bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying Needs and Community Resources in Arthritis Care
Authors: Liebman Judith J. , Hull Alan I. , Blauner Michael , Barkey John , Vignos Paul J. , Moskowitz R.W.
Published: May 2007

A project was undertaken to determine the need for community services of persons with arthritis. It was first necessary to ascertain patients' viewpoints about what is most needed. A structured interview was developed and submitted to 189 primarily urban patients. Five sources were drawn upon to determine items for the interview: (1) selected arthritis literature; (2) patient interviews; (3) health professionals' viewpoints; (4) functional assessments; and (5) inquiries made to Arthritis Foundation staff. Sixty‐six questions based on 25 content areas were then developed. Functional states and demographic and medical information were also solicited. A factor analysis indicated three groups of needs: (1) general information; (2) personal care and medical services; and (3) assistive devices and equipment. Needs were matched with a comprehensive list of countywide resources derived from a computer data bank; a service directory was prepared and printed based on the compatibility between needs and community resources, and distributed to health and social service professionals, selected patients, and community leaders. The process used to select items for the interview was time consuming, but added face validity to the content areas selected. The outcome was vital to determining community resources capable of responding to need for service.
The Need for Graduate Education in Community Health Nursing: A Survey
Authors: Hanchett Effie S. , Chambers Bianca M.
Published: May 2007

Home health care agency administrators and staff members were surveyed to determine areas of interest for a proposed expansion of the graduate program in community health nursing at Boston University School of Nursing. Two interrelated questionnaires were designed, one for administrators, the other for staff, and were mailed to agency directors. Forty‐six percent of the administrators and 29 percent of staff members responded. Roughly half (49%) of the staff members were graduates of baccalaureate programs in nursing and interested in graduate education in nursing. Clinical specialization within home health care was the area of greatest interest for both administrators and staff members, followed by home health care administration. Many agencies provided released time for the part‐time evening study preferred by staff. It was concluded that there is a great deal of interest in graduate education in home health care, including both clinical specialization and administration. Agency directors stated they were willing to hire graduates of such programs, and the overwhelming majority of staff members who were eligible for and interested in graduate study identified an interest in the subject.
Health Needs of Homeless Persons
Authors: Bowdler Jo Ensign , Barrell Lorna Mill
Published: May 2007

This study assessed the multidimensional health needs of the homeless population of Richmond, Virginia, using the Neuman systems model as the conceptual framework. A combination of indicator, key informant, and survey approaches was implemented. Specific health problems existed in the economic, social, mental, and physical health variables. Many of the homeless persons reported being single, having family problems, and being unemployed. Of particular interest were findings of a high prevalence of mental disorders, substance abuse, and infectious/parasitic diseases among the homeless. Implications of study results led to suggested program components for the nurse‐run health clinic targeting the homeless of Richmond, as well as for continuing nursing evaluation to document the effectiveness of this clinic.
Religion's Role in the Health and Well‐being of Well Elders
Authors: Mull Carolyn S. , Cox Cheryl L. , Sullivan Judith A.
Published: May 2007

We examined the relationship between religiosity and well elders' perceived health status and sociopsychologic well‐being. A random sample of 380 residents of specialized housing units for seniors participated in a face‐to‐face structured interview. Ninety‐four percent agreed that religion was important in their lives. For those with adequate health and functional status, church or synagogue attendance was vitally important. As more symptoms were reported, personal religious practices increased, including frequency of prayer and listening to religious programs, as well as the importance of religious beliefs. Religious practices and beliefs may serve as a coping mechanism to deal with life's problems and/or as a social network and source of social support. The public health nurse's assessment of this aspect and its importance to older clients allows for the development of appropriate interventions that may mediate positive health and well‐being.
Prevention of Battering During Pregnancy: Focus on Behavioral Change
Authors: Helton Anne , McFarlane Judith , Anderson Elizabeth
Published: May 2007

To establish the prevalence of battering during pregnancy, 290 black, white, and hispanic women attending public and private prenatal clinics were randomly selected and interviewed. In all, 36 percent had been battered or were at risk for battering. Injuries included slaps, kicks, punches, broken bones, choking, and sexual assault. None of the pregnant women reported being assessed for abuse by their health care provider. To prevent the battering of pregnant women, an educational program was initiated based on a model of behavior change. Behavioral change expected was increased knowledge and routine abuse assessment by health professionals. This program was applied to 841 health providers working with pregnant women. After completing the program, 75 percent of the participants were assessing pregnant women for physical abuse or in the process of developing an assessment protocol.
The Public Health Nurse as a Discharge Planner: Patients' Perceptions of the Discharge Process
Authors: Kromminga Shellie K. , Ostwald Sharon K.
Published: May 2007

