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Biomedical subjects

M H Palmer

Publications and source records attributed to M H Palmer.

At least 19 recordsLinked to original sources
PubMed1995

Nurses' knowledge and beliefs about continence interventions in long-term care.

Incontinence in nursing homes is a prevalent condition requiring a programmatic approach due to its diverse aetiology. Awareness of antecedent factors, such as knowledge and beliefs about incontinence and its treatment by the individuals responsible for establishing and maintaining a continence programme, is important prior to implementation. A questionnaire was administered to licensed nurses who attended a workshop on urinary incontinence in nursing homes. One purpose of the questionnaire was to elicit information about beliefs regarding the effects of continence programmes on residents and staff and potential staff reaction to implementation of a continence programme in their facility. Responses by licensed practical nurses (LPNs) were compared to the responses of registered nurses (RNs). Attribution for causes of incontinence differed between LPNs and RNs. There were no significant differences in the report of current routine nursing care which included scheduled toileting, changing clothing when necessary, and use of adult briefs and underpads. Most nurses anticipated a favourable reaction by the staff to the implementation of a continence programme. However, at least 20% responded that the nursing staff would be apathetic or resistant to a programme. Administrative support was infrequently chosen as the most important factor in the implementation of a programme. The implications of these findings to continence programmes that are integrated into the organization and provide comprehensive services, including preventive interventions, are discussed.

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PubMed1994

Level 1: basic assessment and management of urinary incontinence in nursing homes.

Urinary incontinence (UI) in nursing home residents is a prevalent condition that can be assessed and treated without using sophisticated testing or technology. NPs play a major role in the assessment, treatment, and management of incontinence using the Resident Assessment Profile of the Minimum Data Set to identify potentially reversible and readily treatable causes of incontinence. This article describes the basic (Level I) assessment and management of UI in nursing home residents and provides guidelines for referral to more advanced levels of continence care.

Aged↗
PubMed1994

The management of urinary incontinence in the long-term patient.

Urinary incontinence affects 50%-80% of residents in nursing homes, presenting a challenge to the health care team. Assessment of urinary incontinence is crucial to selecting appropriate treatment. This article addresses the scope of the problem, incontinence assessment, and treatment specific to nursing home residents.

Homes for the Aged↗
PubMed1991

Risk factors for urinary incontinence one year after nursing home admission.

Secondary data analysis was conducted from a longitudinal nursing home study to identify nonurologic risk factors for continence outcomes at 1 year after admission. Of 434 nursing home admissions, 196 subjects (45%) remained. At 1 year prevalence of incontinence was 43.8%. Age was not associated with prevalence or incidence. Risk factors identified were of male gender, urinary incontinence and poor behavioral adjustment at 2 weeks, presence of dementia and impaired mobility at 2 months. Once established, incontinence tended to persist. The data suggest types of residents who might be targeted for early preventive intervention.

Activities of Daily Living↗
PubMed1990

Urinary incontinence.

Symptoms of urinary incontinence are distressing and disruptive to everyday life. They can also be indicative of more serious underlying disorders. Many methods of symptom management are available. Matching the affected person to the most effective and appropriate treatment method is a significant challenge for nursing. Just as pressing is the need to develop and test a cogent conceptual model for symptom management that includes primary prevention.

Aged↗
PubMed1989

Individual professionalism: part of the solution to the nursing shortage crisis.

Changes in the health care delivery system in the United States have affected the practice of nursing. Disruption in the status quo has led to confusion as to the functions and role of nurses among health professionals, the public, and the nurses themselves. As demand for nursing services has increased, more and more nurses are leaving practice and fewer individuals are choosing nursing as a career. Others have proposed causes and solutions to this most recent shortage, which are primarily directed at changing the structure of the delivery system or the reward system for practice. The authors suggest that individual nurses have a role in the solution.

Attitude of Health Personnel↗
PubMed1989

Do nurses consistently document incontinence?

1. Urinary incontinence is inconsistently documented on medical records of nursing home residents. 2. Documentation of urinary incontinence by professional nurses may be improved by changes in organizational factors such as staffing, policy implementation, and staff education. 3. Forms that employ cue words for eliminative status show more documentation of continence status than forms that have an open format. 4. Evaluation of changes in nursing practice in the nursing home setting can benefit from nursing studies that employ an organizational perspective.

Aged↗
PubMed1988

Incontinence. The magnitude of the problem.

Prevalence figures from various settings reveal a confusing picture of the true nature of incontinence, a disorder that causes physical and psychological stress in affected adults and their caregivers. One message that is evident from the literature, however, is that once incontinence begins, it tends to persist. The prevalence data from the studies reviewed are indicative of this persistence. Incontinence is more common in women than in men. It appears to become more severe with advanced age and other infirmities, such as immobility. Incontinence has also been linked with an increased risk of death. The reality of the problem is not difficult to gauge from the existing data. Nurses must use this information with their knowledge of the aging process and of the disruption of incontinence to plan intervention strategies. Targeting of appropriate groups for health education, clinical assessment, and intervention is necessary to alleviate or at least modify incontinence. Health care providers often do not recognize disruptions in urinary function. Some, like social workers, have difficulty in explaining the causes for incontinence and in identifying the appropriate treatment. Often, containment or management practices are the only measures utilized. Reliable and standardized methods for verifying the frequency and severity of incontinence in incontinent community-dwelling elderly persons are being tested. Methods of recording the pattern and amount of incontinence are also being tested. Nurses and ancillary staff within health care institutions are often left to manage incontinence without the aid of input from other disciplines, especially physicians. In the community, older adults may go to elaborate lengths to hide or disguise their incontinence. Knox reported that women are tolerant of incontinence. This statement is supported by the evidence that incontinent adults often do not utilize existing services. The energy expended in such futile attempts to deny or hide incontinence would be better spent in seeking care from knowledgeable and sensitive health professionals.

Acute Disease↗
PubMedDate not supplied

A health-promotion perspective of urinary continence.

The purposes of this article are to discuss continence in older adults from a public health perspective, to expand a previously reported conceptual model of continence health promotion, and to provide a primary prevention focus to nursing research efforts regarding continence. The conceptual model shows that there has been a strong interest in secondary and tertiary prevention strategies, but little interest in primary prevention. Use of the matrix allows the nurse researcher identify primary, secondary, or tertiary prevention research questions and the target population for study. Historically, nurses have had a central role in the care and management of incontinent people. Nurses will continue to play a critical role in the evolution of research-based practice that includes identification of risks, health promotion, and preventive nursing strategies.

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