau k-p., lam w-m., chan l-n., ng j.s.c. & chan k-s. (2010) Healthcare professionals' perceptions of existential distress in patients with advanced cancer. Journal of Advanced Nursing,66(7), 1510,1522. Abstract Title.,Healthcare professionals' perceptions of existential distress in patients with advanced cancer. Aim., This paper is a report of an exploration of the phenomenon of existential distress in patients with advanced cancer from the perspectives of healthcare professionals. Background., Existential distress is an important concern in patients with advanced cancer; it affects their well-being and needs to be addressed in the provision of holistic care. Method., Focus groups were conducted from November 2008 to February 2009 with physicians, nurses, social workers, occupational therapists, physiotherapists, and chaplains working in a palliative care unit that served patients with advanced cancer in Hong Kong. Data collection and analysis were guided by the grounded theory approach. All categories were saturated when five focus groups had been held with a total number of 23 participants. Findings., We found three causal conditions of existential distress: anticipation of a negative future, failure to engage in meaningful activities and relationships, and having regrets. Three basic (caring, relating and knowing) and six specific (positive feedback, religious support, new experiences, task setting, exploring alternatives and relationship reconciliation) intervening strategies were identified. Whether the intervening strategies would be effective would depend on patients' openness and readiness; healthcare professionals' self-awareness, hopefulness, and interest in knowing the patients; and a trusting relationship between patients and healthcare professionals. A sense of peace in patients was considered a consequence of successful interventions. Conclusion., This paper acknowledges the lack of an accepted conceptual framework of existential distress in patients with advanced cancer. It is based on healthcare professionals' views, and further studies from the perspectives of patients and their families are needed. [source] Identifying attitudes, beliefs and reported practices of nurses and doctors as immunization providersJOURNAL OF ADVANCED NURSING, Issue 7 2010Karen L. Pielak pielak k.l., mcintyre c.c., tu a.w., remple v.p., halperin b. & buxton j.a. (2010) Identifying attitudes, beliefs and reported practices of nurses and doctors as immunization providers. Journal of Advanced Nursing,66(7), 1602,1611. Abstract Title.,Identifying attitudes, beliefs and reported practices of nurses and doctors as immunization providers. Aim., This paper is a report of a study conducted to examine the attitudes, beliefs, behavioural intentions and self-reported behaviour of nurses and physicians relating to key immunization behaviours and compare the findings for nurses and physicians. Background., Immunization is an important and effective public health intervention. Understanding immunization providers' attitudes and beliefs toward immunization has the potential to improve educational efforts and lead to behavioural change. Method., A postal survey was conducted with all immunization providers in British Columbia, Canada, in 2005. The survey elicited data on demographics, practice characteristics, attitudes, perceived social norms and perceived behavioural control related to key immunization behaviours. Results., Responses were received from 344 nurses and 349 physicians. The response rate was 67% for nurses and 22% for physicians. More nurses than physicians thought that administering all recommended vaccines at one visit was important (89·2% vs. 63·2%P < 0·001); nurses felt more pressure from parents to administer all recommended vaccines (82·4% vs. 48·7%P < 0·001), and nurses were also more likely to intend to give all recommended vaccines at one visit (98·8% vs. 73·8%P < 0·001). Both nurses and physicians thought that their own receipt of influenza vaccine each year was important (88·9%, 87·1% respectively P = 0·65). Conclusion., The foundational work done to develop the survey tool can be used to modify it so that survey findings can be validated according to the Theory of Planned Behaviour. The results could inform the development of behavioural change interventions targeting the identified determinants of immunization provider behaviour. [source] Spiritual health, clinical practice stress, depressive tendency and health-promoting behaviours among nursing studentsJOURNAL OF ADVANCED NURSING, Issue 7 2010Ya-Chu Hsiao hsiao y.-c., chien l.-y., wu l.-y., chiang c.-m. & huang s.-y. (2010) Spiritual health, clinical practice stress, depressive tendency and health-promoting behaviours among nursing students. Journal of Advanced Nursing,66(7), 1612,1622. Abstract Title.,Spiritual health, clinical practice stress, depressive tendency and health-promoting behaviours among nursing students. Aim., This paper is a report of an exploration of the association of spiritual health with clinical practice stress, depressive tendency and health-promoting behaviours among nursing students. Background., Several studies in western countries have demonstrated an association between spirituality and health. Spirituality-related research in eastern countries, however, is still in its infancy. Methods., A cross-sectional design was adopted and structured questionnaires were used for data collection. We adopted the Probability Proportional to Size cluster sampling method to recruit nursing students in senior grades. Data were collected in 2005 using the Spiritual Health Scale, Perceived Clinical Practice Stress Scale, Beck Depression Inventory-II and Health Promotion Behaviours Scale. Results., A total of 1276 nursing students with an average