ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00223.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractFactors influencing the remarkable growth of home health care include increased elderly population, decreased average length of hospital stay, and technological advancements that reduce the need for hospitalization. Societal changes have prompted increasing concern about personal risk to home care providers. The purpose of this pilot study was to: 1) ascertain factors related to perception of risk by home health care administrators and staff and to identify strategies used by home health care administrators to reduce risk to staff; and 2) determine whether quality of care is affected when home‐visit situations present risk. A convenience sample of 36 home health care administrators and 62 staff was surveyed about risks and measures provided by the home health care agency to minimize risk. Factors associated with risk are geographic location, high incidence of crime, inappropriate patient or caregiver behavior, infectious diseases, and evening assignments. Strategies used to minimize risk include safety programs, preplanning of visits, personal protective equipment, escorts, and buddy systems. Perceived ability to refuse high‐risk assignments, however, is questionable, as 66% of the staff stated that they leave a situation “as soon as possible.” These findings will be used to strengthen inservice programs and to provide a basis for future

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00224.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractImprovement of the health of the nation demands that we prepare nurses to deliver care to those within our urban settings. Yet students frequently are uncomfortable visiting clients in urban settings. Our initial efforts were to refine the Environmental Comfort Scale (Carter, Carroll,&Hayes, 1994), an instrument developed to measure comfort levels in various urban scenarios. This article reports the results of this instrument refinement as well as the inductive process leading to the initial conceptualization of a model that addresses threats to safety. These threats, in turn, generate fear of nursing in community‐based settings. The study participants were 120 volunteer junior students in a baccalaureate nursing program. The Environmental Comfort Scale II was administered to students at the beginning of an orientation session prior to their initial clinical nursing course. The instrument consisted of 15 items: 3 demographic items, 11 items asking students to rate their level of comfort and of fear in relation to various urban situations, and 1 open‐ended question. Analysis of data led to conceptualization of two factors that could influence comfort levels in the urban environment. The first factor was personal‐emotional (affective) and the second factor was cognitive (objective). The interaction and interdependency of these two factors led to the creation of a

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00225.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA pilot project is described that was initiated to provide a comprehensive clinical experience for community health nursing (CHN) students despite local cutbacks in field nursing services. The project, entitled the Nursing Elementary Education Outreach Project (NEEOP), is used as a basis for discussion on the CHN role in community‐focused health care reform. One‐third of the CHN students in one school of nursing during one academic year (n= 16) participated in the NEEOP. One salaried CHN faculty member assumed primary responsibility, and equipment funding was granted by a local corporation. Collaboration was established with the county's proactive school nurses' association. CHN students developed and conducted health education presentations in elementary schools, worked with school nurses, and participated in other community health activities. Three levels of evaluation were utilized: elementary students to nursing students, nursing students to nursing faculty, and school nurses to nursing faculty. The NEEOP was a success by all evaluation criteria, and plans are currently in progress to expand its focus. Innovative clinical placements such as the one described can promote student understanding of CHN practice with its broad‐based emphasis on the promotion of healthier commun

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00226.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA significant amount of the mortality and morbidity experienced by Americans of all ages today is preventable. Research directed toward the identification of health promotion needs of traditional students in college environments may contribute to the development and implementation of programs and activities that assist students to adopt healthy lifestyle behaviors throughout their life spans. The purpose of this descriptive survey study was to identify the health promotion needs of traditional students in a college environment. More specifically, the research question was: What are the health promotion needs of traditional students in a college environment? Subjects were male and female students, 18‐21 years of age, and enrolled in a full‐time (minimum of 12 hours) program of study at one of two college campuses in a metropolitan southern city. One of these was a 2‐year state‐affiliated community college and the other was a private 4‐year coeducation university. A randomized sample of 148 subjects was computed. Results of this study emphasize the distinctive individual and group health promotion needs of traditional students in a college environment. Identification of the health promotion needs of this population will enable health care providers to develop interventions to assist students in developing healthy lifestyle

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00227.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractHealth care reform can provide opportunities for collaboration between universities and the public at large. An advanced community nursing class within a post‐RN program at a university combined resources with a nearby rural community to complete a community health and social needs assessment. The partners in the project included the local hospital, health unit, and the university; funding was secured from the Regional Center for Health Promotion and Community Studies and the two health agency partners also made a financial donation. Community liaisons who were both registered nurses and residents of the community were instrumental in completing tasks and activities related to the project. The students were taught the various data collection methods and participated in class assignments refining the necessary skills required for the actual assessment. This project benefited the community by providing baseline health status and social needs data in an era of dramatic health care reform while simultaneously affording undergraduate nursing students the opportunity to apply theory to practic