The trend toward earlier patient discharges from hospitals has provided new incentives for hospitals and public health nurses to work together to ensure that patients receive uninterrupted quality care after discharge. This study investigated perceptions of the discharge process using a structured telephone interview to survey a sample of 30 adult patients who had been hospitalized for at least 24 hours in a small, rural community, hospital in the upper Midwest. The county public health nursing agency contracted with the hospital to provide discharge planning services. Patients identified discharge needs in 15 different areas, with a mean of 5.8 needs per patient. Twenty‐seven percent of the patients received referrals for the services of a public health nurse, homemaker, or both before discharge. One week after discharge 37 percent of the patients continued to need assistance appropriate for referral back to the professionals or agencies with whom they had had initial contact. Elderly patients with chronic illnesses were more likely to have received referrals at the time of discharge than younger patients with acute illnesses. Family and friends were heavily involved in providing support services in the postdischarge period.
Addressing the Needs of Underserved Populations in Community Health Nursing Education
Authors: Drapo Peggy J. , Patrick Charlotte R. , Kemp Charles
Published: May 2007

Community health nursing that focuses on populations rather than individuals as clients is a concept that is challenging to teach. Nursing students at two centers of Texas Woman's University have been working with two diverse groups of populations that are considered underserved. One group is made up of Cambodian refugees who have been located in urban settings in Dallas, Texas. The second group, in a rural setting, is composed of migrant children who have moved with their parents to the area for agricultural work. They are mostly Mexican families. This article reports the means to use clinical sites to expose students to community‐level nursing of populations at risk while maintaining uniformity with the curriculum for the College of Nursing.
Administrative Diagnosis—Implications for the Public's Health
Authors: Porter Eileen Jones
Published: May 2007

The nursing diagnosis of the health care needs of population groups has been deemed the responsibility of community nurse‐administrators. Yet it was not known whether these nurses actually formulate nursing diagnoses pertaining to population groups. The purpose of this study was to describe the diagnostic reasoning of these nurses so as to enable the development of a factor‐isolating theory of population group diagnosis using the grounded‐theory method. Data were obtained from 31 community nurse‐administrators regarding the health services they had created or discontinued within the last three years; it was assumed that these data could illuminate the diagnostic decisions that had preceded service change. The data revealed a first‐stage diagnostic process in which the group's state of health was determined. Prior to service change, a second‐stage diagnosis was made about the degree of match between the group's need and existing services; the nursing goal was to cultivate a need‐service match that would positively affect the group's health status. Labels for the first‐ and second‐stage diagnoses were developed based on the emergent theory and the relevant literature. The resultant factor‐isolating theory of community nurse‐administrator diagnosis was stated and the implications of the theory for the public's health were discussed.
Job Satisfaction Assessment of Public Health Nurses
Authors: Lucas. Mary D. , McCreight. Lillian M. , Watkins Joyce G. , Long Suzanne E.
Published: May 2007

Abstract To provide empirical data for dealing with problems of low morale and high turnover in a few districts of a state public health nursing department, survey research was designed to measure the job satisfaction of the public health nurses. Questionnaires that measured satisfaction with 12 job components were received from 741 nurses for a 68 percent response rate. Top‐ranked satisriers were job importance, interpersonal relations, and achievement. Lowest‐ranked satisfiers were job mechanics, recognition, and salary/benefits; administrative interventions were developed to deal with these areas. High levels of job satisfaction were associated with increased educational preparation, increased age and longevity, administrative positions, and program assignment in tuberculosis or child health.
Clinical Excellence, but too High a Cost: The Metropolitan Life Insurance Company Visiting Nurse Service (1909‐1953)
Authors: Hamilton Diane
Published: May 2007

Abstract In the winter of 1909, Metropolitan Life Insurance Company, a large company within the private sector, identified visiting nurses as a means of lowering mortality rates, while improving the image of the company. Although initially associated with the nurses of Lillian Wal&dcar;s Henry Street Settlement House, the Metropolitan Visiting Nurse Service eventually formed an alliance with over 650 Visiting Nurse Associations across the United States, caring for over 30 million policy holders. The purpose of this historical research was to analyze the liaison between business and the profession of nursing, identifying factors that served as an impetus for the origin, growth, and decline of the Metropolitan Visiting Nurse Service. Data were gathered in the Metropolitan Life Insurance Company Archives; the Visiting Nurse Association Archives of New York and Chicago; the New York Public Library; Chicago Historical Society; Schlesinger Library at Radcliffe College in Cambridge, MA; Haven Emerson Public Library in New York; National League for Nursing Education Historical Collection in New York; Walter Library, University of Minnesota, Minneapolis, MN; American Public Health Association Historical Collection, Washington, DC; and Special Collection of Virginia Commonwealth University in Richmond, VA. The results indicate that visiting nurses were masters of improvisation, demonstrating clinical excellence under demanding conditions. Although both nursing and business leaders demanded efficiency, nursing focused on quality of nurses, while business viewed cost of a nursing visit as the priority. Unfortunately for the profession, increased educational sources for nurses coupled with declining volume of visits drove the cost of a nursing visit higher than Metropolitan was willing to pay. Consequently, in 1950 Metropolitan made the decision to terminate the service. In a time when the nursing profession seeks both clinical excellence and cost containment, this study uses the past to stimulate questions about the future: Can the nursing profession provide quality care in an era where cost of care is emphasized? Can the profession use the knowledge and principles of the business world to reach mutually satisfying goals of quality patient care and cost effectiveness? Can nursing balance the values inherent in achieving a cost/care attitude?
Activities and Consultation Patterns of Nurse Practitioners with Master's and Certificate Preparation
Authors: Nolan JoEllen W. , Beaman Margaret , Sullivan Judith A.
Published: May 2007

