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Biomedical subjects

M E Duffy

Publications and source records attributed to M E Duffy.

At least 19 recordsLinked to original sources
PubMed2005

International community health networking project: two year follow-up of graduates.

AIM: This paper presents the perceptions of graduates 2 years post-exchange in a USA-European Union funded programme. The primary goal of this 8-week exchange programme was to increase cultural knowledge and sensitivity by teaching a common module of community health assessment and planning to multi-national groups of undergraduate students in four countries. BACKGROUND: Cultural diversity and globalization are among the factors that encourage faculty in nursing to develop programmes of international exchange for students. The challenge is to combine the exchange with the teaching of other courses required by the home institution during the same semester. METHODS: Twenty-one graduates of participating USA schools responded to an open-ended interview by telephone or email 2 years after graduation. Bennett's continuum (1993) of intercultural sensitivity was used to assess cultural development. FINDINGS: Graduates overwhelmingly supported international education and described its continued impact personally and professionally. Gains in cultural sensitivity were perceived as the greatest benefit and influence on their practice. The majority of graduates were believed to be in Bennett's ethnorelative categories of acceptance and adaptation. The depth and breadth of previous cultural experiences, specific host and home schools, and previous travel were found to be related to development on the intercultural sensitivity continuum. DISCUSSION: Most important are the findings from this evaluation that provide insight into the factors enhancing growth of intercultural sensitivity. Previous travel, characteristics of the home and host institutions, and the opportunity and willingness to be a cultural outsider were important influences.

Adult↗
PubMed2001

A critique of cultural education in nursing.

UNLABELLED: AIM(S) OF THE PAPER: This paper critiques cultural education in nursing. Current approaches to cultural education, embedded in traditional anthropology, are obsolete and fail to acknowledge the global environment that impacts even the most remote and isolated cultures. The argument is made that new, transformative approaches to cultural education are needed. BACKGROUND: Cultural awareness of the other is the foundation of existing strategies to teach cultural education. Students are encouraged to learn about each culture, often described as a monolith, by learning the unique characteristics of a group with a common race, ethnicity, or other distinguishing feature. Despite the increased emphasis on cultural education in nursing worldwide, culturally based problems persist. Nurse and health care researchers continue to report disparities in health, an unequal distribution of health care, and the lack of knowledge and sensitivity when caring for clients from another culture. DISCUSSION: Globalization contributes to differences within cultures that may equal or exceed differences between cultures. Evidence is presented that current nursing education emphasizes cultural distinctions that do not persist in the postmodern world. Problems adherent to the continued use of cultural monoliths as the foundation of cultural education are discussed and expanded perspectives on culture and cultural education are presented. CONCLUSION: The principles of transformative education are offered as an alternative to the current approaches to cultural education. Students are encouraged to be vulnerable to personal change when interacting with people from other cultures because transformative education is as much about personal growth as it is about enhanced care of others. This modernized approach to cultural education transcends the standard adaptation of care from the dominant culture of the health care delivery system to the culture of the client/patient.

Anthropology, Cultural↗
PubMed2001

The development and psychometric evaluation of the Ethical Issues Scale.

PURPOSE: To describe the Ethical Issues Scale (EIS), its conceptual development and psychometric evaluation, and its uses in determining how frequently nurses experience ethical issues in practice. DESIGN: The EIS was validated with a sample (N = 2,090) of New England registered nurses (RNs) currently in practice. The sample was randomly split into two approximately equal samples. The calibration sample was used to derive the underlying components; the validation sample was used to confirm the component structure. METHODS: Psychometric analysis of the 35-item EIS included: (a) item analysis, (b) confirmatory principal components analysis (PCA), and (c) internal consistency reliability using Cronbach's alpha. RESULTS: Three components (end-of-life-treatment issues, patient care issues, and human rights issues) were demonstrated, confirming the original conceptually-derived structure. The calibration sample accounted for 42.4% of initially extracted common variance; the validation sample accounted for 41.5% of initially extracted common variance. CONCLUSIONS: The three EIS subscales had satisfactory internal consistency reliability and factorial validity for use as independent scales in future studies.

Ethics, Nursing↗
PubMed2000

The development of an instrument to measure the compliance of adolescents with a chronic disease.

The purpose of this paper was to describe the process of developing an instrument for measuring the compliance of adolescents with a chronic disease. The aim was to develop an instrument that could be used in a clinical setting to evaluate the compliance of young people with a chronic disease and to test a theoretical model of compliance, which had been developed along with the instrument. The instrument was originally developed to measure the compliance of adolescents with diabetes and later adjusted to measure the compliance of adolescents with asthma, rheumatoid arthritis and epilepsy. To test and develop the instrument, face and criterion validity, factor analyses, linear structural relations (LISREL) analyses, correlation coefficients and Cronbach's alpha were used. The instrument has 13 background questions and 41 items to measure compliance and factors connected to it.

Adolescent↗
PubMed2000

Conceptual analysis of compliance.

Compliance has been studied from a wide range of scientific perspectives including medicine, nursing, psychology and health economics. There is no agreement regarding a commonly accepted definition. Lack of consistency in the definition and measurement of compliance is a major problem in research which becomes more complicated in an international study. The response to the confusion over the term compliance has been to suggest and use alternative terms such as adherence, co-operation, mutuality and therapeutic alliance. These terms are ill-defined and often are used as synonyms. The purpose of this paper is to analyse definitions of the concept of compliance. Abstracts from MEDLINE have been analysed in order to identify the types of compliance research that have been carried out.

Cognition↗
PubMed1998

Family nursing practice in public health: Finland and Utah.

