Nursing Research

Reducing and eliminating the use of restrictive practices, such as seclusion and restraint, is a national priority for Australia’s mental health services. Whilst legislation, organization and practice changes have all contributed to a reduction in these practices, forensic mental health services continue to report high rates. This paper details the findings of research that examined the experiences of nurses working in the inpatient forensic mental health setting.
The research aimed to (i) document the experiences of nurses working in the forensic mental health setting, (ii) articulate their perceived unique skill set to manage challenging patient behaviours, and (iii) determine how their experiences and skill set can inform practice changes to reduce the use of restrictive practices. Thirty-two nurses were recruited from one Australian forensic mental health service. Data were collected using semi-structured interviews and analysed using inductive content analysis. Four categories were identified that influenced practice experiences: (i) working in a challenging but interesting environment, (ii) specialty expertize, (iii) exposure to aggression and resilience as a protective factor, and (iv) the importance of effective teamwork and leadership. Forensic mental health care is complex, highly specialized, and often delivered in an unpredictable environment. Whilst high rates of restrictive practices may be linked
to the unique characteristics of forensic patients, training, teamwork, and leadership are critical factors influencing their use in this setting. Nurses working in this area need to be educated and supported to work confidently and safely with this high-risk patient cohort.

A number of articles in the nursing literature discuss the differences between descriptive and interpretive approaches to doing phenomenology. A review of studies demonstrates, however, that many researchers do not articulate which approach guides the study, nor do they identify the philosophical assumptions on which the study is based. Such lack of clarity makes it difficult for the reader to obtain a sense of how the knowledge produced by the study is to be evaluated and used. In this article, the authors compare the philosophical components of descriptive and interpretive approaches to doing phenomenology and illustrate types of knowledge produced by each through reviewing specific studies. They focus on the various uses of phenomenology in generating useful knowledge for health care practice.

Women with chronic illnesses face challenges during childbirth and recovery. However, Schizophrenic postpartum women are especially challenged during this period due to inadequate prenatal care, decreased tolerance for pain, and a psychotically distortion of reality 1, 5.  Most of these women experience overwhelming anxiety 1, 2. To handle the clinical needs of these patients, the postpartum nurse must possess excellent clinical skills and utilize all the available resources. The goal is for quality postpartum care and safety for the patient, baby, family, and staff.

RNs make measurable contributions to the health and wellness of individuals living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively affect resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based on eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness...

Since its inception, phenomenological philosophy has exerted an influence on empirical science. But what is the best way to practice, use and apply phenomenology in a non-philosophical context? How deeply rooted in phenomenological philosophy must qualitative research be in order to qualify as phenomenological? How many of the core commitments of phenomenology must it accept? In the following contribution, I will take a closer look at Max van Manen’s work. I will argue that van Manen’s understanding of and presentation of phenomenology is quite problematic and that his book "Phenomenology of Practice" rather than amounting to a clear and accessible presentation of the phenomenological method that would make it do-able to researchers who are not themselves professional philosophers is in fact both abstruse and excessively complicated. I will then turn to nursing, and by taking that as my example, outline a better way to apply and practice phenomenology.

Scientific evidence on the impact of small-scale living facilities (SSLFs) on quality of life of nursing home clients remains scarce. In this study a simulation model is developed to examine the performance of SSLFs, in terms of meeting the time preferences of their residents. We model scheduled care using historical data and unscheduled care using a Poisson-Gamma mixture model. The model is used to explore the impact of a change in demand characteristics, duration of care delivery, travel time, allocation flexibility, shifts, number of clients and allocation policy. The results show that to further improve the performance, the focus should lie on: (1) increasing the allocation flexibility of care workers and the number of clients per SSLF, and (2) time dependent staffing. Furthermore, this study shows that simulation is a useful tool for assessing and improving daily nursing home operations. The presented simulation model provides a basis for building a decision support tool for nursing home managers.

Coping is a cognitive process and behavior that aims at reducing depression while facing stress situation. Treating patient with schizophrenia is a stressor for family and the family will tend to undergo pressure situation from either the environment or the inside part until it can influence family-coping in treating family who suffers mental disorder, such as schizophrenia. Moreover, this research aimed at knowing factors that influenced mechanism of family-coping in treating patient with schizophrenia. Data analysis utilized logistic-regression-test. The result showed that the factors that influenced against family-coping were self-esteem and social-support, meanwhile, the factors that did not influence it were knowledge, stress, and patient's behavior in social-isolation.

