bluuebunny/crossref_metadata_2025 huggingface dataset:
Community Determinants of Health for Rural Elderly
Authors: Craig Carol
Published: May 2007

AbstractAlthough community health nursing practice supports community‐level interventions, the influence of communities on the health of older members is not well known. Ethnographic design and methods were employed to study the health of older residents in a western plains farming community. Relationship was a key component for understanding life in this town. Reciprocal relationships in which older people and the community were mutual benefactors were crucial to the acceptability of help and support. Stressors were lack of privacy and isolation for those who did not conform to prevailing norms. Nurses in rural areas have to foster a sense of relationship and reciprocity within a community, since assistance is accepted most easily when older people can repay in kind. Advocating the use of government supports and programs may not be successful if the programs do not require such contributions. Close relationships can be stressful as well as supportive, and increasing social support and monitoring for an older person may inadvertently decrease privacy and promote stress.
Influences on Mothers' Use of Clinician Help in the Infants' First Three Months
Authors: Pridham Karen F. , Chang Audrey , Chiu Yiu‐Ming
Published: May 2007

AbstractFactors that influenced use of physician and nurse help were explored for 49 mothers of healthy, term‐born infants for two study periods in the first three months. These factors were concepts pertinent to mothers' internal working models of help use, their resources, perceived problem‐solving competence, and clinical evaluation of maternal competence in use of help. Variables contributing to the frequency with which help was used and to the ratio of that help to other communal help sources differed for nurse and physician help and for the time period. For physicians, the number of infant caretaking issues a mother identified contributed to the frequency of help use in both study periods. The problem‐solving help nurses gave emerged as a critical help in the second study period. The ratio of help from nurses to that from other sources was higher when mothers identified reassurance from the nurse as a critical help and, in addition, as the infant grew older, when the nurse's evaluation of the mother's use of help was more positive. In contrast, throughout the first three months, the more infant care experience a mother had, the higher the proportion of help from physicians relative to communal sources of help. The findings suggest that nurses and physicians may have complementary functions when a mother uses help.
Use of Home Care Nursing Resources by the Elderly
Authors: Helberg June L.
Published: May 2007

Abstract
We explored the influence of nursing dependency over and above sociodemographic factors and medical conditions on the use of home care nursing resources by patients 65 years of age and older. Use measures were number of visits made by home care nurses, and length of nursing stay. Nurses' reports, direct observation of nursing care provided, patient interviews, and record abstraction were used to obtain data on 236 patients who were admitted to and discharged from a certified public home health agency. Nursing dependency explained a significant amount of variance over and above sociodemographic factors and medical conditions in number of visits made by nurses and length of nursing stay. Measures of nursing dependency should be incorporated into future studies that examine factors related to use of home care nursing resources.
Public Health: People Participating in the Creation of Healthy Places
Authors: Hudson‐Rodd Nancy
Published: May 2007

Abstract
At the end of the twentieth century, with concern being expressed about the global environmental crisis, the world is being seen as the home for diverse cultures who share a common responsibility, the sustenance of place. The future health of communities lies in this recognition of the importance of creating and sustaining viable places on local, national, and global scales. The contextual turn, growing from past approaches in the research and practice of public health, is addressed. Geographers and public health practitioners will find it advantageous to work collaboratively toward creating healthy places. It is especially important to reconsider the senses of place from viewpoints of indigenous and non‐indigenous peoples in Australia and Canada, to redefine whose health, whose place.
Afghan Health Education Project: A Community Survey
Authors: Lipson Juliene G. , Omidian Patricia A. , Paul Steven M.
Published: May 2007

Abstract This study assessed the health concerns and needs for health education in the Afghan refugee and immigrant community of the San Francisco Bay Area. The study used a telephone survey, seven community meetings and a survey administered to 196 Afghan families through face‐to‐face interviews. Data were analyzed qualitatively and statistically. Health problems of most concern are mental health problems and stress related to past refugee trauma and loss, current occupational and economic problems, and culture conflict. Physical health problems include heart disease, diabetes and dental problems. Needed health education topics include dealing with stress, heart health, nutrition, raising children in the United States (particularly adolescents), aging in the United States, and diabetes. Using coalition building and involving Afghans in their community assessment, we found that the Afghan community is eager for culture‐ and language‐appropriate health education programs through videos, television, lectures, and written materials. Brief health education talks in community meetings and a health fair revealed enthusiasm and willingness to consider health promotion and disease‐prevention practices.
A Care Plan for Children with Tuberculosis
Authors: Buttaro Terry Mahan , Ezell Bernice , Gray Venus
Published: May 2007

