Biomedical subjects

M E Byrd

Publications and source records attributed to M E Byrd.

7 recordsLinked to original sources

PubMed1999

Questioning the quality of maternal caregiving during home visiting.

PURPOSE: To formulate theory that will provide a meaningful framework for practice and for studies examining the efficacy of maternal-child home visits. DESIGN: Field research, over a period of 8 months, 1995-1996, conducted with one nurse employed by a visiting nurse association in rural New England. A total of 53 home visits were observed; documents and records were reviewed. METHODS: Data collection, field-note recording, and analysis were simultaneous. Informal interviewing and observation of the key nurse participant throughout the day focused on her intentions, actions, and meanings as she anticipated, enacted, or reflected on her visits. Client-nurse interaction and client characteristics were described and interpreted. Analysis focused on the nurse's home visits and the consequences of these visits. FINDINGS: The nurse conducted a specific type of home visit, identified as "child-focused," in three patterns: single, short-, and long-term. The short-term pattern, labeled "questioning the quality of maternal caregiving," is described in this article. The nurse minimally questioned and then confirmed the quality of maternal caregiving during some visits, while she seriously questioned and then continuously doubted the quality of caregiving in others. The categories of potential consequences of these visits were maternal, child, interactive, and environmental. CONCLUSIONS: Future research should address the most effective processes for working with families when nurses doubt the quality of maternal caregiving. Field research was helpful in developing a beginning typology of maternal-child home visits, in understanding practice, and as a basis for further research examining the efficacy of maternal-child home visits.

Caregivers↗

PubMed1998

Long-term maternal-child home visiting.

Families with children with special needs, with acutely and chronically ill children, and with foster children comprise an increasing portion of many public health nurses' caseloads. The nursing processes during maternal-child home visiting have not been identified and variations in these processes, as well as their attendant outcomes, across client populations have not been described. The aim of this study was to describe the process of home visiting, as it was enacted by an experienced nurse, and to identify potential influencing factors and attendant consequences. During this field research investigation, one nurse in a visiting nurse association in rural New England was observed and interviewed throughout her day, every one to two week over a period of eight months. A total of 53 home visits were observed, three clients were interviewed subsequent to visits, and documents and records were reviewed. A specific type of home visiting, labeled child-focused, which the nurse conducted in three distinct patterns--single, short-, and long-term, emerged. The long-term pattern is described in this article. An admiring, familiar, trusting, supporting, reassuring, and validating seeing and exchanging subprocess ran through these visits. Potential maternal, child, and environmental consequences were identified.

Child↗

PubMed1997

Child-focused single home visiting.

Home visiting is a central, long-standing, and yet theoretically underdeveloped public health nursing process. The general aim of this study was to expand and refine a preliminary model of home visiting. A stylized field research investigation was conducted in the area of maternal-child health with one nurse in a visiting nurse association in New England. A specific type of home visiting, identified as child focused, emerged, with phases labeled as surveying and designating; selling and scheduling; approaching the home and the visit; entering the home; gaining permission to ask questions and access the infant--starting with the mother's expressed concerns; making the caregiving judgment--asking questions and weighing and examining the infant; and ending the visit. "Haunting and telling" was an additional phase for certain visits. The nurse conducted child-focused home visiting in three patterns. The single pattern is described in this article. Potential maternal, child, interactive, and environmental consequences were identified, as were factors influencing the process of maternal-child home visiting. Social exchange theory emerged as useful in describing how the nurse initiated, maintained, and ended the home visiting process, and in describing attendant client consequences.

Community Health Nursing↗

PubMed1997

A typology of the potential outcomes of maternal-child home visits: a literature analysis.

Home visiting the maternal-child population has been a major focus of public health nursing. The focus of a large portion of empirical studies of maternal-child home visiting has been on the demonstration of outcomes. Despite a general consensus about its benefits, public health nursing has experienced difficulty conclusively demonstrating the effectiveness of maternal-child home visitation. A systematization of potential client outcomes across studies has not been conceptualized. With the aim of tracing overall trends in past attempts to identify, measure, and validate the potential outcomes of maternal-child home visits, an overview and analysis of these studies is presented chronologically. How specific outcomes were identified and measured are analyzed, and support and nonsupport for potential outcomes are summarized. A tentative typology of maternal-child home visitation client outcomes is proposed. Four types of outcomes reflecting an ecological conceptualization of the client, emerged from this analysis. Maternal-child home visiting outcomes were concerned with the mother (maternal outcomes), the child (child outcomes), the relationship and interaction between the mother and child (maternal-child interaction outcomes), and the relationship of the family with the extended family, neighborhood, and community (environmental outcomes).

Home Care Services↗

PubMed1995

The home visiting process in the contexts of the voluntary vs. required visit: examples from fieldwork.

Home visiting is a frequently used nursing intervention for families at risk. Yet, research on the nature of home visiting is lacking. Little empirical research has been conducted to corroborate or refine the definition of home visiting and phases of the home-visiting process. The "Hybrid Model of Concept Development" by Schwartz-Barcott and Kim (1986) was used to identify the nature of home visiting. The Hybrid Model combines theoretical analysis with empirical observation. The first phase includes theoretical analysis, continuing into the second phase, consisting of fieldwork. In the final analytical phase, theoretical findings are compared with the fieldwork findings. The completed review of historical and current literature and a definition of home visiting were presented earlier (Byrd, 1995). The findings of the fieldwork and final analytic phases are presented here. Two contexts of home visiting, "voluntary" and "required," emerged as distinctive. In the voluntary context, entry was relatively easily accomplished, interaction was client-controlled, and the tone was informal and friendly. In contrast, in the required context, entry was difficult, interaction was nurse-controlled, and the tone was formal, polite, and investigatory. Themes of resistance and distorted nurse-client communication emerged in this type of visit. Client characteristics and properties of the referral were contextual factors, influencing the process. The concept's initial definition was corroborated, and the model was expanded based on this empirical observation of maternal-child preventive home visits.

Adult↗

PubMed1995

A concept analysis of home visiting.

Throughout the history of community health nursing, home visiting has been and remains a central nursing intervention. Yet little conceptual clarification has dealt with this intuitively very valuable nursing intervention. Here, the concept of home visiting was investigated through a concept analysis. The nature of home visiting as it emerged over time was gleaned from historical and current literature. A working definition, capturing the essence of home visiting and implying new measurement possibilities, was formulated. Home visiting emerged as a specific nursing intervention, preceded by an antecedent event, unfolding as a process, with phases labeled as "contacting," "going to see," "gaining entry," "seeing," "terminating," and "telling." Nurse sub-outcomes, nursing strategies, contextual factors influencing the process, and potential consequences of home visiting were uncovered.

Europe↗

PubMed1992

Changing patterns in colorectal carcinoma: a 25-year experience.

The pattern of colorectal carcinoma, especially with respect to stage and tumor location, has changed noticeably over the past 25 years. During that time period, 1,959 patients came to Hahnemann University Hospital with colorectal cancer, 1,584 of whom were reviewed in this study. There was a significant relationship between extent of disease and date of diagnosis, with the trend being toward decreasing stage at the time of diagnosis. In addition, there has been a demonstrable "rightward shift" in tumor location, especially over the past 15 years. This has been accompanied by a slight increase in the detection of rectal lesions as well. The trend toward earlier and more proximal lesions is likely due in large part to the increasingly widespread use of surveillance colonoscopy and sigmoidoscopy.

Colorectal Neoplasms↗