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Biomedical subjects

B J Polivka

Publications and source records attributed to B J Polivka.

At least 19 recordsLinked to original sources
PubMed2000

Ohio APNs: lead poisoning knowledge and practices.

PURPOSE: To determine lead poisoning knowledge and practices of Ohio's advanced practice nurses (APNs). DATA SOURCES: Original research conducted by mailed survey sent to all APNs registered in Ohio (N = 1448). The response rate was 72%. APNs from nine specialties and 70% of counties responded. CONCLUSIONS: Respondents correctly answered approximately 80% of the questions. Knowledge gaps in primary prevention strategies were noted. Of APNs serving pregnant women and/or children < 6 years, 57% screen for lead poisoning and 16% report no one provides lead education. IMPLICATIONS FOR PRACTICE: Lead poisoning is a preventable health problem. Education of APN students and preceptors is needed in the areas of primary lead poisoning prevention issues and practice protocols. Results from this study can help focus educational efforts and outreach programs.

Adult↗
PubMed1999

Rural residents' knowledge of lead poisoning prevention.

This cross-sectional study assessed rural adults' knowledge of lead poisoning prevention. Residents of three rural Ohio counties were randomly selected to answer 15 True/False lead poisoning prevention questions and 12 demographic questions via telephone. Because not all residents have a phone, the survey was also mailed to Women, Infants and Children (WIC) recipients without phones in the three counties using Dillman's (1978) mailed survey methods. Both groups of respondents correctly answered an average of two-thirds of the questions. In the random sample (n = 1,211) correct scores were related to being elderly, unemployed, female, having a high school education or less, and not being exposed to lead poisoning prevention education during the previous week. Factors predictive of lower lead knowledge scores for the WIC respondents without phones (n = 69) were age (22 and 27 years), unemployment, marital status (married), type of dwelling (other than a single family home or apartment), and having fewer children. Most respondents were able to identify groups at high-risk for lead poisoning, that lead poisoning could occur in ways other than ingestion of lead paint chips, lead poisoning results in long-term learning problems in children, and a blood test is used to determine blood lead levels. Respondents were less knowledgeable about methods of lead exposure and the importance of prevention measures. Gaps in lead poisoning prevention knowledge exist for rural residents and educational efforts should focus on decreasing these gaps.

Adolescent↗
PubMed1999

Self-reported health status of low-income mothers.

PURPOSE: To determine the self-reported health status of low-income mothers before major health and welfare policy reform in the state of Ohio, to compare the health status of this group with the general population age-based norms, and to examine differences in health status among insurance and racial subgroups. Policy makers and others have a need for key health-status information about low-income mothers, a topic for which little empirical data currently exist. DESIGN: Descriptive using a cross-sectional survey with convenience sampling; 502 women were interviewed at intake sites in four countries in central Ohio, 1995 to 1996. METHODS: Health status was measured using the general health status index developed by J. E. Ware and colleagues (1995). Two summary measures, one indicating physical health and one indicating mental health, were used and compared with published norms. Multivariate logistic models were examined for depression and physical health status. FINDINGS: A significant level of depression in the population of low-income mothers was found as were differences in physical health scores by insurance group. People insured privately had the highest physical health scores, while those enrolled in fee-for-service Medicaid had scores indicating the poorest health. No significant difference was found between racial groups in self-reported health status. CONCLUSIONS: Self-reported mental health status is low among some low-income female populations. Physical health is worse for the Medicaid-enrolled group compared to both uninsured and privately insured groups. This poor state of health will likely diminish the success of welfare reform to improve the economic self-sufficiency of these women unless comprehensive health services are available.

Adult↗
PubMed1998

A qualitative assessment of inner city elementary school children's perceptions of their neighborhood.

Three hundred seventy-nine youths from an inner city elementary school were surveyed to determine their perceptions of their neighborhood. Using a qualitative, word association format, older students responded to 20 descriptive words (e.g., dirty, safe, quiet, dangerous) while younger youths drew pictures in response to three words (safe, sad, happy). Using content analysis techniques, findings indicated that the youths found neighborhood areas and residents that were perceived as safe, quiet, beautiful, friendly, fun/happy, and helpful. However, safety issues and a dirty, noisy neighborhood also emerged as major themes. Collaborative initiatives focusing on cleaning up the neighborhood and reducing violence are suggested, as are areas of intervention and further research.