age of 20·1 years (sd = 1·6 years) participated in the study. Spiritual health was negatively associated with clinical practice stress (r = ,0·211, P < 0·001) and depressive tendency (r = ,0·324, P < 0·001) and positively associated with health-promoting behaviours (r = 0·611, P < 0·001). Using hierarchical regression analysis to control for demographic factors, spiritual health was found to be an important predictive factor for clinical practice stress, depressive tendency and health-promoting behaviours. Conclusion., These results are consistent with research findings from western countries. Educators should develop strategies to address nursing students' spiritual health. This may help nursing students to manage their stress, to reduce depressive symptoms and to enhance health-promoting behaviours. [source] Effectiveness of cutaneous warming systems on temperature control: meta-analysisJOURNAL OF ADVANCED NURSING, Issue 6 2010Cristina Maria Galvão galvão c.m., liang y. & clark a.m. (2010) Effectiveness of cutaneous warming systems on temperature control: meta-analysis. Journal of Advanced Nursing,66(6), 1196,1206. Abstract Title.,Effectiveness of cutaneous warming systems on temperature control: meta-analysis. Aim., This paper is a report of a meta-analysis to identify the effectiveness of different types of cutaneous warming systems in temperature control for patients undergoing elective surgery. Background., Hypothermia is a common and serious complication of surgery. Different cutaneous warming systems are used to prevent hypothermia during surgery but there have been no previous meta-analyses of the effectiveness of different warming systems in controlling temperature. Data sources., We conducted a search of the CINAHL (2000 to April 2009), Medline (2000 to April 2009), Embase (2000 to April 2009) and the Cochrane Register of Controlled Trials (2000 to April 2009) databases for randomized controlled trials published in English, Spanish and Portuguese. The primary outcome measure of interest was core body temperature. Methods., A systematic review incorporating meta-analysis was carried out. Results., From 329 papers, 23 trials compared warming systems. Forced-air warming systems had a strong tendency towards superior temperature control over passive insulation via cotton blankets (mean difference: 0·29°C; 95% confidence interval: ,0·02 to 0·59, three trials 292 patients) and radiant warming systems (mean difference: 0·16°C; 95% confidence interval: ,0·01 to 0·33, three trials, 161 patients). However, circulating water garments tended to be more effective than forced-air warming systems (mean difference: ,0·73°C; 95% confidence interval: ,1·51 to 0·05, I2 = 97%; four trials, 198 patients). Pooled results approached statistical significance and indicated clinically meaningful differences in temperature control. Conclusion., Current evidence suggests that circulating water garments offer better temperature control than forced-air warming systems, and both are more effective than passive warming devices. [source] Dental hygiene education for nursing staff in a nursing home for older peopleJOURNAL OF ADVANCED NURSING, Issue 6 2010Erika Kullberg kullberg e., sjögren p., forsell m., hoogstraate j., herbst b. & johansson o. (2010) Dental hygiene education for nursing staff in a nursing home for older people. Journal of Advanced Nursing,66(6), 1273,1279. Abstract Title.,Dental hygiene education for nursing staff in a nursing home for older people. Aim., This paper is a report of a study evaluating the effect of a repeated education programme for nursing staff in a home for older people. Background., A strong relationship exists between oral infections and general health complications (especially aspiration pneumonia) among nursing home residents and hospitalized older people. Thus, nursing staff need to be educated in oral hygiene measures. Methods., Forty-three nursing home resident older people (12 men, 31 women, age range 69,99 years) were included in a dental hygiene and gingivitis evaluation using gingival bleeding scores and modified plaque scores. Evaluation was conducted before and 3 weeks after a repeated dental hygiene education for nursing staff at a nursing home in Sweden in 2008. Dental hygiene education had been given 1·5 years previously. Findings., Forty-one residents (12 men and 29 women) were available for evaluation after the repeated dental hygiene education (one died, one had had teeth extracted). There was a reduction in gingival bleeding scores (P < 0·001), and in plaque scores (P < 0·001). Conclusion., Repeated dental hygiene education improves the dental hygiene among nursing home resident older people. In order to succeed it may be necessary to address attitudes and perceptions towards oral care in such a dental hygiene education programme for nursing staff. Improved oral hygiene contributes to reducing the incidence of healthcare-associated pneumonia among nursing home resident older people, and thus to reduced healthcare costs. [source] Experience of parents with head and neck cancer who are caring for young childrenJOURNAL OF ADVANCED NURSING, Issue 6 2010Cherith J. Semple semple c.j. & mccance t. (2010) Experience of parents with head and neck cancer who are caring for young children. Journal of Advanced Nursing,66(6), 1280,1290. Abstract Title.,Experience of parents with head and neck cancer who are caring for young children. Aim., This paper is a report of a study exploring the experience and support needs of parents with head and neck cancer, who are also caring for their young children. Background., The incidence of head and neck cancer is steadily rising in the younger age groups (under 50 years). As a direct consequence, more parents of young children are being diagnosed