Abstract The practice of nurse practitioners (NPs) may change as a result of the perceived oversupply of physicians. Examination of current NP practice is essential to understand how best to manage the future of the profession. This study examined differences in activities and consultation patterns between master's‐prepared and certificate‐prepared NPs. The 1S79 NP students who responded to a nationally mailed questionnaire were surveyed again six months to one year after graduation. A total of 50 activities spanning as many as four client types (adults, infants/children, maternal, family planning) were included in the questionnaire. Participation in general activities for well and ill clients was high for NPs with both types of education. Nurse practitioner activity related to specific health problems decreased as the severity of the problems increased. This was accompanied by increased consultation. In ten activities the difference was significant between the two levels of NP preparation: more master's‐prepared NPs performed six holistic‐oriented activities and more certificate‐prepared NPs performed four technically oriented activities. A significant difference in the numbers of NPs needing heavy consultation was noted for 15 activities; in every case, fewer master's‐prepared NPs required heavy consultation. These results support the emphasis of NP master's degree programs on practice autonomy, especially with well clients. In terms of curriculum, more emphasis should be placed on the care of newborns and mothers.
Nursing on a Construction Crew in Nicaragua
Authors: Lynch Margaret A. , Lenihan Mary I.
Published: May 2007

Abstract In the winter of 1985, two Boston‐area community activists organized the Vecino Brigade iyecino is neighbor in Spanish) to build a health center in the town of Estelf, Nicaragua. The center is now the Eduardo Selva Clinic, serving this town of about 70,000 people. The authors, both registered nurses, traveled with the crew of 38 women and men as organizers of the group's health care and as unskilled construction workers. This article describes their experiences.
Educational Needs of Community Health Nursing Supervisors
Authors: Duffy Sonia A. , Fairchild Nancy
Published: May 2007

Recent legislative trends toward early hospital dismissal and cost containment have shifted the setting for health care from the hospital to the home. Consequently, community health nursing supervisors are becoming increasingly responsible both for coordinating care for sicker clients with fewer available resources, and for guiding staff nurses who provide high‐tech nursing skills in the home. This has resulted in new educational needs for these supervisors. To determine their educational needs and the barriers to implementing their roles, 160 community health nursing supervisors employed by community health nursing agencies in Michigan were surveyed. They reported educational needs related to labor relations, reimbursement procedures, fiscal management, marketing, and computer systems. Several types of educational experiences were found to influence their abilities to handle supervisory responsibilities, including enrollment in an educational program, highest level of education, and selected content areas taught in their formal educational programs. Nursing implications include using the research results to develop educational programs to meet the needs of community health nursing supervisors. Those who are adequately prepared educationally will be better able to provide effective supervision of staff nurses and ultimately, coordinate high‐level client home care.
Cardiovascular Risk Assessment in School‐Age Children: A School and Community Partnership in Health Promotion
Authors: Cowell Julia Muennich , Montgomery Andrew C. , Talashek Marie L.
Published: May 2007

There is little doubt that the primary prevention of cardiovascular disease is a pediatric problem that nursing must address. Cardiovascular health‐promotion activities for children have generally used an ecologic model, providing community‐based education programs in the schools. The purpose of this study was to identify changes in cardiovascular risk among sixth‐grade cohorts over eight years. Four variables known to be associated with such risk‐weight (obesity), pulse rate recovery index, blood pressure, and total cholesterol level‐were measured on 4900 students, and changes in their prevalence were analyzed.

