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Biomedical subjects

Mary B Killeen

Publications and source records attributed to Mary B Killeen.

7 recordsLinked to original sources
PubMed2006

Rural residents with disabilities confront substantial barriers to obtaining primary care.

OBJECTIVE: To learn about the health care experiences of rural residents with disabilities. STUDY SETTING: Rural areas in Massachusetts and Virginia. STUDY DESIGN: Local centers for independent living recruited 35 adults with sensory, physical, or psychiatric disabilities to participate in four focus group interviews. DATA COLLECTION METHODS: Verbatim transcripts of interviews were reviewed to identify major themes. PRINCIPAL FINDINGS: Interviewees described the many well-recognized impediments to health care in rural America; disability appears to exacerbate these barriers. Interviewees reported substantial difficulties finding physicians who understand their disabilities and sometimes feel that they must teach their local doctors about their underlying conditions. Interviewees described needing to travel periodically to large medical centers to get necessary specialty care. Many are poor and are either uninsured or have Medicaid coverage, complicating their searches for willing primary care physicians. Because many cannot drive, they face great difficulties getting to their local doctor and especially making long trips to urban centers. Available public transportation often is inaccessible and unreliable. Physicians' offices are sometimes located in old buildings that do not have accessible entrances or equipment. Based on their personal experiences, interviewees perceive that rural areas are generally less sensitive to disability access issues than urban areas. CONCLUSIONS: Meeting the health care needs of rural residents with disabilities will require interventions beyond health care, involving transportation and access issues more broadly.

Adult↗
PubMed2005

Primary care experiences of people with psychiatric disabilities: barriers to care and potential solutions.

This study examined the barriers that 16 focus group participants with psychiatric disabilities confront in obtaining primary care services and their recommendations on improving quality of care. They cited a) difficulty identifying a primary care physician with good empathic and communication skills, b) physicians' misunderstanding of the nature of psychiatric disability, c) inadequate information about the side effects of psychotropic medications, and d) costs due to inadequate insurance coverage. In addition to suggestions for improving patient-physician communication and expanding physician knowledge, participants emphasized strategies to become empowered in their relationships with physicians and to obtain personal support.

Adult↗
PubMed2004

Challenging expectations: how individuals with psychiatric disabilities find and keep work.

The results of this qualitative study involving in-depth interviews of 32 individuals with psychiatric disabilities document the importance of beliefs and expectations with regard to employment. Each of the participants were either currently receiving Social Security benefits or had received them in the past due to his or her psychiatric disability. The authors briefly describe the systemic and programmatic barriers to employment that study participants encountered. They discuss how negative beliefs and expectations concerning employment are imbedded within the policies and programs that impacted these participants. They also describe the representative experiences of three study participants who were successful at overcoming these barriers and maintaining employment. Finally, they identify and discuss some of the common factors that may have contributed to successful employment.

Adult↗
PubMedDate not supplied

A successful teaching strategy for applying evidence-based practice.

Evidence-based practice (EBP) is the conscientious use of the best evidence contained in the literature to guide healthcare decisions. The authors describe how their baccalaureate program prepares its graduates to be successful in implementing EBP in their nursing practice. Outcomes of sustained student projects in agency settings are presented. They posit that bachelor of science in nursing students, agency personnel, and faculty can lead practice innovations supported by EBP.

Attitude of Health Personnel↗
PubMedDate not supplied

Cyclic perimenstrual pain and discomfort: the scientific basis for practice.

OBJECTIVE: To review and organize the science related to cyclic perimenstrual pain and discomfort for the fifth research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses. DATA SOURCES: Computerized searches in CINAHL, MEDLINE, and the Cochrane Library, as well as hand searches of cited references. Keywords included cyclic pelvic pain, comfort, pain guidelines, and dysmenorrhea. DATA EXTRACTION: All relevant articles prior to 1999 were considered. Thirty-three research-based articles (1992-1999) were reviewed for relevance by the science team as part of the fifth research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses. DATA SYNTHESIS: The literature review and synthesis resulted in a cogent description of cyclic perimenstrual pain and discomfort and the development of three nursing diagnoses: perimenstrual cyclic pelvic pain, perimenstrual discomfort, and perimenstrual negative affect. Cyclic pelvic pain is a new concept, developed by the science team during the project. Perimenstrual cyclic pelvic pain is an acute, subjective experience defined by pelvic pain that presents in a repeating time frame associated with the menstrual cycle. It is usually clustered with other discomforts and appreciably affects a woman's quality of life. Because the science about interventions is complex and extensive, data synthesis led to organization of the interventions within seven categories. CONCLUSIONS: Translation of research into practice is essential. Cyclic perimenstrual pain and discomfort is an important clinical issue, yet the science had not previously been comprehensively reviewed with the mission to translate it for nursing practice. Translation of this complex literature was accomplished though an innovative clinical practice guideline and subsequently evaluated in nursing practice through the research-based practice project.

Dysmenorrhea↗