ANALYSIS OF A NURSING PRACTICE AS A MODEL HEALTH CARE SERVICE FOR PERSONS WITH MENTAL RETARDATION.
Contributors: Florence Heller Graduate School for Advanced Studies in Social Welfare.
Published: 1987
Number of pages: 248
Subjects: Health Sciences, Nursing.
Description: This study uses several different methodological approaches to evaluate a nursing practice as a model health service for persons with mental retardation who live in the community. This practice is owned by three nurse practitioners who contract with physicians to provide medical consultation. Financing for these services is on a prospective basis through a contract with the area agency on mental retardation.

Field methods of observation and interview are used to describe the process of caregiving that occurs in this practice. The findings of this study bear out the hypothesis that given nurse ownership and a clientele consisting of persons with mental retardation, the emphasis of this practice would be on supportive tasks rather than clinical scientific tasks. Nurses were observed to spend more time with clients than was reported in the literature; to design individualized approaches to meet clients' health needs; to emphasize normalization and independence with medical self care and to foster health and wellness in addition to treatment of illness. The nurses were also found to have a specific supportive role in their availability to direct care staff in sheltered workshops.

A pre and post design is used to examine outcomes of care for 24 of the 30 clients served by this practice. The wilcoxon matched pairs sign ranks test was used for the analysis. Clients served as their own controls in a pre and post entry into practice comparison on variables that measured medical self care and use of health care services. Clients were found to be significantly more independent in medical self care activities after twenty-one months in the practice. A medical record review revealed that a significantly greater number of acute problems were identified in the year after clients' entry into the practice than in the preceding year. There was no significant difference pre and post entry into practice on all other variables measuring use of health services.

A cost study revealed that the cost to the area agency for this nurse practitioner model was less than the cost using a traditional physician model of health care delivery.
Notes: Source: Dissertation Abstracts International, Volume: 48-08, Section: B, page: 2266.

Thesis (PH.D.)--BRANDEIS U., THE F. HELLER GRAD. SCH. FOR ADV. STUD. IN SOC. WEL., 1987.

School code: 0541.