Abstract Tuberculosis (TB) increased 34.1% among children 5 to 14 years old and 36.1% among those 0 to 4 years old in 1992 (American Academy of Pediatrics, 1994). In light of this resurgence, a care plan for children with TB has been developed. Health care workers, especially community health nurses, must be knowledgeable about the transmission, pathogenesis, diagnosis, and treatment of this disease. Armed with this knowledge, an effective teaching program for nurses must be initiated to interrupt the spread of tuberculosis. The purpose of this paper is to present information regarding the spread of tuberculosis in children, current treatment regimens, a care plan specifically for children, and a description of the nurse's role in the care of the pediatric client with this disease.
The Home Visiting Process in the Contexts of the Voluntary vs. Required Visit: Examples from Fieldwork
Authors: Byrd Mary E.
Published: May 2007

Abstract Home visiting is a frequently used nursing intervention for families at risk. Yet, research on the nature of home visiting is lacking. Little empirical research has been conducted to corroborate or refine the definition of home visiting and phases of the home‐visiting process. The “Hybrid Model of Concept Development” by Schwartz‐Barcott and Kim (1986) was used to identify the nature of home visiting. The Hybrid Model combines theoretical analysis with empirical observation. The first phase includes theoretical analysis, continuing into the second phase, consisting of fieldwork. In the final analytical phase, theoretical findings are compared with the fieldwork findings. The completed review of historical and current literature and a definition of home visiting were presented earlier (Byrd, 1995). The findings of the fieldwork and final analytic phases are presented here. Two contexts of home visiting, “voluntary” and “required,” emerged as distinctive. In the voluntary context, entry was relatively easily accomplished, interaction was clientcontrolled, and the tone was informal and friendly. In contrast, in the required context, entry was difficult, interaction was nurse‐controlled, and the tone was formal, polite, and investigatory. Themes of resistance and distorted nurse‐client communication emerged in this type of visit. Client characteristics and properties of the referral were contextual factors, influencing the process. The concept's initial definition was corroborated, and the model was expanded based on this empirical observation of maternal‐child preventive home visits.
Staying Connected: The Core of Facilitating Health Care for Homeless Persons
Authors: Jezewski Mary Ann
Published: May 2007

Abstract A grounded theory study explored the ways nurses and others in nurse‐managed shelter clinics facilitate health care for homeless persons. Analysis of in‐depth interview and participant observation data yielded a core category, “staying connected,” that represents the essence of what the staff do to facilitate care for homeless persons. The three most important aspects of “staying connected” are the links that nurses establish with the homeless patient, the connections nurses establish in the form of networks with other providers, and facilitation of the homeless person's connections with the health care system. The nurses' descriptions of “staying connected” demonstrate the barriers to facilitating health care and the breakdowns that occur while trying to facilitate care for homeless persons. The barriers include lack of health insurance, insensitivity of health care providers towards homeless persons, stigmatization, cultural barriers, and communication breakdowns. Homeless persons are socially, economically, and politically vulnerable in the American health care system. Nurses have a powerful influence, both macro‐ and micro‐socially, in facilitation of care for this population.
The Interactive and Organizational Model of Community as Client: A Model for Public Health Nursing Practice
Authors: Kuehnert Paul L.
Published: May 2007

AbstractThe Interactive and Organizational Model of Community as Client is presented as a conceptual framework for the specialty of public health nursing. A descriptive study was undertaken that explored a construct of the model, community‐focused nursing. The study used a survey mailed to a stratified, random sample of directors of public health nursing (n= 145) in local health departments in an eight‐state region of the mid‐western United States. Seventy‐nine percent (n= 115) of the directors responded. The vast majority reported performance of community‐focused nursing functions. Implications for nursing‐model development, education and practice are discussed.
The Changing Spirit of Rural Community Nursing: Documentation Burden
Authors: Congdon JoAnn G. , Magilvy Joan K.
Published: May 2007

Abstract Rural community and public health nursing are characterized by an impressive commitment of nurses to their communities and a connectedness of people to one another. Home care as an integral part of long‐term and acute care for the older adult population has emerged as a vital practice area in community health nursing. The purpose of this ethnographic field study was to describe rural home care for frail older adults from the perspective of those providing and receiving care. More than 250 interviews were conducted with home care providers, recipients and their families, and other community members. The setting included eight culturally and geographically diverse counties in rural Colorado. One major theme is presented: the perceived change in the spirit of rural community nursing due to the overwhelming documentation required for home care reimbursement. Oppressive paperwork requirements impeded practice and resulted in fewer home visits per day, low job satisfaction, increased nursing staff turnover, decreased quality of care, and changed the spirit of community nursing from an emphasis on caring and community service to a focus on reimbursement. The study results have timely implications for health policy formulation as the United States undergoes major health care reform.
Use of Primary Caretakers as Proxies to Measure the Health Care Needs of Patients with AIDS
Authors: Berk Ronald A.
Published: May 2007

Abstract This study evaluated the validity of patient‐proxy responses to the Healthcare Needs Scale for Patients with HIV/AIDS. This scale measures environmental and psychosocial support, financial resources, health behaviors, social support, and health management. A sample of 35 patients with HIV/AIDS and their primary caretakers was selected from a hospital inpatient AIDS unit in Baltimore, Maryland, between 1990 and 1992. The significance of discrepancies between the patient and caretaker responses was tested with Wilcoxon's matched pairs/signed ranks test. None of the 19 scale items exhibited a significant Z statistic. It was concluded that the primary caretakers of PWAs can serve as informed proxies and provide accurate information on the patients' healthcare needs.
Public Health Nurses and the Prevention of and Intervention in Family Violence
Authors: Bekemeier Betty
Published: May 2007

Abstract This article seeks to describe the current efforts of public health nurses involved in family violence prevention while on home visits, participating in community groups, working on special projects, and developing innovative policies. Despite a dearth of outcomes research and data regarding public health nursing practice in this area, both strengths and weaknesses in public health nursing practice are evident. Improvements in nursing education related to family violence, an increase in multidisci‐plinary collaboration by public health nurses, and improvements in the utilization of public health nurses in the public health infrastructure and in primary prevention efforts would remove many barriers to effective family violence prevention strategies.
East and West of Main Street: Racism in Rural America
Authors: Supples Joanne Marky , Smith Marlaine C.
Published: May 2007

Abstract This article describes the presence in three rural communities of racism uncovered during recent community‐analysis projects. The roots of racism are viewed and analyzed from three theoretical perspectives. Based upon theoretical concepts, intervention strategies are described, and suggested methods of implementation are offered that can guide the community health nurse in the legitimation and empowerment of the various oppressed groups in the communities served.
Predictors of Progress in Smoking Cessation
Authors: Macnee Carol L. , Talsma AkkeNeel
Published: May 2007

Abstract This study examined the ability of two specific measures of stressors associated with smoking cessation to act as predictors of progress through the stages of smoking cessation as described by Prochaska and DiClemente (1983). Specifically, a 19‐item scale measuring barriers to smoking cessation and a 14‐item scale measuring smoking cessation self‐efficacy were completed by 127 smokers and self‐quitters at three time points over a six‐month period. Subjects who made progress through the stages of smoking cessation had lower barriers scores initially and had significant changes in their self‐efficacy and barriers scores over the six‐month period. In contrast, non‐progressors had no significant change in either their self‐efficacy or barriers scores over the time period. These results suggest that the two scales may provide clinically useful data to public health nurses working with smokers.
Evolution of a Public Health Nursing Program, Yukon Kuskokwim Delta, Alaska, 1893‐1993
Authors: Nord Elfrida H.
Published: May 2007

Abstract The role of public health in a reformed health care system is currently a matter of great debate at the national and state levels. Many public health nursing leaders have expressed concern about changes in public health policy and funding sources that have led to the near demise of the generalist public health nurse. Generalist public health nurses may be an endangered species; however, the role is still in existence in rural Alaska. Will they be one more example of how “what we learn from history is that we don't learn from history?” Taking the discrete area of the Yukon Kuskokwim Delta of Alaska and studying the forces of geography, politics, economics, social factors and health issues, this article provides an historic account of the development of a unique health care delivery system and the role of the public health nursing structure within it, from earliest known records to present day. The long‐standing efforts to document these data were spurred by the National Centennial of Public Health Nursing activities, celebrated in 1993.
The Use of Human Ecology and Epidemiology in Nonorganic Failure to Thrive
Authors: Reifsnider Elizabeth
Published: May 2007

AbstractChildren with nonorganic failure to thrive (NOFTT) comprise a population at risk for small stature, poor growth, slower development, and lower intellectual outcomes. These children are often seen in the Women, Infants, and Children Supplemental Nutrition Program (WIC) and child health clinics and in caseloads of high‐risk families. Public health nurses may not be sure how to intervene in the problem of NOFTT because of its multifactorial etiology. A model of nursing care that addresses the many factors that affect the development of NOFTT can enable the public health nurse to appropriately care for the child with NOFTT. The Eco‐Epi model, a combination of human ecology and epidemiology, is a conceptual model that can provide a framework for the public health nurse to plan interventions. Even though children with NOFTT are the target population for this model, it can be applied to other public health nursing populations at risk for multifactorial problems. In the Eco‐Epi model, the epidemiological concepts of agent (food), host (child), and environment (home) are examined in the context of the microsystem (parent‐child interaction, daily activities of the family), the mesosystem (interactions between different environments), and the exosystem (the child's community). The concepts of microsystem, mesosystem, and exosystem are from the theory of human ecology. Examples of how the model works to assess a family and design interventions are provided.
Client Characteristics Associated with Not Keeping Appointments for Public Health Nursing Home Visits
Authors: Josten LaVohn E. , Mullett Sara E. , Savik Kay , Campbell Ronald , Vincent Pauline
Published: May 2007

Abstract Home visits have been identified as an intervention strategy for high‐risk pregnant women. A necessary component of this intervention strategy is for the women to be home for the visit with the nurse. The purpose of this study was to identify factors associated with women not keeping their home visit appointments with a public health nurse. Subjects were 232 lowincome high‐risk pregnant women who received at least one home visit by a public health nurse. Younger age, more stressful life events, receipt of medical assistance, inadequacy of prenatal care, noncompliance with health recommendations, and longer gestational time were associated with not keeping public health nursing appointments. While this study provides some insight into the factors associated with women not keeping their appointments with the public health nurse, further investigation is warranted to identify strategies to reduce the incidence of not‐kept appointments.
What Is Known about the Health of Rural Homeless Families?
Authors: Wagner Janet D. , Menke Edna M. , Ciccone Janet K.
Published: May 2007

Abstract Families represent the fastest‐growing subgroup of the homeless population. Most of the research has focused on urban homeless families and not on rural homeless families. The purpose of this study was to describe the characteristics and health of rural homeless families in Ohio. A descriptive crosssectional design was used to study 76 families who had 125 children under 12 years of age. An interview schedule, the Denver Developmental Screening Test (DDST), the Child Behavior Checklist (CBCL), and the SCL‐90‐R were used to collect data. The majority of the mothers perceived themselves and their children as having no physical health problems. Twenty‐four of the children were behind on their immunizations. Forty‐four (52%) of the children under 6 years of age had DDST scores that indicated they might have developmental lags and 15 of the children over 4 years of age had CBCL scores that indicated they might have behavioral problems. The reported use of illegal drugs, alcohol, and cigarettes was high for this group of mothers. Strategies are included that nurses can use in working with rural homeless families.
The Value of Community Health Nursing: A Phenomenological Study of the Perceptions of Community Health Nurses
Authors: Leipert Beverly D.
Published: May 2007

Abstract This study explores and describes the value of community health nursing from the perspective of community health nurses. The phenomenological method as defined by Colaizzi (1978) guided this exploration. Eleven community health nurses from the health department of a large urban center were interviewed for the study. The data revealed five major themes: 1) the value of activities in community health nursing: 2) the value of the purposes of community health nursing; 3) the value of prerequisites for community health nursing; 4) the value of the visibility of community health nursing; and 5) the value of community health nursing as the way to the future in health care. The findings of this study are particularly important in light of recent government interest in community health. However, if community health nurses are to capitalize upon this window of opportunity, they must clearly and forcefully articulate and make visible their value. Further research, particularly from a qualitative perspective, could help to advance this field of practice. Research that articulates the value of community health nursing in various settings and from the perspectives of various nurses, clients, and colleagues could also clarify and promote the collective and individual value of community health nursing.
Characteristics of Clients Who Receive Home Health Aide Service
Authors: Hays Bevely J. , Willborn Elizabeth Hazen
Published: May 2007

Abstract Nurses who plan and supervise home health aide service must have a good understanding of the amount and intensity of nursing care and the amount of home health aide service that individual clients will need. However, there is little in the nursing literature that describes how clients who receive both RN and home health aide services differ from clients who receive only RN care. Indeed, there have been few reports on how need for home health aide service relates to the amount of nursing care received. Secondary analysis of data from a study on resource consumption in home care revealed that clients who receive home health aide service: 1) are older; 2) are more likely to be women; 3) have a higher rating using the Community Health Intensity Rating Scale; and 4) are discharged from the caseload due to death or institutionalization at a higher rate than those who receive only RN care. Clients who received both home health aide services and RN care needed assistance with activities of daily living, but they also required more RN care than did clients who received only RN care. These data hold implications for nurses in addressing agency staffing, focusing home health aide training, and advocating for resources to address service needs of this segment of their care population.
The Effects of Community Differences on Health Status, Health Stress, and Helping Networks in a Sample of 900 Elderly
Authors: Preston Deborah Bray , Bucher Julia A.
Published: May 2007

Abstract Documenting the social and environmental conditions that promote the health and well‐being of individuals is an important step in the advancement of community health nursing knowledge. With the current growth of community‐based health care, it would seem to be a prerequisite for planning community‐level interventions. The purpose of this research was to link structural properties of communities to the functioning of individuals. We examined the link between levels of community education and percent population change as derived from census data from 18 randomly selected communities and individual measures of health, health stress, and network support in a sample of 900 elderly living in these communities. Results indicate that when community education levels are high, community growth does not affect the health of the elderly which results in less stress with health and the need for fewer helpers. If, however, community education levels are low, and the population is growing, elderly experience poorer health and more health stress and they need more help.
Safety Concerns Affecting Delivery of Home Health Care
Authors: Kendra Mary Agnes , Weiker Aloise , Simon Susan , Grant Abigail , Shullick Diane
Published: May 2007

