Medicine and Health Sciences Commons^™

Innovativeness In Nursing: A Phenomenological And Constructivist Study, Maria Joseph

Maria (Lindell) Joseph

Hospital administration and the medical field have maintained the status quo of nursing practice, in which nurses have adopted bureaucratic structures where conformity and regimentation are maintained to ensure large-scale efficiency. The lack of control to act on nursing knowledge and expert judgment is linked to work conditions of oppression, lack of autonomy, dissatisfaction, concomitant patient mortality, and morbidity. A climate of innovativeness is one strategy to reverse the negative impact caused by hospital administration and the medical field. The purpose of this phenomenological study was to explore the behavioral characteristics of lived experiences and knowledge of innovativeness among nurses …

An Examination Of The Sustainable Adoption Of Whole-Person Care (Wpc), Maria Joseph, D. Laughon, Richard Bogue

Maria (Lindell) Joseph

AIM: This study illustrates how King's theory of goal attainment was used to focus an examination of whole-person care (WPC) and to extend the range of knowledge needed for WPC and nursing practice. BACKGROUND: Leadership implemented a faith-based innovation using continuing education for patient care that incorporates body-mind-spirit and eight principles called CREATION. Three questions arose: (1) Is there an evidence-based framework to determine whether the philosophy supports the discipline of nursing? (2) How extensive is the adoption and application of WPC? (3) Does the model make a difference in the context of nurse-patient interactions and outcomes in support of …

Work Environment Characteristics Of High-Quality Home Health Agencies, S. Tullai-Mcguinness, J. Riggs, Amany Farag

Amany A. Farag

This concurrent mixed-method study examines the nurse work environment of high-quality Medicare-certified home health agencies. High-quality (n=6) and low-quality (n=6) home health agencies were recruited using agency-level publicly reported patient outcomes. Direct care registered nurses (RNs) from each agency participated in a focus group and completed the Practice Environment Scale of the Nurse Work Index (PES-NWI). No significant differences were found in the PES-NWI results between nurses working in high- and low-quality agencies, though nurses in high-quality agencies scored higher on all subscales. Nurses working in all the high-quality agencies identified themes of adequate staffing, supportive managers, and team work. …

Expanded Adult Day Program As A Transition Option From Hospital To Home, K. Jones, S. Tullai-Mcguinness, M. Dolansky, Amany Farag, M. Krivanek, L. Matthews

Amany A. Farag

This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants …

Ndec Guidelines For Development And Evaluation Of Diagnoses, Martha Craft-Rosenberg, Connie Delaney, J. Denehy

Martha J. Craft-Rosenberg

No abstract provided.

Contexts For The Study Of The Economic Influence Of Nursing Diagnoses On Patient Outcomes, M. Lavin, K. Avant, Martha Craft-Rosenberg, T. Herdman, K. Gebbie

Martha J. Craft-Rosenberg

PURPOSE: To examine the historical, legal/ organizational, informatics, clinical, economic, and policy contexts underlying economic consequences of nursing diagnoses on patient outcomes. DATA SOURCES: Published literature, online material. DATA SYNTHESIS: Nursing diagnoses influence diagnostic-specific patient outcomes and other outcome variables such as length of hospital stay, morbidity, and mortality. CONCLUSIONS: Examination of the economic ramifications of nursing diagnosis on patient outcomes can be facilitated using standardized language and databases containing nursing-sensitive measures.

Health Care Quality And Outcome Guidelines For Nursing Of Children And Families: Implications For Pediatric Nurse Practitioner Practice, Research, And Policy, C. Betz, J. Cowell, Martha Craft-Rosenberg, M. Krajicek, M. Lobo

Martha J. Craft-Rosenberg

No abstract provided.

The Disclosure Decisions Of Parents Who Conceive Children Using Donor Eggs, S. Hahn, Martha Craft-Rosenberg

Martha J. Craft-Rosenberg

STUDY OBJECTIVE: To identify variables that influence the disclosure decisions of parents who conceive children using donor eggs and to compare such variables among disclosing, nondisclosing, and undecided families. DESIGN: Exploratory, comparative, descriptive. SETTING: A university hospital-assisted reproductive technology program in the Midwest. PARTICIPANTS: Thirty-one couples with children conceived with anonymously donated eggs. METHODS: Audiotaped telephone interviews, measures of social support and family environment, and a demographic survey. MAIN OUTCOME MEASURES: Content analysis of interview transcripts and comparison of recurring themes among groups. RESULTS: The majority of parents intended disclosure. Dominant themes among disclosing parents included the belief that a …

Report Of The American Academy Of Nursing Child-Family Expert Panel: Identification Of Quality And Outcome Indicators For Maternal Child Nursing, Martha Craft-Rosenberg, M. Krajicek, D. Shin

Martha J. Craft-Rosenberg

Core values and assumptions regarding child health care are identified. Concepts that are generalized across settings are defined. The dimensions of care involve the child, the family, the system, and the community. The Child-Family Expert Panel will continue to work within specialties on standards, processes, and outcomes.

Academic Freedom: Protecting "Liberal Science" In Nursing In The 21st Century, S. Kneipp, M. Canales, N. Fahrenwald, Janette Taylor

Janette Y. Taylor

Generating new knowledge through science is one of the most valued contributions of American universities, and is wholly dependent on the tenets of academic freedom. This article provides an overview of academic freedom in the United States, lack of attentiveness to academic freedom in the discipline of nursing, and its relevance for advancing nursing science. Three issues are critically evaluated as they relate to "the free search for truth" that is imperative for scientific progress to occur, including (a) its importance in a liberal science system, (b) recent trends to politically manipulate science, and (c) movements to restrict speech on …

Colonizing Images And Diagnostic Labels: Oppressive Mechanisms For African American Women's Health, Janette Taylor

Janette Y. Taylor

The purpose of this article is to present colonizing images of African American women and describe how colonizing images and diagnostic labels function together to serve as oppressive mechanisms for African American women's health. The mammy, the matriarch, the welfare mother, the Jezebel, and the Black lady overachiever are representational images of African American women that contribute to how they are viewed and treated within the health care arena.

Academic Freedom And Academic Duty To Teach Social Justice: A Perspective And Pedagogy For Public Health Nursing Faculty, N. Fahrenwald, Janette Taylor, S. Kneipp, M. Canales

Janette Y. Taylor

Public health nursing practice is rooted in the core value of social justice. Nursing faculty whose expertise is in public health are often the content experts responsible for teaching this essential, yet potentially controversial, value. Contemporary threats to academic freedom remind us that the disciplinary autonomy and academic duty to teach social justice may be construed as politically ideological. These threats are of particular concern when faculty members guide students through a scientific exploration of sociopolitical factors that lead to health-related social injustices and encourage students to improve and transform injustices in their professional careers. This article (a) reviews recent …

Assessing Intimate Partner Violence In Incarcerated Women, M. Eliason, Janette Taylor, S. Arndt

Janette Y. Taylor

The purpose of this study to assess the psychometric qualities of a screening instrument for intimate partner violence, the Index of Spouse Abuse (ISA), for use with incarcerated women. Principal components factor analysis was conducted on data collected from 149 incarcerated women. The ISA demonstrated excellent internal consistency with this population and appears to be a psychometrically sound instrument that can be given in a short period of time.

Engaging Racial Autoethnography As A Teaching Tool For Womanist Inquiry, Janette Taylor, Melissa Lehan Mackin, A. Oldenburg

Janette Y. Taylor

Racial autobiography, self-narratives on how one learned about the idea of race, has been underutilized as a tool to familiarize and orient students in the process of critical inquiry for nursing research. The aims of this article are to explore how racial autoethnography: (1) repositions students to effect an epistemological change, (2) challenges dominant ideology, and (3) functions as a link between the student and critical theories for use in nursing research. Students engage in and share reflective narrative about a variety of instructional materials used in the course. Reflective narratives are presented in a framework that addresses white racial …

Race And Ethnicity As Variables In Nursing Research, 1952-2000, D. Drevdahl, Janette Taylor, D. Phillips

Janette Y. Taylor

BACKGROUND: Although the use of race and ethnicity as variables in research has increased over the past five decades, there is confusion regarding the meaning of the terms, as well as how the words are defined and determined in scientific inquiry. OBJECTIVE: To review the use of race and ethnicity as variables in nursing research literature. METHODS: Original research articles published in Nursing Research in the years, 1952, 1955, and every 5 years thereafter through 2000 were reviewed. Those articles describing human characteristics (N = 337) were analyzed for content concerning: (a) frequency of racial and ethnic terms, (b) words …

Womanism: A Methodologic Framework For African American Women, Janette Taylor

Janette Y. Taylor

Although nurse scholars have become increasingly engaged in feminist research and theory development, only a few have included important feminist thoughts expressed by African American womanist theorists. This article presents an abbreviated review and synthesis of Afrocentric ways of knowing, which includes Black feminist, womanist, and Afrocentric perspectives. A developing methodology for use with African American women is also described.

Nursing Work: Understanding A Scarce Resource, Patricia Groves

Patricia S. Groves

No abstract provided.

The 2010 Doris Schwartz Gerontological Nursing Research Award: Kathleen Coen Buckwalter, Phd, Rn, Faan, L. Skemp, Howard Butcher

Howard K. Butcher

No abstract provided.

Interventions Related To Patient Teaching, Barbara Rakel

Barbara A. Rakel

This study validated 13 nursing interventions related to patient teaching. Four of the labels address the process of patient teaching, whereas the other nine concern content specific to teaching efforts. With the help of 46 master's-prepared nurses from across the country, critical (major) and supporting (minor) activities for each label were identified. This study is one of many steps toward the construction of a taxonomy of nursing interventions focused on direct care treatments that nurses perform on behalf of patients. The ultimate goal is to provide nurses with a standardized language that can be used to document their unique role …

Implementation Of The Agency For Health Care Policy And Research Pain Guidelines, K. Schmidt, M. Alpen, Barbara Rakel

Barbara A. Rakel

Implementation of clinical practice guidelines in a large setting is a complex process. This article describes the many issues encountered in trying to implement Agency for Health Care Policy and Research acute pain and cancer pain guidelines in an academic medical center. Issues addressed include the membership of the task forces involved, incorporation of the guidelines into the institution-specific standards of care, selection and implementation of self-reporting tools for assessment of pain throughout the institution, issues involved in standardizing documentation of pain throughout the institution, measurement of the current status of pain control and integration into the existing quality assessment …

Why Not Support(Ed) Parenting, Joanne Nicholson, William Deveney

Joanne Nicholson

No abstract provided.

