{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T06:40:57Z","timestamp":1697179257402},"reference-count":36,"publisher":"Wiley","issue":"11c","license":[{"start":{"date-parts":[[2008,10,15]],"date-time":"2008-10-15T00:00:00Z","timestamp":1224028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:p><jats:bold>Aims.\u2002<\/jats:bold> The aim of this study was to discover whether problems experienced by older people with multiple chronic diseases were considered to be avoidable from the perspective of nurses.<\/jats:p><jats:p><jats:bold>Background.\u2002<\/jats:bold> The concept of avoidability is defined as \u2018that which can be avoided\u2019; when something is perceived as avoidable, action is taken \u2018to prevent the occurrence\u2019. It is possible that the nurses\u2019 perception on the avoidability of problems in chronically\u2010ill older people, could have a role in the decisions they make about the most suitable type of care (e.g. therapeutic, preventive) while if they perceive a problem to be unavoidable they adopt palliative interventions. No literature is available on the factors that nurses take into account when judging whether a patient\u2019s problem could be avoided or not, and no nursing diagnosis title includes the concept of an \u2018unavoidable\u2019 problem (e.g. unavoidable depression related to nursing home institutionalisation).<\/jats:p><jats:p><jats:bold>Design.\u2002<\/jats:bold> A phenomenological method was used to identify and understand the meaning of a human being\u2019s experience by means of direct reporting and interviews.<\/jats:p><jats:p><jats:bold>Method.\u2002<\/jats:bold> Participants were forty 40 nurses working in homecare services and nursing homes in Northern Italy.<\/jats:p><jats:p><jats:bold>Findings.\u2002<\/jats:bold> Various factors were assumed to make certain problems inescapable, such as the interaction of multiple diseases, older people refusing care and inadequate surveillance. Other problems were judged to be completely or partially avoidable such as aspects relating to families\u2019 reactions (the burden of providing care, family members\u2019 inability to provide adequate care), and to healthcare management dysfunctions (poor exchange of information, limited resources).<\/jats:p><jats:p><jats:bold>Conclusion.\u2002<\/jats:bold> The nurses perceived they could only marginally modify the older person\u2019s problems however, they could take action instead to improve the organisational processes, the involvement of family members, and their own skills and sense of purpose.<\/jats:p><jats:p><jats:bold>Relevance to clinical practice.\u2002<\/jats:bold> To reflect on unavoidable nursing problems and related factors is important for the potential consequences of clinical judgment on patients and on nursing care and for ethical implications. The factors affecting avoidable or unavoidable problems need strategic and individualised action to develop healthcare plans including the older people themselves, their families, and members of a multidisciplinary team and to provide adequate resources and educational programmes.<\/jats:p>","DOI":"10.1111\/j.1365-2702.2008.02576.x","type":"journal-article","created":{"date-parts":[[2008,10,15]],"date-time":"2008-10-15T18:45:30Z","timestamp":1224096330000},"page":"390-399","source":"Crossref","is-referenced-by-count":2,"title":["Italian nurses\u2019 perception of the avoidability of problems affecting older people with multiple chronic diseases"],"prefix":"10.1111","volume":"17","author":[{"given":"Luisa","family":"Saiani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debora","family":"Viviani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Lenzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Chissal\u00e8","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvisa","family":"Palese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,10,15]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Applying Nursing Process: A Step by Step Guide","author":"Alfaro R","year":"1994"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547-5069.1989.tb00100.x"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1998.00809.x"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7489(94)90060-4"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0894318404263374"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-6712.2002.00049.x"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7492.612"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001786-200304000-00002"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/019394598700900201"},{"key":"e_1_2_14_11_1","volume-title":"Diagnostic Reasoning Treatment Decision Making in Nursing","author":"Carnevali D","year":"1993"},{"key":"e_1_2_14_12_1","volume-title":"Nursing Diagnosis: Application to Clinical Practice","author":"Carpenito LJ","year":"2006"},{"key":"e_1_2_14_13_1","volume-title":"Working With Chronicity","author":"Dal Ponte A","year":"2004"},{"key":"e_1_2_14_14_1","first-page":"497","article-title":"Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomised control trial","volume":"162","author":"Dalby DM","year":"2000","journal-title":"Canadian Medical Association Journal"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-618X.2000.tb00401.x"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7315.719"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0594.2004.00257.x"},{"key":"e_1_2_14_18_1","volume-title":"Webster\u2019s Third New International Dictionary","author":"Gove I","year":"1986"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.1994.tb01085.x"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.2217\/1745509X.2.2.221"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-196601510-00005"},{"key":"e_1_2_14_22_1","first-page":"640","article-title":"Nursing diagnosis: factors affecting their use in charting standardised care plans","volume":"14","author":"Lee TT","year":"2005","journal-title":"Journal of Advanced Nursing"},{"key":"e_1_2_14_23_1","volume-title":"Nursing Research: Methods, Critical Appraisal, and Utilization","author":"Lo Biondo G","year":"2004"},{"key":"e_1_2_14_24_1","first-page":"587","article-title":"Medical problem solving. A critique of the literature","volume":"60","author":"McGuire CH","year":"1985","journal-title":"Journal of Medical Education"},{"key":"e_1_2_14_25_1","first-page":"23","article-title":"Vigilance: the essence of nursing","volume":"6","author":"Meyer G","year":"2005","journal-title":"Online Journal of Issues in Nursing"},{"key":"e_1_2_14_26_1","volume-title":"Handbook of Qualitative Research","author":"Morse JM","year":"1994"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)93294-W"},{"key":"e_1_2_14_28_1","volume-title":"Essentials of Nursing Research \u2013 Methods, Appraisal, and Utilization","author":"Piven ML","year":"2001"},{"key":"e_1_2_14_29_1","volume-title":"Essentials Nursing Research. Methods, Appraisal and Utilisation","author":"Polit DF","year":"2001"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1995.21061123.x"},{"key":"e_1_2_14_31_1","volume-title":"Qualitative Research in Nursing. Advancing the Humanistic Imperative","author":"Streubert H","year":"2003"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.7.977"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.8.1022"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2000.01420.x"},{"key":"e_1_2_14_35_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1377\/hlthaff.20.6.64","article-title":"Improving chronic illness care: translating evidence into action","volume":"20","author":"Wagner EH","year":"2001","journal-title":"Health Affairs"},{"key":"e_1_2_14_36_1","volume-title":"Strategies for Theory Construction in Nursing","author":"Walker LO","year":"1995"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2702.2002.00580.x"}],"container-title":["Journal of Clinical Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2702.2008.02576.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2702.2008.02576.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T13:51:08Z","timestamp":1697118668000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2702.2008.02576.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,10,15]]},"references-count":36,"journal-issue":{"issue":"11c","published-print":{"date-parts":[[2008,11]]}},"alternative-id":["10.1111\/j.1365-2702.2008.02576.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2702.2008.02576.x","archive":["Portico"],"relation":{},"ISSN":["0962-1067","1365-2702"],"issn-type":[{"value":"0962-1067","type":"print"},{"value":"1365-2702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,10,15]]}}}