Abstract Factors influencing the remarkable growth of home health care include increased elderly population, decreased average length of hospital stay, and technological advancements that reduce the need for hospitalization. Societal changes have prompted increasing concern about personal risk to home care providers. The purpose of this pilot study was to: 1) ascertain factors related to perception of risk by home health care administrators and staff and to identify strategies used by home health care administrators to reduce risk to staff; and 2) determine whether quality of care is affected when home‐visit situations present risk. A convenience sample of 36 home health care administrators and 62 staff was surveyed about risks and measures provided by the home health care agency to minimize risk. Factors associated with risk are geographic location, high incidence of crime, inappropriate patient or caregiver behavior, infectious diseases, and evening assignments. Strategies used to minimize risk include safety programs, preplanning of visits, personal protective equipment, escorts, and buddy systems. Perceived ability to refuse high‐risk assignments, however, is questionable, as 66% of the staff stated that they leave a situation “as soon as possible.” These findings will be used to strengthen inservice programs and to provide a basis for future studies.
Managing Fear Associated with Nursing in Urban Environments
Authors: Hayes Evelyn R. , Carter Shirley V. , Carroll Mary C. , Morin Karen H.
Published: May 2007

Abstract Improvement of the health of the nation demands that we prepare nurses to deliver care to those within our urban settings. Yet students frequently are uncomfortable visiting clients in urban settings. Our initial efforts were to refine the Environmental Comfort Scale (Carter, Carroll, & Hayes, 1994), an instrument developed to measure comfort levels in various urban scenarios. This article reports the results of this instrument refinement as well as the inductive process leading to the initial conceptualization of a model that addresses threats to safety. These threats, in turn, generate fear of nursing in community‐based settings. The study participants were 120 volunteer junior students in a baccalaureate nursing program. The Environmental Comfort Scale II was administered to students at the beginning of an orientation session prior to their initial clinical nursing course. The instrument consisted of 15 items: 3 demographic items, 11 items asking students to rate their level of comfort and of fear in relation to various urban situations, and 1 open‐ended question. Analysis of data led to conceptualization of two factors that could influence comfort levels in the urban environment. The first factor was personal‐emotional (affective) and the second factor was cognitive (objective). The interaction and interdependency of these two factors led to the creation of a model.
Health Promotion Needs of Students in a College Environment
Authors: Fish Cynthia , Nies (formerly Albrecht). Mary A.
Published: May 2007

Abstract A significant amount of the mortality and morbidity experienced by Americans of all ages today is preventable. Research directed toward the identification of health promotion needs of traditional students in college environments may contribute to the development and implementation of programs and activities that assist students to adopt healthy lifestyle behaviors throughout their life spans. The purpose of this descriptive survey study was to identify the health promotion needs of traditional students in a college environment. More specifically, the research question was: What are the health promotion needs of traditional students in a college environment? Subjects were male and female students, 18‐21 years of age, and enrolled in a full‐time (minimum of 12 hours) program of study at one of two college campuses in a metropolitan southern city. One of these was a 2‐year state‐affiliated community college and the other was a private 4‐year coeducation university. A randomized sample of 148 subjects was computed. Results of this study emphasize the distinctive individual and group health promotion needs of traditional students in a college environment. Identification of the health promotion needs of this population will enable health care providers to develop interventions to assist students in developing healthy lifestyle behaviors.
Collaboration Between Communities and Universities: Completion of a Community Needs Assessment
Authors: Kulig Judith C. , Wilde Isabel
Published: May 2007

Abstract Health care reform can provide opportunities for collaboration between universities and the public at large. An advanced community nursing class within a post‐RN program at a university combined resources with a nearby rural community to complete a community health and social needs assessment. The partners in the project included the local hospital, health unit, and the university; funding was secured from the Regional Center for Health Promotion and Community Studies and the two health agency partners also made a financial donation. Community liaisons who were both registered nurses and residents of the community were instrumental in completing tasks and activities related to the project. The students were taught the various data collection methods and participated in class assignments refining the necessary skills required for the actual assessment. This project benefited the community by providing baseline health status and social needs data in an era of dramatic health care reform while simultaneously affording undergraduate nursing students the opportunity to apply theory to practice.
Profile of Postdischarge Rehospitalizations and Acute Care Visits for Seven Patient Groups
Authors: Brooten Dorothy , Naylor Mary , Brown Linda , York Ruth , Hollingsworth Andrea , Cohen Susan , Roncoli Marianne , Jacobsen Barbara
Published: May 2007

Abstract The study's purpose was to examine postdischarge rehospitalizations and acute care visits in seven high risk, high volume, high‐cost patient groups. Subjects were drawn from an urban tertiary teaching hospital. The total sample (N= 764) consisted of seven patient groups (drawn from five randomized clinical trials): very low birthweight (VLBW) infants (n= 79); women post‐unplanned cesarean birth (n= 122) and their infants (n= 123); pregnant women with diabetes (n= 55); women post‐hysterectomy surgery (n= 109); and elderly with medical cardiac Diagnostic Related Groups (DRGs) (n= 142) and elderly with surgical cardiac DRGs (n= 134). The VLBW infant and pregnant diabetic groups were predominantly African American, the elderly and hysterectomy groups predominantly Caucasian, and the cesarean group almost equally distributed. The lowest rate of rehospitalization (2%) occurred in the cesarean group, the highest (35%) in the pregnant diabetics. In four groups (cesarean and infants, hysterectomy and surgical elderly), 60%‐100% of the rehospitalizations occurred within 4 weeks of discharge. Subjects requiring acute care visits ranged from 13% (hysterectomy) to 82% (VLBW infants). Acute care visits demonstrated greater distribution throughout the follow‐up periods but also tended to concentrate in the first 4 weeks postdischarge.
The Relationship of Perceived Benefits of and Barriers to Reported Exercise in Older African American Women
Authors: Jones Maridee , Nies (formerly Albrecht) Mary A.
Published: May 2007

Abstract The purpose of this descriptive study was to determine the perceived benefits of and barriers to exercise of a convenience sample of older African American women in senior citizen centers in an urban area in the mid‐South. This descriptive study utilized a convenience sample of older African American women over 60 years of age and examined the relationship among their current exercise levels, their perceptions regarding the importance of exercise, and the benefits of and barriers to engaging in regular exercise. The level of exercise was measured using the Exercise scale of the Health Promotion Lifestyle Profile (HPLP), the perceptions of the importance of exercise were measured by a Cantril ladder, and the benefits of and barriers to exercise were measured by the Exercise Benefits/Barriers Scale (EBBS) and one open‐ended question on perceived barriers. A significant relationship was found between reported exercise levels and perceived benefits of and barriers to exercise (p < 0.001). Benefits most cited by participants reflected those categorized as life enhancing. Barriers cited most often related to exercise accessibility and availability. Results of this study support the need for community‐based exercise programs for specific populations. Nursing interventions are needed that help women in general and African American women in particular to adopt exercise as a daily health‐promotive activity.
To Pauperize or Empower
Authors: Erickson Grace P.
Published: May 2007

Abstract From its inception, public health nursing has provided health care and teaching to all people including those who are disadvantaged and impoverished. Based on the work and beliefs of Florence Nightingale and Lillian Wald, public health nurses developed positive relationships with people which resulted in healthier environments and lifestyles among diverse families and communities. And, despite societal concern that nursing care for the poor would pauperize them, it did not. It empowered them. A review of concepts of poverty and comparisons of issues and circumstances at the turn of the 20th and 21st centuries underscores the values inherent in these early initiatives and their continuing relevance to public health nursing practice that can empower, rather than pauperize, those who are disadvantaged or living in poverty.
Latino Women and AIDS Risk
Authors: Peragallo Nilda
Published: May 2007

Abstract This study describes risk behaviors among Puerto Rican women and identifies variables related to high‐risk behavior, including sociodemographic status, knowledge about HIV and AIDS, religiosity, acculturation, and attitudes toward contraceptive use and homosexuality. Puerto Rican women (N= 121) were recruited through a community‐based organization in Philadelphia. Respondents were an average of 30 years old; 21% were married and not separated, 79% were either single (50.9%), separated (14.3%), divorced (11.6%), or widowed (1.8%); 69% had 1‐3 children. Most women (74%) were at moderate to high risk for AIDS. Results from logistic regression with a single independent variable yielded no statistical significance for the following variables: income, number of children, religiosity, Rosenberg Self‐Esteem Scale, AIDS knowledge, homophobia, Symptom Checklist‐90‐R, and Population Policy Questionnaire items. When the three acculturation variables consisting of a language score, an activity score, and a preference score were examined, however, the language score was highly statistically significant, with a p value of 0.0001. Its positive logistic regression coefficient indicates that AIDS risk increases as preference for English increases. Further research is needed of Latino women that studies other Latino subgroups, given that HIV prevalence varies across subgroups.
The Role of Public Health Nurses in Responding to Abused Women
Authors: Dickson Florence , Tutty Leslie M.
Published: May 2007