Resuhs: Eleven faculty, 11 resident physicians, and 13 emergency nurses were observed. Of 409 total contacts, 272 were clean, 46 were dirty, and 91 were gloved. Hand washing occurred after 32.3% of total contacts (SD, 2.31%). Nurses washed after 58.2% of 146 contacts (SD, 4.1%), residents after 18.6% of 129 contacts (SD, 3.4%), and faculty after t7.2% of 134 contacts (SD, 3.3%). Nurses had a significantly higher hand washing frequency than either faculty (P< .0001) or resident physicians (P< .0081). Hand washes occurred after 28.4% of 272 clean contacts (SO, 2.34%), which was significantly less (P< .0001) than 50.0% of 46 dirty contacts (SD, 7.4%) and 64.8% of 91 gloved contacts (SD, 5.0%).

Background: Some patients do not receive adequate pain and symptom relief at the end of life, causing distress to patients, families and healthcare professionals. It is unclear whether undertreatment of symptoms occurs, in part, because of nurses’ concerns about legal and/or disciplinary repercussions if the patient dies after medication is administered. Aim: The aim was to explore nurses’ experiences and knowledge of the law relating to the provision of end-of-life pain and symptom relief. Design: Semi-structured interviews with nurses were assessed using a six-stage hybrid thematic analysis technique. Setting/participants: Four face-to-face and 21 telephone interviews were conducted with nurses who routinely prescribed and/or administered pain and symptom relief to patients approaching the end of their lives in Queensland and New South Wales, Australia. Results: While many nurses had no personal experiences with legal or professional repercussions after a patient had died, the fea...

StakeholdersÕ perceptions of a research capacity development project for nurses, midwives and allied health professionals Aims To evaluate stakeholdersÕ perceptions of the extent to which a research facilitator post was addressing aims of: • providing academic support to enable research involvement of nurses, midwives and allied health professionals; • supporting dissemination of research into practice; • contributing to research strategy development. Background Barriers to research capacity development have been recognized for nurses, midwives and allied health professionals. A project established in a London NHS trust aimed to address these. Methods A mixed methods approach was used. Results Responses were generally very positive. The post effected improvements in the research culture and perceived increase in research-related activities. Conclusion The post made substantial progress towards its aims. This approach may be useful in other healthcare locations to build research capacity. Implications for nursing management Challenged by increasing priority accorded to research capacity and service research implementation yet recognition of barriers to achievement, this study offers insights from one means to address this.

Health care is in need of change. Major professional and health care organizations as well as federal agencies and policy-making bodies are emphasizing the importance of evidence-based practice (EBP). Using this problem solving approach to clinical care that incorporates the conscientious use of current best evidence from well designed studies, a clinician's expertise, and patient values and preferences, nurses and other health care providers can provide care that goes beyond the status quo. Health care that is evidence-based and conducted in a caring context leads to better clinical decisions and patient outcomes. Gaining knowledge and skills in the EBP process provides nurses and other clinicians the tools needed to take ownership of their practices and transform health care. Key elements of a best practice culture are EBP mentors, partnerships between academic and clinical settings, EBP champions, clearly written research, time and resources, and administrative support. This article provides an overview of EBP and offers recommendations for accelerating the adoption of EBP as a culture in education, practice and research.

This study examined the extent of adoption by clinical nurses of 14 research-based nursing practices and explored characteristics of the nurses which may have influenced their use of innovations. The relationship between the nurses&amp;#39; adoption of innovative practices and their perception of organizational support in the form of a hospital policy about the practice was also examined. The 14 nursing practices used in the study met the criteria established by the 1982 Conduct and Utilization of Research in Nursing (CURN) Project. The Nursing Practice Questionnaire (NPQ) developed by Brett (1987) to explore nurses&amp;#39; stage of innovation adoption was sent to a random sample of nurses in 10 medium sized hospitals throughout North Carolina; 113 nurses responded. The majority of the sample were aware of 9 of the 14 nursing practices. The percentage who were aware of individual practices ranged from 28% to 93.8%. Eight of the 14 practices were used regularly by more than half of the sample.