The data presented in this paper were compiled from a screening program conducted by a local health department in partnership with a school district's health‐education program. Although the school‐based health‐education program has been in existence for eight years, the prevalence of cardiovascular risk in sixth‐grade students has not declined, suggesting the need for nurses to target the children at risk, and address more directly the motivational and affective domains in addition to cognitively focused programs.
The Effectiveness of Public Health Nursing Services to Prenatal Clients: An Integrated Review
Authors: Baldwin Kathleen A. , Chen Shu‐Pi C.
Published: May 2007

The effectiveness of public health nursing interventions with prenatal clients was summarized from 17 studies, conducted between 1963 and 1988, that were identified through a comprehensive reference search. The review indicated that public health nursing interventions can increase birthweight, and the use of prenatal medical services, nutritional services, and childbirth classes. Because of methodological problems, however, it is difficult to conclude with certainty that such interventions make a significant difference in client outcomes. These problems included lack of construct validity, lack of specification of interventions, small convenience samples, lack of power to detect small treatment effects, nonexperimental research designs, lack of reliability information, and self‐selection and history biases. To overcome these problems, the authors suggest the use of conceptual frameworks, power calculations prior to initiation of research, experimental or quasi‐experimental designs, replication of research with different populations, and the calculation and reporting of reliability information.
A Framework for Planning Public Health Nursing Servicesm to Families
Authors: Vahldieck Rosemary K. , Reeves Sharon R. , Schmelzer Margaret
Published: May 2007

We designed a model to assist public health nurses and nursing supervisory staff in planning, delivering, and evaluating their services to families. Specifically, the intent was to assist nurses to estimate the numbers and types of services required. The model includes a gradient of family health characteristics, an original delineation of nine basic public health nursing services, a coping index and scoring guidelines, and a methodology for integrating assessment of health needs and coping abilities.
Patient Classification in Home Health Care: Are We Ready?
Authors: Cox Cheryl L. , Wood Joan E. , Montgomery Andrew C. , Smith Patricia C.
Published: May 2007

This longitudinal descriptive study retrospectively profiled the acutely ill patient in home health care and explored the utility of using patient record data in predicting agency resource use and patient outcome. The findings suggest that those variables traditionally relied on for reimbursement qualification and as components of patient‐classification schemes may not be wholly adequate to explain resource use and patient outcome in the home health setting. Professional nursing judgment of the patient's prognosis was found to be the most sensitive variable predicting outcome. Selected diagnoses and self‐care capacity of the patient were the major predictors of resource use. Suggestions are offered for further studies that may move public health nursing more quickly toward the development of consistent and accurate home health care case mix measures.
Public Health Nurses and Family Planning
Authors: Oakley Deborah , Swanson Janice , Swenson Ingrid , Marcy Shirley
Published: May 2007

Unintended pregnancy is a health problem that is particularly important in the practice of public health nurses (PHNs). Data from 844 PHNs showed that they were likely to practice in settings that incorporate family planning services and were knowledgeable about specific family planning methods. They favored family planning services and an expanded supportive government role in both family planning and abortion. Since PHNs are an important resource for the community activism required to build the consensus needed to expand these services, a multiple‐regression analysis was performed to determine predictors of activism. Political participation was the major predictor for activism on both family planning and abortion.
A Study of Community Differences in Stress Among the Elderly: Implications for Community Health Nursing
Authors: Preston Deborah Bray , Crawford Charles O.
Published: May 2007

It has long been known that stressful states are linked to physical and mental health. An important dimension of emotional stress is community environment. That is, communities can produce stress in individuals but can also provide the coping resources that help modify these stressors. We examined differences in stress responses among a random sample of 900 elderly living in nine metropolitan and nine non‐metropolitan, randomly chosen communities in six northeastern states. Respondents were asked if, in the past year, they had experienced anything upsetting or stressful in their lives connected with family and friends, their health, and their finances. The findings support the existence of community differences in stress responses for these elderly respondents, and show evidence of a link between community structure and individual behaviors.
Rationale and Design for Health Promotion with Older Adults
Authors: Ruffing‐Rahal Mary Ann
Published: May 2007

The paper underscores the relevance of preventive and well health practices for older adults, given the current potential for extended life spans. One model for health promotion interventions consists of self‐care skills, emotional and spiritual integration, and social integration. It was based on research in which older adults identified dimensions of everyday well‐being.
Prestige: Key to Job Satisfaction for Community Health Nurses
Authors: Riordan Jan
Published: May 2007

Abstract By examining and predicting dimensions of job satisfaction of community‐based nurses, this study sought to provide information for recruiting and retaining community nurses. Data were collected from a sample of 104 community health, school health, and home health nurses. Prestige had the highest positive correlation with and was the single significant predictor of job satisfaction. Three other subscales, autonomy, social interaction, and organizational requirements, correlated with job satisfaction as moderately positive. Weak positive relationships were found with years of work, years on the job, age, and years of education. Pay was not associated with job satisfaction for these nurses.
The Concept of Poverty
Authors: Carney Patricia
Published: May 2007

