Biomedical subjects
Publications and source records attributed to W R Cowling.
This article presents several approaches to therapeutic group work with the elderly, drawing from experience in designing and implementing several group interventions for frail nursing home residents. What is important to recognize is that the common preconception that the elderly, in general, and the frail, in particular, cannot participate in therapy and groups is a misconception at least, if not a prejudice.
In planning and implementing a study, we unintentionally and serendipitously obtained data about changes in resident mix over a 2.8-yr. period. We screened residents of a 184-bed nursing home for cognition and sensorium in October 1984 to assess sampling feasibility for a grant proposal in preparation. At that time, 65.2% of the residents met the sampling criteria. However, in July/August 1987, after award of funding, only 5.4% of residents of the same nursing home met the cognitive and sensory criteria. We were forced to recruit from an additional six nursing homes, in which only 9.3% of residents met the sampling criteria.
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Unitary pattern-based practice is one creative approach to nursing intervention based on the conceptual and theoretical perspective of the Science of Unitary Human Beings. Considerations for practice were derived from the major concepts and theoretical tenets of the framework. Continued clarification and operationalization of the conceptual features in practice is warranted. A template for nursing practice with specified constituents provides a mechanism for implementing practice strategies. Processes of pattern appraisal, deliberative mutual patterning, health patterning, and evaluation were elaborated for the consideration of clinical scholars. Debate and dialogue on these issues is anticipated to further explicate the practice potential of this conceptual system.
The nursing shortage continues to be described as a crisis. Attempts to delineate the nature and scope of the problem and its impact on all aspects of health care from the individual human to the organizational and societal levels have been direct and comprehensive. A growing body of facts and perceptions has led to some specific recommendations for action. The potential for elaborating and explicating a base of scientific knowledge is powerful. The view expressed in this article is that a body of knowledge that can guide action to remedy the shortage problem requires directing knowledge development to serve the purposes of nursing and its constituents, clarifying and creating conceptual and theoretic perspectives, and giving attention to critical methodologic analysis of the current and emerging research programs in this domain. Knowledge directions will be guided by the goals and aims of nursing. Conceptual and theoretic perspectives derived from the phenomena of concern and congruent with knowledge development directions will provide a base for organizing and interpreting the growing body of facts. Finally, the understanding of research as modes of engagement will supply a means to analyze critically the methodologic approaches and the consequences of knowledge development in the domain of the nursing shortage inquiry.
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The older man's significant health concerns have relevant implications for practice. The identification of and discussion about the issues of health, retirement, dependency, and sexuality of the older man represent a good beginning to understanding the health concerns of the aging man; however, it is only a beginning. There still remains a critical need for additional studies to elucidate other sex-related differences in aging as well as to clarify how these differences affect the lifestyles and the health care of both older men and women.