Family theoretical perspectives and implications for nursing practice

Health care professionals have focused for the most part on individuals within families as they provide care in acute care settings. The lack of a theoretical perspective to permit observing the family as a unit with interacting parts has contributed to this practice. This article presents an overview of trends and of four theoretical frameworks that have contributed to family practice and research, both for other disciplines and for nursing. Symbolic interactionism, systems, developmental, and social exchange theories are promising frameworks for considering family relationships now and into the future. The purpose, major concepts, and implications for nursing practice of each theory are presented.     

Substitution in nursing practice: clinical, management and research implications

The introduction of market forces into health care delivery systems has had a number of important influences on the roles nurses perform. There have been increasing efforts to find alternative and more cost-effective ways of delivering care. One facet of this situation has been the examination of the roles and responsibilities of registered nurses (RNs) with the view of exploring different ways of using professional skills and determining if RN services are always required. One result of this has been the increased use of unlicensed personnel. The substitution of professional nursing staff by unlicensed personnel has become a major concern for practitioner, manager and client alike. This paper reviews some of the concepts of economic substitution as well as the assumptions advanced for the use of unlicensed personnel in clinical areas as a substitute for nursing services. While there has been increased use of unlicensed staff, the evaluation of clinical outcomes has been poor. This paper reviews primarily the hospital-based evidence about the impact of using unlicensed personnel in practice, and suggests there are methodological problems with the research published to date. Findings suggest that substitute service providers generally 'do no harm'. By contrast, evidence is presented indicating the major contributions nurses make to client care when adopting advanced practice roles (acting as a substitute for other professionals).     

Some implications of postmodernism for nursing theory, research, and practice.

This paper explores ways in which some aspects of postmodernist thought impact upon nursing theory and research. The focus is on postmodernist accounts of epistemology and language, in particular notions such as multiple truths, uncertain and provisional knowledge, and claims as to the purposes of knowledge development. Common themes of postmodernism are articulated, including antifoundationalism, the dissonance between competing discourses, and the rejection of "grand theories." The paper concludes with a short set of suggestions for a postmodern approach to nursing practice.     

Language, research and nursing practice

AIM OF THE PAPER: This paper highlights the centrality of language in constructing knowledge. It aims at making us sensitive to the political nature of knowledge production and the complex power relationships that may emerge as a result of our efforts to create new knowledge. BACKGROUND: Science, as understood here, is a linguistic construction, rather than a mirror reflection of reality. A number of examples are presented, demonstrating the complex ways in which language is central in shaping all our attempts to know, science included, and nursing practice. CONCLUSION: Based on the analysis presented in this paper an argument is made for a substantial re-thinking of nursing research and its relationship to nursing practice. Research needs to be an integral part of everyday nursing practice, a way of posing questions and reflecting on answers. Further, nurses need to be aware of the potentially coercive nature of knowledge as well as its liberating effect.     

Bereavement and the elderly: a critical review with implications for nursing practice and research

Loss is a common occurrence in the lives of the elderly. One of the most profound losses is the death of a spouse. Yet, frequent and predictable as this event is for older adults, we know very little about the grieving process or the resolution of grief among this age group. For nurses who care for older clients an understanding of loss and bereavement is important in order to provide appropriate and timely support.
In this paper the nature of grief and bereavement behaviour is discussed beginning with the earliest empirical work done in 1930 and including a synopsis of six major variations of grief. A comprehensive review and critique of current investigations provides the basis for suggesting that, because of flaws in conceptualization and design, there are substantial limits on the relevance of existing knowledge of grief for an understanding of this phenomenon among the aged bereaved.
A beginning theoretical integration and discussion of key concepts related to bereavement and the elderly is provided. This discussion is summarized in a proposed model. The paper concludes with suggestions for nursing research and practice.     

适时护理推送模式在自体造血干细胞移植患者中的应用

目的观察适时护理推送模式在自体造血干细胞移植患者中的应用效果。方法选择适时护理推送模式实施前2018年1—10月我院行自体造血干细胞移植患者43例作为对照组,将实施后2018年11月至2019年8月于我院行自体造血干细胞移植患者43例为试验组,对照组接受自体造血干细胞移植术常规护理,试验组接受适时护理模式干预,对两组干预后的各观察指标进行比较。结果试验组患者焦虑抑郁自评分值、消化道并发症发生率显著低于对照组,护理满意度评定分值显著高于对照组,(P<0.05)。结论采用适时护理推送模式对自体造血干细胞移植患者实施干预,可明显改善患者心理困扰,降低并发症风险,提高护理满意度。     

A review of forgiveness literature with implications for nursing practice

This article describes clinical practice where forgiveness is a central patient/family issue. In this case, the professional nurses learned substantively from the family about the tragic consequences of forgiveness withheld and the transformative nature of forgiveness extended. The concept of forgiveness is defined and forgiveness as a primary, secondary, and tertiary intervention is considered. Implications for professional practice are developed. Practical forgiveness-based assessment questions are included. A review of instrumentation from other disciplines measuring interpersonal dimensions of forgiveness is offered. Significant aspects of the process of forgiveness are elucidated and opportunities for forgiveness-related nursing research are identified.     

