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Biomedical subjects

M A Neary

Publications and source records attributed to M A Neary.

10 recordsLinked to original sources

Native American graduate nursing students' learning experiences.

PURPOSE: To identify learning experiences of Native American graduate nursing students in a university-based nurse practitioner program. DESIGN: The phenomenological approach of Heideggerian hermeneutics. METHOD: A purposive sample of 11 Native American graduate students in a nurse practitioner program were given the choice of participating in a focus group or completing an individual interview to elicit common meanings and shared experiences. FINDINGS: Four themes and two constitutive patterns: (a) Native American students' worldviews reflected unwritten knowledge that served as a background of common understanding, (b) academic environment as a rigid environment with only one way to learn and constant evaluation, (c) faculty-student relationship barriers to establishing a supportive learning environment, and (d) strategies to survive, including a commitment to succeed, conforming to unwritten rules, helping each other, and ultimately changing themselves. Constitutive patterns were: (a) value conflicts when students' values conflicted with academic behavioral values, and (b) on the fringe, when students felt isolation from the main student body, and open to attack (evaluation). Students struggled to be successful in their commitment to complete the degree, but often questioned the applicability of the program in their cultural setting. CONCLUSIONS: A more flexible supportive environment is needed to support students' goals to attain degrees, as well as to encourage dialogue on differing cultural values. Faculty who teach culturally diverse students may need to examine rigid behavioral standards that mandate an assertive practitioner persona and may be a barrier to attainment of goals.

Adaptation, Psychological↗

Faculty experiences teaching Native Americans in a university setting.

Nursing faculty told their stories about the beginnings of a Native American Family Nurse Practitioner Recruitment Program. Through hermeneutical analysis, the authors' findings reveal a strong academic worldview, active in maintaining professional standards. This traditional view tends to override efforts to provide individualized programs that are culturally relevant to the Native American worldviews. By understanding the value conflicts active in this study, nursing faculty can begin dialogue to create new learning experiences that are more culturally relevant.

Attitude of Health Personnel↗

Dysphagia following anterior cervical spine surgery.

Although previous reports have identified dysphagia as a potential complication of anterior cervical spine surgery (ACSS), current understanding of the nature and etiologies of ACSS-related dysphagia remains limited. The present study was undertaken to describe the patterns of dysphagia that may occur following ACSS. Thirteen patients who exhibited new-onset dysphagia following ACSS were studied retrospectively by means of chart review and videofluoroscopic swallow study analysis. Results indicated that a variety of swallowing impairments occurred following ACSS. In 2 patients, prevertebral soft tissue swelling near the surgical site, deficient posterior pharyngeal wall movement, and impaired upper esophageal sphincter opening were the most salient videofluoroscopic findings. In another 5 patients, the pharyngeal phase of swallowing was absent or very weak, with resulting aspiration in 3 cases. In contrast, an additional 4 patients exhibited deficits primarily of the oral preparatory and oral stages of swallowing including deficient bolus formation and reduced tongue propulsive action. Finally, 2 patients exhibited impaired oral preparatory and oral phases, a weak pharyngeal swallow, as well as prevertebral swelling. Thus, a variety of swallowing deficits, due possibly to neurological and/or soft tissue injuries, may occur following ACSS.

Adult↗

Physical restraints: has OBRA made a difference?

1. A component of the Omnibus Budget Reconciliation Act of 1987 declared that nursing home residents have the right to be free from physical or chemical restraints that are not required to treat specific "medical symptoms." 2. The literature suggests that the use of restraints has a negative influence on the caregiving process by restricting creativity and individual treatment. 3. Decreased reliance on restraints can be accomplished in nursing homes without an increase in staffing. 4. Transition to limited restraint use requires an organized, planned effort to change attitudes, beliefs, practices, and policies of a facility.

Aged↗

Community services in the 1990s: are they meeting the needs of caregivers?

The community-based, long-term care system not only sustains the older person in the community but also helps to maintain him or her at the highest level of functioning possible. A broad spectrum of services exists, including personal care, transportation, home-delivered meals, adult day care, and respite care. One hundred sixty-eight primary caregivers were were interviewed regarding awareness of, inquiry into, utilization of, and satisfaction with community services during the caregiving period. The majority of caregivers were aware of and utilized 7 of the 15 services listed, including personal care services, home-delivered meals, rehabilitation services, housekeeping services, nursing services, and information referral services. Nurses remain the key individuals in providing linkages among elderly and their families and community-based services. One of the key roles that nurses can play is to inform caregivers about available community services, to help caregivers recognize the need for these services, to assist them in accessing these services, and to recognize their need for support during this process. Finally, the community nurse can also provide support to the caregiver when institutionalization of the older family member becomes a reality.

Aged↗

The nursing dilemma of restraints.

This study provides a data base for developing intervention strategies aimed at helping staff cope with concerns regarding restraints. Most respondents believe patients should be restrained for safety even if it means loss of dignity, and that a caring manner should be conveyed to restrained patients. A large percentage felt that family members did not have the right to refuse the use of restraints, but that they should have that right if they were patients, suggesting negative attitudes toward restraints, of which they are unaware. Personal and professional characteristics, such as knowledge about restraints, years in geriatrics, and experience with elderly family members, showed no significant relationship to attitudes.

Adult↗

What nursing staff members really know about physical restraints.

Although the use of physical or mechanical restraints is decreasing in long-term care facilities, there always will be some patients who require them. If a restraint is to be employed at all, it needs to be used correctly. A convenience sample of 118 nursing staff members who work in a county nursing home was asked to complete an 18-item knowledge questionnaire regarding restraint usage. Scores ranged from 6 to 17 (potential range 0-18), with a mean score of 13.2 (SD = 2.1). Overall, the staff's knowledge level can be considered good; however, there were some areas of concern. For example, a majority of the respondents (82.2%) believed that it was appropriate to keep a patient restrained lying flat in bed. Implications for administrators and rehabilitation nurse clinicians are identified.

Adult↗

A short-term geriatric nursing programme in the US for Japanese Nurses.

Providing quality care to their growing elderly population is a top priority for Japanese nurses. As geriatric nursing has become a significant subspecialty in the US, this expertise was sought by the Japanese Hospital Administration in collaboration with Kyoto University. The result: a geriatric nursing programme developed to meet the specific needs of Japanese nurses in caring for the elderly, but yet adaptable to meet the needs of nursing students and registered nurses in other countries.

Curriculum↗