Images and sensations of war: a common theme in the history of military nursing.

We analyzed interviews with 22 military nurses who had served in wars or conflicts since World War II, up to and including Operation Desert Storm. Using a method of hermeneutic phenomenology, we found several common themes in the interviews. In this article, we report on the theme Images and Sensations of War. Within that theme, the subcategories sights, sounds, and other sensations (climate and weather, taste, smell, and comfort) were discovered. We categorized the images and sensations as pleasant, unpleasant, and horrible. The findings from this analysis may be useful to professionals who recruit military nurses, provide ongoing military training, help military nurses return to civilian life, and treat posttraumatic stress syndrome. Furthermore, the findings could be used as a basis for future quantitative studies to determine how widespread this theme is in larger groups of military nurses.

Shared experiences and meanings of military nurse veterans.

OBJECTIVE: To determine the shared perceptions, feelings, and experiences of U.S. military nurse veterans. DESIGN: Phenomenological based on Heideggerian philosophy. POPULATION, SAMPLE, SETTING: The population was of military nurse veterans in the U.S.A. from World War II, Korea, Vietnam, and Operation Desert Storm. The convenience sample was 22 nurses recruited from local and national veterans' groups who volunteered to be interviewed. METHODS: Transcribed interviews with team members producing written interpretations; the team produced consensus about themes. Each interview was summarized and validation from the research team and respondents was sought. CONCLUSIONS: Five common themes or shared meanings emerged: reacting personally to the war experience, living in the military, the meaning of nursing in the military, the social context of war, and images and sensations of war. CLINICAL IMPLICATIONS: A coherent review of wartime nursing.

Dimensions of urine loss among older women with genuine stress incontinence.

The specific maneuvers that cause women to be incontinent can become important diagnostic aids and major factors in differentiating the effectiveness of the current pharmacological, surgical, and behavioral treatments for urinary incontinence. The purpose of this study was to evaluate whether meaningful dimensions could be identified within the multiple movements that produce urine loss in stress-incontinent women. The Stress Incontinence Questionnaire (SIQ) was constructed from items derived from a compilation of studies and reports of urinary incontinence experts. An exploratory factor analysis using maximum likelihood method of extraction and a varimax rotation procedure identified four dimensions: active maneuvers, passive maneuvers, planned maneuvers, and unplanned maneuvers. The alpha coefficients for the four identified factors were acceptable and ranged from .71 to .79, with 8-week test-retest correlations for the active (r = .87), passive (r = .87), planned (r = .85), and the unplanned maneuvers (r = .60) all highly significant. The four factors also showed differential patterns of relationships with various gynecologic and urologic measures. These latter findings suggest that the factors identified in this study may be acknowledging different types or components of stress incontinence. In either case, the findings may have implications for treatment approaches to stress incontinence. Further research is needed to substantiate the various components of stress incontinence found in this study and the implications these findings may have for treatment of incontinence.

Health practices of critical care nurses.

Little is known about the health practices of critical care nurses (CCNs). Because their health behaviors may influence their inclinations to counsel patients, it is important that CCNs engage in a healthy lifestyle and serve as health exemplars. The purpose of this survey was to describe the health practices of 499 CCNs. Data were gathered by questionnaires that elicited information regarding smoking habits, oral health and dietary practices, energy expenditure, seat belt use, alcohol consumption, and health surveillance behaviors. This article is a sequel to a previous manuscript that reported findings relative to the smoking practices of CCNs. Results of the study suggest that the CCNs surveyed were not fulfilling their roles as health exemplars. Although some reported favorable health practices, many indicated habits that were less than desirable. These data document the need to develop strategies for improving the health behaviors of CCNs, thereby protecting their future health. Ultimately, these strategies may benefit their patients.

Chemical impairment in colleagues: perceptions of Western New York nurses.

The purpose of this study was to determine nurses' perceptions about substance abuse in professional colleagues, opinions about strategies for dealing with substance abuse, and knowledge about resources available for dealing with the problem of chemical impairment. Subjects included a convenience sample of 161 nurses from Western New York. Data were gathered by a questionnaire that included "The Perceptions of Nursing Impairment Inventory" and items regarding respondents' background characteristics, suspicions about alcohol and drug abuse in nurse colleagues, and knowledge about and use of peer assistance services available through District I of the New York State Nurses Association. The major outcome of the study was identification of a knowledge deficit on the extent of the substance abuse problem in nursing, ability to recognize an impaired colleague, and awareness of services available. These data substantiate the need for implementing educational programs to increase nurses' basic knowledge of, and sensitivity to, the problem of chemical dependency.

Evaluation of the school of nursing dean.

We have expressed the importance of periodic evaluation of the dean, as well as why an evaluation is desirable. This article presents information about the instrument our faculty used to evaluate the dean of nursing in a large university center. It served to provide input from faculty members as well as providing the dean with the opportunity to become more fully aware of her strengths and weaknesses as perceived by faculty. This instrument can be easily modified to fit a variety of circumstances that may exist in other schools of nursing.