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00228.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractAn urban shelter in Charleston, South Carolina developed and began a tuberculosis (TB) prevention and control plan that addressed the priorities recommended by the Centers for Disease Control and Prevention. After an increase in TB in the shelter in 1992, the local health department, the homeless clinic nurse practitioners, and Medical University of South Carolina College of Nursing faculty and students collaborated with the shelter staff to provide initial mass screenings for contact investigation. They also developed and implemented new policies and procedures for an ongoing TB prevention and control program. The new policies required that guests obtain screening for TB within 7 days of arrival at the shelter and every 6 months thereafter. Also, a public health nurse began providing directly observed therapy twice weekly at the shelter. Of the initial 22 persons who started TB preventive therapy in 1993, 17 (77%) completed therapy. The clinic nurse practitioners, nursing students, and public health nurses had important and defined roles in the mass‐screening process, case identification and treatment, policy development and implementation, health education, and establishing methods of communication between the shelter, clinic, and health department. An ongoing health care community collaborative effort may successfully reduce tuberculosis disease in a homeless shelter populatio

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00229.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe study's purpose was to examine postdischarge rehospitalizations and acute care visits in seven high risk, high volume, high‐cost patient groups. Subjects were drawn from an urban tertiary teaching hospital. The total sample (N= 764) consisted of seven patient groups (drawn from five randomized clinical trials): very low birthweight (VLBW) infants (n= 79); women post‐unplanned cesarean birth (n= 122) and their infants (n= 123); pregnant women with diabetes (n= 55); women post‐hysterectomy surgery (n= 109); and elderly with medical cardiac Diagnostic Related Groups (DRGs) (n= 142) and elderly with surgical cardiac DRGs (n= 134). The VLBW infant and pregnant diabetic groups were predominantly African American, the elderly and hysterectomy groups predominantly Caucasian, and the cesarean group almost equally distributed. The lowest rate of rehospitalization (2%) occurred in the cesarean group, the highest (35%) in the pregnant diabetics. In four groups (cesarean and infants, hysterectomy and surgical elderly), 60%‐100% of the rehospitalizations occurred within 4 weeks of discharge. Subjects requiring acute care visits ranged from 13% (hysterectomy) to 82% (VLBW infants). Acute care visits demonstrated greater distribution throughout the follow‐up periods but also tended to concentrate in the first 4 weeks post

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00230.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis article describes how indigenous interviewers were used to collect data about the health needs and resources in a black South African township. The survey was done during the dismantling of the apartheid political system of South Africa. The political unrest, distrust, and tension were barriers to carrying out a survey and threatened the quality of the data collection. A vulnerability of survey research is the difficulty in controlling the variables of the community and the interviewer during the process of data collection. How this survey was carried out, in this unstable setting, influenced the quality of the data and the validity and reliability of the research. The data‐collection requirements were carried out in a way that was functional in the real‐world setting while maintaining research standards. The criteria used for hiring interviewers and the content and delivery of training were effective in this tense, educationally disadvantaged community setting. Methods that were used to motivate and supervise interviewers were successful and are recommended for use in similar survey resea

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00231.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractCervical cancer is the second leading cancer among Alaska Native. American Indian women, who have a high incidence of cervical cancer and low survival rates (Boss, 1991; Michalek&Mahoney, 1990; Page&Asire, 1985). The purpose of this Grounded Theory study was to gain a greater understanding of the meaning of the papanicolaou (Pap) test to the Yakama Indian women of eastern Washington to support the Tribe in the design of effective screening interventions. Data from 15 interviews, focus groups, and participant observation were included in the data analysis. The major theme was: Walking the Journey of Womanhood. Four phases of the journey were identified: (a) Starting the Journey, (b) Blooming, (c) Heading the Household, and (d) Becoming an Elder. In this study we found that interventions to influence Pap test screening among the Yakama women must address structures of care, provider‐patient communications, and education for the women. Women heading the households and elders were identified as priority populations for education because they have negative attitudes from previous experiences and have a great influence on the younger women. Messages need to be wellness oriented and traditional methods of education, such as the talking circle, role model, and storytelling, need to be use

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00232.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY