Biomedical subjects
Publications and source records attributed to A K Carruth.
Violations of nurse practice acts and disciplinary actions against RNs continue to increase. This study profiles the disciplined nurse, describes the prevalence of violations, and qualitatively examines the nurses' experiences with disciplinary action, as well as initiatives that guide nurse managers in addressing the ethical/legal dilemmas nurses face each day.
The impact of environment on health is a growing area of concern for nurses. The purpose of this study is to describe and characterize residents living near an abandoned hazardous waste site, assess their past and present exposure risk, and describe health concerns and psychosocial effects. Data were obtained by a door-to-door outreach effort. Networking was also used to identify residents with health concerns. Extensive field notes were taken to record the responses of residents. A preliminary windshield survey was conducted to approximate the number of residents living in the geographic area, assess the residential community, analyze drainage pathways away from the site, and observe outdoor activity patterns. Community concerns from the residential population were collected and analyzed for recurrent themes. Significant off-site activity patterns included use of drainage ditches as play areas for children. Foraging on-site activities included picking berries, crawfishing, geophagy (clay eating), and rabbit hunting. Common health problems described by residents included skin rashes, respiratory-related complaints, reproductive difficulties, and headaches. The majority of residents were concerned about the incidence of cancer in the area. Identifying the concerns of residents and indicators of health problems helps nurses begin to understand the relationship between the environment and health.
PURPOSE/OBJECTIVES: To describe the development and implementation of one approach to standardize and document interdisciplinary chemotherapy education for patients and families. DATA SOURCES: Cancer center interdisciplinary team. Oncology Nursing Society standards of care, clinical experience, and published literature. DATA SYNTHESIS: Because chart reviews of patient records demonstrated inconsistent chemotherapy education, a comprehensive chemotherapy curriculum pain was designed as a template for patient education. A flowsheet was developed to document use of the patient curriculum as well as other chemotherapy-related education materials. Patient chemotherapy curriculum included information regarding cancer and its treatment, adverse effects, and self-care measures and material about psychosocial and spiritual care. CONCLUSIONS: A standardized approach dramatically improved chemotherapy-related patient education as well as interdisciplinary documentation of patient education. The curriculum and the flowsheet are interdisciplinary and consistent with the patient and family education standards required by the Joint Commission on Accreditation of Health Care Organizations. IMPLICATIONS FOR NURSING PRACTICE: The combination of a patient chemotherapy curriculum and a documentation flowsheet saves time and standardizes content. Patient information is comprehensive and consistent, yet open to individual interpretation. Use of the flowsheet also has increased interdisciplinary collaboration, and the standardized curriculum has decreased redundancy between providers because all members of the interdisciplinary team know what is required and what information has been taught by whom.
The purpose of this study was to explore the impact of background characteristics, motivating factors, exchange patterns, and diagnosis of dementia on caregiver reciprocity. Adult children of parents with dementia (n = 110) and without dementia (n = 195) completed the Caregiver Reciprocity Scale, Motivating Factors Index, Exchange Patterns Index, and a demographic data sheet. ANCOVA analysis indicated adult children of parents with dementia gave more direct instrumental and supervisory care, received more negative and fewer positive exchanges, and reported significantly lower levels of warmth and regard, intrinsic rewards of giving, and balance within family caregiving when compared to adult children of parents without dementia. Hierarchical multiple regression analyses indicated that 64% of the variance of warmth and regard; 42% of intrinsic rewards of giving; 48% of love and affection; and 31% of balance within family caregiving was explained by antecedent demographic variables, motivating factors, exchanges given and received, and dementia. Surprisingly, the diagnosis of dementia did not contribute to explained variance in caregiver reciprocity.
A financial analysis compares the cost of a traditional bed bath to a bag bath. The study measured labor, laundry and supply costs. Results show some predicted and unexpected advantages.
Support groups are an effective intervention strategy to address the unique psychosocial needs of women in transition. The task of establishing a support group can be overwhelming for the CNS who possesses expertise in women's health but not in establishing a support group. Securing the services of an external nurse consultant with experience in group process and project management skills is an invaluable resource to the CNS in charge of developing a formal proposal, setting goals and planning actions, and/or implementing and evaluating interventions. The CNS's role as a consumer of the formal consultation process is addressed.
