Journal of advanced nursing
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The purpose of this paper is to assist advanced practice nurses to recognize, identify, and diagnose cognitive change in older adults. ⋯ It is essential to understand how the 4 'D's' are expressed and to recognize the potential contributing factors to an observable change in cognitive function for diagnosis and treatment. Recommendations for obtaining a person's history are included.
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Nursing codes of ethics bind nurses to the role of patient advocate and compel them to take action when the rights or safety of a patient are jeopardized. Reporting misconduct is known as whistleblowing and studies indicate that there are personal and professional risks involved in blowing the whistle. ⋯ These findings indicate that nurses may respond to ethical dilemmas based on different belief systems.
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The use of the randomized consent design (commonly known as the Zelen design) is a controversial issue in randomized controlled trials. In the Zelen design, participants are randomly allocated prior to seeking consent. Those participants allocated to the intervention group are then approached and offered the intervention, which they can decline or accept. Zelen first proposed the design in 1979. It has been used infrequently since this time, although there are some notable exceptions in nursing, midwifery and some medical specialities. ⋯ It is hoped that by presenting issues pertaining to the Zelen design, other nursing and midwifery researchers may be prompted to consider its use when designing clinical research. The Zelen design is controversial, and debate about its merits and shortcomings is useful. This paper contributes to the ongoing debate.
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To develop and evaluate psychometric properties, that is reliability and validity, of an instrument to measure strategic and clinical quality indicators in postoperative pain management. ⋯ The results suggest initial support for the new instrument as a measure of strategic and clinical quality indicators in postoperative pain management, but it must be further refined, tested and evaluated.
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The aim of this phenomenological study was to find out what menopause was like as an experience for women who were not yet 40 years old. ⋯ This study revealed that the experience of menopause came as a shock for the women--it was perceived as a major epiphany in their lives and they were confronted with a multitude of issues related to the timing of the event and their embodied understanding of menopause. The experience of menopause resulted in multiple disruptions in the women's lives. The women discussed many aspects of their lives that now seemed to be 'out of synchrony'.