Biomedical subjects

T Smyer

Publications and source records attributed to T Smyer.

9 recordsLinked to original sources

PubMed2000

Health maintenance behaviors of individuals with severe and persistent mental illness in a state prison.

The purpose of this grounded theory study is to define health and health-seeking behaviors of incarcerated individuals experiencing severe and persistent mental illness (SPMI) in a state prison. The strategies used to prevent loss of control and maintain health in the prison environment were examined. Nineteen incarcerated individuals with SPMI were interviewed in a state prison. Constant comparative analysis of the data revealed that while establishing a "fit" with the core variable "loss of control" and its identified properties, differences were found in the enactment of health maintenance behaviors related to properties in the prison environment. Several of these behaviors are inconsistent with behaviors expected of individuals in a community day treatment center and reflect a need for bridging programs to facilitate entry into the "free" world. Correctional nurses and mental health providers in this system can advocate for incarcerated individuals with SPMI by developing programs that provide cost-effective intermediate care and collaborating with community health systems for continuity of care. The findings related to alcohol and drug abuse among incarcerated individuals with SPMI challenges mental health providers in both correctional facilities and community-based programs to generate appropriate and effective substance abuse treatment programs for these individuals.

Activities of Daily Living↗

PubMed1999

Maintaining health: proactive client-oriented community day treatment centres for the chronic mentally ill.

This grounded theory study compared the definition of health by clients of two rural mental health day treatment centres, Big Sky Centre and Montana Centre. Based on an original grounded theory study of seven chronic mentally ill/disabled clients in Big Sky Centre (Yurkovich et al. 1997), the core variable, 'preventing loss of control' and related properties, were validated with nine residents of Montana Centre. While establishing a 'fit' with previous research findings, differences emerged between these two centres. These differences related to the staffs' philosophical approaches in providing treatment to the chronic mentally ill. Big Sky Centre care providers empowered their clients to learn new behaviours from their peers and assume new roles such as newcomer, member and leader. They also encouraged a prosocial attitude, and created a sense of belonging through valued involvement in their treatment. Montana Centre clients were not empowered to try out new behaviours in the treatment environment, or seek social support networks among their peers at the centre, which would foster a sense of belonging. The result was that clients from Montana Centre relied on the formal healthcare system more often than clients from the Big Sky Centre. The competing forces in healthcare today--family members, mental health providers, and insurance or managed care providers--make it easy to lose sight of or fail to gain the client's perspective about their health status and maintenance, particularly as it concerns day treatment centres. The importance of the day treatment centre as a therapeutic community which requires educational processes, innovative nursing practice, and client-centred interventions will be discussed.

Adult↗

PubMed1999

A typology of consumers of institutional respite care.

In this descriptive ethnography, a typology of consumers of institutional respite care and phases of respite care were formulated from the data collected over a 1-year period at a 24-bed hospital-based skilled nursing facility in the western United States. The sample was drawn from facility billing records, which verified the type of care under the term respite care. Using anthropological fieldwork methods, data were obtained from 14 caregiving dyads plus two care recipients who did not have family caregivers. The identified caregiver categories were depletion, maintenance, caregiver surgery or illness, and no available family caregiver. Phases of respite care provided information regarding the caregivers' experience in the process of decision making, transitioning to time away from the care recipient, and postrespite adjustment. This model has implications for the structure and process of respite care design and decision making. This may provide a promising avenue in the respite care research arena.

Aged↗

PubMed1998

Shift report: a time for learning.

Shift report provides an opportunity for professional communication that supports role socialization and development of a cohesive group process in the health care system. In this learning project, nursing students were able to practice professional behaviors, prioritize information, and reduce material to the boundaries of a work setting without relinquishing the holistic approach to the client. Critical thinking, direct application, self-analysis, peer critiques, and problem-solving processes were used by the student groups which will assist in their role transition to professional nursing practice.

Communication↗

PubMed1997

Stay safe! Stay healthy! Surviving old age in prison.

