bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Profession: The Evolution of Public Health Nursing
Authors: Frachel Rae R.
Published: May 2007

Abstract From its inception in the late nineteenth century, public health nursing has aspired to professional ideology. The life and times of one early leader, Lillian Wald, illustrate the historical, scientific, and social forces that shaped the evolution of the discipline.
Mothers of Preschool Children: Coping Effectiveness
Authors: Brailey L. Joan
Published: May 2007

Abstract Public health nurses are actively involved in helping family members cope with stresses in their daily lives. They are looking for research data about methods people actually use to cope with these stresses and their relative effectiveness. This research study was an analysis of the coping responses used by 153 mothers of healthy preschool children when experiencing stress in their everyday lives with the children, the perceived effectiveness of these responses, and factors related to the coping process. Problem‐focused responses were more effective than emotion‐focused responses. The specific responses that were found most effective were handling the problem in small pieces, drawing on past experience, talking the problem over with someone else, not worrying about the problem, and viewing the problem objectively. Factors affecting the responses used were the type of event; its perceived stressfulness; mother's age, education, and employment status; and mother's appraisal of her life in general and appraisal of her ability to cope as a mother.
Description and Analysis of Preadmission Screening
Authors: Lathrop Laura , Corcoran Sheila , Ryden Muriel
Published: May 2007

The practice of screening applicants for nursing home admission to determine whether less restrictive residential settings are possible is growing as states attempt to limit costs of Medicaid expenditures for long‐term care. Preadmission screening (PAS) is a repetitive task conducted under conditions of complexity and uncertainty. Extensive knowledge and skills are required to make recommendations concerning appropriate residences for elderly persons that match their needs with available services while assuring their autonomy, as well as that of their families. We used task analysis to explicate the specific task characteristics and the knowledge and skill requirements for successful PAS.
A Quiet Day: A Peep at Some of the Varied Homes Visited by a District Nurse in the Course of One “Quiet Day”
Authors: Young Edith E.
Published: May 2007

Historical Reprint

In 1923 when this article first appeared in the February issue of THE PUBLIC HEALTH NURSE it was fairly common for board members to go with a public health nurse on her rounds for a day. Many agencies today would welcome the same opportunity but unfortunately the volunteer board member has less time available for this inside look into an agency. We may smile at the datedness of some of the descriptions but we will be quickly reminded that much of what was practiced then is practiced today. Read and enjoy!

The author of this piece was a member of the nursing committee, Public Health Nursing Department, The United Workers of Norwich, Connecticut.

Ruth N. Knollmueller
Year 2000 Health Objectives for the Nation
Authors: McFarlane Judith
Published: May 2007

An historical account of the development of national health objectives is presented, followed by the current process of formulating year 2000 health objectives. Priority areas are included together with suggested strategies for involvement in the process of setting the objectives.
Evaluating Nursing Productivity in Child Health
Authors: Clark Mary Jo , Conway Marian , Hudson Nancy
Published: May 2007

As nurses are increasingly concerned with assessing and improving their productivity in a variety of settings, they must make systematic use of an evaluation model. The Discrepancy Evaluation Model (DEM) was used to evaluate the productivity of nurses in child health clinics in five centers in the southeastern United States. The first step in any evaluation is to identify standards against which performance can be measured. In this project, no standards were available, and creating them was the first task. Standards for productivity in child health were developed that accounted for differences in clients and the experience level of nurses, while maintaining quality of care. They were situation specific and allowed for the constraints operating in each of the five centers. Discrepancies between the standards and observed performance were identified and underlying factors examined, resulting in a number of recommendations that could streamline the provision of services and improve nursing productivity. The evaluation process can be applied to public health nursing services in a variety of settings.
The Homeless Experience: Clinic Building in a Community Health Discovery‐Learning Project
Authors: Turner Saundra L. , Bauer Geraldine , McNair Evelyn , McNutt Brenda , Walker Wanda
Published: May 2007

The concept of discovery learning is exemplified in this account of four students and their instructor who began and developed a nurse‐run clinic for the homeless in a community health project. The students were registered nurses returning for their bachelor's degrees. They experienced frustration at learning the difference between care based on their assessments of patients' needs and care geared to clients' assessments of desired interventions. The journals that they kept reveal self‐discovery as well as new respect for other humans. In addition, a new type of community care emerged, which gives all indications of surviving.
Evaluation of a Worksite Wellness Program: Impact on Exercise, Weight, Smoking, and Stress
Authors: Blank Sherman Jacqueline , Clark Lauren , McEwen Marylyn M.
Published: May 2007