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The study of ethics will not provide health care professionals with specific answers to specific ethical dilemmas they as individuals may face. it will not provide specific rules of conduct. The ability to examine ethical dilemmas sets forth practical wisdom that provides guidance when making decisions. The study of ethics helps to define problems and establishes basic principles to be used in solving these problems. It can help health care professionals identify appropriate goals and give them direction in achieving those goals. Health care supervisors have an obligation to provide the educational opportunity that will enable professionals to emerge with a perspective that allows them to take an ethical stand and to support that position with sound, rational thinking. In fulfilling this obligation, individuals working within health care facilities can significantly contribute to their profession and to society.
Future trends include a decrease in the number of adult children, an increase in the number of individuals over age 65, single parent families, working women, and individuals with no health care insurance. As more women with multiple roles and responsibilities enter and continue as part of the work force, employers recognize the need for support of family issues. Currently many employers lack initiative to make these needed changes. The occupational health nurses' role in relation to future policy for working caregivers includes assessment of how employment and caregiving impact work performance, job satisfaction, and health; and participation in defining public policy issues.
All individuals interviewed wanted to pursue meaningful activities regardless of their age. Use of medication may facilitate positive adaptation to chronic illness by allowing the pursuit of meaningful activities. When side effects occurred, activities were altered by means of substitution, temporary discontinuance, or modified participation, but most individuals struggled to maintain participation to feel involved. An individual's ability to cope may be interrupted due to adverse effects of medication. Also, hospitalization caused by adverse side effects disrupted meaningful activities and created a need to readapt to an illness. Medication for chronic illness increased the person's ability to seek and use social support. The physical limitations of illness were the cause of loneliness and isolation.
The purpose of this study was to develop and validate the dimensions of caregiver reciprocity. Social exchange and equity theory served as a conceptual framework for examining recprocal intergenerational exchanges of assistance and support. In the first phase of the study, 12 caregivers of elderly parents, including in-laws, were interviewed to provide narrative data from which items were developed. Content validity was judged by two separate panels of experts. The revised CRS was tested with 303 adult children for reliability and validity, including internal consistency, test-retest reliability, exploratory factor analysis, and convergent and discriminant validity testing using structural equation modeling. Support for construct validity was demonstrated for four factors: Warmth and Regard, Intrinsic Rewards of Giving, Love and Affection, and Balance within Family Caregiving.
The purpose of this study was to test a theoretical model developed to explain family satisfaction among 171 caregivers of elderly parents. Using LISREL to estimate path coefficients, the findings support family satisfaction as directly and indirectly influenced by reciprocity, emotional well-being and family functioning. Explanatory variables accounted for 70% of the variance in predicting family satisfaction. Intrinsic rewards derived from giving care, positive affect, and family functioning contributed to higher levels of family satisfaction, while dysphoria contributed significantly to lower levels. Family satisfaction was also indirectly influenced by positive and negative exchanges received by the parent. Increasing caregivers awareness of the reciprocal nature of their relationships with all family members may be an effective strategy in helping them appreciate their contribution to the well-being of their parents and achieve satisfaction in the caregiving role.
PURPOSE/OBJECTIVES: To determine if differences existed in patients' and family members' perceptions of caring behaviors after the transition from a primary to a modular care delivery system. DESIGN: Descriptive, comparative, and correlational. SETTING: Urban, inpatient, acute-care hospital. SAMPLE: A convenience sample of 42 patients with cancer hospitalized for chemotherapy administration or complications arising from their diagnoses and 27 of their family members. Ninety-four data sets were collected--62 from the patients and 32 from the family members. METHODS: Subjects were asked to evaluate their nurse's caring attributes using the Caring Perception index. Caring scores of patients receiving primary nursing care were compared to caring scores of patients receiving modular nursing care. MAIN RESEARCH VARIABLE: Patients' and family members' perception of caring. FINDINGS: Mean caring scores did not differ significantly between patients receiving primary care (mean = 35.9, SD = 5.4) and patients receiving modular care (mean = 36.2, SD = 5.3). Patient and nursing delivery characteristics were used to predict and explain variance in the dependent variable care. Number of days hospitalized accounted for 14% of the variance, with those patients hospitalized longer rating nurses as more caring. CONCLUSIONS: The longer a patient stays in the hospital, the greater the likelihood the patient and family members will feel nurses exceeded exceptions for caring. The findings support other studies that have compared quality care indicators across different types of delivery systems. IMPLICATIONS FOR NURSING PRACTICE: Measures to evaluate quality care should be used when transitioning to new delivery models. Nurses need to recognize that not all patients value the same nurse qualities equally. When receiving care over an extended period of time from same nurse, patients and family members are more likely to rate the nurse as exceeding expectations.