M Luna-Raines | PubMed Health

PubMed1995

Ethical issues in hospital-based nursing practice.

A professional nursing ethic is a living, dynamic set of standards for nurses' professional moral behavior. For a professional ethic to be adequate, it must address the ethical issues perceived as relevant to the profession. The purpose of this descriptive study was to identify the ethical issues hospital-based nurses face in their practice. The authors sought to determine whether there were any differences in these ethical issues over time or according to specialty practice, position, age, educational level, or years in practice. Different groups of nurses (N = 794) were surveyed on five separate occasions over 9 years. Data were analyzed using descriptive and chi 2 statistics. The most frequent ethical issue faced was pain relief and management. Over time, the percentage of nurses who reported being faced with ethical issues related to morphine drips increased. Implications for future research on development of a normative nursing ethic are discussed.

Adult↗

PubMedDate not supplied

Psychological and immunological reactions of family members to patients undergoing bone marrow transplantation.

The authors' goal was to evaluate the impacts of patients' bone marrow transplant (BMT) on their spouse/partner's (subjects) psychological and immunological status at four key points in the course of their transplant. Subjects' (N = 24) psychological and immunological status was prospectively evaluated at four key points in the patient's BMT which included: at patients' admission to hospital and 0-, 20-, and 34-day intervals after BMT infusion. Psychological variables examined included: a) general psychological distress and negative affect; b) tendency to respond in a socially desirable manner; c) state negative affect; and d) coping style, specifically if escape-avoidance coping was used. Immune variables examined included: percentages of total T cells and of CD4+, CD8+ cells, B cells, and natural killer (NK) cells, and NK cytotoxicity. Greatest abnormality in immune variables was detected before the initiation of BMT (i.e., between admission and day 0) with normalization between days 21 and 34 thereafter. During the waiting period before BMT, the subjects had the highest scores on negative affects, escape-avoidance coping, and psychological symptoms. These progressively declined after the BMT procedure. Significant correlations were found among trait anxiety, escape-avoidance coping, and total percentage of T cells and of CD4+ cells. Escape-avoidance coping was reliably correlated with percentage of B cells. The greatest psychological and immunological impacts on spouse/partners of BMT patients were found in the period directly after hospital admission and before BMT infusion. Alterations in immune values occurred in anticipation of BMT in the spouse/partners. Psychological symptoms followed this same pattern, being most elevated before BMT and decreasing in the successive evaluations post-BMT for the spouse/partners. The most significant and consistent psychological variable in predicting immune changes was escape-avoidance coping, with less escape-avoidance coping predicting better immune functioning.

Adaptation, Psychological↗