PubMed Health⌕ Search

Biomedical subjects

Stephanie Myers Schim

Publications and source records attributed to Stephanie Myers Schim.

15 recordsLinked to original sources
PubMed2006

Differences in veterans' and nonveterans' end-of-life preferences: a pilot study.

BACKGROUND: Investigators conducting focus groups on end-of-life preferences noted that veterans voiced opinions that strongly differed from those of nonveterans. OBJECTIVE: The objective of this study was to further explore differences between veterans' and nonveterans' end-of-life preferences. METHODS: Ten focus groups and a pilot survey were conducted. SETTING AND SAMPLE: The focus groups consisted of Arab Muslims, Arab Christians, Hispanics, blacks, and whites stratified by gender (n = 73). Fifteen male veterans were included across all five racial groups. MEASURES: A moderator discussion guide was used to lead the focus groups and a pilot survey asked about demographic information and end-of-life preferences. RESULTS: Veterans were more likely to be married (p < 0.05) and less connected to their cultural group (p < 0.05) than nonveterans. The focus group results indicated that veterans in this study were more likely to oppose the use of heroic measures compared to nonveterans. More so than nonveterans, veterans felt that their doctors should be frank and open (p < 0.05) were strongly in favor of do-not-resuscitate (DNR) orders (p < 0.10), yet were less likely to have a proxy (p < 0.10) or durable power of attorney p < 0.01). Comparing end-of-life preferences, veterans felt less strongly than nonveterans about remembering personal accomplishments (p < 0.05), being listened to (p < 0.05), being with friends (p < 0.01), or being comfortable with their nurse (p < 0.05), but did want to be around their pets at the end of life p < 0.10). IMPLICATIONS: The Department of Veterans Affairs is in a unique position to improve endof- life care for veterans. Providing end-of-life care that is congruent with the veteran's wishes can improve satisfaction and increase cost effectiveness by eliminating unacceptable services.

Aged↗
PubMed2006

Environments of care: a curriculum model for preparing a new generation of nurses.

This article provides a perspective on the community-based curriculum model that has guided undergraduate education for the past decade, discusses some of the problems that have emerged with the community-based approach, and proposes an alternative approach for consideration and discussion. The community-based model is discussed in relation to three major areas of concern: faculty and preceptor implementation of the curriculum, entry into practice and hiring pattern disjunctions, and trends and unexpected consequences of changes in the health care system. The Environments of Care Model, proposed as an alternative curriculum approach, conveys a broad perspective on health and illness, based on a multiple determinants of health paradigm and a systems framework.

Community Health Nursing↗
PubMed2005

Wound care at end of life.

Nurses are in a unique and privileged position with regard to both end-of-life care and wound care. Expert wound care can greatly contribute to the relief of physiologic stress on the human organism and psychosocial and physical distress at the end of life. Using what is known from both domains,nurses apply critical thinking to assist patients, families, and other caregivers in maintaining the maximum possible integrity of the physical body of the dying person. The manner in which nurses approach wound care with dying patients and the ability to preserve patient dignity and family respect while doing necessary palliative interventions also can serve the healing of emotional wounds in the dying process.

Chronic Disease↗
PubMed2005

Cultural competence among Ontario and Michigan healthcare providers.

PURPOSE: To examine variables associated with cultural competence among urban, hospital-based healthcare providers in Ontario (Canada) and Michigan (US). DESIGN AND SAMPLE: A cross-sectional descriptive design with a convenience sample of hospital-based providers was used. The sample was 145 providers (n=71 Ontario; n=74 Michigan). METHODS: Providers completed a survey which included the Cultural Competence Assessment (CCA) instrument. Regression analysis was used to examine associations. FINDINGS: Providers with diversity training and higher levels of educational attainment scored significantly higher on cultural awareness and sensitivity and on cultural competence behaviors. CONCLUSIONS: Variables significantly associated with cultural competence included prior training in cultural competency and higher educational attainment among both Ontario and Michigan healthcare providers.

Adult↗
PubMed2004

Hypertension and diabetes in Detroit Hispanics.

The purpose of this study was to explore the prevalence of hypertension and diabetes alone and together in a sample of Hispanics. There were 111 participants with a mean age of 51 years. Twenty-six percent of the participants were hypertensive, a proportion well above the Healthy People 2010 target of 16%. The majority of hypertensive participants had isolated systolic hypertension, which is consistently associated with greater cardiovascular risk. Thirty-seven percent of the hypertensives were also diabetic. Diabetics were significantly more likely than non-diabetics to have stage 3 hypertension than either stage 1 or stage 2 (chi(2) [1] = 7.17, p <.01). It is important for nurses to screen Hispanic clients who are 18 years and older for high blood pressure. Early case finding will help nurses increase awareness and control of high blood pressure among Hispanics, which is crucial to avoid the enormous human and financial burdens of cardiovascular morbidity and mortality.

Adolescent↗
PubMed2002

Model for community health nursing care: application to an integrated asthma intervention program.

The article describes the use of a model for community health nursing care applied to an integrated asthma intervention program in an inner-city context. Asthma is a chronic childhood disease with broad physical, social, and economic impact on children, families, and communities. Despite recent advances in asthma understanding and treatment, morbidity and mortality continue to rise. This model suggests ways to combine individual, family, school, and community interventions to enhance coordination and increase the impact of services. It outlines needs and opportunities for collegial collaboration between professional nurses in varied practice settings. Application of the model to the management of asthma in the urban setting demonstrates the potential to produce significant improvement in the management of conditions such as asthma and highlights the key role that school nurses play.

Adolescent↗
PubMed2002

Worksite "lunch and learn": a collaborative teaching project.

Overall, the collaborative teaching project in community health nursing was successful in meeting the needs of students, faculty, the HMO, the employer, and the community. Health education program outcomes and the lessons learned from the processes indicated the collaboration should continue and be expanded. In subsequent academic years, faculty and HMO staff worked to identify additional employer groups and to make this type of learning experience available to a larger number of nursing students. As career paths diverged, this specific collaboration dissolved. However, the opportunities and challenges observed in this collaborative teaching project have been carried forward into new collaborations.

Cooperative Behavior↗
PubMedDate not supplied

Health risk assessment in an urban Hispanic community.

PURPOSE: This study describes the health risks of urban Hispanic adults and compares the health risks of persons who identified themselves as "not overweight'' with those who identified themselves as "overweight.'' DESIGN: A descriptive correlational design was used to examine current health risks. SETTING: The study, a part of a larger community action study, was conducted in the predominantly Hispanic/Latino community of Southwest Detroit. A Roman Catholic parish, a central component of this community, served as the study setting. SAMPLE: One hundred ninety-three Hispanic adults participated. METHODS: Following administration of an information sheet, participants were asked to complete the 22-item Personal Health Risk Assessment, available in both English and Spanish versions, which measured health status and demographic characteristics. FINDINGS: Significant differences in blood pressure, diabetes, and the total number of health risks between the "not overweight'' and "overweight'' groups were identified, with the "overweight'' participants scoring higher on these subscales. CONCLUSIONS: Findings from this study highlight the prevalence of cardiovascular risk factors and the greater clustering of cardiovascular risk factors among persons identifying themselves as overweight. IMPLICATIONS FOR PRACTICE: This study supports the need for active participation of clinical nurse specialists in health-promotion activities and intervention research in this growing population.

Adult↗
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

Eating patterns and cardiovascular disease risk in a Detroit Mexican American population.

The purpose of this study was to examine dietary patterns and cardiovascular risk factors in Hispanic adults living in Southwest Detroit. A descriptive design was used. Self-report baseline data were collected using The Rate Your Plate and Personal Health Risk Assessment questionnaires. A nonrandom sample of 32 Mexican American adults was recruited from a large Roman Catholic Church in Southwest Detroit. Participants were selected if they were enrolled in the larger parent research study to test the effects of a lay health educator intervention and planned to participate in the nutrition education portion of the intervention. Unhealthy eating patterns outnumbered heart healthy eating practices. The majority used higher fat salad dressings; ate fried foods, sweets, and high fat snacks; consumed greater than the desired amounts of regular cheese; drank whole milk; and ate few fruits and vegetables. Lack of physical activity, being overweight, and exposure to second-hand smoke were the most prevalent cardiovascular risk factors. The data suggest that effective community-based heart disease prevention programs that emphasize risk factor screening and cardiovascular risk reduction through heart healthy eating are needed.

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

Cultural competence in hospice.

Research shows that ethnic minorities access hospice care significantly less often than Caucasians. In part, this has been attributed to the lack of cultural competence among hospice staff. To assess cultural competence among hospice workers, this article evaluates the results of a descriptive, exploratory survey that was submitted to 125 interdisciplinary hospice employees and completed by 113 of those employees. Cultural-competence behavior scores varied widely based on two factors: increased education and previous cultural-diversity training. The results of this study provide information regarding cultural competence in hospice. In their efforts to provide culturally appropriate end-of-life care, hospices can use the information in this study to implement intervention plans aimed at increasing cultural competence among hospice staff.

Adult↗
PubMedDate not supplied

Enhancing cultural competence among hospice staff.

A critical component in making hospice and palliative care services accessible and acceptable to diverse communities is preparation of all providers to enhance cultural competence. This article reports a study designed to test an educational intervention aimed at expanding cultural awareness, sensitivity, and competence with a multi-disciplinary and multilevel team of hospice workers. The purpose of this quasi-experimental, longitudinal, crossover design was to test the effects of an educational intervention for multidisciplinary hospice providers. Findings demonstrated that even with a modest face-to-face intervention, cultural competence scores were significantly greater after the educational intervention for participants in both groups. Although the intervention proved successful at enhancing cultural competence scores among diverse types of hospice workers, limitations and logistic insights gained from this pilot suggest the need for examination of alternative methods of program delivery.

Adult↗
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↗