Age Factors↗
PubMed1998

Dental utilization by low-income mothers.

OBJECTIVE: This study examines the influence of predisposing, enabling, and need variables on whether low-income mothers sought dental care during the past year. This report is a substudy of mothers and children on their self-reported health status, utilization, access, and satisfaction with health care in general. METHODS: A convenience sample of 502 mothers and youngest child younger than 6 years old was administered a face-to-face questionnaire in four Ohio counties. Information was collected at county human services offices and WIC clinics between November 1995 and July 1996. Using whether or not the mother sought dental care as the dependent variable, logistic regression models were created for the variables within the predisposing, enabling, and need characteristics separately and together. RESULTS: Fewer than one-half of the mothers sought dental care during the past year. Variables associated with the predisposing characteristic explained little about who sought care. Those mothers who have Medicaid coverage are 2.7 times more likely to have a dental visit than those without insurance. Moreover, those mothers who perceive any dental need are several times less likely to have received dental care than those who have no perceived need. CONCLUSIONS: Even among a somewhat homogeneous population of low-income women, source of payment for dental services and perceived need for dental care are discriminating variables in determining who seeks dental care.

Adolescent↗
PubMed1998

Preventive health counseling reported by uninsured women with limited access to care.

Low-income women in the childbearing years are at an increasing risk of becoming uninsured as welfare reforms are enacted and women enter minimum-wage jobs without insurance benefits. This study contrasts preventive counseling reported by low-income uninsured mothers and mothers insured through Medicaid. Low-income women attending Women, Infant, and Children (WIC) clinics and human services offices who had received health care during the previous 12 months (N = 406) were asked if they had received counseling from a health provider regarding any of seven types of preventive health behaviors. Uninsured women were less than half as likely to receive counseling on three or more preventive topics (OR = 0.42) as were mothers on Medicaid. Risk estimates were stable on bivariate analyses and logistic regression models. Findings indicate that opportunities for preventive health counseling need to be maximized for this group already experiencing compromised access to care.

Adult↗
PubMed1997

Collaboration between local public health and community mental health agencies.

Public health agencies (PHA) and community mental health agencies (CMHA) generally are organizationally and functionally autonomous. Collaboration between PHA and CMHA was explored in a statewide survey of nursing directors of PHA (n = 135) and executive directors of CMHA (n = 214). Findings indicated staff did not know each other well; clients, funds, and information were infrequently exchanged; public health nurses rarely were included in planning for the care of those with mental illness; and satisfaction with relationships was minimal. Path analysis was used to test an interagency collaboration model. Awareness of staff from other agencies increased satisfaction with interagency processes and interagency relationships.

Administrative Personnel↗
PubMed1997

Psychiatric symptoms in a community-based medically ill population.

Twenty-five home health nurses used the Psychiatric Symptom Assessment Scale to assess the prevalence of psychiatric symptoms in a convenience sample of 176 medically ill clients in their caseloads. Psychiatric symptoms were observed in 74% of the clients, with somatic concerns, anxiety statements, depressive mood, tension, and helpless/hopeless statements being the most prevalent symptoms. Although most symptoms were rated as mild or moderate, several clients had severe symptoms. Implications for nursing care are discussed.

Adult↗
PubMed1997

Public health nurses' role in the care of adults with mental disabilities.

OBJECTIVES: This paper describes current and potential roles of public health nurses in the care of adults with serious mental disabilities and explores incentives and barriers to the expansion of the role of public health nurses in this area. METHODS: One hundred thirty-five directors of nursing of public health agencies and 214 executive directors of mental health agencies in Ohio responded to a survey about public health nurses' roles and incentives for and barriers against increasing their role in mental health care. RESULTS: The majority of respondents reported that public health nurses work with adults with serious mental disabilities but perceived their role with these clients to consist primarily of making referrals and providing physical health care. Both groups of directors saw the potential for increasing the nurses' roles in these same areas and reported that the major barrier to expanding their roles was lack of financial support. Directors of nursing expressed interest in expanding these roles if they received additional financial support and the nurses received education and consultation. Executive directors were willing to provide the education and consultation but generally were not willing to provide financial support. CONCLUSIONS: Better utilization of public health nurses in the care of adults with serious mental disabilities could improve client health care and make more efficient use of scarce health care resources.

