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Biomedical subjects

F H Outlaw

Publications and source records attributed to F H Outlaw.

11 recordsLinked to original sources

African American grandmothers' perceptions of caregiver concerns associated with rearing adolescent grandchildren.

In 1996, grandparents were the sole providers of care for 269,000 grandchildren. Research findings indicate that grandmothers are usually the primary caretakers of grandchildren. Previous issues associated with raising grandchildren vary, but usually relate to the grandparents' health, financial concerns, or lack of social support. This qualitative descriptive study was designed to describe African American grandmothers' perceptions about the burdens of raising adolescent grandchildren. Using this approach, the researchers were able to study the richness and diversity of the grandmothers' perceptions. Data were collected from 35 grandmothers through a focus group (n = 7) and during a 4-day intervention research study (n = 28) entitled "Grandmother-Grandchild Health Promotion Program." Numerous concerns were voiced by both groups, but those stated most frequently were associated with the well-being of grandchildren (grandchildren's sexual behavior, potential drug use, and potential risk of encountering violence) and relational conflicts with adult children. Unexpected findings were the absence of stated concerns associated with the grandmothers' financial situation or health. Recommendations for intervention, clinical practice, and research are discussed.

Adolescent↗

A study on recruitment of black Americans into clinical trials through a cultural competence lens.

Black Americans are stricken disproportionately with cancer. However, they continue to be underrepresented in clinical trials aimed at systematically investigating treatment methods or studying the effectiveness of cancer detection and prevention. Because participation in clinical trials can offer patients access to state-of-the-art therapy in a research context, it is imperative that black Americans have proportional representation in such trials. The purpose of this article is to describe findings from the first phase of a two-phase project on recruitment of black Americans into clinical trials. In the first phase, physicians and data managers in a large, urban prestigious cancer center were asked to identify factors they believed prevent black Americans from participating in clinical trials. Findings from this study were congruent with the literature about why physicians and other health care providers believe black Americans do not participate in clinical trials. However, the findings were examined through a cultural competence lens, adding a fresh perspective to the consideration of what interventions can be developed to eradicate underrepresentation of black Americans in clinical trials. The second phase will assess the knowledge, beliefs, attitudes, and behaviors of black Americans related to clinical trials in the geographic area of the cancer center.

Adult↗

Integrated primary health care. Opportunities for psychiatric-mental health nurses in a reforming health care system.

As changes in our health care system evolve, making the transition to greater parity of mental and physical health is paramount to move health care in the direction of prevention and health promotion. Although parity is the goal, the most feasible path to reaching it may lie in relinking mental health to physical health in managed care models of primary health care. This article identifies emerging directions in the mental health field and points to new opportunities for advancing the practice of psychiatric-mental health nurses.

Health Care Reform↗

Advanced practice psychiatric-mental health nursing in a community-based nurse-managed primary care program.

In the evolving health care environment, advanced practice opportunities for psychiatric-mental health nurses may lie in managed care models of community oriented primary health care. As providers, care managers, health promoters and educators, and client advocates with family systems expertise, psychiatric-mental health advanced practice specialists are a necessary component of all primary health care. This article describes the development of a community-based primary care practice that integrates physical and mental health care on the same site.

Adult↗

An attributional study of seclusion and restraint of psychiatric patients.

This descriptive study used two attributional frameworks to examine the causes psychiatric inpatients and nurses gave for the seclusion and restraint of patients. Patients were interviewed in restraints. The reasons patients and nurses gave for the patients restraint were recorded verbatim. A nominal system using the recorded responses was developed by two attribution researchers and were also coded along the dimensions of locus, controllability, and stability. The findings supported attribution theory and research in that most patients and nurses gave causes for the patients' restraint. However, the data suggest more research is needed in this area.

Adult↗

Seclusion. The nursing challenge.

The research to date shows that there is not much data to guide nursing decisions about the use of seclusion. The justification for its use is not always as clear as one might hope. Although many patients are secluded for violence against themselves or others, there are others who have not been violent who are secluded. There may be justification for secluding violent patients, but, as indicated earlier, it may reinforce the behavior it is designed to stop. There probably is no justification for secluding patients who make loud noises, refuse to take medication, or refuse to participate in activities. In addition, it is disconcerting that a large percentage of patients are secluded for "escalating agitation," that is, they have not acted violently against themselves or others. What is problematic is that staff are undoubtedly predicting violent behaviors in these patients--predictions that might be erroneous. Thus, there is ample room for injustice to occur. The potential for injustice is even greater if certain patients are singled out for seclusion or if patients are secluded longer than they or the staff think that they need to be, as is indicated in some of the studies to date. Moreover, if unit variables are associated with seclusion activity, this too, may be indicative of decision making at certain times of the day or by certain staff members that may not be in the best interest of the patient. What seems fairly clear is that secluding a patient is a distressing event for staff and is viewed extremely negatively by some patients and as a reward by others.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Spiritual conflicts associated with praying about cancer.

A secondary analysis of data from a study designed to describe how persons use prayer to cope with cancer is presented in this paper to illuminate the spiritual conflicts that can be experienced among persons with cancer. Employing phenomenological methods, 30 persons from various phases of the cancer experience and religious backgrounds, were interviewed in depth about why, when, and how they prayed, as well as what they prayed about and the outcomes they expected. The secondary analysis revealed that many of these informants had hesitancies about petitionary prayers for particular things, a cure, or for themselves. They also indicated questions about theodicy and the meaning of having cancer, the nature of God, and acknowledged 'unanswered' prayer. Several described an inner conflict about releasing control to God. A few referred to bargaining with God, and a few doubted their personal spirituality and worth, if they were praying correctly, and if prayer was efficacious.

Adaptation, Psychological↗

Psychiatric-mental health nursing at the interface: revisioning education for the specialty.

In the emerging health care environment, families and communities are facing a broad range of conditions that require more integrated views of wellness and illness, mind and body, and the biomedical and the behavioral. This also calls for an enhanced care delivery system. Three interfacing areas of practice have particular significance for the psychiatric-mental health nursing workforce: enhanced primary care, public health or population-focused health interventions, and managed care. This paper addresses the broad range of knowledge, skills, and competencies that are required for the future of advanced practice psychiatric-mental health nursing and describes interactive learning experiences and new pedagogies to deliver them.

Curriculum↗

Stress and coping: the influence of racism on the cognitive appraisal processing of African Americans.

Individuals who experience repeated stressful events are at risk for developing physical and psychological illnesses. African Americans are an ethnic group that is exposed to a range of stressors over time, including racism which leads to discrimination. African Americans also suffer disproportionately from hypertension, cardiac disease, obesity, and drug and alcohol abuse--all illnesses that have been linked to stress. This paper describes a model to guide nursing practice, research, and education about the influence of racism on the cognitive appraisal, stress, and coping of African Americans. Lazarus and Folkman's (1984) phenomenological approach to cognitive appraisal, stress, and coping is the theoretical framework on which the model is based.

Adaptation, Psychological↗