ஜர்னல் ஆஃப் நர்சிங் & கேர்

Background: Nurses must understand the needs and barriers of people who are homeless when they are in a health care environment in order to render effective care.
Objective: The objective of this review is to synthesize research findings on studies that examine the needs and barriers of people who are homeless in Canada when they intersect with health care providers.
Methods: A scope of manuscripts, published in English from 1980 to 2011 that assess the needs and barriers of people experiencing homelessness in Canada when in the health sector without limitation on study design from different electronic databases and manual searches, was conducted.
Results: Six articles (N=4 qualitative, N=2 quantitative) met the inclusion and exclusion criteria. Eight themes emerged from a narrative synthesis of the findings.
Conclusion: Individuals who are homeless have multiple needs when in the health care sector. Thus, collaboration among different disciplines is essential in order to provide them with holistic care.

Background: Health status self-reports are increasingly recognized as an important source of key follow-up data after hematopoietic stem cell transplantation (HSCT).
Purpose: The purpose of this study was to evaluate the occurrence of self-reported symptoms and concerns in longterm survivors and compare their prevalence’s between allogeneic and autologous transplant recipients with various post-HSCT follow-up lengths.
Interventions/Methods: This cross-sectional survey included a convenience sample of 226 autologous and allogeneic HSCT recipients (54% male; 1 to 26 (median 6) years post-transplant) treated as outpatients by the multidisciplinary team of a Swiss stem cell transplant ambulatory. Symptoms and concerns were measured by a self developed self-report questionnaire.
Results: The median number of self-reported physical symptoms per patient was 5 (IQR 4-10), the most frequent being dry skin (47.8%), tiredness (42%), and dry eyes (42%). The most commonly cited concerns were difficulties managing stressful emotional situations (23.9%), anxiety regarding relapse (22.1%) and memory disturbance (21.2%). There were no notable differences in appraisal of performance and number of symptoms between different time groups.
Conclusion: The high frequency of self-reported symptoms and concerns in long-term survivors indicates a need for continuous monitoring by stem cell transplant follow up clinics, which would allow timely and effective interventions to prevent or alleviate late effects.
Implications for Practice: There seems to be good opportunity for health professionals to support long-term survivors by using self-report as clinical tool in follow-up care. Sharing information about problems and symptoms patients face post-treatment will benefit both professionals and patients.

Better organization may improve quality of care around meal serving in a hospital unit.
Background: The organization of care regarding serving of food, monitoring and assisting patients with meals is a complex nursing task, however, to a low degree investigated. This study was done at request from the department multi professional nutrition team, as nutrition monitoring was difficult to achieve. Furthermore meal serving, especially regarding dinner, was found chaotic and unsatisfying.
Aim: To explore practise and organization around meal serving regarding dinner and find reasons for poor monitoring of nutrition intake.
Methods: Observations as well as patient and staff interviews and observation in a department of gastroenterology in 2010.
Results: Ten patients, six nursing staff and four service staff members were interviewed. Observations weredone for nine hours during two days of dinner servings. A positive and helpful attitude was seen. How ever, lack of time, knowledge, lack of assignment of responsibility and many competing tasks interfered with the meal serving and elated tasks. Low priority was given to assisting patients with eating and to documentation of individual nutritional assessment and care. Poor monitoring of nutrition intake was seen, due to insufficient training of service staff and lack of communication of responsibility.
Conclusion: A poor organisation of the overall work was found. The nurses had too many competing tasks. Lack of knowledge, documentation and acknowledgement of importance of own actions, was profound among the nursing-staff regarding nutritional care during dinner serving.

It has become exceedingly challenging for nurses to manage alcohol withdrawal syndrome because their patients’ clinical symptoms have become much more complicated, especially when they present with complex co morbidities. Additionally, it is critical that nurses and physicians work collaboratively with alcohol withdrawal assessment protocols, so that patients receive the most effective detoxification treatment. The purpose of this case study is to present one approach to implementing an alcohol assessment training protocol using the CIWA/ Ar at a southern New England acute care hospital on the psychiatric unit. Consequently, the planning and implementation process created a more cohesive team among the nurses and physicians, which may potentially contribute to positive patient outcomes.

Phenomenology is one of several qualitative research traditions. Undergraduate and graduate nursing students have sought to understand the differences between Husserl’s descriptive and Heidegger’s interpretive phenomenology. This article is a basic resource for nursing students that describes and interprets the differences between the two philosophical phenomenological schools of thought. The origin of phenomenology is presented. A descriptive and an interpretive article from two peer reviewed nursing journals are compared and contrasted based on their purpose, data collection and data analysis. The selected articles were chosen based on their topic of relevance related to nursing students in educational settings.

Aim: This paper reports on a study that explores psychiatric nurses` explanations of self-harming behaviors in secure forensic psychiatric environments.
Background: There is evidence suggesting that there is a differential perception between psychiatric nurses and service users of the reasons for self-harming behaviors in secure settings. This gulf in perception, which may negatively impact on the care offered to service users, is a function of nurses’ lack of or limited knowledge of self-harm.
Yet, research concerning nurses’ reasons for service users’ self-harming behaviors is limited.
Methods: The study utilized a phenomenological methodology with semi-structured individual interviews (n=25) and focus group interviews (n=6x6). The data were analyzed thematically using Interpretative Phenomenological Analysis.
Results: The findings indicate that the behavior of self-harm does not have fixed causes rather it has multiple causes which, in the main, relate to affect regulation, limited coping skills, rigid institutional regime and practitioners` negative attitudes.
Conclusions: These findings have implications for practice and recommendations are made to improve this. Regular training and support should be provided for psychiatric nurses in secure environments in order to broaden their understanding of self-harm and its underlying motives. Improved understanding of self-harm may result in improved nurse-service user relationships and thus, safer and effective care provision.