Adult↗
PubMed1996

Rural sex education: assessment of programs and interagency collaboration.

The purposes of this study were to assess the sex education programs offered in three rural Ohio counties, the agencies involved, and the extent to which agencies collaborated, and to compare interagency collaboration across counties. This cross-sectional study occurred in two phases. Using key-informant interviews (n = 85), Phase 1 identified current programs. Phase 2 assessed interagency collaboration via a mailed survey (n = 116). Results indicated that there were five to nine sex education programs per county, each involving five to eight agencies. Sex education was offered inside and outside of schools; programs were available to keep pregnant/parenting youth in school, enhance self-esteem, provide parenting education to teens, and advocate for abstinence. Sex education also occurred via a newsletter and an adolescent health conference, and in various clinics. Minimal collaboration was noted among agencies providing these programs. Public health nurses are ideally situated to identify current programs and agencies involved and form an interagency group to plan and implement comprehensive, collaborative sex education programs for youth. Further research is needed to longitudinally assess the impact of such program development on interagency collaboration, teen sexual activity, and pregnancy rates.

Adolescent↗
PubMed1995

A conceptual model for community interagency collaboration.

Although interagency community collaboration has been suggested to increase programming and decrease costs, theoretical understanding for this in nursing is limited. A conceptual framework for community interagency collaboration is described that depicts collaboration as a function of environmental conditions, organizational situations, and task characteristics. Transactional patterns including intensity, formalization, interrelational patterns, and structured relationships are discussed as are outcomes pertaining to organizations, interorganizational relations, clients, and communities.

Community Health Nursing↗
PubMed1994

A collaborative system of care for youth with severe emotional disturbances: an evaluation of client characteristics and services.

The closing of a state children's psychiatric hospital resulted in the mandated development of a regional children's mental health system for youths with severe emotional disturbances. The purpose of this article is to describe the demographic profiles and service usage patterns of youths enrolled in this system (Project youths) compared with random samples of non-Project youths involved with the mental health system. Data were obtained from two existing statewide databases (508K and MHIS). The 508K database revealed that Project youths (n = 393) were significantly older, had more severe functional impairments, more out of home placements, lower functional abilities, and were ill longer than non-Project youths (n = 747). Using the MHIS database, service usage patterns were assessed over time, across groups, and across the six local mental health authorities (LMHAs). Project youths (n = 266) received more case management, emergency, day treatment, and inpatient services than did non-Project youths (n = 262) and there were significant increases in case management and residential services over time. Differences among the LMHAs were found in all service types. Findings from this study indicated that Project youths were the most severely disturbed in the mental health system and received the most services. This study demonstrates the usefulness of analyzing existing statewide data in evaluating mental health systems.

Adolescent↗
PubMed1993

Cerebral palsy: evaluation of a model of risk.

The purpose of this study was to assess a model of risk for cerebral palsy (CP) in preschool children. The research was structured as a retrospective case-control study in which cases (n = 112) were children with CP while controls (n = 153) were either friend referrals or population-based. Data were collected via structured telephone interviews. While significant associations with CP were found on univariate analyses for a number of variables, only four variables--birth weight/gestational age, 5-min APGAR, medication for miscarriage, and urinary tract infection during pregnancy--were found predictive in multivariate analysis. These variables accounted for 36% of the log-likelihood explained by the model.

Birth Weight↗
PubMed1993

The effect of environmental sound and communication on CCU patients' heart rate and blood pressure.

The effects of high ambient stressors (equipment sounds) and social stressors (conversation) on heart rate (HR) and blood pressure (BP) were examined in coronary care patients. Simultaneously occurring sound level in decibels, actual sound, electrocardiogram, and BP were recorded three times/day over 2 days for 20 subjects. Repeated measures ANOVA and pairwise comparisons revealed maximum HR to be significantly higher during conversation than during low ambient sounds (quiet). High ambient stressors did not affect HR for these subjects. BP did not significantly change during any of the sound conditions. Further research is needed to delineate cardiovascular effects of specific social stressors.

