1,720,966 research outputs found
The Experiences of National Guard Fathers When Communicating With Their Young Children During Combat Deployment
Get PDFThe number of military fathers separated from their children due to a combat deployment increases as the Global War on Terrorism continues. Father absence may have negative effects on child wellbeing, including behavioral and mental health issues. Communication is important to the father-child relationship, especially when separated thousands of miles away. The Army (Active Duty, Reserves, and National Guard) has deployed more military members than the Air Force, Navy, and Marines combined. However, there is a paucity of literature regarding how Army fathers, particularly National Guard (NG) fathers, communicate with their young children during combat deployment. Therefore, the purpose of this study was to examine the experiences of NG fathers of young children to understand more about communication patterns used to maintain the father-child relationship while deployed to a combat zone.
Interpretive phenomenology provided a framework to study and interpret the experiences of eight NG fathers deployed to a combat zone. Data analysis of semistructured interviews with 8 NG fathers was completed using the interpretive method. Four themes emerged from the interviews with NG fathers: 1) don’t forget me; 2) we make sacrifices; 3) a father’s role; and 4) being a National Guard father means pride.
NG fathers articulated the importance of their fathering role and the great lengths they went through to maintain the father-child relationship during combat deployment. NG fathers felt there were sacrifices they and their families made in support of the military mission. Although NG fathers used many strategies to stay connected to their young children, these fathers still felt a loss of their fathering identity. NG fathers and their families exhibited a sense of pride in the NG father’s service to his country, despite the sacrifices they make. This study contributes to nursing knowledge by increasing the understanding of the needs of NG fathers and their families during a combat deployment.
Recommendations for nursing practice, education, and research were identified in this study and include: early assessment and intervention to reduce negative outcomes, health policies to support this population, and research to determine specific needs and the effects of maternal gatekeeping during combat deployment
The Perceptions of Non-Palliative Care Hospitalist Physicians Referring Patients to a Hospital Palliative Care Program
No full textMany hospitalized patients need holistic care, symptom management, advanced care planning, stronger patient-family-provider communication, strategic goals-of-care planning, and improved coordination of care. These services are provided by palliative care teams. Hospitalist physicians are responsible for the oversight of most hospitalized patients and for referring patients to palliative care when needed. Little is known about hospitalist physicians’ perceptions of palliative care services. A qualitative study using an interpretative phenomenological research design was conducted. Six hospitalist physicians were recruited using purposive sampling. Questions focused on assessing their experiences, facilitators, and barriers related to palliative care referrals. Their responses were transcribed and underwent thematic analysis. The findings were as follows: (a) theme 1: when hospitalist physicians want help (subthemes of when they cannot do any more/renegotiating goals of care, need of time to listen, and pain management) and (b) theme 2: barriers to referral (subthemes of family refusal, oncologists, and meaning of ‘‘palliative’’). The study participants sought palliative care when they needed goals of care clarified, more time for listening to patients and families, and pain management. Barriers to palliative care included biases that some patients’ families and other physicians may have about the goals and meaning of palliative care
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The Experiences of Medically Fragile Adolescents Who Require Respiratory Assistance
Get PDFThe population of medically fragile adolescents has grown in recent decades because of the sequelae of prematurity, injuries, and chronic or terminal illnesses. Medically fragile adolescents who require respiratory assistance are part of this unique population with challenges in their daily lives, yet as nurses, we know little about their experiences and the best approaches to use in caring for them. The purpose of this study was to explore the experiences of medically fragile adolescents who require respiratory assistance.
Interpretive phenomenology was used to describe and interpret the experience of 11 medically fragile adolescents who required respiratory assistance. The adolescents ranged in age from 13 to 18 years of age and required respiratory assistances of tracheostomies, ventilator support, and Bi-level positive airway pressure (BiPap). Audiotaped semi-structured interviews were conducted with the adolescents. Data analysis was completed using the steps delineated by Diekelmann and Allen (1989). Six themes and one pattern were identified from the interviews with the adolescents. The major themes were “Get to know me”, “Allow me to be myself”, “Being there for me”, “No matter what, technology helps”, “I am an independent person”, and “The only one I know of”.
This study explored medically fragile adolescents who required a specific technology, respiratory assistance, within a distinct developmental stage. These adolescents have a clear view of who they are as a person. They want nurses to view them as a person, not just a patient. The adolescents felt that friends were there for them when they needed support. This was in contrast to those that they did not consider friends who were judgmental. Technology had meanings that encompassed enhanced daily living and existing as a part of their day, not their whole day. The adolescents viewed themselves as an independent person and were actively engaging in activities and strategies to achieve their goals of independence. This study contributes to nursing knowledge by helping nurses to understand what these adolescents experience in their daily lives and aiding nurses in providing better care for these adolescents. Recommendations for nursing practice, education, and research were identified in this study
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Accuracy of Emergency Department Nurse Triage Level Designation and Delay in Care of Patients with Symptoms Suggestive of Acute Myocardial Infarction
Get PDFMore than 6 million people present to emergency departments (EDs) across the US annually with chief complaints of chest pain or other symptoms suggestive of acute myocardial infarction (AMI). Of the million who are diagnosed with AMI, 350,000 die during the acute phase. Accurate triage in the ED can reduce mortality and morbidity, yet accuracy rates are low and delays in patient care are high. The purpose of this study was to explore the relationship between (a) patient characteristics, registered nurse (RN) characteristics, symptom presentation, and accuracy of ED RN triage level designations and (b) delay of care of patients with symptoms suggestive of AMI. Constructs from Donabedian’s Structure-Process-Outcome model were used to guide this study.
Descriptive correlational analyses were performed using retrospective triage data from electronic medical records. The sample of 286 patients with symptoms suggestive of AMI comprised primarily Caucasian, married, non-smokers, of mean age of 61 with no prior history of heart disease. The sample of triage nurses primarily comprised Caucasian females of mean age of 45 years with an associate’s degree in nursing and 11 years’ experience in the ED.
RNs in the study had an accuracy rate of 54% in triage of patients with symptoms suggestive of AMI. The older RN was more accurate in triage level designation. Accuracy in triage level designations was significantly related to patient race/ethnicity. Logistic regression results suggested that accuracy of triage level designation was twice as likely (OR 2.07) to be accurate when the patient was non-Caucasian. The patient with chest pain reported at triage was also twice as likely (OR 2.55) to have an accurate triage than the patient with no chest pain reported at triage. Electrocardiogram (ECG) delay was significantly greater in the patient without chest pain and when the RN had more experience in ED nursing. Triage delay was significantly related to patient gender and race/ethnicity, with female patients and non-Caucasian patients experiencing greater delay. An increase in RN years of experience predicted greater delay in triage. Further studies are necessary to understand decisions at triage, expedite care, improve outcomes, and decrease deaths from AMI.Doctor of Philosophy (PhD)Nursin
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