Disasters have been increasing through-out time, both natural and man-made, and it’s agreed upon, that disaster can gravely affect communities and countries if they are not prepared for them. One major part of this preparedness is in the healthcare systems, and primarily in the hospital’s Emergency Departments. Finland has disaster preparedness as part of its national laws, and the Ministry of Social Affairs &amp;amp; Health (STM) has also provided guidelines for Healthcare District Municipalities(SHP) and hospitals. International research has been increasing on this subject recently, but no public national research had been found. This thesis explored the current level of disaster preparedness of nurses in working in an Emergency Department (ED) in a middle size hospital in Finland. The research attempted to identify the different types of disasters which the ED nurses are prepared for, and what trainings and education they have. As well as to identify the factors affect the nurse’s preparedness levels. An empirical qualitative research was performed using inductive thematic data analysis. Data was collected by interviews with 4 charge nurses from an ED. Patricia Benner’s theory “From Novice to Expert” was used as framework, along with the STM guidelines. The findings revealed a lack of knowledge in some areas of disaster preparedness, as well as a lack of sufficient training and education, which affected the participants’ confidence in themselves when it came to some specific major events, and in the ED’s level of preparedness, especially since many of the nurses working there currently were new.

ABSTRAK Pendahuluan: Kanker serviks menjadi penyebab utama morbiditas dan mortalitas di seluruh dunia. Program pencegahan kanker serviks yang kurang baik menyebabkan keterlambatan penanganan sehingga sebagian besar responden mengalami kanker serviks stadium lanjut. Penelitian bertujuan untuk mengetahui hubungan faktor personal, self efficacy dengan upaya pencegahan kanker serviks pada wanita usia produktif. Metode: desain penelitian ini adalah deskriptif korelatif dengan pendekatan cross sectional. Populasinya adalah semua wanita usia produktif di wilayah Puskesmas Kenjeran Surabaya. Besar sampelnya adalah 64 responden wanita usia produktif dengan menggunakan Probability Simple Random Sampling. Variabel independen adalah faktor personal dan self efficacy. Variable dependen adalah upaya pencegahan primer dan sekunder. Data dianalisis menggunakan uji statistik Spearman's rho untuk mengetahui variable yang berhubungan dengan upaya pencegahan kanker serviks. Hasil: hasil penelitian menunjukkan hubungan antara faktor personal dan upaya pencegahan kanker serviks menghasilkan p = 0,025 (α ≤ 0,05). Sedangkan variable hubungan self efficacy dengan upaya pencegahan kanker serviks pada wanita usia produktif menghasilkan p = 0,094 (α ≤ 0,05). Diskusi: Faktor personal berhubungan dengan upaya pencegahan kanker serviks pada wanita usia produktif sedangkan self efficacy tidak berhubungan dengan upaya pencegahan kanker serviks pada wanita usia produktif. Untuk peneliti selanjutnya dapat menggunakan variabel lain dari teori Health Promotion Model untuk melakukan upaya pencegahan kanker serviks. ABSTRACT Introduction: Cervical cancer is a major cause of morbidity and mortality worldwide. Bad cervical cancer prevention program cause delays in treatment. Thus, leading most of the respondents had cervical cancer in advance stadium. The study aims to determine the correlation of personal factors, self efficacy in the prevention of cervical cancer in women of childbearing age. Methods: The study design was descriptive correlative with cross sectional approach. The population were all women of childbearing age in Puskesmas Kenjeran Surabaya. Samples were 64 respondents gathered by using simple random sampling. The independent variable were the personal factor and self efficacy. The dependent variable was the primary and secondary prevention efforts. Data were analyzed using Spearman's rho test to determine the variables which associated with the prevention of cervical cancer. Results: The results showed the correlation between personal factors and prevention of cervical cancer with p = 0.025 (α ≤ 0.05). While self efficacy had no correlation with the prevention of cervical cancer with p = 0.094 (α ≤ 0.05). Discussion: Personal factors related to the prevention of cervical cancer in women of childbearing age, while self efficacy is not related to the prevention of cervical cancer in women of childbearing age. For the next researcher to use other variables of the theory Health Promotion Model to take steps to prevent cervical cancer.

Numerous articles describe barriers to nurses conducting research and achieving evidence-based practice as well as strategies for overcoming barriers. The Research Roundtable format is one such strategy. It is an interactive means for providing novice nurse researchers and nursing students with the skill sets required to drive application of existing evidence to nursing practice and conduct outcome studies to derive new evidence. The authors discuss their Research Roundtable series that addressed a number of barriers to research, research utilization, and evidence-based practice and how the series increased nurses knowledge and skills, demystified the research process, provided role models, demonstrated managerial and collegial support, and provided library, fiscal, and other resource support to complete staff projects. The details of the Research Roundtable series will guide others in replicating the process in their own organizations and academic communities.

