Medicine and Health Sciences Commons^™

The Journey Through Nursing Doctoral Education: An Inside Story, Nila Reimer

Nila Reimer

Students who gain new knowledge by integrating scholarliness and stewardship for the nursing profession possess key ambitions for succeeding in nursing doctoral education. In this narrative inquiry, a student reflects on themes of scholarly integration, intellectual community, and stewardship that are embedded in the values and attitudes evidenced in the culture of a Doctor of Philosophy in nursing program. The doctoral student’s personal reflection demonstrates professional growth during the experience of nursing doctoral education. This inquiry provides guidance for other students as they embark on their journey toward scholarly development and stewardship during their doctoral education experience.

Can Hopelessness And Adolescents' Beliefs And Attitudes About Seeking Help Account For Help Negation?, Coralie Wilson, Joseph Ciarrochi, Frank Deane

joseph Ciarrochi

This article reports the first time the help-negation relationship for suicidal thoughts (i.e., the inverse relationship between help-seeking intentions for suicidal thinking and levels of suicidal ideation) has been specifically examined, and established, in a non-clinical adolescent sample. The study raises major implications for national and international suicide prevention policy development, clinical practice and strategies for ongoing prevention and early intervention

Perioperative Nurses’ Attitudes Toward The Electronic Health Record, Laura Yontz, Jennifer Zinn, Edward Schumacher

Edward J Schumacher

Background: The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. There are limited data; however, regarding the attitudes of perioperative nurses toward the use of the EHR. Purpose: The purpose of this project was to identify perioperative nurses’ attitudes toward the use of the EHR. Design: Quantitative descriptive survey was used to determine attitudes toward the electronic health record. Methods: Perioperative nurses in a southeastern health system completed an online survey to determine their attitudes toward the EHR in providing patient …

Barriers And Facilitators For Colorectal Cancer Screening Practices In The Latino Community: Perspectives From Community Leaders, Ana Natale-Pereira, Jonnie Marks, Marielos Vega, Dawne Mouzon, Shawna Hudson, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

BACKGROUND: Colorectal cancer (CRC) is the second-leading cause of cancer-related death in the United States and the third most commonly diagnosed cancer among Latinos. While Latinos represent one of the fastest-growing ethnic groups in the United States, their participation in cancer prevention and treatment trials is low. METHODS: Thirty-six Latino community leaders participated in five focus groups that examined factors affecting CRC screening practices among Latinos. RESULTS: The top four barriers identified were low knowledge and awareness of CRC, language barriers, lack of insurance, and undocumented legal status. Additional barriers included seeking health care only when sick, fatalism, fear, denial …

Perspectives On Cancer Screening Among Latino Community Members And Internal Medicine Residents, Debbie Salas-Lopez, Dawne Mouzon, Jonnie Marks, Neil Kothari, Ana Natale-Pereira

Debbie Salas-Lopez MD, MPH

BACKGROUND: Latinos have lower rates of cancer screening, partially because of cultural beliefs that conflict with those of health care professionals. Moreover, established programs for training physicians in cultural competency often fail to incorporate input from the community.

METHODS: To explore beliefs about cancer and cancer screening among Latino community members and internal medicine residents. Three focus groups of Latino community members (n = 31) and one focus group of internal medicine residents (n = 9) were conducted to compare ideas regarding cancer and cancer screening.

RESULTS: We identified clear disconnects between residents and Latino community members regarding their understandings …

Mental Health Clinicians' Beliefs About Medicines, Attitudes, And Expectations Of Improved Medication Adherence In Patients, Mitchell Byrne, Peter Caputi, Frank Deane

Mitchell K Byrne

Nonadherence to antipsychotic medications remains a major factor in poor clinical outcomes. This study sought to identify clinician beliefs about patients who do not adhere to treatment, the clinicians' own beliefs about medicines, and the impact of beliefs on efforts to enhance patient adherence. In total, 292 clinicians responded to an anonymous questionnaire that included questions about their beliefs and their efforts to enhance adherence. Results indicated that clinicians' beliefs about their own adequacy to enhance adherence significantly predicted actual efforts to enhance adherence. Both pessimism about outcomes and empathy for the patient predicted outcome expectancy. It was concluded that …