This study evaluated the effects of a wellness program at the workplace in relation to its impact on exercise, weight, smoking, and stress of the employee participants. A quasi‐experimental design was selected in which data were collected at three specific intervals: before and immediately after program completion, and three months after program completion. The sample consisted of experimental and control groups. Persons (n = 59) who did participate in the wellness program made up the experimental group, and those (n = 49) who did not participate in the wellness program served as controls. Descriptive statistics were used to summarize the data. No significant differences were noted between participants and nonparticipants in the areas of exercise, weight, smoking, and stress between the initial evaluation and after completing the wellness program. The areas of stress reduction and increased exercise were emphasized more in the participants than the nonparticipants, however.
Constructs of Health Promotion and Wellness in a Salvadoran Population
Authors: Boyle Joyceen S.
Published: May 2007

Theoretical frameworks are necessary to clarify concepts of health promotion in diverse groups, as nursing interventions must be shaped to fit populations' cultural and health profiles. This study explored health‐promoting beliefs and practices of a group of Salvadoran refugees. Data were collected through the use of ethnographic methods, including focused and open‐ended interviews as well as participant observations. Four major constructs of health promotion were derived from the literature and used to operationalize the concept of health promotion as a basis for the interview questions; these constructs were nutrition and weight control, exercise and physical fitness, stress management, and social support and help. The 53 subjects described beliefs and practices about health promotion that were relevant in their daily lives. Theoretical constructs, inductively developed from the data, suggested that complex constellations of family, supportive friends, religious affiliations, and work opportunities enhanced well‐being. Personal health practices related to fresh air, sleep, and good nutritional practices were deemed important by the informants. Nurses who understand the community and can obtain access to resources and develop individual care strategies within the context of the family are likely to promote wellness and health functioning in this population.
Rebuilding Public Health Nursing Practice: A Canadian Perspective
Authors: Yiu Matuk Lucia C. K. , Horsburgh Martha E. Chadwell
Published: May 2007

Although the importance of preventive services has been emphasized in Canada, the status of public health nursing appears to be in jeopardy. Major challenges confront the profession, and certain strategies may help to rebuild it as a broad‐based nursing specialty.
The AIDS Pandemic: A Nursing Model
Authors: Talashek Marie L. , Tichy Anna M. , Salmon Maria E.
Published: May 2007

The pandemic of acquired immunodeficiency syndrome (AIDS) calls for global cooperation to develop strategies for interventions both to prevent the disease and to care for persons with it. The conceptual framework “Health for all: A model for nursing's contributions” provides guidance for the processes of assessment, diagnosis, planning, implementation of care, and evaluation of mortality and morbidity related to AIDS. The disease challenges the biologic, sociologic, medical‐technical, and environmental determinants as they affect health. Specific recommendations for health care interventions are relevant to each determinate, with community health status as the focus.
AIDS and Homosexuality: A Longitudinal Study of Knowledge and Attitude Change Among Rural Nurses
Authors: Young Elaine W. , Koch Patricia B. , Preston Deborah B.
Published: May 2007

With no effective medical treatment or vaccine for acquired immunodeficiency syndrome (AIDS) available now or in the near future, nursing can make the most difference by providing emotional support and physical care for people with AIDS and their families. One of the least understood areas in providing such care is the feelings nurses have toward persons with AIDS, especially in rural areas. This study measured changes in knowledge and attitude toward AIDS and homosexuality before, immediately after, and three months after an all‐day AIDS workshop for nurses. The program provided current knowledge about transmission of the human immune virus and risk behaviors, and addressed personal feelings regarding fear of caring for persons with AIDS as well as negative feelings associated with homosexuality. Results revealed significant positive changes in knowledge and attitudes three months later. Participants also became significantly less fearful and more willing to care for persons with AIDS. Feelings of fearfulness and willingness to care for people with AIDS were associated not with knowledge differences but with differences in attitudes toward the disease and homosexuality. Therefore, this program's affective component was more closely associated with precursors to behavior change than was cognitive education. As the education needs of rural and community nurses increase, programs specific to them must continue to be developed and studied. Future research must also explore and evaluate actual nursing care of AIDS patients in relation to education program objectives.
The Mutual‐Participation Relationship: Key to Facilitating Self‐Care Practices in Clients and Families
Authors: Pesznecker Betty L. , Zerwekh Joyce V. , Horn Barbara J.
Published: May 2007

The relationship among formal providers, clients, and families in home care is critical. If clients and family care givers are to develop adequate and safe self‐care practices, they must be involved in mutual decision making concerning issues related to the illness and the care to be given. A relationship of mutual participation involves facilitating and negotiating goals with clients and their family members.
Public Health Nursing Interventions to Improve the Use of a Health Service: Using a Pilot Study to Guide Research
Authors: Selby Maija L. , Riportella‐Muller Roberta , Sorenson James R. , Quade Dana , Sappenfield Mary M. , Potter H. Belle , Farel Anita M.
Published: May 2007