This research into the concept of support was undertaken because of the recurrent use of the concept in nursing research and especially because of the vital importance of support to family carers of older persons. To inductively develop a definition of support, specifically in the context of family care of frail aged persons. The study followed the evolutionary method of concept analysis. The study was based on data from scientific publications, encyclopaedias and dictionaries. In order to secure a representative sample, highly systematic means of sampling were used. Working with the data underpinning this study, it was possible to put forward a definition of support for family carers who care for a frail aged person at home. The two major dimensions, as described under attributes, were merged into the following definition: &quot;Support entails the provision of general tangibles such as information, education, economic aid, goods and external services. They are prerequisites for fa...

Much of the domestic violence and abuse literature contains reports of quantitative research approaches that quantify the experience, identify those at risk, and recommend interventions. Although important, these approaches often fail to describe the experience and understanding from the perspective of and in the language used by women who have experienced abuse. This article reports a phenomenographic study of six women&#39;s understanding of their experiences of domestic violence during their childbearing years, the time period associated with pregnancy and the first twelve months after birth. The women described domestic violence as being experienced as a loss of self, being controlled and destruction. This report presents the women&#39;s views of domestic violence as a complex and damaging phenomenon that is experienced by them in a number of qualitatively different ways.

A conclusione dell'intenso percorso formativo sullo human caring in regione, è possibile porsi alcune domande e soprattutto cercare di elaborare alcuni spunti che possano essere sfruttati a livello pratico-operativo. Si deve anzitutto partire dal riconoscimento del particolare momento che stiamo vivendo: da un lato, l'attenzione verso lo human caring mai è stata così alta da parte di tutti gli attori del panorama sanitario, pazienti, operatori e dirigenza/politici; dall'altro, la riflessione filosofica è finalmente uscita dalla proverbiale torre d'avorio e ha preso consapevolezza che specialmente l'etica ha un futuro solo come etica applicata ai casi concreti della vita. Uno dei problemi evidenziati sin dall'inizio nello human caring è che esso per definizione necessita di una formazione permanente. Occorre dunque pensare ad un approccio articolato su più fronti. Anzitutto occorrerebbe iniziare a fare una prima sintesi delle varie riflessioni fatte in ambito etico finora. Dato per acquisito che il fondamento dello HC è l'etica, si tratta di capire quale sia il modello etico migliore. Inoltre nell'elaborarlo si deve tenere conto delle specificità della situazione italiana. Dall'altro lato, si deve iniziare ad affrontare la questione dell'inserimento dello HC nei curricula di studio e formazione (o rendere questi ultimi permanenti) e magari pensare a creare occasioni di formazione post-laurea e post-diploma sul modello di alcuni esempi esteri. Articolo di Claudio Magris sul Corriere del 6 novembre: In questi anni ho avuto occasione di frequentare, per me e soprattutto per persone a me care, medici delle più svariate specialità ed è stata una delle forti e liberatrici esperienze della mia esistenza. Nelle più varie discipline che si confrontano con i mali che assalgono l'uomo — dall'oncologia all'oculistica, dalla dermatologia alla pediatria, dalla cardiologia alla neurologia, alla chirurgia — ho avuto modo di toccare con mano una radicale trasformazione del rapporto fra medico e paziente, che significa un vero passo in avanti dell'umanità. Ho visto clinici di diverse specialità — e ne ho anche scritto, citando nomi e cognomi — capaci di dare serenità dicendo la verità, una verità spesso tutt'altro che allegra. Ho accompagnato di recente una persona a me carissima dalla sua oncologa, tanto inesorabilmente precisa nella sua descrizione dello stato delle cose quanto incredibilmente capace di comunicare queste nozioni neutralizzando il loro potenziale d'ansia, sicché siamo usciti dal colloquio non ossessionati dalla malattia, bensì pervasi da un profondo senso della vita e della sua creatività, che comprende il meglio e il peggio, entrambi guardati chiaramente in faccia. Certo, quando il numero dei pazienti che giustamente fanno ansiose e ripetute domande si fa alto, la necessaria fretta e lo stress a essa legato possono rendere più difficile questo momento di creatività non solo professionale ma umana.

