Journal of advanced nursing
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Review Comparative Study
Caring: theoretical perspectives of relevance to nursing.
Caring as a central concept within nursing has led to the development of several caring theories, the most well known being Madeleine Leininger's Theory of Culture Care and Jean Watson's Theory of Human Caring, both of which were formulated in the 1970s. This paper explores a total of four caring theories: the two established theories presented by Leininger and Watson, Simone Roach's theory developed in the 1980s, and a recent caring theory developed by Boykin & Schoenhofer. ⋯ Additionally, simplicity as a central component of internal structure is examined in relation to each. Based on this analysis, similarities and differences are highlighted, concluding with a discussion of the utility of the caring theories within nursing practice.
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Comparative Study
A comparison of three strategies for risk-adjustment of outcomes for AIDS patients hospitalized for Pneumocystis carinii pneumonia.
The need for risk-adjustment of patient outcomes has been driven by the competitive health care market and the subsequent increase in comparative outcome reporting among health care institutions, among managed care plans, and among individual providers for some procedures (e.g. coronary artery bypass graft surgery). However, if the outcomes reported do not take into account patient characteristics that can be considered dimensions of risk for poor clinical outcomes or increased utilization of services, there is the possibility that inaccurate conclusions will be drawn about the quality of care provided. ⋯ The findings of this study confirm the findings of other investigators that measures of acute clinical stability and functional status have utility as risk-adjustment approaches for the outcomes of mortality and length of stay. Further research is needed that compares the utility of generic vs. disease-specific measures for prediction of outcomes in HIV/AIDS.
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The aim of this study was to describe health care professionals' way of experiencing their encounters with in- or outpatients, while working in acute medical care hospitals. One main question was addressed: What are the experiences which health care professionals have of their encounters with in- or outpatients in clinical settings? Eleven health care professionals (physicians, registered nurses and enrolled nurses) were interviewed and a phenomenographic approach was used, where data were analysed qualitatively. ⋯ The third showed encounters where the health care professionals experienced difficulty in understanding the patients' expressions of suffering. There is a need therefore to support health care professionals in improving their understanding of patients' suffering.
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Comparative Study
Validation of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV).
Symptom management for persons living with HIV disease is recognized as an extremely important component of care management. This article reports the validation of a new sign and symptom assessment tool designed to assess the intensity of HIV-related symptoms using two samples (study 1: n=247; study 2: n=686) of people living with HIV disease. Study 1 data were collected between 1994 and 1996 before the initiation of highly active antiretroviral therapy (HAART). ⋯ These six factors have strong reliability estimates and a stable factor structure that supports the construct validity of the 26-item instrument. Additional evidence supports the concurrent validity of the scale as well as its sensitivity to change over time. The final version of the SSC-HIV is a 26-item scale available for use by clinicians and researchers to measure the patient's self-report of HIV-related signs and symptoms.
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Postoperative pain, if unrelieved, will impede patients' recovery. A theoretical model of factors which influence nurses' choices of titrated dosages of intravenous (IV) morphine was constructed for this study. This study aimed to examine whether or not a patient's vital signs would influence nurses' choices of titrated dosages of IV morphine for relieving pain following cardiac surgery. ⋯ The importance of accepting patients' verbal reports of pain as well as the provision of optimal dosages of IV morphine for pain relief is highlighted. A disadvantage of using a vignette and questions method is that the patients' clinical status is somewhat unreal. Further studies, however, were also recommended.