The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières
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Research into violence against women in intimate relationships has begun to uncover women's experiences of abuse. However, there is a paucity of research addressing women's mothering experiences in the context of partner abuse. The purpose of this study was to explore the experience of motherhood from the perspective of women who have been battered. ⋯ Five mothers who had been battered were interviewed twice. Analysis revealed that the abuse shaped their experiences of motherhood and that they faced complex mothering challenges, but that motherhood nevertheless acted as a buffer against the abuse and as a source of strength. The findings extend our understanding of the complexities of mothering in the context of abuse and provide direction for improving health-care support for mothers who have been abused.
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Historical Article
Twentieth-century social and health-care influences on location of death in Canada.
Providing the right care, in the right place, to dying persons is hampered by a lack of understanding of where death and dying normally take place and ignorance about what influences location of death. This paper reports the findings of a multidisciplinary historical investigation of 20th-century influences on location of death in Canada. It builds on a study that found a hospitalization-of-death trend in Canada over much of the 20th century but a reduction in hospital deaths beginning in 1994. ⋯ A number of developments limited the availability of home care for chronically ill and terminally ill persons, including the increased participation of women in the workforce and the shift in nursing from private home duty to hospitals. Although some health and social support for home care has developed recently, this support clearly does not match that for hospital care. These findings indicate that location of death is an important focal point for studying and planning improvements in end-of-life care.
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Equipoise, a state of uncertainty about the relative merits of 2 or more treatments or therapeutic approaches, is fundamental to the ethical conduct of clinical research. The degree of uncertainty necessary for ethical conduct of a clinical trial is the subject of ongoing debate. The concept of equipoise has not received sufficient attention from nurse authors. ⋯ In order to provide the best treatment possible, they must believe that what they are doing is in the best interests of their client. Yet, in order to accept randomization, they must, to some extent, relinquish that belief. Case examples are used to examine how discrepancies with respect to the "equipoise status" of researchers, clinicians, and research participants may be problematic in achieving methodologically sound, ethical clinical nursing research.
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Despite extensive knowledge of pain and pain management, critical-care nurses commonly withhold analgesia from patients for extended periods prior to and during weaning from mechanical ventilation. Nurses working in critical care were interviewed (n = 10) to gain insight into the importance of pain management during weaning and the nature of decision-making in pain management. Using the research method of grounded theory, the author found decision-making to be a dynamic and continuous process of knowledge gathering, knowledge interpretation, and action, influenced by nurses' beliefs concerning (1) the existence of and importance of managing pain, and (2) the role of the nurse. The emergent theory has the potential to guide the development of interventions in which nurses make effective, holistic, competent decisions about pain management during weaning from mechanical ventilation.