Abstract: This article demonstrates how a pilot study can provide useful direction for a research project. In planning a study to improve the use of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program for Medi‐caid‐eligible children, we tested our research methods and interventions (mailed pamphlets, telephone calls, home visits) on a small scale (N= 100) prior to implementing a large‐scale (N > 2000) project. The issues and obstacles included obtaining cooperation from many agencies involved in administering the Medicaid program, addressing informed consent, assessing feasibility of methods for random sampling and random assignment, identifying sources of Medicaid data, designing and assessing validity and reliability of research tools, and testing the feasibility of implementing interventions in the field. Our experience may be particularly helpful for public health nurses who plan to investigate approaches to improve the use of services in federally mandated health programs where cooperation from federal, state, and local agencies is required.
The Resource Dependence of a County Nursing Department: Efforts to Thrive in the 1980s
Authors: Felton Bette B. , Parker Sheryl J.
Published: May 2007

This case study documents analysis and planning in a contemporary public health nursing organization using resource dependence organizational theory. Several internal and external factors affect the organization and its relationships with its resources. We attempted to use knowledge of the environment‐organization relationship in several ways. Three examples from inside and outside the county system demonstrate opportunities for nursing to decrease the organization's traditional resource dependence and expand its base of funding and influence. Application of this theory can assist other organizations to adapt and survive in this era of diminishing health care resources.
Information Needs in Home Care: A Review and Analysis
Authors: Helberg June L.
Published: May 2007

Before prospective payment can be implemented in home care, providers and administrators in home care agencies require information in a variety of areas. This article reviews the literature on several factors likely to influence the market for home care services, including hospital use trends, the response to diagnosis‐related groups by home care agencies, proposed reimbursement patterns, patient disease and demographic profiles, and patient needs. Research must be conducted in several areas before prospective payment can be implemented in home care.
Care Coordination: A Resource‐Intensive Component of Home Health Nursing Practice
Authors: Cloonan Patricia A. , Sinister George F.
Published: May 2007

Coordinating patient care is an activity central to home health nursing practice. Nurses believe that this component of care contributes in a meaningful way to patient well‐being. Yet changes in the home care environment at the patient, agency, and system levels could jeopardize nurses' care coordination activities. This study describes the nature of the care coordination activities delivered by home health nurses and explicates the amount of time expended in these activities. A convenience sample of 143 nurses, employed in 24 home health agencies in a southeastern state, participated. They recorded their time, in 15‐minute intervals, for 10 consecutive working days. On average, they spent 29% of their time in direct care (i.e., home visits), 18% in travel, 18% in record‐keeping activities, and 16% in care coordinating activities. New mechanisms to reimburse home care are on the horizon. Studies such as this that begin to explicate the nature of care requirements are critical if appropriate decisions are to be made about the structure of a reimbursement system for home health care.
The Development of Nursing Diagnoses for Aggregates and Groups
Authors: Neufeld Anne , Harrison Margaret J.
Published: May 2007

A focus on aggregates, groups, or communities as clients is an important characteristic of community health nursing practice. Community health nurse practitioners have identified population groups as one of five functional components in a typology of community health nursing practice. Questions have been raised, however, as to whether such groups need different forms of nursing diagnoses than those used for individuals. We attempted to use nursing diagnoses in a senior community health nursing course with undergraduate students that included experience working with aggregates or groups. Issues were identified in relation to the scope of the role of nurses in the community, the selection of the client, and the use of a taxonomy.
Ethics Committees in Home Health Agencies
Authors: Abel P. Elizabeth
Published: May 2007

Home health care providers are increasingly faced with ethical dilemmas. Advancing technology, fiscal allocation guidelines, and patients requiring more complex care influence the delivery of services. Nurses providing home health care frequently must practice independently, and the possibility that they may not be adequately prepared in ethical decision making compounds the problem. As was the case in hospitals a decade ago, it is time to develop ethics committees in home health care agencies.
Preventing Low Birth Weight: Marketing and Volunteer Outreach
Authors: May Kathleen M. , McLaughlin Fern , Penner Mary
Published: May 2007

Tow birth weight (LBW) contributes to infant mortality and continues to be a public health concern in the United States. A community‐based prenatal program was established to prevent low birth weight through early and continuous prenatal care. Two key dimensions of the program were marketing and the use of volunteer neighborhood outreach workers. This paper explores the role of the program's public health nurses in relation to these dimensions and makes recommendations regarding marketing and use of outreach workers.
Phenomenologic Research as a Theoretic Initiative in Community Health Nursing
Authors: Streubert Helen J.
Published: May 2007

