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Descriptors:
Caregivers; Nursing; Older Adults; Problems; Well Being; Health Services

Abstract:
Purpose of the study: To examine (a) whether the content of caregiving tasks (i.e., nursing vs. personal care) contributes to variation in caregivers' strain and (b) whether the level of complexity of nursing tasks contributes to variation in strain among caregivers providing help with such tasks. Design and methods: The data came from the Cash and Counseling Demonstration and Evaluation study conducted in Arkansas, Florida, and New Jersey. The paper analyzes the physical and emotional strain of 1,926 paid American caregivers who helped adult Medicaid recipients with personal and nursing care in the home. Results: Over 80% of home caregivers were providing assistance with nursing care, and over 50% of those were providing help with moderate or high complexity tasks. Caregivers who were providing any type of nursing care reported significantly more strain than caregivers who were providing only personal care. Those providing highly or moderately complex nursing care exhibited more caregiver strain than did those providing low-complexity nursing care. Implications: Medical complexity is an important contributor to caregiver strain. Policymakers should consider medical complexity in the development of practices to assist the caregivers of Medicaid long-term care recipients, especially through consumer-directed supportive service programs. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Health Promotion; Health Services; Foreign Countries; Nursing; Clinics; School Nurses; Sexuality; Parent Attitudes; Marketing; School Health Services; Barriers

Abstract:
School-based sexual health clinics are emerging as one of the key ways to promote sexual health among young people, and school nurses play an important role in developing and delivering these services. This study used a qualitative design to explore the experiences of health professionals and policy makers involved in setting up such services in U.K. schools. It presents the internationally transferable messages from this study for school nurses. Particularly, the ways in involving young people in developing and evaluating services, dealing with social and parental objections, and building alliances with school staff are important aspects of working in this important but socially sensitive area of school health. It also explores how sexual health services can be branded and marketed and highlights some of the barriers and facilitators for developing successful school-based or school-linked sexual health clinics. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Learning Disabilities; Evidence; Nurses; Accessibility (for Disabled); Health Services; Access to Health Care; Nursing; Nursing Education; Health Needs; Attitudes toward Disabilities; Change Strategies

Abstract:
It is being increasingly recognised that the achievement of improved health outcomes for people with learning disabilities is central to the role of learning disability nurses. This is in recognition of the fact that an increasing body of evidence has demonstrated that these people often have poorer health outcomes than those in the mainstream population. Whilst accepting the role of the nurse in this regard, this paper argues that the continued enactment of that role solely within the margin, whether metaphorical or literal, will fail to achieve improved outcomes and will prolong the marginalisation of people with learning disabilities. In identifying the basis of such outcomes to be social inequity, it proposes that nursing must act in two orientations: health-oriented service provision and social activism. It is argued that only when such an approach is adopted will there be a real opportunity for people with learning disabilities to achieve optimal health outcomes. (Contains 3 figures and 1 footnote.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Obstetrics; Nursing; Masters Programs; Nurses; Higher Education; Females; Prenatal Care; Patients; Health Services; Health Education; Pregnancy

Abstract:
With Boston serving as a hub of both educational and medical excellence, it's no wonder that New England has a high reputation to uphold in both of these areas. However, Boston and the rest of the region lack a specific degree program that is putting New England below the radars of potential midwives. Certified nurse-midwifery is a popular field with registered nurses seeking higher education who wish to have a larger role in managing prenatal patient care than they would as labor and delivery nurses. Expectant mothers are also showing interest in using the midwife model for a more holistic method of perinatal care than they might get with the traditional obstetric approach. But New England, home to more than 250 colleges and universities, offers this degree in only two places: (1) a satellite program at Baystate Medical Center in Springfield, Massachusetts (in which the degree-granting institution is Philadelphia University); and (2) Yale University. With the nation focused intensely on the cost of healthcare, it would be beneficial for New England to train and employ nurse-midwives, who have proven to provide clinically competent perinatal care to women at a lower price. So why don't New England's colleges and universities see the potential in educating certified nurse-midwives? If there's interest and support from the midwifery community, it seems like the decision would be an easy one. Unfortunately, programs in the region have found that it's not that simple. Despite the fact that a school gets inquiries from interested students, a master's program in nurse-midwifery is an expensive program to run and without the proper funding it just isn't feasible. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Nursing; Health Needs; Program Effectiveness; Stakeholders; Foreign Countries; Mental Retardation; Patients; Hospitals; Focus Groups; Role Models; Access to Health Care; Interviews; Allied Health Personnel; Caregivers; Nurses; Diseases; Patient Education; Adjustment (to Environment); Health Services; Adults

