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Biomedical subjects

J K Bartek

Publications and source records attributed to J K Bartek.

17 recordsLinked to original sources
PubMed1998

Health problems of sheltered homeless men using a mobile health van: a 4-year study.

The number of homeless persons in the United States is increasing on an annual basis, with men accounting for the greatest number. Accessing health care for this group is difficult for many reasons, particularly those related to finances, transportation, lack of insurance, and transiency of lifestyle. Consequently, data regarding homeless men's health problems/concerns are difficult to obtain, and often the information reported is only for acute care services provided by emergency rooms and clinics. The purpose of this study was to determine the demographic characteristics and health problems/concerns of sheltered homeless men using the services of a mobile van for health care over a 4-year period. A total of 2,086 records, representing 1,171 men aged 19 and over, were retrospectively reviewed to determine demographic and health characteristics (age, sex, self-reported medical and addiction histories, and self-reported medication use). Data on presenting concerns, diagnoses, visit patterns, treatments, medications and teaching provided were also collected and analyzed. Recommendations to improve the quality, continuity, and follow-up of care for homeless men are included.

Adult↗
PubMed1997

Managed care credentialing of advanced practice nurses.

The enormous and rapid changes taking place in health care delivery are forcing institutions, organizations, and individual providers of care to reexamine their relationships and create new methods of assuring both quality of care and safety for consumers. One result has been the emphasis on systematic methods of credentialing, privileging, and measuring and evaluating an individual's qualifications and actual performance. This article discusses the credentialing and privileging processes that are either in place or evolving for physicians in the managed care health care systems. With the continued evolution of managed care in this country, advanced practice nurses may need to expand their credentialing process. This article provides information on the evolutionary events leading to credentialing and privileging, current and anticipated credentialing measures, sources of measurements, medicolegal issues, and suggestions for expansion of nurse credentialing. A comprehensive credentialing system will provide additional evidence of the nursing profession's capacity to play a major role in the reformed health care system.

Credentialing↗
PubMed1988

Nurse-identified problems in the management of alcoholic patients.

The purpose of this exploratory study was (1) to identify and rank the patient problems of hospitalized alcoholics that medical-surgical nurses view as difficult to manage, (2) to identify the factors that contribute to the difficulty in care, (3) to identify interventions used by nurses in an attempt to resolve patient problems and (4) to describe relationships between nurses and the identified patient problems. Subjects (N = 83) completed and returned an open-ended questionnaire by listing the physiological and psychosocial patient problems, factors and interventions. Selected demographic and biographic data were also collected. A nursing diagnosis classification described by others served as a basis and was adapted for the nursing diagnosis categories. Nominal data were analyzed using frequency distributions and percentages. The most difficult physiological problems in caring for alcoholic persons were categorized from subjects' responses using the nursing diagnoses of "potential for injury," "alterations in nutrition-elimination" and "fluid volume deficit." The nursing diagnosis categories of "ineffective individual coping," "ineffective family coping" and "noncompliance" comprised the most difficult psychosocial patient problems. A majority of subjects reported having limited classroom and clinical experience with alcoholism; 80% expressed a need for additional inservice education. It is recommended that nursing educational programs include didatic and clinical content about alcoholism, focusing on problem areas identified and on family dynamics, communication, coping strategies and time-management strategies.

Adult↗
PubMedDate not supplied

Use of a mobile health van by a vulnerable population: homeless sheltered women.

Little is known about the health status of homeless women. In this study, we examined the health problems of and services provided to sheltered, homeless, Midwestern women who used a mobile health van. Our objectives were to document these women's ages, self-reported past medical histories, self-reported histories of addictions and hospitalizations, presenting concerns, diagnoses, and visit patterns. To this end, we performed a retrospective review of the 689 records of 408 women who had sought care during a 3-year period. The data were divided into three groups, representing women ages 15-25 (n = 111), 26-40 (n = 211), and 41-70 (n = 86). In all three age groups, respiratory disorders were most frequently treated. Preventive health maintenance concerns were also major concerns of all age groups. Recommendations for improving the quality, continuity, and follow-up of care are offered.

Adolescent↗
PubMedDate not supplied

The alcoholic family: a nursing diagnosis validation study.

This study was designed to develop and validate a new nursing diagnosis, altered family processes: alcoholism. The Delphi technique was used to obtain nurse experts' (N = 201) ratings of terms for the definition, related factors, and defining characteristics. Degree of consensus was determined by analyzing the mean, frequencies, and Fehring's (1987) Diagnostic Content Validity Index for items. Findings supported a proposed definition and related factors including family history of alcoholism and lack of problem-solving skills. Defining characteristics were grouped into three categories: feelings (e.g. mistrust, insecurity, powerlessness, unhappiness), roles, and relationships (e.g. disturbed family dynamics, inconsistent parenting, marital problems), and behaviors (e.g. impaired communication, dependency, denial). Future research includes the proposal and testing of nursing interventions for alcoholic families.

Adult↗
PubMedDate not supplied

Clinical validation of characteristics of the alcoholic family.

PURPOSE: To validate, from a client and family perspective, the defining characteristics for the nursing diagnosis altered family processes: alcoholism; and to identify demographic, family, and selected treatment information from clients and family members. METHODS: Subjects (N = 150) completed Fehring's (1987) Clinical Diagnostic Validation (CVD) Index for 110 defining characteristics of the nursing diagnosis altered family processes: alcoholism. FINDINGS: Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness. CONCLUSIONS: These clinically validated characteristics will complete the assessment phase of this research and direct the path to future studies to determine appropriate goals/outcomes and interventions related to alcoholic families.

Adult↗
PubMedDate not supplied

Health problems of sheltered homeless children using mobile health services.

Homeless families are an increasing problem in the United States, with children representing 34% of the total homeless population. This retrospective study describes the demographic characteristics and health care problems and concerns of sheltered homeless children who used the services of a mobile health van over a 1-year period in a midwestern metropolitan area. The patterns of utilization, medications prescribed, and referrals are also described. Medical records of 175 sheltered homeless children who sought care from a mobile health van were reviewed. Forty-eight percent of the children were female; 52% were male. The majority were under 6 years of age (15% infants, 22% toddlers, 22% preschoolers, 23% school-age children, and 18% adolescents). The major reasons for seeking health care, the primary diagnoses, and treatments are presented. Recommendations for using a mobile van to provide efficient, quality health care for this population are discussed.

Adolescent↗