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Biomedical subjects

K D Melillo

Publications and source records attributed to K D Melillo.

At least 19 recordsLinked to original sources
PubMed2001

Perceptions of older Latino adults regarding physical fitness, physical activity, and exercise.

Healthy People 2000 has identified the importance of physical activity for healthy aging, but little is known about what motivates older individuals, older Latino adults, in particular, to be physically active. The purpose of this research was to examine the perceptions of older Latino adults toward physical fitness, physical activity, and exercise. This study used a qualitative focus group design. The sample of Latino adults age 60 and older resided in Northeast Massachusetts and was recruited from community settings which serve older Latino adults. Three focus groups, consisting of four to eight individuals in each group, were conducted and audiotaped. Data analysis used a combination of open, axial, and selective coding procedures. Focus group participants viewed physical fitness as being able to do anything; the mind and body working together; and feeling "light," being healthy. Support was viewed as a motivator of physical activity and exercise and included community resources, group support, cultural unity, and health provider assistance Barriers of fear and a feeling of inappropriateness were identified by focus group participants. Although the study was exploratory and the sample size small, it provides useful cultural knowledge and information for community health and gerontological nurses. Knowledge about older Latino adults' perceptions of motivators and barriers to physical activity and exercise is a necessary first step for nurses to prescribe activities that will help improve functional independence and quality of life. Nurses can serve as links for older Latino adults in accessing community resources. Sociocultural factors that influence Latino adult perceptions must be assessed if health promotion program planning is to be tailored to meet individual and group needs.

Aged↗
PubMed2000

Physical activity and exercise counseling in primary care.

Despite the known health benefits of regular physical activity and exercise, physical inactivity is prevalent among American adults. The primary care provider is in an optimal position to provide physical activity and exercise counseling. The Physician-based Assessment and Counseling for Exercise (PACE) program, which utilizes the stages of change theory, provides a valuable framework for exercise counseling. This article discusses exercise counseling theories and research and provides an overview of the PACE program, including the PACE protocols and the model's utility in primary care.

Adult↗
PubMed2000

Perceptions of nurse practitioners regarding their role in physical activity and exercise prescription for older adults.

Health promotion related to physical activity and exercise is an integral part of the nurse practitioner (NP) role. Yet, studies suggest that only 30% of primary care clinicians provide counseling to their sedentary patients (Clinician's Handbook of Preventive Services, 1994). This percentage may be even less with clients who represent the oldest old or a minority population. Information about the extent to which NPs counsel patients about physical activity and exercise prescription has not been well documented. The purpose of this research study was to identify the NPs role in providing individualized exercise prescription and to determine what strategies NPs use in assisting older adults to initiate and maintain an exercise program. The study utilized a focus group design comprising two focus groups, ranging in size from 6 to 7. Purposive sampling was used to enlist NP focus group participants. Content analysis of each transcript revealed that NP participants in these two focus groups utilize health history taking and observation skills in determining an older adult's physical fitness, physical activity, and exercise. None of the NP participants used a formalized instrument, nor did they use specific guidelines in prescribing physical activity and exercise recommendations. Frailty and socioeconomic status were variables that NPs consider in their physical activity and exercise recommendations, whereas ethnicity, age, and gender were not. Overall, NPs reported using a very small percentage of their time to physical activity and exercise counseling in primary care visits. Given the well-documented benefits of physical activity and exercise (U.S. Department of Health and Human Services, 1996; American College of Sports Medicine, 1998), it remains a matter of serious concern that more than 60% of American adults are not regularly physically active (Office of the Surgeon General, 1996). It is imperative that policymakers include physical activity and exercise counseling as a condition for reimbursement in primary care visits.

Adult↗
PubMed1998

Clostridium difficile and older adults: what primary care providers should know.

Clostridium difficile poses particular risk for older adults, who are subject to more serious symptoms than younger patients. Antibiotic exposure and other risk factors are associated with the pathogenesis of C. difficile-associated disease. Treatment goals include prescribing anti-C. difficile activity agents (when indicated), attending to volume status and prescribing oral rehydration therapy as needed, avoiding the use of antiperistaltic drugs, discontinuing any offending antibiotics, avoiding the indiscriminate use of broad-spectrum antibiotics, providing supportive therapy, following infection control protocols, and eliminating environmental contaminants.

Clinical Competence↗
PubMed1996

Perceptions of physical fitness and exercise activity among older adults.