Although elderly inmates form a small minority in the U.S. prison population (6.6%), this number is expected to increase by 2005. Elderly prisoners consist of first-time offenders, habitual offenders, and those who have "aged in place" (received very long sentences at a young age). Violence is an identified stressor affecting the elderly prisoner. This enduring stressor can add to physical deterioration, particularly in the inmate with chronic illness. Violence in prison falls into three categories: prisoner-prisoner, staff-prisoner, or prisoner-staff (Clear & Cole, 1994). Prisoner-prisoner incidents account for the majority of violence within prison systems. The convict in today's prison will use extremes of violence to combat threats to his or her reputation or self-concept of "machismo," or if the inmate feels "disrespected." The aging prisoner may have chronic, pervasive stress levels disguised under a tough veneer, although he or she may no longer be strong enough physically or emotionally to fend off potential attackers. Interventions with elderly prisoners include thorough physical and cognitive assessment, including signs and symptoms of depression or stress related to environmental disturbances. Educational training for correctional staff about age-specific developmental changes is necessary. Building partnerships with community, state, and national organizations can assist elderly inmates in their adjustment to prison and foster successful community release programs. Special care units may be considered for frail elderly inmates or those with chronic health problems.

Adaptation, Psychological↗

PubMed1996

The aging inmate.

Aging inmates form a distinct cultural subgroup. The antecedents for their unique patterns and needs come from the life cycle of aging within the confines of a total institution. The inmate who ages in place will lack the common social markers experienced by his age cohorts in the outside world. The aging inmate faces challenges to his self-concept related to loss of family, employment, and sexual identity. His sense of autonomy is threatened by loss of self-selective behaviors, personal possessions, and privacy. Needs of the aging prison population will challenge traditional prison resources, including correctional nursing staff and mental health and counseling services. Substantive assistance for the inmate who has aged in prison must be accompanied by an awareness of the cumulative effects of living and aging within the unique sociocultural environment of the total institution.

Adolescent↗

PubMed1991

The public library system. Social services resource for the geriatric population.

The public library system is targeting the geriatric population and instituting programs to meet informational and recreational needs. From retirement planning, visual aids, and screening, to accessing library material to the elderly, the public library system attempts to meet the challenge of providing service to this special population. Although not a formal group, the library has inherent therapeutic effects that benefit the elderly who participate in their programs. The clinician would be advised to take advantage of these various programs. Because each local and regional center will offer different programs, calling a local library is the most effective way to find out what a specific public library system has to offer. Nurses may also consider joint efforts to initiate programs in their library systems to better meet the population's needs.

Aged↗

PubMedDate not supplied

Loss of control and the chronic mentally ill in a rural day-treatment center.

PROBLEM: What do chronically mentally ill clients consider to be the core variable in maintaining health, and how do they go about doing this? METHODS: A grounded theory design with analysis of interviews of seven chronically mentally ill clients in a rural day-treatment center. FINDINGS: The core variable in maintaining health according to chronic mentally ill clients is preventing loss of control. A process was discovered that clients used to do this. CONCLUSIONS: Chronic mentally ill clients prevent loss of control by using informal relationships to adapt behaviors, attitudes, and feelings within a supportive environment. If this fails, they turn to formal sources of control such as therapists, case workers, or other mental health providers.

Adaptation, Psychological↗

PubMedDate not supplied

Strategies for maintaining optimal wellness in the chronic mentally ill.

TOPIC: Ways the chronic mentally ill avoid loss of control and the importance of both the therapeutic environment and the nurse-patient relationship in helping them do this. PURPOSE: To examine the strategies people with chronic mental illness use to prevent loss of control and maintain health, and ways nurses can help with this process. SOURCE: Findings from a previously published study of seven chronically mentally ill clients in a rural day-treatment center. CONCLUSIONS: Four properties related to the core variable of "preventing loss of control" are relationships, feelings, good attitude, and functional activity. These properties must be examined within the context of the therapeutic environment as well as the nurse-patient relationship.

Adaptation, Psychological↗