ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00245.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to develop a productivity measurement method applicable to home health care registered nurses (RNs) by identifying and quantifying the areas of knowledge and ability that define productive nursing practice in home health care. A descriptive, correlational design using qualitative and quantitative methods of data collection and analysis identified 35 knowledge and ability variables that grouped into seven dimensions: Client/Family Management, Practice Management, Knowledge/Skill Maintenance, Communication, Nursing Process, Written Documentation, and Home Health Care Knowledge. There were no significant differences in productivity variables among four major types of agencies. Among agencies considered preeminent, intellectual skills appeared to be of greater importance to productive practice than direct‐care skills. The seven productivity dimensions that emerged from this study show promise in providing 1) a theoretical basis for understanding the knowledge and abilities associated with RN productivity in the home health setting. 2) a description of nurse inputs in a home health services productivity model, and 3) a reality‐based measurement tool that has utility in managing RN productivity in home health c

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00246.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis study explored the relationship between the strength of the sense of coherence (SOC) and perceptions of different aspects of risks perceived by field‐workers making home visits for Medicare‐certified home care agencies. SOC is the disposition that individuals have toward stimuli. Field‐workers with a strong SOC identified fewer risk encounters, attributed a lower level of risk to characteristics of home visits that have the potential for injury, and evaluated fewer situations as having the potential to be threatening than their weak SOC counterparts. Strong SOC field‐workers were prepared to use behaviors similar to those of their weak SOC counterparts to protect themselves from harm should a situation become threatening. Knowledge of the strength of the SOC of field‐workers can be helpful in the screening, selection, and orientation of potential field‐workers as well as in designing programs to enhance the safety of home health care a

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00247.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to continue research related to the identification of social support systems for an older adult homebound population of people who have diabetes compared to a control group of elder home care clients without diabetes, their knowledge level, and the significance of home health care intervention in these support networks. A sample of 11 older adult homebound people with diabetes and 11 older adult home care controls without diabetes from two home care agencies in Connecticut were used for this pilot study. A large sample was projected, but home‐visiting scheduling difficulties arose. Eighty‐two percent of both groups had adequate support systems. There was some difficulty with interpretation of the Homebound Diabetes Knowledge Level Questionnaire and further refinement is needed, especially in relationship to non‐insulin‐dependent diabetes mellitus client responses. Results from chart review, utilizing the Diabetes Clinical Indicator Tool, yielded a 59%‐66% rate of the criteria met in the four categories outlined. It is evident that social support makes a significant contribution to the physical and psychological well‐being of the home care elder, but further study is needed to examine the relationship between an individual's personal and professional network of support in t

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00248.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe public health nurse (PHN) has a unique opportunity to identify and provide support to women who are abused by their partners. Earlier studies indicated, however that health professionals identify less than 10% of the abused women in their practice. In this study, a sample of 125 nurses responded to a measure called the Public Health Nurse's Response to Women Who Are Abused (PHNR), which consists of a vignette portraying a home visit to a young mother who showed indicators of abuse. The average PHNR score obtained was 80.8% indicating a high frequency of thoughts, feelings, and interventions that would facilitate abused women feeling helped. High scores were correlated with increased age, personal experience, number of years of public health experience, and workshop attendance. The PHNs' responses to open‐ended questions revealed that they experienced a wide range of strong emotions in dealing with these dangerous situations. While the nurses believed that addressing abuse was within their professional role, 55% were unsure of what to say to initiate the topic. Suggestions about how to introduce the subject of family violence and the training needs of PHNs are presente

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00249.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThere is a dearth of evaluation research regarding shelter health care. Health needs outweigh health services which are rarities within shelter settings (Gross&Rosenberg, 1987). The purposes of this article are to review the need for shelter health care, describe how shelter‐based advanced practice nurses (APNs) addressed health care needs and program goals in one shelter setting, and report findings from an impact evaluation study where APN services were rated by shelter clients (n= 69) for themselves and their children (n= 95). APNs have the ability to manage health care in shelter settings, but need to seek creative funding by documenting their worth. A 21‐item evaluation survey was designed to measure components of health assessment and education provided to clients by APNs. Content and construct validity were addressed by a statistician and nursing experts, and the internal consistency reliability coefficient (Cronbach's alpha) was measured at .91. Results showed that clients (96.1%) identified strongly positive responses to health services provided with some weak areas detected. Implications include the need to continue programs that serve vulnerable populations in times of cutbacks. Measuring program effects via impact evaluation is recommended for services in process to monitor quality and to give impetus to funding opportunit

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00250.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractCare coordination is a Medicaid benefit designed to help low‐income women gain access to pregnancy‐related services. Measuring the outcomes of care coordination is hampered because experimental designs are difficult to carry out on entitlement programs. The purpose of this study was to examine whether a care coordination‐adequacy index, based on number of home visits, onset of home visits, and weeks' gestation at delivery, would outperform a simple count of the number of home visits in predicting birthweight. Data from a pilot project in Indianapolis were used. The adequacy index outperformed “number of home visits” in the prediction of birthweight with this sample. Those who received intermediate level of care coordination delivered infants weighing 162 g more than those who received inadequate care coordination. The adequate level of care coordination did not predict birthweight, which may have resulted from an insufficient number of participants in this category (n= 20). An inherent selection bias based on the length of gestation when admitted to the program is also discussed. Research on care coordination with clear delineation of the measurement issues involved must continue to ensure effective program design and continue

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00251.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe study purpose was to determine differences in number, type, and predictors of community‐based service use among elders in three age groups. Existing data from a regional Area Agency on Aging were used and the sample (n= 2.474) included vulnerable elders, men, African Americans, low income, and rural residents. Services most frequently used were case management, congregate meal, home‐delivered meal, outreach, and recreation. Differences existed among the young, middle, and old old age groups in the number and types of services used. Race, residence, transportation capability, payment source, and function were the most frequent predictors of

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00252.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractHealthy adults experience a variety of symptoms and health problems each day and the responses to these symptoms and problems vary significantly from doing nothing to consulting professional help. Patterns of daily symptoms for well adults, the symptom experience, and responses to daily symptoms are reviewed. Nurses and other health care professionals must be aware of the dynamic process of symptom identification, monitoring, lay and professional consultation, and decision making to facilitate client's health promotion and disease prevention efforts.

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00253.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY