bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Disabled Adults' Perceived Quality of Life in Nursing Facility and Home Settings
Authors: Hulsman Barbara , Chubon Sandra J.
Published: May 2007

Abstract: In an attempt to prevent premature institutionalization of disabled adults, some states have developed services funded under a Medicaid waiver to maintain these clients in their homes. Evaluation reports of these programs have emphasized cost analysis and have described various approaches to case management. No studies have reported on the quality of life of the clients receiving the services. In this exploratory study, the quality of life of 20 clients in a community long‐term care program was compared with that of 20 persons requiring comparable levels of care but residing in a nursing home. Mean scores on the quality of life measure were virtually equal for the two groups, but the distribution of scores by group was very different. Demographically the groups differed. Community residents were younger than nursing home residents and included a larger percentage of blacks. Part of one's judgment of quality of life may stem from a comparison of oneself with one's peers. Verbal, oriented nursing home residents may rate themselves more favorably in comparison to peers with dementia, while community residents compare themselves with healthy adults and rate their quality of life as lower.
An Epidemiological Approach to Community Assessment
Authors: Finnegan Lorna , Ervin Naomi E.
Published: May 2007

An epidemiological approach to community assessment is useful for students and practicing nurses. Shamansky and Pesznecker's definition of community is applied to the community assessment process in order to provide an organized framework for data collection, data analysis, and community diagnosis. We applied the framework to an actual community in a case study format.
Public Health Nursing and The Future of Public Health
Authors: Ward Debbie
Published: May 2007

The recent Institute of Medicine report. The Future of Public Health, reviews the history, current status, and potential of the public health system in the United States, and makes detailed recommendations for its revitalization. Although public reports such as this risk speedy obscurity, many are used by planners and legislators and a few exert significant influence. Public health nursing is inadequately represented in this potentially influential document, and this has unfortunate implications for public health nursing.
The Life Span Perspective: A Developmental Approach to Community Health Nursing
Authors: McCool William F. , Susman Elizabeth J.
Published: May 2007

Following the nursing theorists' tradition of using an interdisciplinary approach to community health model building, the concepts of the life span perspective on human development were applied to the practice of community health nursing. As with the perception of individual development from this perspective, communities are viewed as evolving over time, with changes occurring across levels of influence‐ human, societal, historical, and cultural. These levels are interdependent, and factors from any one or more can affect the growth and functioning of the community. Implied in this interdependence is the ability not only to intervene in a community's development, but to go beyond this and recognize that a community has a degree of control over its own development. To be accurate and thorough in working with communities, the community health nurse who takes a life span perspective must be cognizant of the fact that communities do exist in a continual, multilevel, interactive manner that develops through time. Demonstrating the practical use of this perspective, a model for the assessment phase of the nursing process as applied to community study was developed. A pilot study was performed using this model, and initial results suggest that taking a life span perspective toward community health is both valid and practical, and warrants further scholarly investigation.
Holistic Concepts and the Professionalization of Public Health Nursing
Authors: Allen Carol Easley
Published: May 2007

The sociology of knowledge provided the conceptual and methodologic basis for this study of the relationship between the philosophic concept of holism and the professionalization of public health nursing. Set in the context of the history of ideas, the discussion examines the various meanings of holism and the circumstances surrounding their adoption, modification, and use in public health nursing. The nursing literature from the late 1800s to the 1980s was analyzed to explicate the pragmatic consequences of holism for public health nursing, and to examine holism's moral value and its part in establishing and extending public health nursing's professional domain.
Specialty Roles in Community Health Nursing: A National Survey of Educational Needs
Authors: Riportella‐Muller Roberta , Selby Maija L. , Salmon Maria E. , Quade Dana , Legault Claudine
Published: May 2007

This study identified population groups, health conditions, and employment settings considered appropriate for graduate‐level community health nursing (CHN) practice and employment, and described the relative importance of each of these areas as assessed by CHN leaders. According to 588 leaders in CHN service and education, (1) the population groups most in need of graduate‐prepared CHNs are the elderly, persons of low socioeconomic status, the homeless, adolescents, and the unemployed; and (2) the health conditions most in need of CHN services are AIDS, pregnancy and prenatal problems, low birth weight and infant mortality, stress‐related illness, and Alzheimer's and other chronic diseases of the elderly. Among the many employment settings rated as having a great need for CHNs are state and local health departments and home health agencies. The findings provide the direction and justification for developing specialty options within CHN that correspond to these identified and changing needs. This article provides suggestions and possible alternatives for initiating educational change to prepare graduate‐level CHNs for these various specialties and for the settings in which the specialties will be applied.
Assessing for Abuse: Self‐Report Versus Nurse Interview
Authors: McFarlane Judith , Christoffel Karen , Bateman Louise , Miller Virginia , Bullock Linda
Published: May 2007

Estimates are that 1.8 million women are physically abused each year by their husbands. To prevent abuse and promote physical safety, routine assessment is essential. Planned Parenthood of Houston and Southeast Texas added four self‐reported abuse assessment questions to their standard intake form completed by all initial and annual‐visit clients. After one month of self‐report by 477 women, the prevalence of physical abuse was 7.3%. To compare self‐report to nurse interview assessment, the same four questions were asked of 300 women coming to the same clinic for initial or annual visits. The reported prevalence of abuse after a nurse interview was 29.3%.
A Framework for Community Assessment: Designing and Conducting a Survey in a Hispanic Immigrant and Refugee Community
Authors: Urrutia‐Rojas Ximena , Aday Lu Ann
Published: May 2007

Abstract This article introduces a framework for the study of access to medical care that has been used extensively in national and local surveys, and demonstrates its application to an assessment of health and health care needs in a Hispanic immigrant and refugee community. The presentation of the framework, study design, findings, and implications for research and planning points out the utility of this framework for organizing systematic community assessment data‐gathering activities; demonstrates how such an assessment could be incorporated into a public health nursing curriculum or readily adopted by public health nurse professionals in their communities; illustrates the potential for effective partnerships between public health practitioners and academics in conducting and disseminating the findings; and provides a broader conceptual, empirical, and policy‐oriented context in which to view local community‐assessment activities and their relevance for health policy and program development.
Obesity in Mexican‐American Preschool Children‐A Population Group at Risk
Authors: Alexander Mary A. , Sherman Jacqueline Blank , Clark Lauren
Published: May 2007

Abstract This research built on our previous work focusing on the Mexican‐American population as one group at risk for the development of obesity. The purpose of this study was to explore the relationship among knowledge of nutrition, feeding practices, values, and select demographic variables of Mexican‐American mothers and obesity in their preschool children. One hundred forty‐three mothers of children were recruited to participate. Each mother was interviewed and asked to complete questionnaires regarding maternal nutrition knowledge, maternal feeding practices, weight locus of control, and ideal infant body habitus. Compared to thin infants and their mothers, obese children had a significantly greater mean birth weight and their mothers had a significantly greater body mass index. Analysis of responses to the ideal infant body habitus scale revealed that mothers of obese children selected a chubby baby as ideal significantly more often than mothers of nonobese children. The data collected from this study can alert public health nurses to children at risk for obesity.
School Nursing Is Alive and Well in Kalamazoo,Thanks to Nazareth College Nursing Students
Authors: Czajka Laurie , George Tamara Bloom
Published: May 2007

Abstract Kalamazoo, Michigan, public schools have not had nurses employed by the board of education for over a decade when nurses were cut from the school budget as an austerity measure. Approximately 26,000 school‐age children live in Kalamazoo County, including a large inner‐city, low‐income population, many of whom have meager access to health care. Two part‐time public health nurses provide consultation and limited direct services. Nazareth College's commitment to community service has resulted in the placement of nursing students in elementary school settings. The nursing faculty orients the students and takes responsibility for their experience. These students have planned and implemented health‐promotion projects that have been well received. Suicide prevention, disaster response, nutrition, and personal hygiene are examples of topics. The challenge for school nursing is as great today as it was in 1902 when Lillian Wald first identified a need for school nurses. Through this program, the students are gaining rich experience, increased independence, and a sense of helping to meet a community need as they meet their own learning needs in community health nursing.
Quality Circles in the Public Health Sector: Implementation and Effect
Authors: Schmele June A. , Allen Mary E. , Butler Sandra , Gresham Deborah
Published: May 2007

Abstract Although the quality circle (QC) process has been used in health care, there is a conspicuous gap in the literature about its use in community health nursing. The purpose of this service/education project was to implement QCs in the public health nursing sector throughout a southern central state. The major objective was to provide QC training to approximately 250 supervisors and staff nurses so that this participative group problem‐solving approach might be used as a systematic method of dealing with concerns related to quality of care. Evaluation tools, such as the Science Research Associates' attitude scale and the quality management maturity index, were used to determine whether or not the implementation of the QC program influenced the level of morale and quality management maturity. The data obtained reflected positive changes and favorable supervisory responses.
Nursing Diagnosis in the North Carolina Public Health System: A Statewide Project
Authors: Zotti Marianne E. , Reed Joy
Published: May 2007

Abstract A group of North Carolina public health nursing leaders initiated a two‐phase process of providing a continuing education module on nursing diagnosis for all public health nurses in the state. In the first phase the authors developed the module to teach the skill of nursing diagnosis and evaluation tools, and statewide workshops were held to teach public health nurse administrators and nurse consultants how to use it with their staffs. Results of the evaluation revealed a significant increase in cognitive learning and a more positive attitude overall toward nursing diagnosis among 148 participants. Written comments revealed two major concerns for using nursing diagnoses: the need for additional practice, and charting issues. Both were addressed in this project. Phase two, in which administrative nurses are using the module to teach nursing diagnoses to their staffs, is under way.
Health Education and the Immigrant Haitian Mother: Cultural Insights for Community Health Nurses
Authors: DeSantis Lydia , Thomas Janice T.
Published: May 2007

Abstract Lack of information about health education from the perspective of immigrants was the basis of a descriptive survey of 30 Haitian mothers in southeast Florida. Subjects were interviewed regarding the value of health education received while seeking preventive health care for infants and preschool children in community health settings, their access to other sources of health education, and their perceptions of what community health care providers could do to assist them in improving child health. Ninety‐seven percent took children for well‐child care to medical facilities, and 66% received health education during the visits. Seventy percent had access to health‐education programs through clinics or the media. Impediments to effective health education were lack of providers who speak Haitian Creole, need for more nurses, and long clinic waiting periods. Nurses were considered the best persons to do health teaching; radio and clinic lectures were the preferred media. Teaching was valuable if it was understandable and practical, reinforced parenting abilities, and allowed time for questions. Results are related to socioeconomic and political factors, traditional Haitian health culture, and cultural views of the cognitive development in children. Culture‐specific strategies related to the modes and foci of health education are discussed.
Secondary Data on Health‐Related Subjects: Major Sources, Uses, and Limitations
Authors: Brown Julia S. , Semradek Joyce
Published: May 2007

Abstract Although secondary data are generally neglected by nurses, they are useful for nurse researchers, practitioners, educators, administrators, and policy makers. Major sources of data on health‐related subjects are medical records, administrative records, the census, vital statistics, surveys of the National Center for Health Statistics, social science archives, and nursing archives, each with its specific uses and limitations.
Nutrition Care for Children with Special Health Needs: A Chart Review
Authors: Lee Mary , Freeman Rebecca , Cialone Josephine , Lichtenwalter Lee
Published: May 2007

Abstract A random sample of 182 client charts at local agencies serving children with special needs were reviewed to identify any children at nutrition risk and determine if they had access to nutrition services. A standardized protocol was used to review data on clinical and dietary variables. The findings indicate a need for improved data collection, better use of collected data, and greater agency use of registered dietitians.
The Impact of Organizational and Environmental Factors on Staffing in Home Health Care
Authors: Burman Mary E.
Published: May 2007

Abstract Home health care agencies are experiencing changes in staffing demands. I evaluated the staffing patterns of such agencies and investigated the impact of organizational and environmental factors on staffing. Disproportionate stratified random sampling, based on type and region of agency, was used to select Visiting Nurse Associations and hospital‐based agencies. Seventy‐three percent responded to the mail survey, 120 and 156, respectively.) On average, the majority of staff nurses and supervisors in individual agencies had associate degrees or diplomas. Nursing experience and medical‐surgical nursing experience were of greater importance than having a B.S.N. or home health care experience for potential nursing applicants. Type, size, and age of agency and types of services provided had relatively little impact on staffing patterns. However, the director's degree was associated with the percentage of staff nurses and supervisors by educational degree. Competition had little impact on staffing patterns, although the extent of rural service area and Medicare involvement were related to educational backgrounds of nurses and hiring preferences.
AIDS‐Related Knowledge, Fear, and Behavioral Change Among Nurses in Taiwan
Authors: Wang Janet F. , Simoni Patricia S. , Paterson John
Published: May 2007

Abstract Current literature documents a phenomenon of fear that affects the willingness of health care professionals to care for persons with acquired immunodeficiency syndrome (AIDS). We attempted to identify differences between nurses who exhibit fearful attitudes toward AIDS and those who do not, based on knowledge and behavior. Taiwan, site of the study, is only beginning to identify the first of its citizens with AIDS. The subjects were a population of caregivers from a culture with little exposure, therefore, either through education or experience, to the disease and the issues it engenders. A cross‐sectional, self‐administered survey was conducted in 1990 of 1759 nurses in 12 institutions throughout Taiwan. Data on AIDS‐related knowledge, fear, and behavior, as well as selected demographic data, were gathered. Analysis revealed significantly less fear of AIDS among nurses who reported three behavioral changes related to AIDS than among those who reported fewer changed behaviors (F= 4.43, df= 3; P < 0.004); those with higher levels of education (F= 3.54, df= 3; P < 0.014); and those who were single rather than married (t= 2.81; P < 0.005).
Collaboration in Investigator Initiated Public Health Nursing Research: University and Agency Considerations
Authors: Oda Dorothy S. , O'Grady Roberta S. , Strauss Julia A.
Published: May 2007

Abstract There is a significant difference in the collaborative process between whether a public health nursing research project is requested (of the researchers) by the agency or if it is conceived by an outside investigator. This article discusses the underlying concepts of negotiation, mutuality, and respect that support the process of an externally initiated study in an agency. In a progressive listing format, the important components within the planning, development, implementation, and completion phases are then described so that they can be useful to beginning researchers as a guide and to experienced researchers as a reminder.
An Ecological Approach To Health Risk: A Case Study of Urban Elderly Homeless People
Authors: Reilly Fay E.
Published: May 2007

AbstractThe purposes of this paper are: to describe an ecological approach to assessing health risk, and to apply the approach to a sample of elderly homeless within the context of a single day in a single urban setting. In the approach described, a method of progressive contextualization was used by adding different hazards to the risk profile in a single geographic area. The various hazards were applied to the same time and space frame, that of a 24‐hour period and in the urban space used by elderly homeless people. Incorporated into the approach are the concepts of high‐risk areas and space‐time geography, and the theory of disease ecology. The spatial‐temporal distribution of resources, factors in the natural environment (patterns of daylight and dark and ambient temperature) and factors in the human‐created environment (traffic and crime patterns) were identified as important hazards within the urban environment. Homelessness itself, the effects of aging, the social milieu, and behavior patterns commonly seen in homeless people—particularly, alcohol abuse‐were identified as important hazards for elderly homeless people. Each hazard's spatial‐temporal pattern within the 24‐hour period is discussed. Then the convergence of hazards forming an interactive effect is discussed. Finally, approaches to nursing interventions aimed at reducing risk are presented.
Community as Client: A Challenge for Nursing Education
Authors: McKnight Janet , Dover Leslie Van
Published: May 2007

Abstract The mandate of public health departments has been, and continues to be, to provide and deliver a variety of health programs and services pertinent to local circumstances and needs. Public health nurses are the largest group of health care professionals who deliver these services. The objectives of this paper are to identify what policy makers expect of public health nurses related to community development for health, and to describe the educational components necessary for baccalaureate nursing curricula if these expectations are to be met.
The New Paradigm: Concepts and Application in Community Health Nursing
Authors: Hays Bevely J.
Published: May 2007

Abstract The central role of community health nursing in future health care delivery systems is undisputed. The abilities and characteristics of nurses who will practice in those systems depends to a large extent on their learning experiences in basic nursing programs. Educators are being asked to prepare skilled, compassionate scholar‐clinicians to provide care for the complex needs of clients, despite already packed curricula. The curricular changes cannot be additive; learning must be designed to empower students to become nurses who are both skilled and compassionate. Certain faculty attitudes and behaviors are essential to this new educational paradigm, and student activities and assignments must foster confident, effective practice.
A Sociodemographic Comparison of Families of Very Low‐Birthweight Infants: 1982‐1991
Authors: Gennaro Susan , York Ruth , Brown Linda , Stringer Marilyn , Brooten Dorothy
Published: May 2007

Abstract Social and demographic characteristics were investigated in families who had very low‐birthweight infants between 1982 and 1984 (historical cohort). Since those data were collected, the number of women using drugs during pregnancy has increased significantly. Therefore, between 1989 and 1991 (current cohort) we continued to document sociodemographic characteristics of families of very low‐birthweight infants (144 mothers, 156 infants). Data were collected from review of hospital charts and outpatient health records, and monthly interviews. The two cohorts were similar demographically. Changes in family composition occurred more frequently in the current cohort. There was a startling increase in illicit drug use between the two groups of women: 3% in the historic cohort and 20% in the current cohort. In the historical cohort all infants went home to their mothers; however, in the current cohort 7.8% of infants were placed with other family caretakers. Infant health outcomes for the first six month after hospital discharge were similar in both groups. From 1982 to 1991 the increases in substance abuse, nonmaternal caretakers, family moves, and changes in family composition have implications for health care providers involved in infant follow‐up care.
Effects of a Community Health Nursing Parent‐Baby (Ad) Venture Program on Depression and Other Selected Maternal‐Child Health Outcomes
Authors: Vines Susan W. , Williams‐Burgess Christine
Published: May 2007

Abstract This pilot study measured the effects of a community health nursing parent‐baby (ad)venture program for first‐time mothers who were at risk for child abuse or neglect and depression. A quasi‐experimental pretest‐posttest design was used. Fifteen high‐risk mothers in the program were compared with 15 similar mothers who received home visits from the community health nursing staff. Measures of depression, health behaviors, self‐esteem, state anxiety, and maternal‐infant adaptation were measured in both groups when the mothers were 4 and 16 weeks postpartum. After controlling for pretest differences, the findings showed that program mothers reported significantly higher levels of self‐esteem at the three‐month period than those receiving home visits (P < 0.013). In addition, over time these mothers had significantly decreased levels of depression (P < 0.009) and significantly improved their health habits (P < 0.003). Those who received home visits showed no significant changes over time.
Pornography and Abuse of Women
Authors: Cramer Elizabeth , McFarlane Judith
Published: May 2007

Abstract To study the association between male pornographic use and physical abuse of women. 87 battered women filing charges against their male partner at the district attorney's office in a large metropolitan city were surveyed. Forty percent reported that their male partner used one or more such materials. Use of the materials was significantly associated with the women being asked or forced to participate in violent sexual acts including rape.
HIV and the Work Intentions of Public Health Nurses
Authors: Tessaro Irene , Highriter Marion
Published: May 2007

Abstract Studies have examined the association between attitudes about the human immunodeficiency virus (HIV) and nurses' willingness or intentions to work with infected persons. However, the relationship between these intentions and perceived concern from nurses' family and friends, or factors of professional nursing experience is relatively unexplored. An anonymous questionnaire was completed by 311 public health nurses from areas with high and low prevalence of acquired immunodeficiency syndrome (AIDS) in North Carolina. Multiple regression analysis showed that nurses had stronger intentions to work with HIV‐infected clients if they had more favorable attitudes about the disease, perceived friends and loved ones to be supportive of such work, had stronger professional ties to public health, and had worked fewer years in public health. In addition, nurses from low AIDS‐prevalence areas had stronger intentions to work with these clients if they had professional nursing care experience with them. These findings are consistent with the Theory of Reasoned Action, but also identify professional nursing experience as independently associated with behavioral intentions. This suggests that attitudinal, normative, and professional experiences are all important in examining nurses' intentions to work with clients infected with HIV.
The Substance Abuse Pandemic: Determinants to Guide Interventions
Authors: Talashek Marie L. , Gerace Laina M. , Starr Karen L.
Published: May 2007

Abstract
The substance abuse pandemic calls for a comprehensive model from which nurses can organize the vast array of drug and alcohol knowledge required for practice in the community. The model health for all: a model for nursing's contributions provides a framework for organizing factors that affect health status into four determinants: biologic, sociocultural, medical‐technologic‐organizational, and environmental. The model serves as an organizing mechanism to present key information about alcohol and drug abuse.
Discharge Planning from Home Health Care and Patient Status Post‐Discharge
Authors: Stewart Cynthia J. , Blaha Arlene J. , Weissfeld Lisa , Yuan Weiying
Published: May 2007

Abstract An exploratory study of 57 elderly patients discharged from home health agencies sought to identify how they and their caregivers were prepared for discharge and how they were managing. Data were collected from the home care records and post‐discharge interviews with patients and caregivers. Results indicate little evidence of formal discharge planning. However, home care records appear to underreport what home care staff do. On follow‐up, over half of the patients had improvement in their health, two‐thirds were independent in activities of daily living, and few patients had need of formal services.
Application as Scholarship: A Community Client Experience
Authors: Hemstrom Marion M.
Published: May 2007

Abstract A community health nursing experience with a complex aggregate client was developed for B.S.N. completion students at a private university. Working in collaboration with the neighborhood group, a survey based on Spradley's notion of healthy neighborhoods and Cottrell's idea of community competence was developed. Community health nursing students drew a representative sample of neighborhood dwellers and interviewed them to assess their concerns. Data were summarized, inferences drawn, and problems amenable to nursing intervention identified and prioritized. Students presented their findings to the neighborhood group, city service providers, and various volunteer agencies. This experience provided service to the community client, public service for faculty, and an exceptional learning opportunity for students.
Women with Diabetes during Pregnancy: Sociodemographics, Outcomes, and Costs of Care
Authors: York Ruth , Brown Linda P.
Published: May 2007

Abstract This study provides sociodemographic, outcome, and cost data on a population (N= 55) of predominately low‐income, diabetic women who were hospitalized during pregnancy. Study findings indicated that 43 percent received no prenatal care in the first trimester, 20 percent delivered a low‐birthweight infant, 47 percent had a cesarean delivery, and 63 percent reported an annual income under $12,500. Following the women's initial admission for glucose control, 19 acute care visits and 32 rehospitalizations were recorded for them. The mean hospital charges for antepartum initial hospitalization for glucose control were $4,665 (4.3 days). The mean charges for postpartum hospitalization were $7,793 (4.3 days). The mean hospital charges per infant were $12,991. Given the data presented in this study, it is imperative that monies be targeted to provide a broad spectrum of health care services that will meet the unique needs of this population. These services should address not only the needs related to superimposed disease state but also identify mechanisms to assist women to receive care prior to conception, or at the very least to begin prenatal care in the first trimester of pregnancy.
Evaluation of Public Health Nursing Home Visits to Pregnant Women on WIC
Authors: Zotti Marianne E. , Zahner Susan J.
Published: May 2007

Abstract Selected pregnant women participating in the Special Supplemental Food Program for Women, Infants and Children (WIC) were receiving public health nursing (PHN) home visiting services. The purposes of this study were to describe PHN services provided to pregnant women on WIC; and to compare birth outcomes and prenatal care (PNC) utilization between two groups, women with WIC services only and women with WIC plus PHN services. In this retrospective cross‐sectional study, the sample consisted of all women on WIC (N= 398) at the Madison Department of Health who delivered singleton births during 1991, divided into the WIC‐only group (n= 301) and the WIC + PHN group (n= 97). Three instruments were used for data collection: birth certificates, the WIC record, and the antepartal nursing record. Data were described; differences between groups were tested. Primary PHN activities included: assessment of physical and behavioral indicators, parenting skills, and support systems; teaching about nutrition, use of drugs, danger signs, labor signs, and stress management; and referrals to a variety of community resources. No difference in adequacy of PNC or in birth outcomes was found between the two groups. Findings have been used to plan the agency's future PNC coordination services.
Tuberculosis Health Education Needs in Homeless Shelters
Authors: Kitazawa Susan
Published: May 2007

Abstract Tuberculosis has reemerged as an important public health concern, particularly with the rise in multi‐drug‐resistant strains. The homeless are at increased risk for infection, for active disease, and for incomplete treatment. Public health authorities have recommended that tuberculosis health education materials be developed specifically for residents and staff of homeless shelters. In this study, a diverse sample of 20 adult homelessshelter residents responded to open‐ended questions regarding 1) their knowledge of tuberculosis and tuberculosis screening and treatment, 2) their perceptions of access to health care services related to tuberculosis, and 3) their views of health education regarding tuberculosis. The majority of the subjects had limited knowledge of tuberculosis and of screening and treatment for the disease. Many had misconceptions about the disease, particularly regarding its transmission. An analysis of the subjects' responses within the framework of the Health Belief Model indicated that basic tuberculosis health education programs for residents of homeless shelters are needed. The study findings indicated that a small‐group educational format utilizing written materials and video aids might be most effective.
Female Adolescent Contraceptive Use or Nonuse at First and Most Recent Coitus
Authors: Felton Gwen M.
Published: May 2007

Abstract The purpose of this study was to determine factors that differentiate contraceptive use behaviors of sexually active adolescent women. A sample of 159 subjects, recruited from three publicly supported family planning clinics, were classified according to nonuse, inconsistent, or consistent use of contraceptives at first and most recent coitus. The Health Promotion Model provided the organizing framework for this study. Factors entered into the discriminate functions included self‐image, problem solving, health‐promoting behavior, race, age at first coitus, previous pregnancy. contraceptive history, chronological age, family structure and size, mother's education, and Medicaid status. Three‐group multivariate discriminate analysis resulted in two significant functions that explained 38.7% of the variance in contraceptive behavior. The three groups of adolescents were discriminated by age at first coitus, history of previous pregnancy, health‐promoting behavior, self‐image, problem‐solving skill, chronological age, family size, and race. In particular, the findings suggest public health nurses and other health care providers can reduce unintended pregnancy through interventions that address the alterable factors.
Component Analysis of Productivity in Home Care RNs
Authors: Benefield Lazelle E.
Published: May 2007

Abstract The 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 care.
Community Caring
Authors: Davis ReNel
Published: May 2007