Abstract:
Background: There have been significant concerns about the care and treatment of people with intellectual disabilities (ID) when attending general hospitals, which have led to inquiries that highlight service and systems failures. One response has been the development of Learning Disability Liaison Nursing (LDLN) Services across the UK that aim to ensure that additional, specialist support is available for patients, their carers and general healthcare professionals. Methods: A mixed-methods study to investigate the impact of LDLN Services across four Scottish NHS boards was undertaken. In total, 323 referrals made over 18 months were analysed along with qualitative data drawn from interviews and focus groups with a sample of 85 participants including patients with ID (n = 5), carers (n = 16), primary care healthcare professionals (n = 39) and general hospital professionals (n = 19) and learning disability liaison nurses (n = 6). Results: The referral patterns to the four liaison nursing services closely matched the known health needs of adults with ID, with common admissions being due to neurological, respiratory and gastrointestinal issues. The LDLN role was seen to be complex and impacted on three key areas: (i) clinical patient care; (ii) education and practice development; and (iii) strategic organisational developments. Specific patient outcomes were linked to issues relating to capacity and consent to treatment, fostering person-centred adjustments to care, augmenting communication and the liaison nurses acting as positive role models and ambassadors for people with ID. Conclusions: The LDLN Services were valued by stakeholders by achieving person-centred outcomes. With their expert knowledge and skills, the liaison nurses had an important role in developing effective systems and processes within general hospital settings. The outcomes highlight the importance of supporting and promoting LDLN Services and the challenges in delivering the multifaceted elements of the role. There is a need to take account of the complex and multidimensional nature of the LDLN role and the possible tensions between achieving clinical outcomes, education and practice developments and organisational strategic initiatives. (Contains 1 figure and 5 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Higher Education; Student Projects; Nursing; Masters Degrees; Foreign Countries; Action Research; Comparative Analysis; Models; Universities; Partnerships in Education

Abstract:
In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master's level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students' postgraduate degree projects within the second cycle of higher education (master's level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Health Promotion; Health Personnel; Supervision; Diabetes; Public Health; Program Implementation; Social Work; Child Health; Program Descriptions; Self Management; Outcomes of Education; Community Centers; Health Services; Qualitative Research; Case Method (Teaching Technique); Supervisors; Training; Nursing; Dietetics; Exercise; Diagnostic Tests; Biochemistry; Program Effectiveness

Abstract:
We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included pre/post-knowledge outcomes and encounter data from the field. CHWs and their supervisors were interviewed providing qualitative outcome data of the training process and program implementation. There were statistically significant increases in the scores of CHWs' self-reported knowledge in 8 of 15 curricular domains. Qualitative analysis revealed that CHWs preferred skill-based and case-based teaching, shorter training days but more contact hours. CHWs reported that pre-deployment training alone is insufficient for successful integration into care teams. CHW supervisors reported that CHC's readiness to accept CHWs as members of the care team was as important to successful deployment as training. With respect to implementation, supervision by social workers was deemed more successful than nursing supervision. Field data showed that patient encounters lasted less than 30 min and self-management goals focused on appointment keeping, diet, exercise and glucose testing. Integration and analysis of qualitative and descriptive field data provide an opportunity to continuously evaluate the effectiveness of implementation. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; College Freshmen; Majors (Students); Nursing; English Language Learners; English (Second Language); Reading Attitudes; Reader Text Relationship; Childrens Literature; Fantasy; Novels; Films; Video Technology; Reading Comprehension; Control Groups; Experimental Groups; Textbooks; Pretests Posttests; Learner Engagement

Abstract:
The purpose of the study was to investigate the effects of the use of children's literature and DVD films on EFL adult language learning. A total of 89 non-English majors enrolled in two Freshman English classes participated in the study. The study employed a quasi-experimental, pretest/posttest comparison group design. The participants in the experimental group were exposed to the children's literature and DVD films. In the control group, the participants were exposed to the English Language Teaching (ELT) textbook. The experiment was conducted for two hours per week over two months. Then the reading comprehension sections of the Elementary GEPT posttests were administered and their outcomes were compared with those of the pretests. At the end of the course, the questionnaires were administered to the participants in the experimental group to elicit their perceptions about the various aspects of the use the children's literature and DVD films. The findings of the study revealed that alternately, reading, viewing the film, and discussing a children's fantasy novel significantly increased the scores on the reading comprehension subtests over the control group with exposure to the ELT textbook. (Contains 2 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Higher Education; Learning Strategies; Foreign Countries; Student Experience; Independent Study; Lifelong Learning; Nurses; Nursing; Nursing Education; Research Projects

Abstract:
The concept of the independent learner has become increasingly important within the higher education sector. However, there appears to be no consensus and rarely any clarification of what is meant by the term. As a result, students may fail to understand what is expected of them as independent learners, with implications for retention, progression and the student experience. This paper describes a research project that aimed to clarify what students and staff understood by the phrase. The results suggest that while most staff and students were familiar and comfortable with the concept, there remains potential for misunderstanding and confusion. (Contains 4 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Older Adults; Nursing; Nurses; Adjustment (to Environment); Nursing Homes; Interviews; Family Relationship; Grounded Theory; Intervention; Foreign Countries

Abstract:
This grounded study examined the process of acclimatization or the process of changing perspectives of a person so as to get used to or feel "at home" among a select group of Filipino elderly in a nursing care facility. As institutionalization of the elderly is not typical in the Philippine context, varied responses were analyzed to understand the factors and the course that an elderly person undergoes over a set period of time to achieve acclimatization. Twenty elderly (n = 20) residents were purposively recruited and subjected to an in-depth interview that chronicled their experiences on their previous and present lives and on the process by which they were able to adjust to a relatively new setting. Preliminarily, a "robotfoto" was devised to obtain demographic data including visitation frequencies and familial relationships, and this was followed by an in-depth interview. Through the constant comparison method, an interesting model called the Hourglass of Acclimatization emerged. This model yielded two distinct phases contributing to successful acclimatization. One is the Conversion phase, or imbibing the main notion of transforming one's perspectives of him or herself and his or her environment; there is also the Immersion phase, which describes how an elderly involves him or herself completely into the life he or she is supposed to live. This emerged model can contribute to the development of nursing interventions focusing on elderly experiences in the entire course of relocation to a new environment other than what they call "home." (Contains 1 table and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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