Intention-to-treat (ITT) in randomized controlled trials involves keeping participants in the treatment groups to which they were randomized regardless of whether they withdraw following randomization. Intention-totreat is a strategy for maintaining the integrity of randomization and strengthening the trial's internal validity. Although ITT is advocated by the Consolidated Standards of Reporting Trials (CONSORT) guidelines, there is confusion about what ITT means and little specific advice on how to achieve it. The purpose of this article is to present definitions of ITT and to suggest strategies for implementing ITT as a total design strategy in nursing clinical trials. Recommendations are offered regarding study planning, study design, subject retention, sampling, data collection, data analysis, and reporting within the context of ITT. ß

Nursing care dependency and similar terms are frequently used in nursing literature. However, their meanings are still to be adequately defined. This paper seeks to operationalize the concept of dependency for use in long-term nursing care practice. An analysis of the concept of dependency, specifically with regard to nursing care, will present a frame of reference from which a theoretical definition can be stated. Variable dimensions, observable indicators and means for measuring the indicators are presented. The paper concludes with implications for further research.

Cancer and venous access (CAVA) trial has highlighted some issues and problems from the different departments linked to this clinical trial. This clinical service review attempted to reflect on this problems and offered some insights as to how address these problems.

This paper reports a questionnaire-based investigation into the knowledge sources used by nurses in two Turkish university hospitals, and whether these knowledge sources were related to sociodemographic variables. 78.5% of the nurses said that practice should be based on evidence and 75.9% stated that this evidence should come from research. 80.7% stated that evidence-based practice was useful. However, evidence that was not based on research constituted the first three most frequently used sources of knowledge. Sources of evidencebased on research were detected as being in the 4th, 5th, 6th, 8th, and 10th positions regarding the frequency of use. The nurses expressed a belief that nursing practices should be based on evidence, but did not reflect this belief in their behavior.

زمينه و هدف: مراقبت از بيماران مبتلا به دمانس و بالاخص آلزايمر از آسيب پذيرترين و چالش برانگيزترين
نوع مراقبتهاست كه مراقبين ممكن است با آن مواجه شده و باعث تجربه استرس زياد در آنها مي گردد. در اين
ميان فقدان آموزشهاي لازم نيز مشكلات آنها را دو چندان نموده است. هدف اين مطالعه تعيين تاثير بحث
گروهي و مشاوره تلفني بر استرس درك شده زنان مراقبت كننده از سالمند مبتلا به آلزايمر بوده است.
روش بررسي: در اين پژوهش تجربي، 150 زن 18 تا 60 سال كه از وابستگان درجه يك سالمند مبتلا به
آلزايمر بوده و مراقبت مستقيم از سالمند مبتلا به آلزايمر را به مدت حداقل 6 ماه به عهده داشتند با روش نمونه
گيري مستمر مبتني بر هدف انتخاب شده و آزمودني ها با روش تصادفي بلوكه شده به تصادف در دو گروه
آزمون و كنترل قرار گرفتند. گروه آزمون در يك برنامه مداخلهاي شامل يك جلسه بحث گروهي، دريافت يك
پمفلت آموزشي و دو مشاوره تلفني شركت نمودند. 6 هفته پس از مداخله، پسآزمون براي هر دو گروه انجام
گرفت. ابزار گردآوري اطلاعات، پرسشنامه اطلاعات دموگرافيك و استرس درك شده بود. براي مقايسه متغيرها
از آزمونهاي آماري تي زوجي، تي مستقل، كاي اسكوئر و آناليز واريانس يك طرفه استفاده شد.
57 % از / 50 % نمونهها در گروه آزمون و 3 / يافتهها: نتايج نشان داد كه قبل از بحث گروهي و مشاوره تلفني 7
نمونهها در گروه كنترل استرس درك شده بالايي داشتند. پس از انجام بحث گروهي و مشاوره تلفني ميانگين
بين استرس .( P< 0/ 22 تقليل يافت ( 001 /45±5/ 28 به 55 /38 ±8/ استرس درك شده در گروه آزمون از 62
از نظر آماري ارتباط ( P=0/ و وضعيت اقتصادي ( 01 (P=0/ درك شده و متغيرهاي وضعيت تحصيلات ( 03
معنيدار وجود داشت.
نتيجهگيري: زنان مراقبتكننده از سالمند مبتلا به آلزايمر به عنوان مهمترين مراقبين غيررسمي، سطوح استرس
بالايي را تجربه ميكنند كه همين امر سلامت آنها و سالمندان تحت مراقبت ايشان را تحت الشعاع قرار ميدهد،
لذا لزوم مداخله براي اين مراقبين به منظور بهبود وضعيت آنها پيشنهاد ميشود.