Abstract American society is demanding that health care organizations design a health care system that is more responsive to the needs of their communities. In their efforts to respond, organizations are challenged to better understand organizational dynamics, community needs, and community relationships. The purpose of this study was to explore and understand the meaning of caring for the community from the perspective of care providers in a hospital‐based ambulatory program. Using a focused ethnographic design, the study was conducted in a community hospital close to a large metropolitan city. Research methods included open‐ended interviews, participant observations, and examination of documents. Analysis of data revealed five major themes related to the experience of caring for the community. Themes reflected different perspectives of communities, recipro‐cal relationships and teams, education and prevention, shared values, and understanding community needs. At the same time, an overarching theme related to wellness, growth, and empowerment emerged. Results provided knowledge that may help increase understanding of organizational culture that impacts the development of healthy communities. Findings may also help facilitate organizational change toward the development of new models of care that are integrated with the community.
Development of the Health‐Promotion Activities of Older Adults Measure
Authors: Padula Cynthia A.
Published: May 2007

Abstract The purpose of this research was to develop an instrument to measure participation in health promotion that was specific to the unique needs of the aging population. Development of instruments that are psychometrically sound and have been used with older adults represents a critical step in the design and implementation of health promotion strategies specific to the aged. The Health‐Promotion Activities of Older Adults Measure is a 44‐item instrument composed of five subscales: Collaborative Health Management/Injury Prevention, Stress Reduction/Rest and Relaxation, Exercise, Substance Abuse Prevention, and Nutrition. This instrument was developed and tested with two distinct populations of older adults; evidence supportive of validity, and very acceptable reliabilities, were found. Further use and examination of this instrument are indicated.
Health Care Delivery in Faith Communities: The Parish Nurse Model
Authors: Weis Darlene , Matheus Rosemarie , Schank Mary Jane
Published: May 2007

Abstract Religious institutions and nurses have a common bond—both are committed to empowering individuals to achieve their full potential and believe in the self‐care capacity of individuals. The purpose of this study was to examine parish nursing as an evolving model of care within faith communities. Annualization of monthly reports and parish nurse interviews revealed that parish nurse activities contributed to the empowerment process and to the attainment of Healthy People 2000 objectives.
Policy Advocacy for Public Health Practitioners: Workshops on Policy Change
Authors: Badovinac Kimberly
Published: May 2007

Abstract This article describes two workshops on health‐promoting policy change, developed and delivered to more than 1,000 public and community health practitioners across one Canadian province. The workshops were designed to increase knowledge about the process of policy change and provide opportunities for skill development. Three basic instructional methods‐mini‐lectures, individual pen‐and‐paper exercises, and small‐group activities—were used. Workshops were delivered using a host organization arrangement, meaning organizations willing to host workshops could do so if they provided the venue and invited members of other organizations in the community. Initial evaluations indicate that practitioners find the workshops useful and that many have integrated the information into their day‐to‐day work. To the author's knowledge, no other workshops of this nature have been delivered in this systematic way.
Population‐Focused and Community‐Based Nursing—Moving Toward Clarification of Concepts
Authors: Baldwin Joan H. , O'Neill Conger Cynthia , Abegglen JoAnn C. , Hill Elisa M.
Published: May 2007

Abstract Rapid health care delivery system changes combined with the Institute of Medicine's (1988) call for refocusing public health practice into the Core Functions provide an opportunity to shape community/public health nursing (C/PHN) education and practice for the future. Critical examination is the key to clarifying C/PHN practice. What is the practice now? Is it population‐focused, community‐based, or both? And what do these terms mean today? The purpose of this paper is to share the authors' thinking about what it is that makes population‐focused nursing “different” from community‐based practice, as well as unique and useful to the health care delivery system, through the examination of old and new terms and concepts. The significance of this article lies in its ability to encourage dialogue among our colleagues. It is hoped that thoughts shared here will stimulate action to define C/PHN practice in broader arenas.
Data Sources to Estimate Local Area Supply and Demand for Nurses
Authors: Kovner Christine T. , Reimers Cordelia
Published: May 2007

Abstract This paper examines existing data sources that can be used to estimate the local supply and demand for registered nurses (RNs). An analysis of the strengths and weaknesses of these data is provided.
Child Safety Seat Misuse: Home Visiting Assessment and Intervention
Authors: Block Derryl E. , Hanson Tabitha K. , Keane Anne
Published: May 2007