Case Managers' Attitudes Toward The Use Of Homework For People Diagnosed With A Severe Psychiatric Disability, Peter Kelly, Frank Deane, Nikolaos Kazantzis, Trevor Crowe

Peter Kelly

The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework administration practices. A survey examining attitudes toward the use of homework was completed by 122 Australian mental health case managers. Case managers who held more positive attitudes reported better client responses to homework. Systematic homework administration was predicted by the degree to which case managers felt that homework enhanced client outcomes and the importance that case managers placed on the use of homework for severe psychiatric disabilities. The use of training and supervision programs to promote systematic …

Patients' Attitudes To General Practice Registrars: A Review Of The Literature, Andrew Bonney, Lyn Phillipson, Samantha Reis, Sandra Jones, Donald Iverson

Don C. Iverson

Introduction With the population ageing, it is imperative for training practices to provide GP registrars with sound experience in managing the health problems of older persons, especially chronic conditions. However, it is reported that a significant proportion of these patients will be resistant to consulting registrars, with concerns regarding disruption of continuity of care being a significant factor. The challenge for training practices is to identify approaches to engage registrars in the management of older patients whilst maintaining patient satisfaction. This paper presents a review of the literature on patient attitudes to general practice registrars to better understand the nature …

Older Patients' Attitudes To General Practice Registrars: A Qualitative Study, Andrew Bonney, Lyn Phillipson, Sandra Jones, Donald Iverson

Don C. Iverson

Background Research suggests that older patients may be reluctant to engage general practice registrars (GPRs) in their care. The authors undertook a qualitative study of the attitudes of older patients to GPRs to investigate this issue. Method Thirty-eight patients aged 60 years and over from three training practices participated in semistructured telephone interviews, which explored patients responses to GPRs. The interviews were recorded, transcribed and analysed using a template analysis approach. Results Analysis of the interviews produced five major themes concerning patient attitudes to GPRs: desire for continuity, desire for access, openness, trust and a desire for meaningful communication. Discussion …

Pulling Together And Pushing Apart: Tides Of Tension In The Icu Team, Laura Hawryluck, Sherry Espin, Kim Garwood, Cathy Evans, Lorelei Lingard

Lorelei Lingard

No abstract provided.

The Anatomy Of The Professional Lapse: Bridging The Gap Between Traditional Frameworks And Students' Perceptions, Shiphra Ginsburg, Glenn Regehr, David Stern, Lorelei Lingard

Lorelei Lingard

PURPOSE: To support students' developing professionalism, it is necessary to understand the professional challenges and dilemmas they perceive in the clinical setting. This study systematically documented and catalogued students' reports of professional lapses. METHOD: Six focus groups were conducted with senior medical students (n = 29) at three universities. Using a grounded-theory approach, three researchers analyzed the students' reports of specific lapses in professionalism for recurrent themes. The resulting coding structure was applied using NVivo qualitative data analysis software. RESULTS: A total of 120 pages of text yielded 48 specific incidents of professional lapses, which were analyzed by three researchers …

Exploring The Gap Between Knowledge And Behavior: A Qualitative Study Of Clinician Action Following An Educational Intervention, Tara Kennedy, Glenn Regehr, Jay Rosenfield, S. Roberts, Lorelei Lingard

Lorelei Lingard

PURPOSE: Many medical education interventions improve clinicians' knowledge but fail to change behavior. The authors exposed this knowledge-behavior gap through standardized clinical interactions, thus allowing in-depth exploration of the contributing factors. METHOD: A typical evidence-based educational intervention in one clinical domain (early signs of autism) was administered to family medicine residents at the University of Toronto in 2001-02, and change in knowledge was assessed through a multiple-choice test. Six to eight weeks later, participants' relevant knowledge was documented, and their clinical behavior was observed during four interactions with standardized patients. Factors producing a knowledge-behavior discrepancy were then explored using semistructured …

Childhood Immunization. How Knowledgeable Are We?, Helen Heurter, Karen Breen-Reid, Leya Aronson, Lorelei Lingard, David Manning, E. Ford-Jones

Lorelei Lingard

No abstract provided.