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  • ISSN: 2379-9501
    Volume 4 Issue 3
    Research Article
    Gaetano Auletta*, Chiara Gagliardi, Alessia Bolamperti, Enrico Finale, Katja Battistella, Carla Rigo, and Barbara Suardi
    Background: In order to develop the best possible nursing practice, is necessary to launch structured and coordinated research plan. One of the most recognized strategies to achieve this goal is to define nursing research priorities. The aim of this study is to define nursing research priorities in an Oncology Department of a Northern Italy Hospital
    Materials and methods: This is three rounds Delphi Study.
    Results: Forty-eight nurses (87.27 %) completed all three rounds. Seventy-three emerged themes were recorded and organized in three areas (clinical, organizational and relational), in which were identify nursing research priorities
    Discussions and conclusions: The main themes chosen, identify as the most important, suggest the attention of enrolled nurses in: management of central venous devices, symptoms and chemotherapy drugs.
    Misae Ito, Keiko Hattori, Kyoko Murakami, Sue Turale, and Takuma Ichihashi
    Aim: Ethical issues often arise when people become ill and medical treatment decisions need to be made, however many people do not make such decisions in advance, creating difficulties for family and medical staff. This study aimed to clarify the degree to which Japanese people wished to either self-decide, or involve their family or physician in decision-making, for five clinical assumptive cases. The relationship among the self-decided degree and demographic characteristics was examined.
    Materials and methods: Forty-three adults, community residents from Western Japan, who had previously experienced hospital admissions, were selected by convenience and snowball sampling and underwent a structured interview using the Decision-making Degree for Medical Practice Questionnaire. They were asked to imagine they had hypertension, stroke, physical paralysis, early cancer, and terminal cancer, and to state their decision-making preferences for each of these.
    Results and discussion: Of the five cases, terminal cancer scored the highest value of decision-: aking degree for medical practice. The degree of self-decision-making was lower for stroke, whilst for terminal cancer, the self-determination degree of all items was higher than the decision-making degree of family or physician. When making decisions to select medical treatment, even for patients with mild health conditions, opinions of physicians tended to be well-respected. For decision-making regarding care in the terminal phase, the degree of self-decision-making was higher, indicating that participants wanted to spend their remaining time according to their own wishes.
    Conclusion: It is vital that the decision-making values and wishes of patients are taken into consideration by health professionals and families. These vary between patients according to context and health conditions, and need to be assessed early in treatment.
    Review Article
    Hsueh-Fen S. Kao*, Yueh-Ling Wang, Diana L. Woods, and Show-Mei Lin
    Older adults' cancer diagnosis and decision making for its treatment can be shocking and burdensome to the whole family, especially to their designated caregivers. The decision making process for cancer treatment is complicated and sometimes changeable in complex ways, giving the unique structure of each family. While formal community based long-term care is designed to deliver the needed care to older adults in reducing their institutional or hospital admissions and facilitating aging in place, the formal care may be hard to involve in decision making process for cancer treatment that encompasses more than logical rationales within the family infrastructure. Thus, family members play an important role in making decision for cancer treatment when the older adults are physically and emotionally overwhelmed. In this article, we provide an overview on various responses in decision making for cancer treatment, critique what aspects of health services could be improved, and make suggestions to better inform patients, families, and health professionals who serve the aged population undergoing cancer treatment.
    Case Report
    Farida Bibi Mughal* and Bibi Hajira Irshad Ali
    Theoretical framework always guides nursing practice and nurses follow this unconsciously. This paper highlights the work of Florence nightingale who, identified the application of environmental theory in nursing practice. Nightingale has defined 13 canons of environment and explained each aspect in detail. Her major canons include: ventilation, noise, cleanliness of walls/rooms, light, bed and bedding, personal cleanliness, and taking food. Nightingale has beautifully described the effect of application of her theory. The theory when applied, yields a positive impact on patient’s health. The learning outcomes of this research will help the people in medical science to understand the correlation between environmental theory and nursing practices for the wellbeing of patients. And if one is failed to apply all of the concepts in clinical area then it can lead to delayed recovery of the patient.
    Ingrid Brenner*
    Encouraging physical activity in stroke patients can help with their recovery. Apart from delaying disease progression, encouraging patient participation in regular physical activity programs can increase functional capacity and improve a patients’ quality of life. This article aims to enhance the nurse’s understanding of the positive effects which passive exercise training can have in a hemiplegic stroke patient. A prospective, descriptive case report was used to follow one patient who suffered from a major stroke (BI score less than 40) and who began physical therapy at 13 weeks post-stroke. Improvements in motor and cognitive function were observed over time and in response to training. Due to the lack of evidence for the efficacy of this type of intervention, this report explores the acceptability and feasibility for designing a future randomized control trial.
    Short Communication
    Chelsea J Riley*, Roger Rochat, and Andrew Dott
    In this small retrospective cohort study we analyzed birth data from the International Center for Maternity’s [CIMA] database from 2009-2015 (n=5,291) to evaluate if primary cesarean section rates are associated with midwives’ attitudes towards the medical model of birth. CIMA is a midwife-led practice that mainly serves Hispanic immigrants in the Atlanta, GA area. CIMA has a primary cesarean section rate of 13.7%; the national average is 21.5%. After developing survey questions, we used a focus group of five midwives. The survey had a total of 13 points possible; a low score indicates commitment to the medical model of birth. We used simple linear regression to investigate each of the survey questions and the total score with primary cesarean section rates as the dependent variable. Scores ranged from 6.4-12.8 out of 13 possible points. The average score for CIMA’s 11 midwives was 10.33 [95% CI: (8.82, 11.83)]. The results suggested an inverse relationship between the survey’s holistic score and primary cesarean section rates. Using the total score as the independent variable, the model yielded an r2 of .45. Our results indicate that CIMA’s midwives identify more with the holistic model of birth and that this algorithm could statistically predict, to some degree, a midwife’s primary cesarean section rate. Our findings, taken in context with previous midwife studies, suggest that a survey detailing midwives’ attitudes towards the medical model of birth might predict primary cesarean section rates.
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