Phenomenologic research is a means of developing clarity on the concepts or phenomena that are the focus of community health nursing practice. Phenomenologic methodology is used in a number of disciplines, including nursing. This paper addresses how the researcher identifies the phenomena of interest, decides on the number of participants, gains access to those individuals, collects data, and analyzes and uses the findings. Specifically, community health nurses can use phenomenology to begin to define the concepts perceived to be of primary concern in the practice arena.
A Model Research Design for Comprehensive Evaluation of a Public Home Health Agency
Authors: Gandy Michael J.
Published: May 2007

The Mississippi State Department of Health developed a five‐stage model to perform an evaluation study of its home health services program. A singular element in the process was the deferral of developing the final research design structure until the second stage of evaluation was completed. Primary areas of investigation included identification of verifiable, nonverifiable, and erroneously believed factors affecting program operations; recommendations for changes that could be made in light of research findings to improve program operations both to deliver services and to maximize program earnings; and elements affecting program performance held in common with other home health programs in Mississippi and in other states.
Effects of a School Nurse Prenatal Counseling Program
Authors: Chen Shu‐Pi C. , Fitzgerald Marilyn C. , DeStefano Leona M. , Chen Edwin H.
Published: May 2007

To determine the effects of a school‐based, nurse‐run prenatal counseling program, records of prenatal care visits of students and their infants' birth weights (i.e., cases) were obtained from the state live birth certificate tape for 1985‐1987. From the same tape, a mother residing in the same community but not enrolled in the program was matched with each case on eight criteria to serve as a control. A total of 288 matched case‐control pairs were obtained. Using McNemar's test, a significantly higher percentage of the cases received adequate prenatal care than did the controls.
Drug‐Exposed Infants at Home: Strategies and Supports
Authors: Saylor Coleen , Lippa Beverly , Lee Gwen
Published: May 2007

Abstract This longitudinal, descriptive study gathered information on drug‐exposed infants at home and identified effective public health nurse interventions for them and their caregivers. These infants exhibit symptoms that may well interfere with their ability to give clear cues as part of the infant‐care‐giver interactive system. This may amplify or perpetuate the effects of the drugs and low birth weight. Fifteen infants with a positive toxicology screen were compared to controls at birth and followed for up to 12 months of age through home visits by a public health nurse practitioner. The drug‐exposed infants were significantly smaller at birth, and their most common initial problems were the need for nonnutritive sucking, excessive extensor tone, infections, and irritability. The mean weight, length, and head circumference went from the 10th to the 25th percentile at birth to the 25th to 50th percentile at 12 months. The support system and organization of the home predicted the family's ability to sustain caregiving for these infants. Effective strategies to care for these infants included recognizing states and cues, swaddling, use of pacifier, waking to eat, and smaller feedings. The role of the public health nurse was crucial for conducting early assessment, implementing strategies, and facilitating a therapeutic relationship.
Parental Adaptation to Adolescent Drug Abuse: An Ethnographic Study of Role Formulation in Response to Courtesy Stigma
Authors: Barton Judith A.
Published: May 2007

Abstract Community based nurses have increasingly been involved in caring for the parents of drug abusing adolescents. They are in need of research data about how parents are coping with the problem. This study analyzed parental role formulation in response to their position as parents of deviant children. The method of inquiry was ethnographic. Data were gathered from nonparticipant observations, parent informant journals, and interviews with parents involved in a survival group. Parents move through three phases of role formation, the content of which has implications for nursing assessments. The similarities of these parents to those of physically and mentally handicapped children is striking. Both are outside the conventional norm and are constantly involved in interpreting situations with others as to their different parenting role. A peculiarity in the findings is that the parents were less discredited by their family and friends than had been anticipated. They met their greatest discreditation from community institutions, including the school, police, and court systems, institutions that were expected to assist them in bringing their child's drug abuse under control.
Predictors of Breast‐Feeding Duration Among WIC and Non‐WIC Mothers
Authors: Hill Pamela D.
Published: May 2007

Abstract Many women cease breast‐feeding during the first eight weeks after childbirth. Few studies have assessed the relationship of social status to the duration of breast‐feeding. This research identified variables that predicted breast‐feeding duration for the first eight weeks postpartum among mothers enrolled in the Women, Infants, and Children (WIC) program and those not enrolled. Participation in the WIC program was used as a criterion for measuring socioeconomic status. A total of 400 mothers completed the survey: 200 WIC and 200 non‐WIC. A combination of five variables–introduction of formula, maternal perceived success, frequency of breastfeeding, income, and time of initiation of breast‐feeding after delivery–explained 48% of the variance in the duration of breast‐feeding. The best predictor, introduction of formula, alone accounted for 30% of the variance. There was no difference between aggregates with respect to breast‐feeding duration. Findings suggest that a number of variables can be used to identify those at risk for unsuccessful or curtailed breast‐feeding, with introduction of formula being the most detrimental.
Home Apnea Monitoring: Mothers’Mood States, Family Functioning, and Support Systems
Authors: D'Appolonia Knecht Linda
Published: May 2007