The purpose of this research was to examine older adults' perceptions of physical fitness and exercise. This qualitative study was divided into four stages as described by Berg (1989): identification of the concept of the study; development of the interview guide; collection of data; and data analysis. Twenty-three older adults, aged 63-82 years (9 females, 14 males), participated in the interviews. Transcripts were analysed using content analysis. Three major themes emerged as the participants viewed physical fitness in terms of: functional independence ('being able to do'); holism ('mind-body works together'); and age reference (-for people my age'). Nine elements which impeded or enhanced physical activity were identified. Implications for education, research and practice are discussed.

Aged↗
PubMed1995

A guide for assessing caregiver needs: determining a health history database for family caregivers.

The complex issue of combining caregiving and employment requires an awareness on the part of primary care providers of the health and social impact these responsibilities have on clients. Failure to consider the psychosocial and health-related consequences of caregiving for individuals with dual roles could result in greater health care costs, jeopardize the health of the caregiver, and place the care recipient at risk of institutionalization. The purpose of this article is to offer a guide that can be used as part of a comprehensive health history to assess the caregiving situation and provide a database on which to establish a plan of action. The caregiver assessment guide can be inserted in the client's health record and periodically reviewed during primary care visits.

Aged↗
PubMed1995

Asymptomatic bacteriuria in older adults: when is it necessary to screen and treat?

The incidence of asymptomatic bacteriuria increases with age, and thus it is a common finding in older adults, especially the very old and the institutionalized. Bacteriuria in most older adults, while common, is often transient. The clinical significance is generally minor and the treatment yields very little benefit, is expensive, and may cause substantial drug toxicity. Guidelines to help determine which patients may benefit from treatment are included. Primary care providers for older adults in ambulatory, home, hospital, or institutional settings, should recognize asymptomatic bacteriuria and know when and when not to treat. This management decision will become an increasingly important aspect of gerontological health care.

Aged↗
PubMed1994

Preparing and presenting testimony. Guidelines for the health care practitioner.

Whether presenting to Hillary Rodham Clinton's Health Care Reform Task Force, or as citizens presenting to a Board of Selectmen on issues affecting the Council on Aging, health providers possess a unique and valuable perspective that few policymakers or politicians have. The health practitioner's role as a direct provider of health services, advocate, educator, role model, policymaker, clinician, researcher, consultant, collaborator, administrator, and counselor [1] can be combined to influence policy and policymakers through formal testimony preparation and presentation. Presenting testimony for public hearings is an effort to influence public policy. The purpose of this article is to provide guidelines which will encourage increased legislative involvement on the part of health providers. Those willing to be involved in local, regional, state, or national government activities by providing testimony may effect needed change.

Adaptation, Psychological↗
PubMed1993

Interpretation of laboratory values in older adults.

This article describes age-related physiologic changes in the older adult and the effect of these changes, if any, on commonly ordered laboratory tests. As reported in selected research studies and literature reviews, some laboratory parameters change minimally or not at all with age, still remaining within recommended reference ranges, while others are altered with age. Misinterpretation of an abnormal laboratory value as an aging change can lead to underdiagnosis and undertreatment in some instances (such as anemia). Failure to appreciate age-related changes can lead to overdiagnosis and overtreatment in others (such as hyperglycemia). The results from ongoing national studies are needed to establish uniform older adult reference intervals.

Age Factors↗
PubMed1992

Nurse practitioners in long-term care: perceptions of DONs.

Educator, counselor, advocate, consultant, collaborator and role model are a few of the hats that NPs wear. This study, from a DON's perspective, shows how NPs are ideally suited to care for an older population.

Attitude of Health Personnel↗
PubMedDate not supplied

The faculty portfolio: documenting the scholarship of teaching.

The scholarship of teaching is considered an essential component of scholarship within academic settings. To promote the transfer of knowledge specific to the discipline of nursing, this category of scholarship must include inquiry into the practice of teaching, program development, and professional role modeling, in addition to excellence in teaching itself. Conveying what constitutes teaching scholarship in nursing may present special challenges for nurse faculty in the university setting. A faculty teaching portfolio is one mechanism for explicating, communicating, and enhancing the scholarship of teaching. The methodology for creating, improving, and maintaining a teaching portfolio includes analyzing the mission of the university, articulating a philosophy of teaching, deciding on goals and objectives, designing evaluative mechanisms, processing data, conducting a self-evaluation, applying new approaches, and revisiting and reflecting on the outcomes. Faculty teaching portfolios serve to display, communicate, and document the scholarship of teaching. The creative endeavors surrounding portfolio development are ongoing and recursive, necessitating self-reflection and new approaches. J Prof Nurs 17:180-186, 2001.

Credentialing↗