Promoting successful aging with HIV through hardiness: implications for nursing practice and research

A growing number of adults will age with HIV due to the introduction of highly active antiretroviral therapy, an increase in later-life infections, and an overall aging of the population. Unfortunately, how successful aging will be expressed in this population is unknown. In the gerontological literature, the concept of hardiness is used to describe and hypothesize how people can age successfully. Using the extant HIV literature, this article extrapolates how hardiness may help people age well with this disease. Because nurses provide care for older adults with HIV, possible interventions and clinical implications for incorporating hardiness into practice and research are suggested.     

Parent stress associated with pediatric critical care nursing: linking research and practice

This paper connects research findings to nursing practices that may be helpful when working with stressed parents of critically ill children. Theories and concepts foundational to understanding parental stress related to pediatric critical care are reviewed. Research findings particularly associated with parent role stress are introduced, and suggestions for using these findings to design nursing interventions are presented.     

An overview of nonpathological geroneuropsychology: implications for nursing practice and research

One aspect of successful aging is maintaining cognitive functioning, which includes both subjective cognitive functioning and objective cognitive functioning even in lieu of subtle cognitive deficits that occur with normal, nonpathological aging. Age-related cognitive deficits emerge across several domains including attention, memory, language, speed of processing, executive, and psychomotor, just to name a few. A primary theory explaining such cognitive deficits is cognitive reserve theory; it posits that biological factors such as demyelination and oxidative stress interfere with neuronal communication, which eventually produces observable deficits in cognitive functioning. Therefore, it is important to maintain or improve cognitive reserve to augment cognitive functioning in later life. This article provides a general overview of the principles of geroneuropsychology along with implications for nursing practice and research.     

A nursing perspective on the interrelationships between theory, research and practice

This paper is concerned with the interrelationships between the three concepts of theory, research and practice In the course of discussing the interrelationships between these concepts, research is identified as the link between theory and practice on both a formal (explicit) and informal (tacit) level The role of formal and informal research in the development of nursing expertise is also given some consideration     

自体角膜缘干细胞移植治疗翼状胬肉31例围术期护理

目的:探讨自体角膜缘干细胞移植治疗翼状胬肉的围术期护理方法及效果。方法:将60例(86眼)翼状胬肉患者随机分为干预组31例(48眼)和对照组29例(38眼),干预组给予系统的围术期护理,对照组给予常规护理。观察两组患者术后复发及并发症发生情况。结果:术后随访12个月,干预组复发率及并发症发生率均明显少于对照组(P<0.05)。结论:采取系统的围术期护理可明显减少自体角缘干细胞移植治疗翼状胬肉患者的术后复发率及并发症发生率,严格、科学、合理的护理措施在自体角膜缘干细胞移植治疗翼状胬肉术中发挥着重要作用。     

Spaced Retrieval for enhancing memory: implications for nursing practice and research

Many older adults experience memory problems due to normal or pathological aging, which impairs daily functioning. Spaced Retrieval is a technique that can be used to augment memory function as it relates to a specific, everyday task. This technique requires individuals to recall a single piece of information over progressively longer periods until the information is consolidated into long-term memory. It works effectively in various settings and for individuals with memory problems. Given their direct contact with older adult patients, nurses are in a position to notice memory declines and guide their patients in the use of this technique.     

Cultural, ethnic, racial, and religious factors: implications for ophthalmic nursing practice and research.

In her book, 9226 Kercheval: The storefront that did not burn, Milio (1970) states ... the one who would change others must himself be changed (p.xi). Thus if ophthalmic nursing practice is to have a positive impact upon patient outcomes in the twenty-first century, our nursing interventions and the empirical research that validates and legitimizes these interventions must be predicated upon factors that view the patient holistically. In particular, the integration of orthodox or traditional ophthalmic procedures with the patient's perceptions of health, cultural norms, values, religious doctrines, etc. If compromises between the nurse and the patient are not negotiated, nursing services will be avoided and nursing interventions such as patient education will be ignored (Reinhardt & Quinn, 1977). Sensitivity to cultural, ethnic, racial and religious factors will enhance ophthalmic nursing practice by helping to unravel such issues as patient compliance, differential responses to pain (Davitz, Sameshima, & Davitz, 1976; 1972; Zborowski, 1969; 1952), the relevance for utilizing a variety of teaching strategies for patient education, and family and community influence in the prescribed care of the patient. Having had our philosophy of health care shaped by a middle-class white, and traditionally patriarchal, value and belief paradigm (Donnelly & Sutterly, 1985), we tend to unconsciously gravitate toward ethnocentric attitudes and stereotypic behaviors when caring for patients who hold health beliefs and values different from our own. However, as we become acquainted with and learn to appreciate the norms and values of differing populations, there will be a diminution in ethnocentric attitudes and stereotypic behavior.     

Cerebral vasospasm: theoretical causes, medical management, and nursing implications

Cerebral vasospasm is a potentially life-threatening complication following subarachnoid hemorrhage (SAH) from a ruptured cerebral artery aneurysm. Traditionally, vasospasm has been treated with a variety of medical interventions. However, surgical intervention with an extracranial to intracranial (EC/IC) bypass graft has yielded promising results in a limited group of patients. This article discusses the theoretical causes of cerebral vasospasm, its clinical presentation, diagnosis, and treatment modalities. Nursing interventions for the patient experiencing cerebral vasospasm are also presented.