Smoking practices among nursing students: a comparison of two studies.

Findings of numerous studies that have explored the smoking practices of nurses reveal a high incidence of smoking that is incongruent with the health beliefs of the profession. Nurses who smoke are less likely to teach or positively influence patients who smoke. They may even undermine health teaching efforts of other health professionals. Studies of smoking practices of nursing students also reveal high incidences of smoking. Included among the determinants of this practice are lack of knowledge of the health effects of smoking, the academic setting, and the role that nursing education may play. In this comparison of two independent studies similar in design, smoking rates were similar to that of the female population and to registered nurses. Students who smoke either started smoking or increased their smoking in nursing school. They knew the health hazards of smoking and most had tried to quit in the past. Challenging opportunities exist for nurse educators to study and implement strategies to prevent smoking initiation and encourage cessation among future nurses.

Health practices of nursing students: a survey.

This study describes the health practices of nursing students from several nursing programs in western New York. Findings from a sample of 1,081 female students who responded to a questionnaire showed considerable variability in the extent to which students engage in health-related practices. While the majority obtain six to eight hours of sleep per night, exercise regularly, and have annual dental and physical examinations, less than half those surveyed eat breakfast everyday, over three-quarters eat between meals, and less than one-half limit fat, salt, and sugar in their diets. Most do not wear seat belts consistently; less than one-third perform breast self-examination monthly; and 90% consume alcoholic beverages and one-quarter have five or more drinks per occasion. Analyses demonstrated a statistically significant relationship between preventive-health orientation scores and age and type of basic nursing education. These data suggest that nurse faculty and health educators need to influence students' health-promoting and disease-preventing behaviors. This need is particularly salient since these students are expected to act as exemplars when they complete their education and assume positions in the health-care system.

Smoking practices of critical care nurses.

This study examined smoking practices of 499 critical care nurses, their knowledge about the health effects of smoking, and their perceptions regarding responsibility for promoting and supporting antismoking efforts. Approximately 20% of the critical care nurses surveyed were current smokers. Overall, respondents were knowledgeable about the serious consequences of smoking. Although they tended to view themselves as responsible for taking an active role in smoking cessation efforts, they had reservations about their ability to achieve successful outcomes. This information provides a data base for designing smoking cessation strategies for critical care nurses and educational interventions aimed at increasing skills in helping patients cope with the abrupt withdrawal from nicotine imposed by an episode of acute illness.

Smoking behavior among student nurses: a survey.

The study describes the smoking habits of student nurses and determines the correlates of smoking initiation, continuation, and cessation. The sample included 1,163 students attending 10 nursing schools in Buffalo, NY. Data were gathered by means of a self-administered questionnaire. Approximately 30 percent of the students were current smokers, 25 percent were exsmokers, and 45 percent had never smoked. More than half of the smokers (57 percent) expressed the desire to quit, and 81 percent had tried to do so in the past. Major reasons for trying to quit were to protect future health, save money, self-discipline, and pressure from significant others. Most (90 percent) of the students who had tried to quit had attempted to do so on their own and all at once. Knowledge of the health consequences of smoking was not significantly related to smoking behavior. These data suggest the need for health educators to promote personal health practices among their students that are congruent with the goals of the nursing profession of health promotion and disease prevention.

The Quadriplegia Index of Function (QIF): sensitivity and reliability demonstrated in a study of thirty quadriplegic patients.

The Quadriplegia Index of Function (QIF) was originally developed by the authors in 1980 because the popular Barthel Index was deemed too insensitive to document the small but significant functional gains made by quadriplegics (tetraplegics) during medical rehabilitation. The QIF has now been tested on a group of 30 complete quadriplegic patients at admission to and discharge from inpatient medical rehabilitation. Resultant scores were compared to those simultaneously obtained by the Barthel Index and the Kenny Self-Care Evaluation. The QIF was found to be more sensitive (46 per cent improvement as opposed to 30 per cent by the Kenny Self Care Evaluation and 20 per cent by the Barthel Index). The QIF was also tested for reliability. Ratings by three different nurses, working independently, were found to be significantly positively correlated for all sub-scores (p less than .001). We conclude that the QIF provides a useful option in choosing a functional assessment instrument for use with quadriplegic patients.

Kegel's exercises with biofeedback therapy for treatment of stress incontinence.

True stress incontinence due to a weakened pelvic floor is one of the most frequently cited urologic complaints of multiparous women past age 40. One treatment modality currently used to treat stress incontinence is exercising the pubococcygeus muscle. Combining biofeedback therapy with a vaginal probe (perineometer) helps patients identify the muscle, provides immediate feedback and assists the nurse and patient in assessing problem resolution. This article describes an intervention program using biofeedback, and measured Kegel's exercises on a small number of women with symptoms of stress incontinence. The lessening of symptoms became a major factor in continued compliance with the exercise program.