Abstract The public health nurse (PHN) has a unique opportunity to identify and provide support to women who are abused by their partners. Earlier studies indicated, however that health professionals identify less than 10% of the abused women in their practice. In this study, a sample of 125 nurses responded to a measure called the Public Health Nurse's Response to Women Who Are Abused (PHNR), which consists of a vignette portraying a home visit to a young mother who showed indicators of abuse. The average PHNR score obtained was 80.8% indicating a high frequency of thoughts, feelings, and interventions that would facilitate abused women feeling helped. High scores were correlated with increased age, personal experience, number of years of public health experience, and workshop attendance. The PHNs' responses to open‐ended questions revealed that they experienced a wide range of strong emotions in dealing with these dangerous situations. While the nurses believed that addressing abuse was within their professional role, 55% were unsure of what to say to initiate the topic. Suggestions about how to introduce the subject of family violence and the training needs of PHNs are presented.
Community‐Based Service Use among the Young, Middle, and Old Old
Authors: Wallace Debra C. , Hirst Pamela K.
Published: May 2007

AbstractThe study purpose was to determine differences in number, type, and predictors of community‐based service use among elders in three age groups. Existing data from a regional Area Agency on Aging were used and the sample (n= 2.474) included vulnerable elders, men, African Americans, low income, and rural residents. Services most frequently used were case management, congregate meal, home‐delivered meal, outreach, and recreation. Differences existed among the young, middle, and old old age groups in the number and types of services used. Race, residence, transportation capability, payment source, and function were the most frequent predictors of use.
Managed Care and Public Health
Authors: Beery William L. , Greenwald Howard P. , Nudelman Phillip M.
Published: May 2007

Abstract Critics today charge that managed care organizations, intent on reducing costs to ensure survival and profitability, have forsaken public health. In fact, managed care and public health face common challenges and share common interests. Public health problems ultimately affect managed care enrollees and increase the cost of their care. Managed care organizations, then, must help reduce community‐wide health risks. Public health agencies, traditionally responsible for population health, today face serious challenges due to budget reductions and public indifference. The article to follow proposes a model for mutually beneficial collaboration between managed care and public health. Programs linking managed care with public health in the Puget Sound area illustrate this model's feasibility and value.
Social Support as Road Map and Vehicle
Authors: Bolla Christine Di Martile , Joseph Jeanne De , Norbeck Jane , Smith Renee
Published: May 2007

Abstract As part of a larger study of the impact of a social support intervention on pregnancy outcome for lower‐income African American women, 6 African American women (a medical social worker, a physician's assistant, 2 community outreach workers, a lactation consultant, and a health project representative) participated in focus group discussions concerning the unique social support needs of lower‐income African American women during pregnancy. Transcripts of focus group interviews were analyzed using qualitative content analysis. Emergent themes included strengths of African American communities, deficiencies in social support for many lower‐income African American women, the meaning of pregnancy for African American women, the ability of many pregnant women to “make it” without visible means of support, young women's locations “inside” and “outside” of “mainstream” life, and the importance of social support as a mechanism for guiding and transporting “lost souls” back into the mainstream.
Caregivers' Knowledge and Perceptions of Preventing Childhood Lead Poisoning
Authors: Mahon Irene
Published: May 2007

Abstract Philadelphia is considered a high‐risk area for lead poisoning. The Philadelphia Department of Public Health conducts education and outreach to screen children and promote prevention. Prior to this study there were no systematic data on the community's knowledge and perceptions of lead poisoning prevention. A 32‐item questionnaire was developed to assess knowledge and perceptions of family caregivers of children younger than age 8. The survey was interviewer administered in pediatric clinics in two geographic areas of the city with documented severe and moderate lead poisoning rates. Eighty family caregivers were interviewed while waiting to see the pediatrician. Caregivers in the sample were connected to a health care system and resided in areas where lead community outreach was concentrated. Nevertheless, results suggest that even caregivers of children in high‐risk areas do not mention lead poisoning as a health concern. About 61% of the sample identified eating paint chips as a cause of lead poisoning, whereas only 15% identified lead paint dust as a source of lead poisoning. Approximately 49% of the caregivers reported that they “never” or only “sometimes” perform recommended prevention activities. The Philadelphia Department of Public Health used these findings to review and modify education and outreach to prevent lead poisoning.
Nursing Case Management and its Role in Perinatal Risk Reduction: Development, Implementation, and Evaluation of a Culturally Competent Model for African American Women
Authors: Gonzalez‐Calvo Judith , Jackson Jacqueline , Hansford Centhy , Woodman Connie , Remington N. Sunny
Published: May 2007