Abstract This project piloted the use of nurse‐initiated home visits for child safety seat (CSS) assessment and intervention. Nurses made home visits to 149 rural and suburban Wisconsin women with children under 2 years of age, and assessed CSS misuse through observation and physical manipulation. Over three‐quarters of CSSs were misused, although mothers were aware of only one‐quarter of the instances of incorrect use. Nurses taught proper CSS use through verbal instruction, demonstration with parent's own vehicle and CSS, and supervised parental manipulation of CSS. While mothers were receptive to home visiting for CSS assessment and education, this project involved substantial nurse training. Because thorough CSS assessment and intervention during home visits is resource‐intensive, other options for improving correct CSS use and parental awareness are discussed.
Help‐Seeking Patterns Among Parents with a Newborn Child
Authors: Jansson Annkristin , Isacsson Åke , Nyberg Per
Published: May 2007

Abstract In the child health promotion program in Sweden, the public health nurse is responsible for the majority of the work. The purpose of this study was to test the following hypotheses: (1) there are differences in CHP program utilization between mothers in different social positions: (2) there are differences in CHP program utilization between Swedish and foreign‐born mothers; (3) there are differences in the way mothers in different social positions value formal and informal social support as a means for solving health problems: and (4) there are differences in the way Swedish and foreign‐born mothers value formal and informal social support as a means to solve health problems. A random sample was drawn of 10% of all children born in a particular month. A national postal questionnaire was sent to 850 mothers with children about four to five months old. The response rate was 80%. The CHP program was utilized by 99.6% of the families. When given scenarios describing various problem situations, the mothers stated that they mostly would turn to the public health nurse irrespective of the type of problem. There was no support in this study for the first two hypotheses that there are differences in CHP program utilization between mothers in different social positions and between Swedish and foreign‐born mothers. There was support in this study for the two last hypotheses that there are differences in the way mothers in different social positions and the Swedish and foreign‐born mothers value nurses, other health care services, relatives/friends, and literature/mass media as a means to solve health problems.
Consistency Between Preference and Use of Long‐Term Care Among Caregivers of Stroke Survivors
Authors: Chiu Lian , Tang Kwong‐Yui , Liu Yu‐Hua , Shyu Woei‐Cherng , Chang Ta‐Pang , Chen Tchan‐Ru Jayne
Published: May 2007

ABSTRACT Effective arguments have been made for the importance of expanded attention to understanding how family preferences influence decisions to choose long‐term care. The effects of preference on the utilization of long‐term care deserve further research, especially on a longitudinal basis. The family members of 582 first‐time stroke patients from the neurology departments of four teaching hospitals in Taiwan were categorized into two groups based on their attitudes toward type of long‐term care, i.e., a preference for nursing home care (n1= 324) or a preference for home care (n2= 258). The consistency rate between preference and utilization of the type of long‐term care was estimated by the division of number of families preferring one type of long‐term care by the number of families actually utilizing the services preferred. Results indicated that the consistency rate for those with nursing home preference was 8.3% while the consistency rate for those with home care preference was 94.2%. Accessibility of nursing home facilities near family residences was significantly associated with whether those preferring nursing home services actually utilized them, and the odds ratio was 20.8. The family manpower available for caregiving at home was tremendously associated with whether families utilized home care when home care was preferred; the odds ratio was 33.3. The preference for the type of long‐term care was a strong predictor of the utilization when home care was preferred, yet not when a nursing home was preferred. The low consistency between preference and utilization for nursing homes preferred is due to the low accessibility of nursing home facilities in Taiwan. How to provide sufficient support to families for caregiving at home, and how to deal with the barrier of accessibility to nursing home services should be two major concerns for those who are planning and operating the long‐term care system and for those trying to design institutional services and noninstitutional services as alternatives.
Ethnic Differences in the Incidence of Seizure Disorders in Children from Bradford, United Kingdom
Authors: Hamdy Nermin Aly , Ginby Des , Feltbower Richard , Ferrie Colin D.
Published: May 2007

Summary:  We sought to determine if there are differences in the incidence of seizure disorders between the children of the indigenous and immigrant (predominantly Pakistani) populations of Bradford, United Kingdom. Annual incidence rates per 100,000 for new onset seizures were calculated along with Townsend deprivation scores. The incidence of seizures (including febrile and single) was 153 (95%CI 104–139). The rate was significantly higher in south Asians (SA) (220; 184–255) compared to non–south Asians (non‐SA) (121; 104–139), mainly because of febrile seizures whose incidence was 87 (136–169) overall and 142 (114–170) and 61 (49–74) in SA and non‐SA, respectively. There were no significant differences in the rates of nonfebrile seizures (non‐FebSz) overall and of idiopathic non‐FebSz between racial groups but the rate for symptomatic/cryptogenic non‐FebSz was significantly higher in SA (22; 10–34) compared to non‐SA (6; 2–10). The occurrence of seizure disorders correlated with social deprivation.