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses' perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal ter-Neonatal intensive care decision-making 109 tiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decisionmaking primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decisionmaking, where the view of all team members are considered.

The purpose of this article is to present a framework for nurses to study the impact of built environment on health, particularly in vulnerable populations. Organizing Construct: The framework is adapted from Social Determinants of Health and Environmental Health Promotion, a framework describing how physical and social environments interact to influence individual and population health and health disparities via macro, community-level, and interpersonal factors. Methods: The original framework was modified for public health nursing using nursing research evaluating built environment and health, and supplemented with Nightingale's theory of nursing and health. Findings: The built environment affects health through regional-, neighborhood-, and individual-level factors. Nursing can affect the health of patients by evaluating the neighborhood built environment where patients reside, and by advocating for changes to the built environment. Conclusions: Through development of built environment research, nurses can provide valuable insight into the pathways linking built environment to health of vulnerable populations, providing evidence for public health nurses to advocate for these changes on a neighborhood, state, and federal level. Clinical Relevance: This framework can be used by public health clinicians to understand the pathways by which the built environment may be affecting the health of their patients, and by researchers to investigate the pathways, and to design and test community interventions.

Your assignment: Write a scholarly paper for a nursing course. What is your reaction? Panic!? Confusion? A need to get prepared! Most nursing students ask the following questions: "What is considered scholarly writing style?" "What should be included in the paper?" "Where do I find references?" "What references are appropriate?" "How are references cited?" "How should the paper be typed?" "Why do I need to write papers for nursing courses anyway?" These questions and anxieties are expressed by nursing students across the country, especially since undergraduate and graduate nursing students are asked to write scholarly papers throughout their nursing journey. Nursing papers are often written using the American Psychological Association (APA) (2001) style guidelines, and we've prepared this article so that you'll be on your way to writing a successful paper. We've included information on the APA format, with examples, so that you're not only developing your writing skills while at school but during your career as a professional nurse.

Purpose: To present the Interaction Model of Client Health Behavior (IMCHB) as a model to guide nurse practitioners (NPs) in their practice. Data sources: Selected research-based articles on Cox's IMCHB and selected text and writings on the NP movement and nursing practice models. Conclusions: Many NPs practice in a medical setting where the boundaries between medicine and nursing are blurred. The IMCHB offers a nursing model to guide NPs in their practice. Implications for practice: A nursing model that examines the elements of client uniqueness and assesses the interaction between NP and client can achieve positive health outcomes.

This article describes methodological processes focusing on developmentally appropriate, creative data collection strategies for use with children and adolescents, illustrated from data-based research. The research reported includes adolescents' understanding of physical activity and engagement in designing a computerized questionnaire, adolescent decision making and consent to psychiatric treatment, social skills focus groups for children with behavioral disorders, and development of a longitudinal intervention study to improve the physiological-functional-psychosocial status of children with cystic fibrosis from three qualitative studies of children and adolescents with cystic fibrosis. Use of developmentally appropriate strategies is critical for successful research, contributing to our understanding of the world of children and adolescents.

The use of hospital facilities may greatly improve services to the visiting patients. The standard of good services will lead to positive patient satisfaction resulting in growing patient visit rate. Normally, patients will evaluate the process and physical evidence provided by the hospital. They will assess the actual and the preferred services, as well as the money and time they have spent to get healthcare services from the hospital. If patient satisfaction toward the hospital services is good, the hospital can compete with other hospital in terms of service provision. Regarding this issue, the present study aimed to investigate the correlation between process and physical evidence toward patient satisfaction in private hospital in Medan. It was a quatitative study using cross sectional design with the total number of population was 6.051. Through performing accidental sampling technique, 100 patients were included as samples. The data of this study was collected by administering questionnaire. Data analysis using Chi Square showed that there was a correlation between process and patient satisfaction (p=0,000;p<0.005). It was also found that there was a signifiant correlation between physical evidence and patient satisfaction (p=0,000;p<0.005). Therefore, it is concluded that good process and physical evidence will result in good patient satisfaction. Consequently, the rate of patient visit will also increase. This study suggests to hospital management to improve the process and physical evidence of hospital services to the patients to meet patient satisfaction.

This article calls nursing to engage in the study of religions and identifies six considerations that arise in religious studies and the ways in which religious faith is expressed. It argues that whole-person care cannot be realized, neither can there be a complete understanding of bioethics theory and decision making, without a rigorous understanding of religiousethical systems. Because religious traditions differ in their cosmology, ontology, epistemology, aesthetic, and ethical methods, and because religious subtraditions interact with specific cultures, each religion and subtradition has something distinctive to offer to ethical discourse. A brief example is drawn from Native American religions, specifically their view of 'speech' and 'words'. Although the example is particular to an American context, it is intended to demonstrate a more general principle that an understanding of religion per se can yield new insights for bioethics.

This act of sacrificing nurses for perceived larger interests is a glaring instance of an underrecognized but regular practice in Ontario. More than any other health care profession, as a society we rely on the constant care of RNs to maintain the health of the larger whole -yet the health of RNs is in serious condition and systemic cures are not on the agenda.

Purpose: To examine the concepts of external validity and generaiizabiiity, and explore strategies to strengthen generaiizabiiity of research findings, because of increasing demands for knowledge utilization in an evidence-based practice environment. Framework: The concepts of external validity and generaiizabiiity are examined, considering theoretical aspects of external validity and conflicting demands for internal validity in research designs. Methodological approaches for controlling threats to external validity and strategies to enhance external validity and generaiizabiiity of findings are discussed. Conclusions: Generaiizabiiity of findings is not assured even if internal validity of a research study is addressed effectively through design. Strict controls to ensure internal validity can compromise generaiizabiiity. Researchers can and should use a variety of strategies to address issues of external validity and enhance generaiizabiiity of findings. Enhanced external validity and assessment of generaiizabiiity of findings can facilitate more appropriate use of research findings. JOURNAL OF NURSING SCHOLARSHIP, 2004; 3 6 : 1 , 1 6 -2 2 . © 2 0 0 4 SIGMA THETA TAU INTERNATIONAL.

Nursing research increasingly calls for clinical supervision to support nurses and improve nursing practice. Despite this, clinical supervision is not well established in healthcare organisations. This paper employs a critical interpretive approach to review the clinical supervision literature. The review discusses the current debates and challenges exploring possible ways of moving beyond the current criticisms and limitations in the literature.

Feed efficiency can be improved by changing diet composition though probiotic supplementation and changing key microbial groups through defaunation. This study assessed probiotic supplementation as a way of optimizing rumen defaunation in goats fed low-quality forage. The following treatments were compared in this study: T 1 (intact without probiotic supplementation), T 2 (intact with probiotic supplementation), T 3 (defaunated without probiotic supplementation), and T 4 (defaunated with probiotic supplementation). Six out of the twelve animals were defaunated using ipil-ipil (Leucaena leucocephala) fed for 9 days; the other 6 were fed Napier grass (Pennisetum purpureum) alone. After defaunation, three of the defaunated goats were given probiotic supplement while the other three were not. The same was done to faunated goats. Probiotic supplementation to defaunated goats was successful in increasing protozoal counts (P<0.01) and bacterial counts (P<0.01) as well as stabilizing the pH (P<0.01) of these animals fed low-quality forage. Probiotic supplementation is recommended as a technique to combat the negative effects of defaunation on microbial counts and pH in animals fed low-quality forage.

ABSTRAK Pendahuluan: Kanker masih menjadi penyakit dengan angka mortalitas yang tinggi. Pelayanan kesehatan berkelanjutan untuk penderita kanker yang bisa bertahan hidup (cancer survivors) sangat diperlukan untuk pencegahan kekambuhan dan meningkatkan kualitas hidup penderita kanker. PCHN (Palliative Community Health Nursing) merupakan paket pelayanan perawatan kesehatan masyarakat (perkesmas) paliatif yang diberikan kepada keluarga dan penderita kanker di rumah, yang berfokus pada kegiatan promotif dan preventif. Tujuan dari penelitian ini adalah menjelaskan pengaruh pengembangan PCHN terhadap peningkatan kemandirian keluarga dalam perawatan penderita kanker di rumah. Metode: Jenis penelitian adalah pra eksperimen. Populasi adalah keluarga penderita kanker pascaperawatan yang tercatat di wilayah kerja Puskesmas Mulyorejo, Kota Surabaya. Sampel diambil dengan teknik purposive sampling. Sejumlah 7 orang memenuhi kriteria inklusi. Variabel independen adalah PCHN. Variabel dependen adalah tingkat kemandirian keluarga, dikumpulkan dengan lembar observasi tingkat kemandirian keluarga. Data kemudian dianalisis dengan Wilcoxon Signed Rank Test, α ≤ 0,05. Hasil: Hasil uji menunjukkan ada perbedaan tingkat kemandirian keluarga penderita kanker sebelum dan sesudah PCHN (p = 0,025). Diskusi: PCHN dapat meningkatkan kemandirian keluarga dalam perawatan penderita kanker di rumah. Pelaksanaan PCHN melalui kunjungan rumah dapat memberikan dukungan informasi terkait kanker dan perawatan di rumah bagi keluarga. PCHN dapat dikembangkan sebagai salah satu metode untuk meningkatkan pelayanan paliatif di masyarakat oleh perawat komunitas, dalam rangka meningkatkan kualitas hidup penderita kanker. Penelitian selanjutnya, diharapkan mengembangkan PCHN dengan melibatkan tim yang multidisiplin, baik dari petugas kesehatan, rohaniawan, maupun sukarelawan. Kata Kunci: perawatan kesehatan masyarakat, paliatif, kemandirian keluarga, kanker ABSTRACT Introduction: Cancer still remains a disease with high mortality rate. Sustainable health services for cancer survivors are important to prevent relapse and improve patient's quality of life. PCHN (Palliative Community Health Nursing) is a packet of community health nursing services given to the family and cancer's patient at home, focused on promotive and preventive activities. The aim of this study was to analyze the infl uence of palliative community health nursing to increase family's autonomy in caring patient with cancer at home. Method: This study was used pre-experiment design. The populations were family who lived with cancer's patient post treatment. Samples were taken by purposive sampling technique; consist of 7 people. Variable independent was PCHN. Variable dependent were family's autonomy in caring patient with cancer at home collected by using observation form. The data were then analyzed by using Wilcoxon Signed Rank Test, with α ≤ 0.05. Results: The results had showed the differences between family's autonomy in caring patient at home before and after PCHN (p = 0.025). Discussion: PCHN can increase family's autonomy in caring cancer's patient at home. The implementation of PCHN through home visit can give informational support about cancer and treatment at home to the families. PCHN can be used as one of method to improve palliative services at community, in order to increase cancer's patient quality of life. Further research, should develop PCHN which involve multidicipline team, such as health care provider, clergy, and health volunteer.

Introduction: Preschool-aged children are not able to manage their nutrition independently. They need help, especially from their mother. Mother's behavior has effect on preschool's nutritional status. The aim of this study was to develop nutrition demand enquiry model for preschool-aged children based on Health Promotion Model. Method: Design used in this research was an observational analytic with cross sectional approach that was conducted in Karangturi Village, Gresik, East Java. The population was mothers of preschool aged children listed on Integrated Health Post for Underfi ves (Posyandu Balita) along April–May 2012. Simple random sampling was used to take the sample. Sample size was 90 respondents. The independent variables were personal factors (age, motivation, and ethnicity), perceived benefi t, perceived barrier, perceived self-effi cacy, and commitment. The dependent variable was mother's behavior on nutrition of preschool children. Data were collected using questionnaire and food recall 24 hour. Data were analyzed using PLS (Partial Least Square) Regression. Result: The result showed that 1) personal factors had correlation with perceived benefi t, perceived barrier, and perceived self-effi cacy; 2) perceived benefi t and perceived barrier had correlation with commitment; 3) commitment had no correlation with mother's behavior on nutrition. Perceived benefi t and perceived barrier had direct correlation with mother's behavior on nutrition. Discussion: It can be concluded that mother's perceived benefi t and perceived barrier was correlated with mother's behavior on nutrition. Nurses are key health care professionals responsible for increasing health education activities about how to manage nutrition of preschool age children. So, mother should have good behavior on preschool age children's nutrition.

Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals, results in better patient outcomes. The authors describe the strategic approach to support the maturation of The Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations, establishing structure, building skills, and allocating human and material resources as well as incorporating the model and tools into undergraduate and graduate education at the affiliated university.