Biomedical subjects
Publications and source records attributed to W R Whetstone.
Total quality management transforms quality assurance performance controls into a dynamic system for continuously improving healthcare services to internal and external "customers" in terms of outcomes. Success depends upon gaining and maintaining commitment of physicians, top management and key staff members through a working environment which values and rewards improvement efforts.
The purpose of this descriptive study was to examine the perceptions of rural men and women, ages 50 to 70 years, regarding barriers to health promotion in the treatment of a chronic disease entity--hypertension. Orem's constructs of self-care provided the theoretical framework for the study. Specific study aims were to (a) identify health belief/values, (b) assess perceptions of self-care abilities, (c) determine relative risk through health appraisal, and (d) describe phenomenological perceived barriers to health promotion as a lived experience. Major findings indicated no relationship between health beliefs/values and self-care. The health value scores of females for all four subscales were somewhat higher than the scores for males. Average, appraised and achievable ages for relative risk of dying from all causes were significant for men. Phenomenological themes revealed diet, weight and medication usage to be two factors associated with perceived barriers. Small sample size and voluntary participation limited generalization. Nursing implications included the need for (a) greater assessment of the influence of perceived barriers, (b) better approaches to health teaching, and (c) more appropriate design of educative--supportive nursing interventions for facilitating client self-care.
This cross-cultural study attempted to replicate the nursing phenomena of self-care and self-concept using two self-reporting instruments. Both instruments were translated from English into Swedish and administered on a convenience basis to 187 Swedish subjects, 117 women and 70 men, ages 19-66, compulsory to university educated, and residing in the southern districts of Sweden. Swedish mean self-care scores were lower (112.5) than the United States normative group of university nursing and psychology students, but the mean was comparable to East German (113.6) reported from an earlier study. Self-concept scores were similar to Nebraska teachers and East Germans. Alpha coefficients were used to assess reliability, ANOVA for differences, and item correlation of self-care agency were organized by factor analysis with four subfactors identified. The derived subscales appeared to identify potentially useful factors to aid in unravelling the complexity of the self-care agency construct. Study limitations were addressed. Cross-cultural directives for international nursing are discussed.
The purpose of this empirical investigation was replication for comparing self-care phenomena in a cross-cultural setting. Two self-reporting inventories were employed to measure perceptual dimensions of self-care agency and self-concept. Both inventories were translated into German and administered to a convenience sample of 17 adults living in an agricultural collective in East Germany. One research concern was the usability of American-constructed nursing assessment tools in another culture. Other research questions for cross-cultural comparisons of means were formulated. Self-care and self-concept were related in the East German sample. Self-care agency means for the East German sample were lower than for an American student sample. Study limitations are identified and cross-cultural implications of the findings for nursing are discussed.
The purpose of this study was to investigate the use of social dramatics as a clinical tool for teaching social skills to the chronically mentally ill on adult inpatient units of a state hospital. The research tested the hypothesis that patients exposed to social dramatics with videotape feedback would demonstrate greater ability to perform social skills as measured by the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Fifteen schizophrenic adults of both sexes meeting specific criteria were randomly assigned to experimental and control groups. Subjects were exposed over an 8-week period to randomly introduced social dramatic scenarios. The Wilcoxin test for two independent samples was used for testing differences between experimental and control groups. The research findings supported the hypothesis for one positive factor, social competence. The findings did not support any treatment effect on either social interest and personal neatness or irritability, manifest psychosis, and psychotic depression. There were no significant differences on the total score NOSIE-30. Recommendations for psychiatric nursing are made. Limitations of research methodologies and sample size were addressed.
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