Abstract Although poverty is one of the most familiar and enduring conditions known to humanity, it is an extremely complicated concept to understand. Some researchers view it as a reaction to the stress of being poor, whereas others perceive it as a process of adapting to the condition of poverty. Historical definitions are numerous, but can be classified as relating to either lack of financial income or lower social status. Numerous factors contribute to the concept of poverty, including political, economic, social, and cultural forces. The one that has consistently had the greatest effect on the evolving concept is the passage of time, which encompasses all these forces in a very intricate manner. This author explored the evolution of the concept of poverty to identify relevant themes for consideration in the public health nursing domain.
Accidental Poisoning of Children: Barriers to Resource Use in a Black, Low‐Income Community
Authors: Brannan Jo Ellen
Published: May 2007

Abstract This descriptive study examined factors that influence use of poison‐prevention measures and poison control center resources in a black, low‐income, inner‐city community. Convenience sampling was used to recruit 32 mothers of children under age 10 years at two federally funded health centers and two community food pantries. Participants were interviewed using a semistructured interview schedule. Data were analyzed qualitatively, with the results indicating that the majority of mothers had a considerable degree of awareness regarding poisoning susceptibility, severity, and prevention. However, few had access to or had used the poison control center's telephone number. Only 56% had received direct information regarding poisoning, with recall tending to be more accurate when information was obtained outside of the prenatal and postpartum settings. Lack of awareness of poisoning management and poison control center resources was most frequently cited as a barrier. Although this study was limited to one community, it indicates a possible need to distribute culturally acceptable poisoning information and frequent reinforcement for families with small children.
Use of Breast Cancer Screening by Older Hispanic Women
Authors: Longman Alice J. , Saint‐Germain Michelle A. , Modiano Manuel
Published: May 2007

Abstract The purpose of this exploratory study was to provide information on older Hispanic women's access to and use of breast cancer screening services. Interviews were conducted with 150 Hispanic women, 47 to 93 years of age. in a southwestern city. The results indicated that differences in use and compliance with recommended screening guidelines were due primarily to differences in access to the health care system and attitudes about preventive care. Targeted strategies for these women have to be developed and implemented to ensure that they receive the necessary information to avail themselves of breast cancer screening procedures.
Tetanus Immunity in Older Adults
Authors: Wesche Harry A. , Overfield Theresa
Published: May 2007

Abstract The frequency of tetanus has declined little in the past decade. The majority of cases occur in persons over 50 years of age. A sample of 225 blood donors, between the ages of 50 and 68, from a mixed rural‐suburban county, were tested for tetanus antitoxin levels. Only 14% had protective levels. This low rate indicates the need for increased attention to tetanus immunizations in older adults.
Toward Redefining Public Health Nursing in Canada: Challenges for Education
Authors: Matuk Lucia C. K. Yiu , Horsburgh Martha E. Chadwell
Published: May 2007

Abstract Faced with a recent shift from a hospital‐based to a community‐based health care system. Canadian public health nurses are being challenged to redefine their roles. To empower these nurses to respond effectively, it is imperative that the profession be reclarified as a specialty with a distinct philosophy and mission. Nursing education is key to facilitate this process, and public health nursing educators must lead the way. Certain barriers hinder the response of public health nursing education, and four areas are suggested in which efforts to advance public health nursing may be best directed.
Collaboration: Integrating Practice and Research in Public Health Nursing
Authors: Henry Vonna , Schmitz Kathleen , Reif LuAnn , Rudie Patricia
Published: May 2007

Abstract The need to integrate clinical practice and research has been stressed for many years in both public health and nursing. This article describes such a collaborative project between two rural upper Midwest public health nursing agencies and public health nursing faculty from a small, liberal arts, baccalaureate nursing program. The high‐risk prenatal research project provided an opportunity for nursing staff and faculty research consultants to work together on a clinical study. A model for collaborative research is illustrated, and advantages and disadvantages for practice, administration, and research are discussed.
Community Analysis in Community Health Nursing Practice: The GENESIS Model
Authors: Stoner Martha H. , Magilvy Joan K. , Schultz Phyllis R.
Published: May 2007

A community‐analysis strategy. GENESIS (general ethnographic and nursing evaluation studies in the state), is a comprehensive, holistic portrait of communities obtained through secondary analysis of existing data and qualitative methods. The GENESIS method is delineated and examples of studies are presented. To explicate the method and illustrate the findings, an aggregate‐focused GENESIS study and two studies in which entire communities were the targets are compared and contrasted. Other defining concepts of nursing, such as caring and health, are redefined or explicated to make them congruent with the recognition that for community health nurses, the community is the client.
Evaluation of a Peer‐Education Program on Heart Disease Prevention with Older Adults
Authors: Rose Molly A.
Published: May 2007

