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Biomedical subjects

P Shuler

Publications and source records attributed to P Shuler.

7 recordsLinked to original sources
PubMed1992

Risk factors for disease in a homeless population.

Risk factors of smoking, drug and alcohol abuse, obesity, and sedentary lifestyle were related to health problems of clients at a walk-in clinic for the homeless. The sample of 1252 clients was predominately male (91.4%) and multiethnic, with a majority (65%) age 18 to 40 years. Data on diagnoses of health-related conditions were collected from clinic charts, coded into ICD categories, analyzed for relationships of risk factors to health problems, and compared with categories of diagnoses in a matched national sample of ambulatory care visits. Findings indicate that a larger proportion of homeless suffered from health problems in 24 of 27 diagnostic categories than the nonhomeless. Most prevalent were respiratory, dermal conditions, injuries, and digestive problems, in that order. Risk factors of alcohol abuse, smoking, sedentary lifestyle, drug abuse, and obesity were predictive of health problems in 18 of the categories analyzed. The findings suggest that immediate interventions such as education and rehabilitation to reduce risk factors, and provision of facilities for personal hygiene and cleaning of clothing could reduce some of the health-related conditions in this population while longer-term solutions of housing and employment are sought. The analysis model developed here appears to be a useful way of comparing relative effects of risk factors as a basis for establishing priorities for interventions.

Adolescent↗
PubMed1992

Moving beyond: a generative philosophy of science.

Philosophies of science are perhaps the most covert yet significant forces influencing the direction of change within disciplines. Although the era of logical positivism has waned for many disciplines, newer philosophies may not be satisfactory, especially for the applied disciplines. This article describes an alternative philosophy of science with special significance for nursing. This philosophy was influenced by several of the major existing philosophies, but especially by the paradigmatic view espoused by Thomas Kuhn. The generative philosophy of science was named because of its focus on generating growth among the applied disciplines. Members of these disciplines study questions with social significance and human application. This article defines major concepts, describes relationships among concepts and discusses implications for the development of nursing science and the nursing discipline.

Philosophy↗
PubMed1992

Disease patterns in homeless children: a comparison with national data.

Although homeless children have increased in numbers as poverty has become feminized, minorities have become poorer, and low-income housing has become less accessible, little is known of their health problems. This study compared the health problems of a group of uninsured and homeless children visiting a free, nurse-managed, primary care clinic on Los Angeles' Skid Row with data from children's primary care visits to pediatricians and general and family physicians sampled in the National Ambulatory Medical Care Survey. Diagnoses were classified into the following health service categories: (a) acute, (b) communicable, and (c) chronic disease; (d) preventive and (e) injury care. Comparisons indicated that services to homeless children differed significantly from reimbursed services in the national sample in all categories except chronic disease. Demographic analysis indicated that homeless children were predominantly Hispanic Americans. When data from Hispanic children were examined, the pattern of differences between the homeless and National Ambulatory Medical Care Survey diagnostic categories persisted. This study shows the variations in nursing care which a group of high-risk, severely impoverished, uninsured children require.

Adolescent↗
PubMed1990

Focus group interview: a research technique for informed nursing practice.

AIDS has become a leading cause of death for women between the ages of 25 and 34. An overwhelming proportion of these women are Black (52%) or Hispanic (20%). Despite the disproportionate number of minority women who are HIV infected, the majority of AIDS educational programmes have been directed at the White gay male. The purpose of this paper is to present a qualitative research technique which used focus group interviews to promote the development of a programme devised to reduce risk behaviours in minority populations. A summary of the investigation and implications for nursing are also presented.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Factors affecting prescribed medication compliance of the urban homeless adult.

Compliance with medical treatment may constitute an impenetrable barrier to homeless persons experiencing significant physiological and psychosocial limitations. The purpose of this study was to describe the perceived factors that enhance or diminish prescribed medication compliance of homeless adults. A retrospective descriptive study of 61 urban homeless adults sheltered at the Union Rescue Mission in downtown Los Angeles were interviewed with a compliance questionnaire. Findings revealed that more than two-thirds of the sample reported their health status to be fair to poor. Nearly one-third reported compliance rates ranging from none of the time to half of the time. Deterrents to compliance included structural variables such as availability of drugs and lack of privacy and storage space. Factors enhancing compliance included carrying the medications, being close to the health clinic and understanding the need for the medication. Many of the factors reported to enhance or diminish compliance are within the realm of professional practice.

Adult↗