with this cancer. Methods., Using a qualitative descriptive design, 12 patients with young children under the age of 16 were interviewed during 2008. The data were analysed using cognitive mapping. Findings., At diagnosis, parents experienced the fear of missing milestones in the life of their children and fear of telling the children about their diagnosis. During treatment, parents' inevitable stays in hospital led to separation from the children and the need to prepare their children for the first hospital visit. Parents experienced many debilitating effects of treatment, which had an impact on family activities, especially those that involved eating. There was often changing roles within the family. After treatment, the experience of living with cancer for parents resulted in the desire to get back to day-to-day life. Parents had an increased appreciation of life but were also living with uncertainties. The most important support networks for parents were their spouse, family and friends. Conclusion., Oncology nurses are in an excellent position to offer support and guidance to parents with cancer who have children, and should encourage them to explore with the family the best way of managing role change during treatment. [source] Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocolJOURNAL OF ADVANCED NURSING, Issue 6 2010Eva Abad-Corpa abad-corpa e., carrillo-alcaraz a., royo-morales t., pérez-garcía m.c., rodríguez-mondejar j.j., sáez-soto a. & iniesta-sánchez j. (2010) Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. Journal of Advanced Nursing,66(6), 1365,1370. Abstract Title.,Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. Aim., To evaluate the effectiveness of a protocolized intervention for hospital discharge and follow-up planning for primary care patients with chronic obstructive pulmonary disease. Background., Chronic obstructive pulmonary disease is one of the main causes of morbidity and mortality internationally. These patients suffer from high rates of exacerbation and hospital readmission due to active problems at the time of hospital discharge. Methods., A quasi-experimental design will be adopted, with a control group and pseudo-randomized by services (protocol approved in 2006). Patients with pulmonary disease admitted to two tertiary-level public hospitals in Spain and their local healthcare centres will be recruited. The outcome variables will be readmission rate and patient satisfaction with nursing care provided. 48 hours after admission, both groups will be evaluated by specialist coordinating nurses, using validated scales. At the hospital, a coordinating nurse will visit each patient in the experimental group every 24 hours to identify the main caregiver, provide information about the disease, and explain treatment. In addition, the visits will be used to identify care problems and needs, and to facilitate communication between professionals. 24 hours after discharge, the coordinating nurses will inform the primary care nurses about patient discharge and nursing care planning. The two nurses will make the first home visit together. There will be follow-up phone calls at 2, 6, 12 and 24 weeks after discharge. Discussion., The characteristics of patients with this pulmonary disease make it necessary to include them in hospital discharge planning programmes using coordinating nurses. [source] Clinical Learning Environment Inventory: factor analysisJOURNAL OF ADVANCED NURSING, Issue 6 2010Jennifer M. Newton newton j.m., jolly b.c., ockerby c.m. & cross w.m. (2010) Clinical Learning Environment Inventory: factor analysis. Journal of Advanced Nursing,66(6), 1371,1381. Abstract Title.,Clinical Learning Environment Inventory: factor analysis. Aim., This paper is a report of the psychometric testing of the Clinical Learning Environment Inventory. Background., The clinical learning environment is a complex socio-cultural entity that offers a variety of opportunities to engage or disengage in learning. The Clinical Learning Environment Inventory is a self-report instrument consisting of 42 items classified into six scales: personalization, student involvement, task orientation, innovation, satisfaction and individualization. It was developed to examine undergraduate nursing students' perceptions of the learning environment whilst on placement in clinical settings. Method., As a component of a longitudinal project, Bachelor of Nursing students (n = 659) from two campuses of a university in Australia, completed the Clinical Learning Environment Inventory from 2006 to 2008. Principal components analysis using varimax rotation was conducted to explore the factor structure of the inventory. Results., Data for 513 students (77%) were eligible for inclusion. Constraining data to a 6-factor solution explained 51% of the variance. The factors identified were: student-centredness, affordances and engagement, individualization, fostering workplace learning, valuing nurses' work, and innovative and adaptive workplace culture. These factors were reviewed against recent theoretical developments in the literature. Conclusion., The study offers an empirically based and theoretically informed extension of the original Clinical Learning Environment Inventory, which had previously relied on ad hoc clustering of items and the use of internal reliability of its sub-scales. Further research is required to establish the consistency of these new factors. [source] Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 5 2010Lucy Goulding goulding l., furze g. & birks y. (2010) Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic review. Journal of Advanced Nursing,66(5), 946,961. Abstract Title.,Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic review. Aim., This paper is a report of a systematic