Abstract This investigation evaluated the effect of a peer‐education program on preventing cardiovascular disease in older persons. Peer leaders at two urban senior housing residences were provided with training on cardiovascular disease and its risk factors, strategies to reduce the risk factors, and communication skills. Baseline and follow‐up data were collected on residents at the two intervention and two control sites. The dependent variables were knowledge of cardiovascular disease risk factors; perceived self‐efficacy to reduce calories, dietary fat and salt intake, to lose weight, to stop smoking, and to exercise regularly; and self‐reported cardiovascular risk behaviors. Analysis of individual change scores between baseline and follow‐up surveys showed a statistically significant increase in overall knowledge of heart disease, dietary self‐efficacy, and exercise self‐efficacy for the intervention group compared with the control group. This program appeared to benefit the individuals who lived in housing residences where the peer educators also resided.
Standards of Care for High‐Risk Prenatal Clients: The Community Nurse Case Management Approach
Authors: Mawn Barbara , Bradley Joan
Published: May 2007

Abstract The New Mexico Families FIRST project seeks to reduce maternal and infant morbidity and mortality through a nursing case management approach. The responsibilities of this community nurse include outreach, education, and care coordination of Medicaid‐eligible high‐risk pregnant women and their children. The standards of care for these families are derived from a screening tool that identifies medical, demographic, environmental, and psychosocial risks. Although evaluation of the nurse role and the tools used to identify and care for these women and children has not been completed, sharing the developmental stages of the process should facilitate similar endeavors.
Social Support During Labor and Duration of Labor: A Community‐Based Study
Authors: Pascoe John M.
Published: May 2007

Abstract The effect of a birth companion on duration of labor was examined in a sample of 66 nulliparous women in Michigan. Two‐thirds of the sample were single, 66% received Medicaid, and 88% were white. Using simple linear regression, support during labor explained a significant amount of variance in duration of labor. Duration of labor for 8 unsupported mothers was significantly longer (965 ± 206 min) than that for 58 supported mothers. Using hierarchic regression and including maternal education, marital status, race, amniotomy, and labor induction in the model before support, support during labor continued to explain a significant amount of variance in duration of labor. These findings are similar to those reported from earlier randomized trials of social support during labor. Evidence continues to accumulate that confirms the proposition that labor duration is affected by environmental as well as biologic factors.
Health, Income, and Postretirement Employment of Older Adults
Authors: Toughill Eileen , Mason Diana J. , Beck Theresa L. , Christopher Mary Ann
Published: May 2007

Abstract After a poor response to advertisements for employment for older adults, a community health nursing agency surveyed 216 individuals ranging in age from 60 to 96 years to examine their attitudes toward postretirement work, perceptions of barriers to and facilitators of employment, and the influence of perceived health status and income on these factors related to labor force participation. The findings are consistent with continuity theory of aging, and underscore the need for public policies aimed at supporting the decision of older persons to work or retire.
Knowledge of AIDS and Safer Sex Practices Among College Freshmen
Authors: Dilorio Colleen , Parsons Margaret , Lehr Sally , Adame Daniel , Carlone Joyce
Published: May 2007

Abstract We assessed knowledge of the acquired immunodeficiency syndrome (AIDS) and of safer sex practices among college freshmen. A second purpose of the study was to assess this knowledge among black as well as white students. Students attending classes at three private colleges in a large southern city were asked to participate in the study. Respondents completed the modified AIDS information survey, the knowledge of safe sex practices questionnaire, and a demographic data sheet. A total of 689 questionnaires were received from single college freshmen. The results indicated that respondents were knowledgeable about the cause and transmission of AIDS but were less knowledgeable about medical aspects. Most knew that condoms are effective in preventing the spread of AIDS, but fewer could differentiate between the effectiveness of latex and nonlatex condoms. These findings are useful to health educators in improving AIDS education programs.
Predicting Use of Hearing Protection: A Preliminary Study
Authors: Lusk Sally Lechlitner , Kelemen Marilyn J.
Published: May 2007

Abstract The National Institute of Occupational Safety and Health targeted noise‐induced hearing loss as one of the top 10 occupational hazards. Research has been directed toward reducing noise exposure rather than identifying the factors associated with workers' decision consistently to use hearing protection. The long‐term goal of this program of research is to develop a causal model explaining workers' use of hearing protection to guide development of nursing interventions. This study was a preliminary one to prepare for testing Pender's health‐promotion model (HPM) as a causal model. Ninety‐eight skilled tradesmen completed written questionnaires at their work site. Although 98% indicated they were supposed to wear protection, their reported use averaged 50.3% of the time. Reported use significantly and positively correlated with workers' perceptions of the benefits and self‐efficacy of use, value of outcomes regarding keeping out noise and increased well‐being, and health‐promoting behaviors in the areas of self‐actualization and stress management. Perceptions of barriers of use were significantly and negatively related to use. In regression analyses of use of hearing protection on components of the HPM and dimensions of health behavior and lifestyle, one component of the HPM (benefits) and two dimensions of health behavior and lifestyle (self‐actualization and interpersonal support) significantly predicted use, accounting for 24% of the variance in use of protection. Knowledge of the predictors of hearing protection use will ultimately aid nurses in implementing interventions, increasing use, and decreasing hearing losses.
A Model for Delivering Culture‐Relevant Care in the Community
Authors: Bernal Henrietta
Published: May 2007

