Biomedical subjects

K L Schumacher

Publications and source records attributed to K L Schumacher.

10 recordsLinked to original sources

PubMed2000

Family caregiving skill: development of the concept.

Families increasingly are expected to provide complex care at home to ill relatives. Such care requires a level of caregiving knowledge and skill unprecedented among lay persons, yet family caregiving skill has never been formally developed as a concept in nursing. The purpose of the study reported here was to develop the concept of family caregiving skill systematically through qualitative analysis of interviews with patients (n = 30) receiving chemotherapy for cancer and their primary family caregivers (n = 29). Open coding and constant comparison constituted the analytic methods. Sixty-three indicators of caregiving skill were identified for nine core caregiving processes. Family caregiving skill was defined as the ability to engage effectively and smoothly in these nine processes. Properties of family caregiving skill also were identified. Conceptualizing skill as a variable and identifying indicators of varying levels of skill provides a basis for measurement and will allow clinicians to more precisely assess family caregiving skill.

Caregivers↗

PubMed2000

A new era in home care.

Profound changes in policy and reimbursement are ushering in a new era in home care. The transition from fee-for-service reimbursement to prospective payment/managed care and the mandate for outcomes assessment provide opportunities to expand innovative home care models. The authors describe 3 such models: community-based long-term care (exemplified by PACE, Program of All-inclusive Care for the Elderly), home-based primary care (exemplified by the Veterans Administration Home-Based Primary Care program), and disease management programs (exemplified by Group Health Cooperative of Puget Sound). Professional qualifications for the new era, including certification and graduate education for advanced practice nursing, also are described.

Fee-for-Service Plans↗

PubMed1998

Graduate program: advanced practice nurses in the home.

This article is a curriculum overview of a graduate program of the Advanced Practice Home Care Nursing (APHCN) Program, which began at the School of Nursing, University of California, San Francisco, in 1996. A historical perspective of home care and the need for advanced practice nurses in the home care industry is provided. Curricular components of the APHCN Program are outlined. The roles of the home care clinical nurse specialist, home care nurse practitioner, and home care administrator are presented. Finally, a discussion is presented in which home care nursing demonstrates the efficacy of the advanced practice role and the need for well designed outcomes-based research.

Community Health Nursing↗

PubMed1998

Conceptualization and measurement of doing family caregiving well.

PURPOSE: To review progress in the conceptualization and measurement of five concepts related to doing family caregiving well: caregiving mastery, self-efficacy, competence, preparedness, and quality. Families are increasingly involved in providing complex care to ill or aged family members at home. Their ability to do caregiving well is vitally important and a focus of nursing practice in many clinical settings. ORGANIZING FRAMEWORK: Concepts were organized into two groups: those that refer to caregivers' perceptions of how well they are providing care and those that refer to professional assessment of the quality of care provided. SOURCES: Family caregiving literature from nursing, gerontology, psychology, and social work, 1987-1996. FINDINGS: There is growing interest in doing family caregiving well. However, research in this area is limited by the current state of development of ideas and measures. CONCLUSIONS: Two issues that should be addressed to advance research are the perspective taken on doing caregiving well and change over time in doing caregiving well.

Aged↗

PubMed1996

Reconceptualizing family caregiving: family-based illness care during chemotherapy.

In spite of extensive research on cancer and the family, little is known about the process of taking on the caregiving role when a family member is diagnosed with cancer. Family caregiver role acquisition was investigated in a grounded theory study of 19 family caregivers and 20 persons with cancer, interviewed across the course of chemotherapy. The initial analysis revealed that caregiving could not be understood in isolation from self-care in this sample and a reconceptualization of the target phenomenon was needed. Accordingly, the concept of family-based illness care was developed to encompass both self-care and caregiving. Twelve dimensions of family-based illness care and three prototypical patterns of illness care involvement were identified. Patterns of involvement fluctuated over time, a phenomenon labeled shifting patterns of self-care and caregiving. Shifting patterns of self-care and caregiving was so characteristic of illness care during chemotherapy that it became the core concept of the grounded theory. This conceptualization emphasizes the dyadic nature of family-based illness care during chemotherapy.

Antineoplastic Agents↗

PubMed1995

Family caregiver role acquisition: role-making through situated interaction.

Family caregiver role acquisition is an important, but little studied phenomenon. In this article, a conceptual approach for research on caregiver role acquisition is suggested. Caregiver role acquisition is defined as a family role transition. During this transition, the caregiving role is created through interaction between the caregiver and care receiver and between the dyad and others. Thus, caregiver role acquisition is a role-making process. An approach to social roles that integrates symbolic interactionism and structural role theory suggests that the role-making processes inherent in caregiver role acquisition occur through situated interaction. Concepts are identified from interactionist and structural perspectives that account for variation in individual experience with role acquisition. Indicators of health during caregiver role acquisition are also identified. Included are subjective indicators (role strain and role satisfaction), behavioral indicators (role insufficiency and role mastery), and interpersonal indicators (family conflict and mutuality).

Adaptation, Psychological↗

PubMed1994

Transitions: a central concept in nursing.

Transition is a concept of interest to nurse researchers, clinicians, and theorists. This article builds on earlier theoretical work on transitions by providing evidence from the nursing literature. A review and synthesis of the nursing literature (1986-1992) supports the claim of the centrality of transitions in nursing. Universal properties of transitions are process, direction, and change in fundamental life patterns. At the individual and family levels, changes occurring in identities, roles, relationships, abilities, and patterns of behavior constitute transitions. At the organizational level, transitional change is that occurring in structure, function, or dynamics. Conditions that may influence the quality of the transition experience and the consequences of transitions are meanings, expectations, level of knowledge and skill, environment, level of planning, and emotional and physical well-being. Indicators of successful transitions are subjective well-being, role mastery, and the well-being of relationships. Three types of nursing therapeutics are discussed. A framework for further work is described.

Adaptation, Psychological↗

PubMed1993

The stress process in family caregivers of persons receiving chemotherapy.

The purpose of this analysis was to explore strain and depression among family caregivers of persons receiving chemotherapy for cancer using the Pearlin Stress Process Model. Seventy-five family caregivers of persons receiving chemotherapy participated, completing the Caregiver Strain Index and the Depression Subscale of the Profile of Mood States within 3 weeks of the initiation of chemotherapy. Hierarchical regression analyses indicated that 44% of the variance in strain and 40% of the variance in depression were explained by the antecedent variables of caregiver age and gender, patient age and gender, patient functional status, the presence of recurrent disease, perceived efficacy of coping strategies, and perceived adequacy of social support. Further analysis aimed at delineating the mechanisms through which coping and social support operate in the model found no evidence for a moderating or stress-buffering effect. However, coping mediated the relationship between strain and depression and social support mediated the relationship between functional status and depression.

Activities of Daily Living↗

PubMed1992

(Mis)conceptions and reconceptions about traditional science.

"Traditional" science (ie, scientific work that has evolved from the natural sciences) is still said to rely on theory-neutral facts, quantitative data, and the search for universal laws. This depiction of science is incongruent with much contemporary thinking. This article examines three shifts in recent philosophy that are relevant for nursing science philosophy: the move from foundationalism to an understanding of the fallibility of science, the shift in emphasis from verification to justification of knowledge claims, and the recent examination of explanation by scientific realists. It is suggested that scientific realism may be a fruitful area of inquiry for philosophers of nursing science.

Cognition↗

PubMedDate not supplied

Issues in home health nursing education.

To provide quality preparation in home healthcare, nursing education must attend to important issues that will influence this endeavor. The research reported here outlines issues for both educators and agency personnel.

Community Health Nursing↗