Abstract The authors outline the need for comprehensive perinatal services management for African American pregnant women, based on social/environmental stressors, and propose a workable model for delivery of services based on case management principles. The implications of case management as an intervention to ameliorate these stressors are discussed. Data from 5 years of comprehensive case management are included to support the effectiveness of case management as an intervention among high‐risk women. Steps utilized to develop, implement, and evaluate case management are also discussed.
The Retirement Transition and the Later Life Family Unit
Authors: Smith Sybil D.
Published: May 2007

Abstract The purpose of this investigation was to determine to what extent family worldview and problem‐solving communication style influence individual and family unit adaptation during retirement. A cross‐sectional correlational survey design utilized Pearson correlations and stepwise multiple regressions. The sample consisted of 368 individuals representing 184 later life family units. Operationalized as family unit data, family worldview and family problem‐solving communication style were examined in two series: (1) with outcome variable of family unit adaptation and (2) with outcome variable of individual adaptation. Scoring of family unit data was conceptually, procedurally, and analytically congruent. The investigation extended McCubbins' work into the later life family unit giving empirical support for two propositions of the Resiliency Model (M. A. McCubbin & H.I. McCubbin, 1993). This investigation also extended A. Antonovsky's (1987) work as the second study to apply the Antonovsky Sense of Coherence Scale to a family measurement. Conclusions are that although the way the family views the world is important during retirement, being affirmed by family members is more important. The investigation highlights the importance of a positive problem‐solving communication style for a positive level of family adaptation. Individual adaptation during retirement was more influenced by family worldview.
A Fall Prevention Educational Program for Community Dwelling Seniors
Authors: Schoenfelder Deborah Perry , Why Kyle Van
Published: May 2007

Abstract The purpose of this research was to assess participants' responses to a fall prevention educational program. Fourteen persons volunteered to participate in the study conducted at a large senior center. Descriptive statistics were used to characterize the sample and to assess subjects' awareness about falls, attitudes about fall risk, fall prevention behaviors, and incidence of falls before the fall prevention program and again at one month and three months after the program. Forty‐six percent of the sample had fallen in the previous year. In general, subjects' perceptions that their risk of falling was lower than others of the same age and sex increased following the fall prevention program. Additionally, subjects were somewhat more concerned about falling after attendance at the fall prevention program. Most of the participants completed the home safety checklist; however, very few subjects made changes at home to reduce the risk of falling or did the recommended muscle strengthening exercises. Suggestions for community fall prevention programs are offered based upon the pilot results.
Family Caregiver's Satisfaction with Home Care in the Taipei Metropolitan Area
Authors: Chiu Lian
Published: May 2007

Abstract This research was designed to evaluate the quality of home care by examining family caregiver's satisfaction with home care services received. The sample for this study were 110 families using home care from the Taipei Metropolitan Area. Data were collected from interviews of the family members. The degree of satisfaction with each attribute of services was measured using a Likert scale with 5 responses. The degree of general satisfaction with home care was averaged across 19 attributes. More than 91.0% of the family caregivers believed that the respect, consideration, concern for questions, and acceptance for suggestions from home care workers did not need any improvement. In contrast, at least two‐thirds of the family caregivers felt the speedy provision of services in an emergency and the degree of ease of contacting home care workers by telephone needed improvement. The number of desired attributes that were received was a significant determinant of general satisfaction with home care services received. Family caregivers who received at least 14 attributes tended to be more satisfied with home care services than the respondents who received fewer than 14 attributes of home care services. Overall, subjects receiving home care services were satisfied. The more desired attributes of home care received, the higher the satisfaction with home care.
The Effects of Nursing Case Management on the Utilization of Prenatal Care by Mexican‐Americans in Rural Oregon
Authors: Thompson Maye , Curry Mary Ann , Burton Deborah
Published: May 2007

Abstract This quasi‐experimental, retrospective study used birth certificate and medical record data to evaluate the effectiveness of the Rural Oregon Minority Prenatal Program (ROMPP) in improving patterns of prenatal care utilization by rural‐dwelling, low‐income, Mexican‐American women at risk of poor pregnancy outcomes. The ROMPP intervention provided nursing case management services and peer outreach to pregnant Mexican‐American women in a rural Oregon community. The intervention group had more prenatal visits in months 2, 3, 4, 5, 6, and 7 than the comparison group (P < 0.05). The intervention group had a similar number of emergency room (ER) visits, but had more respiratory diagnoses and fewer urinary tract infections. ROMPP women had more inpatient admissions and longer lengths of stay. No differences were found in the initiation of prenatal care or the total number of prenatal care visits, nor in the timing of screening serum glucose tests. The intervention should be expanded to address the persistent attitudinal, financial, transportation and language barriers to adequate prenatal care. Nurses should increase their cultural competency and sharpen their clinical focus on advocacy, marketing, facilitation of relationships between community groups, and community organizing.