Adult↗
PubMedDate not supplied

Public health nursing directors' perceptions regarding interagency collaboration with community mental health agencies.

Involvement in collaborative interagency relationships is crucial to the future of public health nursing and public health agencies. The purpose of this study was to describe public health nursing directors' perceptions regarding relationships between public health agencies and mental health agencies in their communities. A secondary analysis was conducted of textual responses to open-ended questions and unsolicited comments from 71 (55%) the of respondents to a larger survey of nursing directors of all public health agencies in Ohio. Data were analyzed inductively using content analysis for emergent themes and patterns, which were organized and classified deductively according to a community interagency collaboration framework. Public health nursing directors described environmental, situational, task, and interagency factors that impact collaboration between their agencies and local community mental health agencies. These descriptions provide a context for understanding impediments to collaboration between these two types of agencies, and have implications for designing interventions to enhance public health nursing directors' skills at marketing both their profession and their agencies. Collaborative relationships between public health and mental health agencies could improve care for community-dwelling persons with severe mental disabilities and enhance the future of public health nursing in a changing, competitive health care system.

Community Mental Health Services↗
PubMedDate not supplied

Interagency relationships among rural early intervention collaboratives.

Interagency collaboration is used to coordinate services and programs, pool resources, or achieve goals. This study utilizes the Interagency Collaboration Model to assess interagency relationships of Early Intervention (EI) collaboratives in three rural Ohio counties. The model includes five constructs: environmental factors (broader community environment), situational factors (organizational factors), task characteristics (project's scope and complexity), interagency processes (between agency processes), and outcomes (end products). Respondents from 42 agencies completed the 18-item Interagency Collaboration Assessment Tool (ICAT) and demographic questions. The ICAT uses a 5-point Likert-type scale to assess the five domains of the model. Respondents included public health nurses, representatives from schools, social service agencies, and hospitals. State policies were perceived as encouraging local interagency collaboration; respondents knew staff and goals of other agencies, but agencies did not share funding sources or provide similar services. Diverse specialists were needed to accomplish goals. Some information was exchanged between agencies. Interagency activities were not perceived to be well coordinated and outcomes were only moderately positive. Path analysis revealed that interagency processes were directly affected by environmental and situational factors, but not task characteristics (R2 = 0.42). Situational factors, and interagency processes predicted outcomes (R2 = 0.60). Awareness of personnel, goals and services of other agencies were key to positive interagency process and perceived outcomes.

Analysis of Variance↗
PubMedDate not supplied

Hospital and emergency department use by young low-income children.

BACKGROUND: Limited data are available concerning determinants of health care service usage by low-income young children. OBJECTIVES: To explore predictors of hospitalization and emergency department (ED) use by young children of low-income families by using the Aday and Andersen Access Framework. METHODS: Low-income women (n = 474) with a child younger than 6 years completed a structured face-to-face interview at human service offices or Women, Infants, and Children (WIC) clinics in four central Ohio counties. Women were considered low-income if they or their child were Medicaid eligible or uninsured. Data were collected for both the mother and the index child on sociodemographic status, health services use, health status, and access to care. RESULTS: Fifteen percent of the children had been hospitalized the previous year, and half had an ED visit. Hospitalization was significantly related to maternal hospitalization the previous year (OR = 2.5), child age younger than 1 year old (OR = 2.1) and more than two chronic conditions (OR = 2.2). Maternal ED usage in the last year (OR = 2.2), Medicaid fee for service plan (OR = 1.7), and rural residence (OR = 2.0) were predictive of ED use. CONCLUSIONS: Predisposing characteristics (maternal hospital/ED use) were predictive of both hospitalization and ED use by the index child. Enabling characteristics (fee-for-service Medicaid plan, rurality) were only predictive of ED use, and need characteristics (child's health) were only predictive of hospitalization. Further research to explore linkages between maternal and child use of health care services as well as the effect of changes in health care access, managed care, and other innovations on hospitalization and ED use in young, low-income children is recommended.

Adult↗