Biomedical subjects

Ramona Benkert

Publications and source records attributed to Ramona Benkert.

12 recordsLinked to original sources

PubMed2006

Educational competencies to strengthen tuberculosis curricula in undergraduate nursing programs.

Worldwide, at least two million people die annually from tuberculosis (TB), with projections of 36 million more global deaths between the years 2003 and 2020. To help nursing faculty strengthen TB curricula and standardize TB content in national and international undergraduate nursing programs, the Nurse Discipline Group of the National Tuberculosis Curriculum Consortium (NTCC) has developed comprehensive TB core competencies and specific student objectives for the classroom setting. These core competencies address the knowledge, ability, and/or skills required for an undergraduate nursing student to provide qualified holistic care for patients, families, and communities impacted by TB. The NTCC is comprised of a team of multidisciplinary health care educators in the United States, with the primary mission to instill knowledge, skills, and appropriate attitudes in the management of active and latent TB among undergraduate health care students.

Competency-Based Education↗

PubMed2006

Effects of perceived racism, cultural mistrust and trust in providers on satisfaction with care.

Discriminatory treatment of African Americans in healthcare is well recognized, yet the literature is unclear on the specific role that perceived racism and mistrust play in the patient-provider relationship. The purpose of this study was to test a mid-range theoretical model entitled Perceptions of Racism and Mistrust in Health Care (PRMHC). This model hypothesized that perceived racism influences cultural mistrust, which affects trust in providers--and these combined psychosocial aspects of healthcare affect satisfaction with the care received. One-hundred-forty-five African-American subjects participated in structured interviews to collect demographic and psychosocial data. Provider data was obtained through chart audits. In a group of low-income African Americans in two primary care clinics, perceptions of racism and mistrust of whites had a significant negative effect on trust and satisfaction. Perceived racism had both a significant, inverse direct effect on satisfaction as well as a significant indirect effect on satisfaction mediated by cultural mistrust and trust in provider. Structural equation modeling analysis supported the hypothesized theoretical relationships and explained 27% of the variance in satisfaction with care. The findings add to the existing literature by enhancing our understanding of the complex perspectives on trust and overall satisfaction with care among African-American patients. Results suggest that improving health outcomes for African Americans requires a broader understanding of cultural competence, one that addresses societal racism and its impact on provider-patient relationships.

Adult↗

PubMed2005

African American women's coping with health care prejudice.

African American clients have reported racism and prejudice in health care; yet there is limited documentation of the strategies used to cope with these experiences. This study describes African American women's perceptions of prejudice in health care and the strategies used to cope with the experiences. This qualitative study used the constructivist perspective of interpretive interactionism for paradigmatic and methodological guidance. Participants were 20 women ranging from age 26 to 74 years with 50% having a high school education. Individual interviews consisting of five areas were conducted with three instruments measuring ethnic identity, socioeconomic status, and general demographics. The analyses provide two themes: experience with the "White health care system" and strategies for coping with the prejudice, which included getting angry, learning to unlearn, being assertive, and walking away. Consistent with the discussions of race in the United States, racism in health care has become a subtle entity that infuses health care relationships.

Adaptation, Psychological↗

PubMed2005

Cultural competence of nurse practitioner students: a consortium's experience.

Professional standards require culturally competent care, but competencies are rarely assessed. An instrument adapted from the work of cultural competence experts was used to assess the cultural competence of nurse practitioner students (n = 122). The 30-item instrument indicated adequate reliability scores (.78 to .87). Students reported high levels of comfort with people who are different from themselves and felt that cultural knowledge was important. Students scored fairly low on engaging in community-related culturally relevant behaviors. Predictors of culturally competent behaviors in clinical practice and the community were: comfort with others who are different from themselves, the degree of importance attached to cultural knowledge, and likelihood of future practice in rural areas. Nurse practitioner programs need to concentrate on increasing students' comfort with culturally diverse client groups and stressing a deeper cultural knowledge in clinical practice.

Adult↗

PubMed2004

Creating cross-racial primary care relationships in a nurse-managed center.

Culturally incompetent communication patterns with providers influence the health disparities of African Americans. Limited knowledge exists on cross-racial nurse practitioner nurse-patient relationships (NP-NPRs). The purpose of this paper is to describe how NPs and patients in cross-racial relationships developed primary care relationships in one nurse managed center (NMC). A qualitative design incorporated a social constructivist paradigm and the methodology of Interpretive Interactionism. Twenty cross-racial NP-patient dyads (White NPs and Black patients) participated in individual 1 to 3-hour audiotaped interviews regarding their ongoing relationships and the impact of the NMC. The analysis uncovered a rich description of the relationship processes from the initial meeting to its current state. Multiple themes for each phase, as well as, four typologies of primary care cross-racial NP-NPRs are described. Significant relationship work was needed by both partners to overcome communication misunderstandings, contextual aspects of cross-racial interactions and other overt and covert perceptions.

Adaptation, Psychological↗

PubMedDate not supplied

Clients served and services provided by academic nurse-managed centers.

Currently, no national database for academic nurse-managed centers (ANMCs) exists. These primary care services remain somewhat invisible in the policy and reimbursement areas of the American primary care system and, consequently, are undersupported. The purpose of this article is to describe client and service data from a national study of ANMCs. A cross-sectional survey design was used to collect data from ANMC directors. Usable data were received from 64 centers. ANMCs in the sample were relatively small in terms of patients and volume. Client and service profiles demonstrated variation, which seemed to be reflective of needs relative to populations and communities served. Nearly half of the ANMCs responding served clients of all ages, with services representing the breadth of primary care (i.e., health maintenance and management of minor acute and common chronic illnesses). Evidence of community-focused care was also noted. The reported use of standardized nursing language was low. Standardized medical taxonomies were more commonly used, with International Classification of Diseases, Ninth Revision being the most common. ANMCs provide a small but substantial amount of primary care services in communities served. Findings indicated a need for ANMCs to improve the documentation of their contributions through the use of standardized taxonomies to provide aggregated reporting for policy and research purposes.

Adolescent↗

PubMedDate not supplied

Psychometric evaluation of the cultural competence assessment instrument among healthcare providers.

BACKGROUND: The relevance of healthcare provider cultural competency to the achievement of goals for reduction in extant health disparities has been demonstrated; however, there are deficits with regard to cultural competency measurement. OBJECTIVES: To examine the test-retest reliability of the cultural competence assessment instrument (CCA) among hospice providers, and to examine the reliability and validity of the CCA among healthcare providers in nonhospice settings. METHOD: Test-retest reliability of the CCA was assessed using a sample of 51 hospice respondents who completed the CCA at two time points. The internal consistency reliability and construct validity of the CCA for healthcare providers in nonhospice settings were evaluated using a convenience sample of 405 healthcare providers. RESULTS: The CCA demonstrated adequate test-retest reliability (r = .85, p = .002) in hospice providers over 4 months. Among healthcare providers in nonhospice settings, the CCA had an internal consistency reliability of .89 overall (.91 and .75 for the two subscales). Construct validity was supported by principal axis factor analysis, which showed two factors with item loadings above .40, explaining 56% of the variance. Mean scores of the CCA were significantly higher for providers who reported previous diversity training compared to those who had not. DISCUSSION: Findings for the psychometric properties of the CCA supported its potential as an instrument for measuring provider cultural competence. Knowledge gained will be useful for developing future research studies and specific cultural competence intervention approaches for healthcare providers that may decrease health disparities.

Adult↗

PubMedDate not supplied

Social justice: added metaparadigm concept for urban health nursing.

Historically, the nursing metaparadigm has been used to describe 4 concepts of nursing knowledge (person, environment, health, and nursing) that reflect beliefs held by the profession about nursing's context and content. The authors offer an assessment of the metaparadigm as it applies to community and public health nursing in urban settings and offer an amendment of the metaparadigm to include the central concept of social justice. Each of the metaparadigm concepts and the central concept of social justice is discussed as it applies to a model of urban health nursing teaching, research, and practice.

Attitude of Health Personnel↗

PubMedDate not supplied

Measuring quality in nurse-managed centers using HEDIS measures.

Nurse-managed centers (NMCs) provide viable options for primary healthcare and contribute substantially to filling access gaps for vulnerable populations. The purposes of this paper are to (a) describe a pilot application and adaptation of eight Health Plan Employer Data and Information Set (HEDIS) measures to six NMCs, (b) report the findings from the quality assessments, and (c) compare findings to national HEDIS data. The eight quality assessment areas are asthma, cervical cancer screening, childhood immunizations, depression, diabetes, hypertension, mammography screening, and smoking cessation. The NMCs achieved or exceeded HEDIS 50th percentile levels in a number of important clinical areas, but did not attain the 50th percentile level in others. Thus, HEDIS measures are relevant for the assessment of care quality and provide useful data for quality improvement in NMCs.

Benchmarking↗

PubMedDate not supplied

Development of a Cultural Competence Assessment instrument.

This article describes initial testing of an instrument designed to provide evidence of cultural competence among health care providers and staff. The Cultural Competence Assessment (CCA) instrument was based on a model describing cultural competence components (fact, knowledge, attitude, and behavior). Content and face validity were confirmed through expert panel review, subject feedback, and field-testing. The CCA was administered to an interdisciplinary health care team in a community hospice setting. Preliminary findings suggest that the CCA performed well. Internal consistency reliability for the scale was 0.92. Construct validity by factor analysis demonstrated that 25 items had loadings above 0.42. Construct validity was supported with a significant correlation to the widely used Inventory for Assessing the Process of Cultural Competence among Health care Professionals (IAPCC). Validity also was supported by significant differences between individuals with different educational levels and prior diversity training. The CCA is a promising tool to measure cultural competence in populations with a wide range of educational levels and backgrounds.

Adult↗

PubMedDate not supplied

Patient satisfaction outcomes in nurse-managed centers.

Patient satisfaction remains one of the critical benchmarks of primary care delivery. Although much of the research reporting outcomes related to nurse-managed centers (NMC) has included patient satisfaction, most of the reports have been limited to individual clinical settings. This study collected satisfaction data from 7 NMCs operated by 4 different academic institutions. Results demonstrated 3 components of patient satisfaction: patient perceptions of care, phone contact, and the patient's willingness to return to or recommend the clinic. Consistent with previous research, professional responsiveness and respect and courtesy from nurse practitioners were rated high on the composite satisfaction levels from a heterogeneous sample of consumers.

Academic Medical Centers↗

PubMedDate not supplied

Academic nurse-managed centers: approaches to evaluation.

A comprehensive evaluation plan was developed to assess the outcomes of a multiuniversity project to support the development of academic nurse-managed centers (ANMCs). The evaluation included measuring ANMC impact on the clients and communities served, on students, and on the sponsoring faculties and universities. This article includes a discussion of the processes used in evaluation plan development, the variables measured, the tools developed to measure selected variables, and a summary of evaluation findings. Recommendations for use of selected evaluation components across ANMCs are presented.

Ambulatory Care↗