ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00211.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractComprehensive, community‐based case management has been inadequately studied with regard to case managers' use of community resources. The purpose of the study was to identify what federal, state, and local health and social services are used by case managers in coordinating services for prenatal case management of high‐risk, Medicaid‐eligible women. Thirty‐three case managers in two local health departments and one managed care organization provided three types of data about the community resources to which they refer clients. Categories of types of services were developed using content analysis. The results indicate that case managers refer their clients to 10 types of services. Federal assistance programs of Medicaid and the Women, Infant, and Children (WIC) nutrition program were used most. Hospitals, private physicians, family planning services, and transportation and housing services were frequently used. Implications for practice and research are di

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00212.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTiming of initial public health nurse contact and number of nurse contacts were examined for their relationship to adequacy of prenatal physician care, infant birthweight, and gestational age. Three historical cohort groups were drawn from three downstate Illinois counties: 1) public health nursing clients (N= 506); 2) Women, Infant, and Children Nutrition Program clients (N= 314); and 3) clients receiving neither of these services (N= 403). Data were obtained from local health department records and a state birth certificate data tape. Descriptive statistics and logistic and multiple regression were used to analyze data. Timing of initial public health nursing contact was significantly correlated to adequacy of prenatal physician contact and infant gestational age. No relationship was found between either timing of initial public health nursing contact or number of these contacts and infant birthweight. The number of public health nursing and physician contacts exerted an additive effect on birthweight and gestational age. Findings lend support for case‐finding activities that result in public health nursing contacts early in pregnancy. The importance of multidisciplinary approaches to prenatal care is suggeste

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00213.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractImmunization levels of Mexican American and white non‐Hispanic infants enrolled in Arizona's Medicaid managed care demonstration project, a prototype of the model proposed for a reformed health care system, were compared and the influence of sociodemographic characteristics, acculturation levels, health beliefs of the mothers, and infant health status on immunization levels were assessed. The study used data collected from office records, birth certificates, and household interviews. The random sample included 292 white non‐Hispanic and 274 Mexican American infants. White non‐Hispanic infants received more immunizations by age 1 than the Mexican American infants. However, after controlling for a full set of explanatory variables in a multiple regression analysis, ethnicity was no longer a significant predictor of immunization levels. Significant predictors of a higher number of immunizations included fewer siblings, older maternal age, and higher maternal education. Health insurance and enrollment in a managed care plan were not sufficient to ensure adequate immunization of these Medicaid enrolled infants. Results are discussed in terms of previous research and the essential functions of public health as outlined in the Institute of Medicine's Report on the Future of Public H

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00214.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractPrimary health care (PHC) offers nurses a framework for community‐based practice in a restructured health care system. This study examined a Nursing in Primary Health Care course model. Self‐directed learning readiness among baccalaureate nursing students enrolled in the course was examined in relation to evaluation of course content and instructional methods. The majority of students responded positively to the course methods and significant differences in course evaluations were found to be relative to self‐directed learning readiness. The results suggest the Nursing in Primary health care course model effectively introduces students t

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00215.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractDebate continues about the appropriateness of clinical experiences targeting aggregates in undergraduate community health nursing education. This paper describes a practical model to teach, through experience, the concepts of aggregate/community‐centered practice at the baccalaureate level. As a voluntary alternative to the usual community assessment paper, groups of students worked in partnership with community groups to define health needs and to address one need. Sequential student groups focused the assessment and implemented a plan. The required time for each project varied. One project is described to illustrate the model. While independent community‐centered practice is not expected of the B.S.N. graduate, the model described here develops comprehension of the concepts and process of such pract

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00216.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractKanter's structural theory of power in organizations provided the conceptual framework for this comparative study on perceptions of power of two levels of nurses working in three public health agencies during a time of program transition. Forty‐six public health nurses and 10 nurse managers were surveyed to examine their perceptions of the amount of power existing in their own and their counterparts' jobs. Propositions from Kanter's theory were supported by the data. Both groups rated their work environments to be somewhat low in power, although managers perceived themselves to be significantly more empowered in their work environments than did staff nurses. In addition, staff nurses perceived themselves to have significantly less access to empowerment structures (opportunity, information, support, and resources) than their managers perceived them to have. Staff nurse empowerment was found to be significantly related to perceptions of their immediate managers' power in the organizatio

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00217.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis study explores and describes the value of community health nursing from the perspective of community health nurses. The phenomenological method as defined by Colaizzi (1978) guided this exploration. Eleven community health nurses from the health department of a large urban center were interviewed for the study. The data revealed five major themes: 1) the value of activities in community health nursing: 2) the value of the purposes of community health nursing; 3) the value of prerequisites for community health nursing; 4) the value of the visibility of community health nursing; and 5) the value of community health nursing as the way to the future in health care. The findings of this study are particularly important in light of recent government interest in community health. However, if community health nurses are to capitalize upon this window of opportunity, they must clearly and forcefully articulate and make visible their value. Further research, particularly from a qualitative perspective, could help to advance this field of practice. Research that articulates the value of community health nursing in various settings and from the perspectives of various nurses, clients, and colleagues could also clarify and promote the collective and individual value of community health nursing.

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00218.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractNurses who plan and supervise home health aide service must have a good understanding of the amount and intensity of nursing care and the amount of home health aide service that individual clients will need. However, there is little in the nursing literature that describes how clients who receive both RN and home health aide services differ from clients who receive only RN care. Indeed, there have been few reports on how need for home health aide service relates to the amount of nursing care received. Secondary analysis of data from a study on resource consumption in home care revealed that clients who receive home health aide service: 1) are older; 2) are more likely to be women; 3) have a higher rating using the Community Health Intensity Rating Scale; and 4) are discharged from the caseload due to death or institutionalization at a higher rate than those who receive only RN care. Clients who received both home health aide services and RN care needed assistance with activities of daily living, but they also required more RN care than did clients who received only RN care. These data hold implications for nurses in addressing agency staffing, focusing home health aide training, and advocating for resources to address service needs of this segment of their care population.

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00219.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractUnderstanding older adults' experience of health promotion is essential in effectively preserving health and functional ability and thereby reducing health care costs among members of this rapidly expanding group. During 5 months of participant observation of 80 older adults (ages of 62‐88), data from 31 semistructured interviews, as well as the Health Self‐Determinism Index (HSDI) designed to measure intrinsic motivation for health (Cox, Miller,&Mull, 1987), were analyzed using methods common to grounded theory (Glaser&Strauss, 1967). Patterns central to maintaining health that provide essential theoretical grounding for health promotion practice with older adults were discove

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1996.tb00220.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY