ANS. Advances in nursing science
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Considerable evidence suggests that neocolonialism, in the form of economic globalization as it has evolved since the 1980s, contributes significantly to the poverty and immense global burden of disease experienced by peoples of the developing world, as well as to escalating environmental degradation of alarming proportions. Nursing's fundamental responsibilities to promote health, prevent disease, and alleviate suffering call for the expression of caring for humanity and environment through political activism at local, national, and international levels to bring about reforms of the current global economic order.
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This article overviews the holistic, hospice, and palliative care models as they relate to end-of-life (EOL) care outcomes. Freire's model of overcoming oppression, which builds on Hegel's philosophical approach, is used as a framework for raising nurses' awareness of end-of-life issues. Concerns that require critical dialogue, as well as questions that warrant discussion, are posited.
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Clinical judgments and decisions are an integral component of nurse work and nurses are increasingly being challenged to account for their judgments and decisions. Nursing research is needed to help explain judgment and decision making in nursing, but most research in this area is almost exclusively characterized by descriptive studies. ⋯ This hybrid technique is an excellent method for studying judgments and decisions across settings, roles, disciplines, and countries. This article outlines the steps of the method and demonstrates its applicability with an exemplar from a study across nurses from 3 countries.
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Chronic pain is a worldwide problem with significant physical, psychological, and social impacts. Despite its prevalence and cost, the phenomenon is not well understood. ⋯ A random sample of nursing, psychology, and neurophysiology literature published over a 30-year period (1969 through 1999) was used to generate a consensual definition of chronic pain. The transition in the attributes, antecedents, consequences, related concepts, and surrogate terms of chronic pain is described, and the implications of the findings for practice and research are discussed.
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The emergence of managed care raises new concerns about the ethics of health care financing and its impact on service delivery. The current outcry, however, fails to recognize that American health care financing has presented serious ethical dilemmas for at least 50 years. What follows is a historic overview of American health care financing, contrasted with current challenges. The intersection between ethics, economics, professionalism, and public authority is explicated, with a critical leader/advocate role for nurses presented.