Who uses nursing theory? A univariate descriptive analysis of five years' research articles

BACKGROUND

Since the early 1950s, nursing leaders have worked diligently to build the Scientific Discipline of Nursing, integrating Theory, Research and Practice. Recently, the role of theory has again come into question, with some scientists claiming nurses are not using theory to guide their research, with which to improve practice.

AIMS

The purposes of this descriptive study were to determine: (i) Were nursing scientists' research articles in leading nursing journals based on theory? (ii) If so, were the theories nursing theories or borrowed theories? (iii) Were the theories integrated into the studies, or were they used as organizing frameworks?

METHODS

Research articles from seven top ISI journals were analysed, excluding regularly featured columns, meta-analyses, secondary analysis, case studies and literature reviews. The authors used King's dynamic Interacting system and Goal Attainment Theory as an organizing framework. They developed consensus on how to identify the integration of theory, searching the Title, Abstract, Aims, Methods, Discussion and Conclusion sections of each research article, whether quantitative or qualitative.

RESULTS

Of 2857 articles published in the seven journals from 2002 to, and including, 2006, 2184 (76%) were research articles. Of the 837 (38%) authors who used theories, 460 (55%) used nursing theories, 377 (45%) used other theories: 776 (93%) of those who used theory integrated it into their studies, including qualitative studies, while 51 (7%) reported they used theory as an organizing framework for their studies. Closer analysis revealed theory principles were implicitly implied, even in research reports that did not explicitly report theory usage.

CONCLUSIONS

Increasing numbers of nursing research articles (though not percentagewise) continue to be guided by theory, and not always by nursing theory. Newer nursing research methods may not explicitly state the use of nursing theory, though it is implicitly implied.

Smoking behavior and related factors among Japanese nursing students: a cohort study

BACKGROUND

Although there have been several surveys on smoking behavior among Japanese nursing students, most have been cross-sectional studies. No longitudinal studies, such as a prospective cohort study, have ever been carried out. We therefore conducted a cohort study on, and analyzed smoking behavior and related factors among, Japanese nursing students.

METHODS

A survey on smoking behavior using a confidential questionnaire was conducted on nursing students at two vocational schools of nursing and two nursing colleges/universities located in the Tokyo metropolitan area. Another survey was subsequently conducted in the same manner among the same subjects 1 year later. The surveys were conducted between 1997 and 1999.

RESULTS

Over the 1-year period, the prevalence of smoking among nursing students increased by 10% for students at the vocational schools of nursing (n = 224) and by 3% for students at the nursing colleges/universities (n = 222). The average score for nicotine dependence for students who were daily smokers at both time points rose from 3.6 to 4.4 (P < 0.05). Two factors found to significantly predict smoking behavior were having friends who smoke and living alone.

CONCLUSION

Smoking prevalence is increasing among Japanese nursing students. Smoking prevention and cessation interventions should be instituted in all nursing training programs.

Spectrum analysis of respiratory sound: application to smokers and non-smokers

Previous studies have indicated that respiratory sound signals may contain information useful in the detection of lung diseases. In this study, measurement and recordings of respiratory sound signal segments were obtained in normal subjects (non-smokers) and smokers in both inspiration and expiration phases. By using the autoregressive (AR) method, it is possible to produce power spectra of respiratory sound signals in inspiration and expiration phases for smokers and non-smokers of each group. The selection of the AR model order of the respiratory sound signals is achieved using Akaike criterion. The AR model order of 9 is required for completely described respiration sound signal segments in inspiration and expiration phases for both groups. The power spectra in the smoker group show larger distinct peaks at lower frequencies as well as more harmonics in both inspiration and expiration phases compared to the power spectra of the non-smoker group. Another diagnostic indicator was derived from the relative position of poles of the AR model of respiratory sound signals. In all smokers it was found that the first, third and fourth poles were closer to a unit circle than those in non-smokers (P < 0.01). It seems that the use of these indicators may be useful as early diagnostic tool for lung diseases.