This exploratory study of family nursing practice in public health care was conducted in Finland and Utah. Staff nurses were interviewed in focus groups and asked to describe their practice of family nursing, the factors promoting and restraining practice, and the impact of the changes in health care delivery on practice. Thirty-six Finnish and 30 Utah nurses participated. Pressure to do more activities with fewer nurses and resources, changes in family problems, and skill level of the nurses were common themes. However, differences were evident. Finnish public health nurses used emotional support and information to help families empower themselves to use resources and to strengthen their family unit. Utah nurses focused first on individual level goals and then family cohesion and health. Nurse-initiated referrals and direct physical care were the primary intervention strategies of Utah nurses. Unlike the U.S. health care system, access for all in maternal and child health care and school health allowed Finnish nurses to develop long-term relationships with families, thus advancing family nursing practice. This study identifies several potential variables for further study particularly related to the organization of health care and nurse-family relationships.

Adult↗
PubMed1998

The concept of adaptation: examining alternatives for the study of nursing phenomena.

Clients' adaptation is frequently studied in nursing and used to guide nursing practice. Many nurse authors have suggested that adaptation may be a unique conceptual framework for nursing. Other nurse authors have suggested, however, that in focusing on adaptation, nursing limits its focus to changing clients to fit the environment and neglects to change the social system or environment to meet clients' needs. The purpose of this article is to argue that adaptation theory limits the range of clients' acceptable responses to change. Adaptation theory assumes clients are responsible for adjusting to the norms or standards established by a relatively immutable environment. An alternate set of assumptions broadens the range of acceptable responses by clients and targets the environment for change. On the basis of these assumptions, directives are given for nursing research aimed at studying clients' responses to change.

Adaptation, Psychological↗
PubMed1994

Testing the Theory of Transcending Options: health behaviors of single parents.

The Theory of Transcending Options was developed in a grounded theory study of the health behaviors of female single parents. The 2-year study reported in this article is the first statistical test of the associations between the independent variables identified in the theory and the number of health behaviors practiced by divorced women with children. Data on demographics, psychological variables, and social support were collected from 148 women at three points in time over 2 years. These data were entered into three stepwise multiple regression analyses, with health behaviors as the dependent variable. Each analysis was statistically significant. The independent variables that made statistically significant contributions to health behavior practices in one or more of the regression analyses were education, number of years single, depression level, self-esteem, and total social support. The results of this study indicate that further clarification and testing of the theory are warranted.

Adolescent↗
PubMed1993

Social networks and social support of recently divorced women.

A study of the support networks and social support of recently divorced women with children was conducted over two years. Its purpose was to assess changes in the women's social support and identify their unmet needs. Data were collected from 148 women by mailed questionnaire and telephone interview soon after the final divorce decree, and again at two years. The women did experience a significant decrease in network size and social support over two years; however, the primary members of their networks--family and friends--remained stable. Women with preschool-age children had more family support than those with older children. Nine categories of unmet needs were identified. Most frequently cited, in descending order, were emotional support, financial assistance, need for a boyfriend/partner/spouse, time for herself, and child care. The average number of needs per woman was less than two. The findings of this study confirm the losses in overall network size and support that women experience after divorce. The identification of unmet needs helps nurses to target areas in which women may require assistance to find social support.

Adolescent↗
PubMed1993

Determinants of health-promoting lifestyles in older persons.

The purpose of this study was to determine the degree to which selected components derived from Pender's Health Promotion Model (1982) explained engaging in health promotion practices in a sample of 477 persons 65 years and older. One directional hypothesis was tested using canonical correlation analysis. Three significant canonical variates were demonstrated, explaining 88.7 percent of variance. Older healthy persons with high self-esteem and internal locus of control reported practicing five of the six health promotion strategies. Men with higher income and self-esteem but poorer health less often exercised or ate well. Older married subjects with higher incomes who were internally controlled were more likely to engage in exercise, health responsibility and stress management but not in interpersonal support. Findings provide direct multivariate support for the additive nature of the relationships posited in the Health Promotion Model.

Aged↗
PubMed1990

The process of providing support to recently divorced single mothers.

Social support is a combination of a person's perceptions of support, the belief that the support is personally satisfying, and the actual provision of services. Although the literature is replete with the work of researchers who have addressed the components of support, there is a notable limitation--the perspective of the providers of support. This perspective is important for clinicians who work with a person's natural support system to enhance its effectiveness. In this descriptive study, 252 people identified by recently divorced women with children as providing their most significant support were interviewed. The authors' purpose in conducting the study was to identify the underlying processes involved in social support based on interviews with the women's significant support people. In the qualitative portion of the study the data analysis yielded eleven processes: deliberating, withdrawing, continuing, understanding, availing, anchoring, distancing, protecting, nurturing, valuing, and intruding. Each of these processes is described in this paper.

Adaptation, Psychological↗
PubMed1990

Determinants of functional health of older persons.

The study investigated relationships among demographics, self esteem, health locus of control, health promotion behaviors, perceived health and functional health ratings in 179 older men and women from 65 to 99 years. Canonical correlation and stepwise discriminant analyses demonstrated several meaningful and significant relationships suggesting that exercise and nutrition may be critical health promotion activities associated with better scores on five functional dimensions. The 85+ years age group differed from younger groups through having significantly higher reported exercise scores.

Activities of Daily Living↗
PubMed1990

Personal goals of recently divorced women.

This paper is a report of the synthesis of feminism and science in a study of the personal goals of recently divorced women with children. The divorce records of three counties were used to identify the participants; eight categories described the primary goals identified by 250 women. Independence, followed by employment and education were the most frequently cited categories. Analysis of variance was computed to analyze the relationships among the primary goal categories, the personal characteristics of the women and their feminist attitudes. Age was the only variable related to selection of a primary goal. Older women chose employment and environmental goals more often than they did mental health goals.

Adaptation, Psychological↗