Abstract The increase in cultural diversity of the urban populations of the United States is presenting a challenge for the delivery of culturally relevant care by community health care nurses. We developed a model for delivering such care built on key theoretical concepts derived from community health nursing, transcultural nursing, self‐efficacy, and social support theories.
Maternal Factors That Influence Inadequate Prenatal Care
Authors: York Ruth , Williams Pamela , Munro Barbara Hazard
Published: May 2007

Abstract Fifty‐seven pregnant women who received inadequate prenatal care identified the factors that influenced their decisions related to prenatal care. Data were collected in an institution that serves neighborhood clinics that offer free prenatal care and can be reached by public transportation. Women were interviewed either prenatally (n=23) or postnatally (n=34). The interview questions were drawn from the literature on the adequacy of prenatal care. The women identified 22 personal reasons and structural barriers for receiving inadequate prenatal care. The five most frequently cited reasons were small children at home, no medical assistance card, didn't know reason, sadness or ambivalence about the pregnancy, and just moved to the area. Despite demographic risk and facing the similar barriers, some women manage to receive sufficient care and others do not. Presently, government and other policy‐making groups often believe that public insurance, Medicaid, or socialized medicine is the answer to our high infant mortality rate. However, in some geographic areas where financial barriers are not factors and where services are available that meet pregnant women's needs, some women still do not enter care early and remain in care. Data that expand knowledge on why women receive inadequate prenatal care will be useful in developing community outreach programs, preparing public service announcements, and designing prenatal services.
Loneliness, Depression, and Social Support of Patients with COPD and Their Spouses
Authors: Keele‐Card Gayle , Foxall Martha J. , Barron Cecilia R.
Published: May 2007

Abstract Thirty clients with chronic obstructive pulmonary disease (COPD) and their spouses were interviewed to examine differences in and relationships among loneliness, depression, and social support. Data were collected during structured in‐home interviews using the UCLA loneliness scale, the Center for Epidemiological Studies depression scale, and the social support questionnaire6. The clients and spouses did not differ significantly on measures of loneliness and depression, with mean scores for both groups higher than those in other comparable groups. Spouses, however, tended to be a little lonelier than clients, and clients tended to be a little more depressed than spouses. The two groups were also similar with respect to the number of people in their social networks but different as to network composition. Spouses were less satisfied with their networks than clients. Social support satisfaction was linked to loneliness and depression for clients but not for spouses. Results of the study suggest that community nurses working in home settings must be sensitive to clients' and spouses' psychologic reactions to COPD, which may be expressed in feelings of loneliness and depression.
Environmental Safety Preparation for Community‐Based Nursing Educational Experiences: Measurable Indices
Authors: Carter Shirley V. , Carroll Mary C. , Hayes Evelyn R.
Published: May 2007

Abstract Cities, formerly the hub of cultural activities and entertainment, are now more often associated with crime statistics and poverty. Students' emotional comfort and safety must therefore be prime considerations in planning community‐based nursing education. This study piloted an instrument that promises to be useful in labeling situations that affect an individual's comfort level in an urban setting. Questions that guided the study included: (1) Does the Environmental Comfort Scale (ECS) score vary with the repondents' residential zone (urban = 1, suburban = 2, rural = 3)? (2) Is the instrument (Environmental Comfort [Fear] Scale) reliable? A one‐shot, one‐group, pre‐experimental design was employed. Participants were self‐selected from a junior baccalaureate nursing class (N= 79) that was a predominantly suburban‐bred, relatively privileged population. The ECS contained nine specific environmental‐situation items that could be construed as potentially threatening to safety. Respondents were to indicate on a five‐point Likert scale the extent to which they would be fearful in each situation; 1 = least fearful and 5 = most fearful. Findings showed practically no difference in responses by residential zone and suggest a need for item refinement and a need to lengthen the tool to improve alpha coefficients. Further, the increasing demand for measurable outcomes underscores the need for continued work on instruments to produce such data. The deinstitutionalization of health care from contained grounds to uncontained community‐based settings makes it imperative that nursing education attend to the challenges of safety education.
The Meaning of Holism in Nursing: Historical Shifts in Holistic Nursing Ideas
Authors: Boschma Geertje
Published: May 2007