Blood superoxide dismutase and plasma malondialdehyde among workers exposed to asbestos

Blood superoxide dismutase (SOD) and plasma malondialdehyde (MDA) (an indicator of lipid peroxidation [LPO]) were determined in 97 randomly selected asbestos exposed workers (age range: 25-60 years, mean duration of exposures 19.8 +/- 8.3 years) and in 42 healthy male controls. MDA, SOD, and MDA/SOD ratio in asbestos exposed workers were significantly higher than in controls. Among both the controls and exposed workers neither age nor smoking was related to SOD or MDA levels. SOD was significantly positively correlated with MDA among the exposed workers. Such correlation was not observed among the controls. SOD but not MDA was significantly positively correlated with the duration of exposure to asbestos. Mean levels of SOD or MDA in exposed workers with radiographic signs of lung fibrosis or pleural thickening did not differ significantly from those without such signs. The results confirm the possible involvement of LPO and development of anti-oxidant mechanism(s) of prolonged exposure to asbestos in humans. However, SOD seems not to be the essential anti-asbestos-induced LPO. Relation between these factors and lung fibrosis is still unclear.

Relative cardiac cost and physical, mental and psychological work load among a group of post-operative care personnel

Continuous registration of heart rate and careful minute-by-minute observation of all physical, mental and psychological job-related events was carried out in a group of nine post-operative care personnel. The relative cardiac cost (RCC) correlated significantly with the observed work events. The magnitude of participation of physical, mental and psychological work elements in the changes in RCC varied in the investigated subjects according to the type and magnitude of the different work events. However, collective data on the group indicated that changes in RCC were related mainly to physical effort and to a lesser, albeit significant, extent to psychological reaction. The results indicate the possibility of using the heart rate in monitoring working conditions and, probably, in guiding their improvement.

The cardiac ganglia in streptozotocin-induced diabetic rats

The ultrastructure of the cardiac ganglia of streptozotocin-induced diabetic rats was studied at survival times of 3 and 7 days, 1, 3, 6, 9 and 12 months. At 3-7 days post-induction, some intracardiac neurons showed an overall increase in electron density, with the dendrites darkening first. Some of the affected dendrites appeared jet black and their intracytoplasmic organelles were hardly distinguishable except for some swollen mitochondria. Both electron dense and lucent types of degenerating axon terminals were observed in the interstitial spaces. Several myelinated and unmyelinated axons also showed early signs of degeneration. At 1-6 months post-induction, numerous myelinated and unmyelinated axons were shown to be degenerated. The majority of the intracardiac neurons appeared to be normal. Numerous macrophages containing phagosomes were found in the interstitial spaces. At 9-12 months post-induction, macrophages containing engulfed debris were still commonly observed amongst the neuronal profiles, which appeared to be morphologically normal. It is concluded that degenerative changes occur in the cardiac ganglia of streptozotocin-induced diabetic rats and that these changes appear to be both progressive and prolonged.

Serum choline esterase and liver function among a group of organophosphorus pesticides sprayers in Egypt

This study was initiated to investigate the long term effect of exposure to organophosphorus pesticides (O.P), with consideration to bilharziasis (an endemic parasitic disease in Egypt, usually associated with liver fibrosis). Serum levels of choline esterase (Ch E), glutamic pyruvic transaminase (SGPT), alkaline phosphatase (Alk. Ph.) and proteins were estimated among 100 (O.P.) sprayers with various duration of exposure (3 to 15 years) and among 60 controls. O.P. sprayers showed significantly higher, SGPT and Alk. Ph. and lower Ch E and serum proteins than the controls. Among sprayers, duration of exposure to O.P. was significantly correlated with their levels of Ch E, SGPT, and Alk. Ph. but not with serum proteins. Compared to other parameters, SGPT seems to be a good indicator of the hepatic effect of long term exposure to O.P. Bilharzial infection did not modify the effect of O.P. pesticides on the above mentioned parameters. Ch E of smoker sprayers was significantly less than that of non smokers. This was attributed to increased absorbtion of O.P. during smoking at work places.

Skin photoplethysmography--a review

The photoplethysmograph has been used for over 50 years but there are still misconceptions in how and what is the information obtained. A photoplethysmograph signal from any site on the skin can be separated into an oscillating (a.c.) and a steady-state (d.c.) component, their amplitudes dependent upon the structure and flow in the vascular bed. Many simple applications are available: pulse counters, using the a.c. component, skin colour and haemoglobin saturation meters, using the d.c. component. The d.c. component of the photoplethysmograph signal is a function of the blood flux beneath the device. A good emitter for use in a photoplethysmograph of skin blood flow is one in the frequency range 600-700 nm and the best signal for a.c. analysis is obtained from the finger pulp. The frequency range of the electronic circuitry should be from 0.01 to 15 Hz, then all the information in the signal can be extracted about the autonomic nervous system control of the cardiovascular system, particularly between 0.01 and 2 Hz. Comparative studies may be drawn between similar skin sites on a subject or between subjects if the afferent inputs to the brain stem are controlled or driven at a known frequency. These afferents, inputs, will modulate the efferents, outputs, which generate variations in the a.c. component of the detected photoplethysmograph signal.

Follow-up of hearing thresholds among forge hammering workers

Hearing threshold was reexamined in a group of forge hammering workers investigated 8 years ago with consideration of the age effect and of auditory symptoms. Workers were exposed to impact noise that ranged from 112 to 139 dB(A)--at an irregular rate of 20 to 50 drop/minute--and a continuous background noise that ranged from 90 to 94 dB(A). Similar to what was observed 8 years ago, the present permanent threshold shift (PTS) showed a maximum notch at the frequency of 6 kHz and considerable elevations at the frequencies of 0.25-1 kHz. The age-corrected PTS and the postexposure hearing threshold were significantly higher than the corresponding previous values at the frequencies 0.25, 0.5, 1, and 8 kHz only. The rise was more evident at the low than at the high frequencies. Temporary threshold shift (TTS) values were significantly less than those 8 years ago. Contrary to the previous TTS, the present TTS were higher at low than at high frequencies. Although progression of PTS at the frequencies 0.25 and 0.5 kHz was continuous throughout the observed durations of exposure, progression at higher frequencies occurred essentially in the first 10 to 15 years of exposure. Thereafter, it followed a much slower rate. Tinnitus was significantly associated with difficulty in hearing the human voice and with elevation of PTS at all the tested frequencies, while acoustic after-image was significantly associated with increment of PTS at the frequencies 0.25-2 kHz. No relation between PTS and smoking was found. PTS at low frequencies may provide an indication of progression of hearing damage when the sensitivity at 6 and 4 kHz diminishes after prolonged years of exposure. Tinnitus and acoustic after-image are related to the auditory effect of forge hammering noise.

Cytogenetic effects in a group of traffic policemen in Cairo

The aim of this study was to evaluate the cytogenetic effects in humans exposed to automobile exhaust. The induction of chromosome damage was studied in an exposed group of 28 traffic policemen with exposure of over 10 years and a control group of 15 policemen trainers from the Faculty of Police. The percentage of chromosomal aberrations as well as the mean sister-chromatid exchanges were significantly higher among the traffic policemen than in the control group. The cause for this elevated chromosome damage is most likely due to their exposure to pollutants from automobile exhaust, however, the increase is not correlated with the blood lead level or the duration of employment. On the other hand, the increase in chromosome damage among the traffic policemen is enhanced further by smoking.

Usage of personal protective devices among Egyptian industrial workers

A systematic random sample of 405 workers from metal, asbestos cement pipes, textile, and viscose rayon industries were interviewed using a prepared and tested questionnaire. Personal Protective Devices (PPDs), namely goggles, gloves, respirators, and ear defenders, had been distributed to all workers on the payroll and were used by 31.4%. Usage of PPDs was associated with the educational level, duration of occupation, awareness of the work hazards, and knowledge about the purpose of PPDs. Marked association was found between nonusage of PPDs and discomfort, interference with job performance, and the psychological feeling of lowering the person's prestige by the wearing of PPDs. Nonusage was also associated with lack of maintenance of the device and absence of supervision of its usage. Users were more numerous among married workers and workers with urban residence than among unmarried workers and those with rural residence, respectively. No association could be found between the rate of usage and the worker's age except for ear plugs, for which nonusage was proportional to the worker's age. The most important factors were those related to the role of the safety staff and the discomfort of the devices. Recommendations for occupational health authorities on the basis of the above evaluation are suggested.