A Survey Of Programs For Parents With Mental Illness And Their Families: Identifying Common Elements To Build The Evidence Base, Beth Hinden, Kathleen Biebel, Joanne Nicholson, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

Little is known about the effectiveness of interventions for families living with parental mental illness. Existing interventions offer information about successfully implemented treatments, which may demonstrate effectiveness in research. In the current study, directors of programs for parents with mental illness and their families were interviewed. Qualitative analyses revealed noteworthy similarities with respect to target population; funding; community context; agency context; mission, theoretical orientation, and assumptions; locus of care and essential services; desired outcomes; and moderators. Program similarities were identified to provide parameters for research, and to contribute to the development of testable hypotheses. Family-centered, strengths-based approaches were identified across …

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman

Joanne Nicholson

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of …

A Qualitative Study Of Programs For Parents With Serious Mental Illness And Their Children: Building Practice-Based Evidence, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. …

Achieving The Goal Of Evidence-Based Psychiatric Rehabilitation Practices For Mothers With Mental Illnesses, Joanne Nicholson, Alexis Henry

Joanne Nicholson

There is a growing commitment to evidence-based practices in mental health. There is no well-articulated evidence base for interventions for mothers with mental illnesses. Parenthood is common among women with mental illnesses. Women themselves report motherhood is an important role. The risks of parental mental illness to children have been demonstrated; the challenges that motherhood brings to people with mental illnesses have been described. Because outcomes for both children and adults are multiply determined, there are many intervention opportunities. Recommendations for intervention are drawn from a focus group study and from the existing literature on parent training and support, exemplary …

The Internet, Health Promotion, And Community Participation, Joanne Nicholson, Armando Rotondi

Joanne Nicholson

No abstract provided.

A Comparison Of The Health And Mental Health Status Of Homeless Mothers In Worcester, Mass: 1993 And 2003, Linda Weinreb, John Buckner, Valerie Williams, Joanne Nicholson

Joanne Nicholson

OBJECTIVES: We assessed background characteristics, health status, and prevalence rates of mental health disorders in 2 studies of homeless mothers conducted in Worcester, Mass, one in 1993 and the other in 2003.

METHODS: We compared the women taking part in the 2 studies, which involved similar methodologies, on the key variables of interest over time.

RESULTS: Homeless families taking part in the 2003 study were poorer than those taking part in the 1993 study, and female heads of household in that study reported more physical health limitations, major depressive illness, and posttraumatic stress disorder.

CONCLUSION: Data from 2003 suggest that …

The Responsiveness Of State Mental Health Authorities To Parents With Mental Illness, Kathleen Biebel, Joanne Nicholson, Valerie Williams, Beth Hinden

Joanne Nicholson

The majority of adults with serious mental illness living in the community are parents, many of whom may be receiving services from State Mental Health Authorities (SMHA). Innovative intervention approaches are available to improve outcomes for these parents and their children. Analyses of SMHA and state-level data, as well as qualitative interviews of administrators, service providers, and consumers, underscore the importance of organizational structure and philosophy, an advocacy presence, and available funding to SMHA efforts on behalf of parents and their families.

State Policies And Programs That Address The Needs Of Mentally Ill Mothers In The Public Sector, Joanne Nicholson, Jeffrey Geller, William Fisher, George Dion

Joanne Nicholson

OBJECTIVE: The authors sought to determine whether state departments of mental health have specific policies and programs addressing the needs of mentally ill women served in the public sector who have preschool-age children. METHODS: A questionnaire was sent to the commissioner of mental health for each state and the District of Columbia. Questions addressed whether information was routinely collected on the parenting status of women who receive public-sector psychiatric services, whether services targeting mentally ill women with young children were available, and whether the state had policies concerning hospitalized women who are pregnant or who have young children. RESULTS: Sixteen …

A Comparison Of Mothers With Co-Occurring Disorders And Histories Of Violence Living With Or Separated From Minor Children, Joanne Nicholson, Norma Finkelstein, Valerie Williams, Jennifer Thom, Chanson Noether, Megan Devilbiss

Joanne Nicholson

Data from the Women with Co-occurring Disorders and Histories of Violence Study are used to examine characteristics distinguishing mothers currently providing care for all their minor children (n = 558) from mothers separated from one or more minor children (n = 1396). Mothers are described and compared on background characteristics and experiences, well-being and current functioning, situational context, and services used. Analyses control for number of children, race, and years of education. Mothers separated from children have more children, less education, have more often been homeless, in juvenile detention or jail, and have lower incomes than mothers living with all …