Abstract Home apnea monitoring has been used increasingly for infants with or at high risk for apnea. This study examined mood states, perceived family functioning, and perceived support systems of mothers with infants on home apnea monitors from the first week on the monitor through three months after discharge. It also compared these factors in mothers receiving care through an established home monitor program or through their own physicians. Greatest discrepancies in all three areas of study occurred during the first week at home. During this time the group receiving care through private physicians reported higher discrepancy in professional support than that in the home monitoring program. No other significant differences were found between the two groups across time periods. Community health nurses have an important role in assessing and providing counseling concerning the mood disturbance and changes in family functioning that may take place when infants are receiving this therapy, particularly in the initial time at home.
Depression Assessment and Management: Evaluating a Community‐Based Mental Health Training Program for Nurses
Authors: Badger Terry A. , Mishel Merle H. , Biocca Lana J. , Cardea Jane M.
Published: May 2007

Abstract This mental health training program was designed to increase primary care nurses' knowledge and skills about depression. The program emphasized criteria for assessing depression, presented psychopharmacologic and psychotherapeutic content, discussed care coordination among several agencies and providers, and addressed referral resources. Cultural and developmental issues were highlighted. The 237 participants had significant knowledge gains after the program on comparison of pretest and posttest measures. Client record audit found significant increases in the assessment of and intervention with depression. The training program successfully increased primary care nurses' abilities to use knowledge about depression in clinical practice.
A Comparison of the Health Status of Residents of Sheltered Care Facilities in Monmouth County, New Jersey
Authors: Knight Kathleen , Mason Diana J. , Christopher Mary Ann , Beck Theresa L. , Toughill Eileen
Published: May 2007

Abstract In the past 20 to 30 years the number of sheltered care facilities in the United States has risen dramatically. Serving what many consider to be marginal populations, they are often poorly regulated or unregulated, with little or no attention to the health of residents. A retrospective record review of 647 clients residing in boarding homes, rooming houses, a homeless shelter, and residential facilities in Monmouth County, New Jersey, suggested that whereas some differences exist among facilities in terms of clients’physical and psychosocial health problems, these differences may not be meaningful. Since New Jersey regulations require some minimal health supervision to be provided by residential facilities but not by the others, these results suggest that regulations of the other facilities should be revised to reflect better the needs and problems of the populations they serve.
Self‐Management of Over‐the‐Counter Medications by Older Adults
Authors: Conn Vicki S.
Published: May 2007

Abstract Older adults' use of over‐the‐counter (OTC) medications is usually a self‐initiated behavior that may have important health consequences. A sample of 186 adults age 65 years and over was interviewed to describe their use of 16 OTC substances and their management of the most commonly used OTC medications. Subjects reported using almost twice as many OTC as prescription medications. A structured interview format elicited subjects' self‐reports of decisions, judgments, and actions used to manage aspirins, laxatives, antacids, and vitamins. Most reported using the specific OTC preparations often. Health care providers were common but not exclusive sources of information about these products; few subjects acknowledged being influenced by advertisements. Although subjects' reported dosages and scheduling of agents were judged appropriate by nurses, some overuse of laxatives was noted, together with some continuation of laxative and antacid administration for excessive lengths of time for persisting symptoms. Few subjects identified precautions associated with the OTC medications. Questions were raised about older adults' perceptions regarding vitamin use for particular symptoms. The results of the study indicate the need for educational programs for older adults and further research about OTC substance use among these individuals.
Stressors in the Workplace: Community Health Nurses
Authors: Walcott‐McQuigg Jacqueline A. , Ervin Naomi E.
Published: May 2007

Abstract A survey questionnaire based on seven categories of stressors was completed by 67 community health nurses from three community health nursing agencies. Responses identified major sources of stress as factors associated with quantitative work overload, uncooperative family members and clients, unfamiliarity with situations, inability to reach physicians, and personal situations. These findings were corroborated by the nurses' responses to open‐ended questions. The intensity of stressors was significantly different by age group in that older nurses experienced less stress. The findings of this study have implications for management of patients, organization of workloads, and policy decisions in community health nursing practice.
Maternal Time and the Care of Disabled Children
Authors: Brust Janny Dwyer , Leonard Barbara J. , Sielaff Bruce H.
Published: May 2007

Abstract Caring for disabled children has become increasingly the responsibility of parents, even when the medical care is complex. To assess the time commitment required, 133 mothers of disabled children were asked to estimate by specific task categories the extra time required to care for the children. Total average daily care time was reported at 12 hours and 6 minutes, with 6 hours and 30 minutes consumed in “vigilant” tasks (i.e., watching a child who cannot be left alone and/or providing emotional support). Multiple regression analysis showed an increase in total caregiving hours associated with a younger child who was more physically and mentally impaired, and who required more medical treatments. The amount of time required by parents to care for their chronically ill children of necessity results in lost opportunities. Because this burden is experienced primarily by women, and because professional nurses could alleviate some of the burden, this issue deserves further study.
Homelessness as a Determinant of Health
Authors: Jackson Marcia Plant , McSwane David Z.
Published: May 2007

Abstract The homeless population in the United States is variously estimated at between 350,000 and 2.5 million. Families and children are among the fastest‐growing segments of this population. A combination of social and economic changes occurring nationally have contributed to this phenomenon. Conditions associated with homelessness have a profound effect on the individual's ability to maintain health, to have access to treatment, and to recuperate. Several health problems are specific to the homeless, and have implications for public health practitioners.
Approaching the Media with Confidence
Authors: Meade Cathy D.
Published: May 2007

Abstract The media are useful in communicating health information to the public. They are also a powerful way to promote and maintain positive nursing images. This paper examines the past portrayals of nurses in the media, explores the benefits of communicating nursing knowledge to the profession and to the community, and suggests strategies to access the media.
A Model Skills List for Orienting Nurses to Community Health Agencies
Authors: Hefty Luella Vig , Kenyon Virginia , Martaus Therese , Bell Mary Lee , Snow Lilyan
Published: May 2007

Abstract Nurse managers in community health can streamline the orientation of new employees by building planning and evaluation on a list of nursing skills that meet requirements for beginning practice. A model list of skills required in public health nursing and home health care can guide individual agencies in tailoring orientation programs to their respective needs, streamlining the process, reducing overall costs, and producing long‐term benefits for nurse managers and nursing staff.
Evaluation Study of a Transcultural Discovery Learning Model
Authors: Barton Judith A. , Brown Nancy J.
Published: May 2007

Abstract This qualitative, descriptive study explored the extent to which students' discovery learning centered around cultural understanding and sensitivity occurs in a clinical rotation involving migrant health care. Thirteen nursing students enrolled in this community health clinical rotation were the study sample. Demographically, they were similar to other baccalaureate students in the school of nursing. Characteristics that set them apart were their levels of maturity, motivation, and independence, and their ability to cope with stress and ambiguity. Student journal entries were used to explore changes in cultural understanding and sensitivity over the course of an intensive six‐week clinical experience. The method of inquiry was qualitative descriptive. Discovery learning from the perspective of the students was analyzed using domain analysis scheme. Themes that emerged from analysis of the data were personal and professional growth, specialized nursing practice roles with ethnic minorities, and health care system needs and issues for culturally sensitive care. Our findings contribute to faculty understanding of the degree to which student nurses make a transformation in terms of cultural understanding and sensitivity, and the process by which increased cultural understanding and sensitivity result in application of theoretical transcultural concepts.
Risk Factors for Disease in a Homeless Population
Authors: Vredevoe Donna L. , Brecht Mary‐Lynn , Shuler Pam , Woo Mary
Published: May 2007

Abstract Risk factors of smoking, drug and alcohol abuse, obesity, and sedentary lifestyle were related to health problems of clients at a walk‐in clinic for the homeless. The sample of 1252 clients was predominately male (91.4%) and multiethnic, with a majority (65%) age 18 to 40 years. Data on diagnoses of health‐related conditions were collected from clinic charts, coded into ICD categories, analyzed for relationships of risk factors to health problems, and compared with categories of diagnoses in a matched national sample of ambulatory care visits. Findings indicate that a larger proportion of homeless suffered from health problems in 24 of 27 diagnostic categories than the nonhomeless. Most prevalent were respiratory, dermal conditions, injuries, and digestive problems, in that order. Risk factors of alcohol abuse, smoking, sedentary lifestyle, drug abuse, and obesity were predictive of health problems in 18 of the categories analyzed. The findings suggest that immediate interventions such as education and rehabilitation to reduce risk factors, and provision of facilities for personal hygiene and cleaning of clothing could reduce some of the health‐related conditions in this population while longer‐term solutions of housing and employment are sought. The analysis model developed here appears to be a useful way of comparing relative effects of risk factors as a basis for establishing priorities for interventions.
One Hundred Years of Powerful Women: A Conversation With Dorothy Talbot
Authors: Highriter Marion E.
Published: May 2007

Throughout 1993, Public Health Nursing will honor living public health nurses whose efforts have paved the way for the kind of practice that will lead us into the 21st century. Appearing in this issue are the first two in a series of oral histories honoring individuals selected by the editorial board.
Application of a Model for Public Health Nursing Program Planning
Authors: Ervin Naomi E. , Kuehnert Paul L.
Published: May 2007

Abstract Community health nurse (CHN) specialists have advanced educational preparation in both nursing and the public health sciences. They are called on to perform numerous advanced practice roles in public health and other community agencies, one of which is program planning. To perform this role effectively, CHN specialists should use conceptual models to guide application of the nursing process in a population‐based practice. One such model developed by a nurse for use in planning community health programs is the McLaughlin model. It was used to address the community diagnosis of risk for childhood lead poisoning, a long‐standing public health problem currently receiving renewed attention from federal public health authorities. Applications of conceptual models in practice settings can test such model's efficacy, enrich the scientific basis of community health nursing practice, and ultimately improve the health of the community.
HISTORIC ARTICLE Nursing and the Community
Authors: Winslow C.‐E. A.
Published: May 2007

The development of a coordinated and effective system of community nursing in home and in hospital, for rich and poor, is one of the most vital social problems today.
Easing the Burden on Health Departments: A Cost‐Effective Method for Public Health Nurses to Increase Private Sector Participation in the Early and Periodic Screening, Diagnosis, and Treatment Program
Authors: Selby‐Harrington Maija L. , Riportella‐Muller Roberta
Published: May 2007

Abstract Federal legislation requires states to increase use of the early and periodic screening, diagnosis, and treatment (EPSDT) program. The program provides comprehensive health services to children from low‐income families on Medicaid and has been shown to improve health and reduce health care costs. Health departments and public health nurses (PHNs) bear a major burden conducting EPSDT screenings because many private physicians choose not to provide these services. Given scarce resources, health departments alone may be unable to meet the mandate for increased EPSDT services. Thus PHNs concerned about children's access to health care may have to encourage provision of EPSDT through the private sector. This project, phase I of the federally funded Healthy Kids Project to increase EPSDT use in rural areas of North Carolina, established the cost‐effectiveness of a mailed intervention to recruit private physicians to do EPSDT screens that exceeded the capacity of health departments. The intervention, consisting of a personal letter, journal article, and pamphlet, was sent to all 73 primary care physicians in six rural counties. Before the mailing, 15 (21%) of the 73 physicians were willing to provide EPSDT screenings; after the mailing the number rose to 25 (34%). The one‐time cost to recruit each provider was less than the estimated annual cost savings associated with each child in the EPSDT program.
Theory‐Based Practice: Attitudes of Nursing Managers Before and After Educational Sessions
Authors: Beynon Charlene , Laschinger Heather K.
Published: May 2007

Abstract In Canada, professional associations are mandating theory‐based nursing as a standard of practice. Few systematic studies of nurses' attitudes toward, knowledge of, and exposure to theory‐based nursing are in the literature. We used a convenience sample of nursing managers in a public health department to describe these aspects before and after an educational program, and to identify preferred ways of learning about nursing models. The managers had moderately positive attitudes toward theory‐based nursing, which increased and were maintained six months after an educational program. Case studies and small group discussions were preferred over lectures and reading as methods of learning nursing theory. The significant increases in positive attitudes after the educational program suggest that knowledge and experience in applying nursing theory had an impact on the managers' attitudes. Managers identified a need to explore a variety of models before making a commitment to one. Leadership, commitment, and careful planning are required when the decision to introduce a model is made.
Illicit Drug Use Among Young Adults with Genital Herpes
Authors: Swanson Janice M. , Remy Linda , Chenitz Carole , Chastain Robert L. , Trocki Karen F.
Published: May 2007

Abstract Although an association exists between illicit drug use and sexually transmitted diseases (STDs) in known high‐risk populations such as prostitutes, gay men, and intravenous drug users, little is known with respect to middle‐class, heterosexual populations thought to be at less risk. We examined findings related to illicit drug use among young adults with genital herpes from a larger study of young adults' adaptation to chronic disease. In this cross‐sectional retrospective study, 70 subjects age 18 to 35 years were interviewed and asked to fill out questionnaires. The sample was predominantly white, heterosexual, employed, and college educated. Responses to open‐ended questions related to illicit drug use were coded and compared with findings from two other surveys: a national household survey, Pacific region, metropolitan areas; and a household survey of a San Francisco Bay area county. All but eight subjects (88.6%) reported that they had used an illicit drug at some time in the past. The median number of drugs used was 4; the maximum number was 11. Only six drug‐using subjects reported that they had restricted their use to marijuana. Those with genital herpes were more likely to report ever using an illicit drug at some time in the past, and, more specifically, in the past year, than subjects in the two comparison surveys. Such findings suggest that programs screen for illicit drug use as a risk factor in middle‐class young adults with genital herpes and other STDs, and for STDs in persons referred for drug abuse treatment.
Consistency and Cost of Home Wound Management by Contract Nurses
Authors: Turner Joan G. , Larson Elaine L. , Korniewicz Denise , Wible Jean M. , Baigis‐Smith Judith , Butz Arlene , Sennett Lynne
Published: May 2007

Abstract The purposes of this descriptive study were to determine the consistency of wound care provided by home health care nurses with the physician's order and the agency's written wound protocol; and the type and cost of wound‐management products and nursing services associated with home care.