review of randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease, and was conducted to determine whether such interventions were effective in changing maladaptive beliefs, and to assess any consequent change in coping and outcome. Background., An increasing body of evidence suggests that faulty beliefs can lead to maladaptive behaviours and, in turn, to poor outcomes. However, the effectiveness of interventions to change such faulty illness beliefs in people with coronary heart disease is unknown. Data sources., Multiple data bases were searched using a systematic search strategy. In addition, reference lists of included papers were checked and key authors in the field contacted. Review methods., The systematic review included randomized controlled trials with adults of any age with a diagnosis of coronary heart disease and an intervention aimed at changing cardiac beliefs. The primary outcome measured was change in beliefs about coronary heart disease. Results., Thirteen trials met the inclusion criteria. Owing to the heterogeneity of these studies, quantitative synthesis was not practicable. Descriptive synthesis of the results suggested that cognitive behavioural and counselling/education interventions can be effective in changing beliefs. The effects of changing beliefs on behavioural, functional and psychological outcomes remain unclear. Conclusion., While some interventions may be effective in changing beliefs in people with coronary heart disease, the effect of these changes on outcome is not clear. Further high quality research is required before firmer guidance can be given to clinicians on the most effective method to dispel cardiac misconceptions. [source] Nurses' perceptions of individualized careJOURNAL OF ADVANCED NURSING, Issue 5 2010Riitta Suhonen suhonen r., gustafsson m.-l., katajisto j., välimäki m. & leino-kilpi h. (2010) Nurses' perceptions of individualized care. Journal of Advanced Nursing,66(5), 1035,1046. Abstract Title.,Nurses' perceptions of individualized care. Aim., This paper is a report of a study of nurses' perceptions of individualized care, the factors associated with these perceptions, and nurses' perceptions of the provision of individualized care in different types of healthcare organization. Background., Although individualized care has been an internationally-challenging and long-standing research topic in nursing, the current literature on individualized care from the perspective of nurses is limited. Methods., A cross-sectional, descriptive and exploratory design using a questionnaire (Individualised Care Scale,Nurse) was employed to survey a stratified sample of 544 nurses (response rate 59%) working as Registered or Enrolled Nurses in one hospital district in Finland in 2008. Data were analysed using descriptive and inferential statistics (General Linear Model, one-way analysis of variance) and Cronbach's alpha coefficients for reliability analysis. Results., Nurses perceived that they supported patient individuality well and that the care they provided took into account patient individuality. Based on the General Linear Model, nurses' background variables were not associated with their perceptions of individualized care delivery. However, between-organization differences were found in all study variables: mental health ward nurses had the most positive perceptions, and nurses working in primary health centre long-term care wards the lowest. Conclusion., Healthcare organizations and work environments need to be evaluated as they may have an influence on individualized care provision. The Individualised Care Nurse instrument is sensitive to healthcare working environments and can be used in evaluating nurses' perceptions of individualized care. [source] Socio-demographic factors related to functional limitations and care dependency among older EgyptiansJOURNAL OF ADVANCED NURSING, Issue 5 2010Thomas Boggatz boggatz t., farid t., mohammedin a., dijkstra a., lohrmann c. & dassen t. (2010) Socio-demographic factors related to functional limitations and care dependency among older Egyptians. Journal of Advanced Nursing,66(5), 1047,1058. Abstract Title.,Socio-demographic factors related to functional limitations and care dependency among older Egyptians. Aim., This paper is a report of a study determining the relationship of socio-demographic factors to functional limitations and care dependency among older care recipients and non-care recipients in Egypt. Background., The population is ageing in Egypt and age-related functional limitations are increasing. Age and gender influence this phenomenon, but its relationship to socio-economic status has not yet been demonstrated for Egypt. Functional limitations are an antecedent to care dependency, which also may be associated with these socio-demographic factors. Method., A cross-sectional study with a two-group comparative design was conducted in Greater Cairo. The sample was composed of 267 non-care recipients and 344 care recipients. Path analysis was used to determine the relationship between variables. Age, gender and acceptance of care were covariates in the multiple regressions. Analyses were conducted separately for care recipients and non-care recipients. Results., Among non-care recipients, lower socio-economic status was related to more functional limitations and higher care dependency. This relationship was not found among care recipients. Conclusion., Older persons from low income groups are more likely to become care dependent but are less able to pay for required care. Currently, untrained volunteer groups of religious organizations try to support these older people in the poorer strata of Egyptian society. Training in the basics of care might help to make their work more effective. [source] | ||||||||||