Abstract Throughout the history of nursing, holistic ideas can be identified that reflect nursing's ambivalence towards changes in health care and in ideas about illness during the 19th and 20th century. The relationship between historical context and the meaning of holism in nursing is described using historical as well as conceptual analyses. Three important periods are discussed: holistic public health nursing in the beginning of the century, a shift towards holistic hospital nursing in the middle of the century, and a modern holistic health nursing model that emerged in the 1960s. Each period reflects a different perspective on nursing's struggle to gain status as a profession, its complicated relationship with medicine, and its difficulty in maintaining the tradition of care and compassion within an industrialized society that becomes more individualized and fragmented.
Case Management and Preventive Services Among Infants from Low‐Income Families
Authors: Erkel Elizabeth A. , Morgan Ellen P. , Staples Myrtle A. , Assey Valerie H. , Michel Yvonne
Published: May 2007

Abstract To determine the impact of an experimental approach to case management on use of child health clinic and immunization services, a nonequivalent control group with covariate measures design was employed in a sample of 98 infants from low‐income families. The innovative pattern of care featured continuity of care; a single public health nurse (PHN) provided child health care to an infant by integrating case management and preventive services. In contrast, the customary pattern of child health care was characterized by fragmentation of services. Case management was segregated from preventive services, and multiple PHNs delivered care to an infant. As predicted, experimental‐group infants (44%) were more likely to achieve adequate child health clinic services than control‐group infants (8%) (p < 0.001). Moreover, the cost‐effectiveness (C/E) ratio (dollar cost per effective intervention) for adequate child health clinic visits in continuous care ($523) was one‐fifth of that in fragmented care ($2,900). The C/E ratio related to adequate immunization was 8% less in continuous care ($359) than in the fragmented approach ($386), although the difference in rates of adequate immunization was nonsignificant (experimental group, 64%; control group, 60%). These findings suggest that continuous PHN care with integrated case management is a more effective, cost‐efficient approach to critical child preventive services than the customary, segregated case‐management approach.
Uniting the Past and the Future in Public Health Nursing: The Michigan Oral History Project
Authors: Gates Marie F. , Schim Stephanie M. , Ostrand Lillian
Published: May 2007

Abstract In 1987 a group of Michigan public health nurses recognized the need to capture the richness of the lives of renowned public health leaders by collecting and preserving their oral histories. With the assistance of the Bentley Collection at the University of Michigan, the Michigan Oral History Project found a home. In this paper, the process of designing and implementing the oral history project is described within the framework of McBride's Orchestrating the Stages of a Career, adapted from the Dalton/Thompson/Price career development model. The steps in selecting interviewers and leaders, conducting the interviews, and keeping track of the completed work are outlined. Finally, the early results and potential uses for the collected data are discussed. This project has special significance in this year for the celebration of the centennial of public health nursing.
Evaluation of Group Health Promotion with Community‐Dwelling Older Women
Authors: Ruffing‐Rahal Mary Ann
Published: May 2007

Abstract Health promotion outcomes with older adults are characterized increasingly in terms of several effects. The outcomes of a health‐promotion intervention with a group consisting of a majority of African‐American older women were evaluated after six months. The study employed a quasi‐experimental design with intervention and control groups all living in the area of a midwestern city with the highest proportion of low‐income and non‐Caucasian elders. Women in the intervention group participated in weekly group meetings over 26 weeks. The intervention was derived from the ecologic well being model and incorporated content related to three areas of outcome evaluation: health practices, psychologic and spiritual well‐being, and social integration. Interviews conducted prior to and on conclusion of the intervention incorporated four single‐item qualitative measures and the following three instruments as outcome measures: the senior lifestyle inventory, the integration inventory, and the social integration subscale. Although no significant increases in outcomes were demonstrated over time for the intervention group, statistical analysis before and after the intervention did reveal significant contrasts among controls in relation to well‐being, health practices, and life satisfaction, suggesting a preventive‐maintenance effect for the participants.
The Effects of Violence on Health and Adjustment of Southeast Asian Refugee Children: An Integrative Review
Authors: Fox Patricia G. , Cowell Julia Muennich , Montgomery Andrew C.
Published: May 2007

Abstract Public health nurses have historically been on the front line in meeting the needs of refugees in their practice communities. Little nursing research has been focused on the needs of refugees, however. The purpose of this integrative literature review was to clarify research focused on the needs of one refugee group, southeast Asians. The integrating factors reviewed were the instruments used, sampling procedures, statistical methods, and clarification of independent and dependent variables. Power analyses were computed on three of the studies to critique further the appropriateness of sample size. Findings indicate that premigration experiences, especially violence, play an important role in health status and adaptation after settling in the United States. Since health problems are often manifested in cultural ways different from Western norms, public health nurses would benefit from continued research clarifying the needs of individuals from other cultures.