Eleven registered nurses were observed providing wound care in 117 home visits to 31 patients. In addition to the observational component, data were also collected by chart review to facilitate comparison of observed vs. documented care.

There were statistically significant differences between observed care given and that which was documented in patients' records. Consistency of care for individual patients was high when care was delivered by the same nurse, but lower when different nurses were involved. The mean dollar value of supplies used for all visits was $9.40, and the average nursing charge per visit was $89.
Family Goals as Indicants of Adaptation during Chronic Illness
Authors: Stetz Kathleen M. , Lewis Frances Marcus , Houck Gail M.
Published: May 2007

Abstract Families that successfully adapt to new situations have been found not only to appraise the situations as manageable but also to possess the necessary resources to meet the challenges. The purpose of this study was to determine the goals that families in which the mother had chronic illness identified for themselves and how these goals related to family functioning. A five‐occasion. 15‐month, descriptive longitudinal design was used to collect data. Data from occasions 2 and 3 were used to generate the coding scheme. This coding scheme was used to analyze the fourth‐occasion data set, which is presented here. The sample at the fourth occasion consisted of 103 families in which the mother was diagnosed with breast cancer, diabetes, or fibrocystic breast disease. Content analysis of responses revealed 10 mutually exclusive categories of family goals: viability of children, cohesion, adaptation, boundary alterations, health maintenance, conflict management, individual achievements and pursuits, acquisition of possessions, financial stability, and family relocation. Types of goals identified did not significantly differ by disease type. The results suggest that family‐system goals are relatively enduring and not readily discarded in response to health or illness disruption.
School Nursing in America—1902‐1994: A Return to Public Health Nursing
Authors: Hawkins Joellen W. , Hayes Evelyn R. , Corliss Carolyn Padovano
Published: May 2007

Abstract In October 1902, Lina Lavanche Rogers began her work in the New York City schools as the first school nurse in the United States. The purpose of this research was to examine the evolution of school nursing as it exemplifies development of a public health nursing specialty. Historiographic methodology was used. Primary sources included materials written by pioneers in school nursing. Secondary sources included journals, books, newspapers, biographical materials, and unpublished materials from the archives of health care and educational institutions and agencies. Public health nurses in 1902 had a model for practice that was considerably more independent and interdependent than that characterizing the practice of hospital nurses. From its origins in public health nursing, the role of the school nurse shrunk in many school systems to that of dispenser of bandages and aspirins, only to return once more to an advanced practice model. HIV, tuberculosis, sexually transmitted diseases, addiction, and violence have returned and/or replaced the contagious diseases of 1902 and the early years of school nursing. New immigrants, poverty, homelessness, and lack of primary care offer challenges to school nurses to meet the needs of schoolchildren and their families in the 1900s.
Traveling for Care: Factors Influencing Health Care Access for Rural Dwellers
Authors: Horner Sharon D. , Ambrogne Janet , Coleman Martha A. , Hanson Charlene , Hodnicki Donna , Lopez Sue Ann , Talmadge M. Christine
Published: May 2007

AbstractThis study explored 19 rural dwellers' perceptions of health care issues through semi‐structured interviews. Sample selection, data collection, and analysis adhered to the grounded theory method in that an interactive design was maintained. The strategy of traveling for care describes how rural dwellers deal with the problem of varying access to health care. This study uncovers the influencing factors that impact on rural dwellers' decisions when traveling for care. Most rural dwellers choose to wait before seeking health care; those factors that contributed to the decision to wait includes limited financial resources to pay for health care, prior experiences within the system, and the prevalent belief that they can provide self‐care effectively. When self‐care was not successful they evaluated their resources to assist in their decision making. The last phase of this strategy was choosing the distance they would go to receive health care. Choosing the distance varied greatly among the participants. A few choose to go without health care whereas others would go to any lengths to resolve their health problem.
Community Analysis: A Collaborative Community Practice Project
Authors: Barker Joyce B. , Bayne Tina , Higgs Zana R. , Jenkin Shirley A. , Murphy Denice , Synoground Gail
Published: May 2007

Abstract
Lack of access to health care is a concern in many communities. A group of representatives from health, social service, other community agencies and nursing education meet regularly to address issues in providing care to homeless, low‐income, and uninsured persons in Spokane. Washington. This group's efforts has been hampered by lack of clearly identified factors that adversely affect access to care. One aspect of community analysis performed by this group used a collaborative community practice model. Community diagnoses were determined from information collected from service providers. Community health nursing faculty, as clinical specialists, can play a role in such a collaborative process.