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The divergences and convergences between the Nursing Assistance model for diabetic patients and the OREM's Self-care Deficit theory are presented. The model studied may be considered an educational program for diabetic patients, differing on the conceptual aspects of OREM's theory.
Models of care from the general field of nursing applied in special hospitals appears to be unworkable in this type of environment in terms of their inability to affect patient care. It is argued that these external models, adopted due to a crisis of confidence in special hospitals, fail because their fundamental constructs clash with that of the institution's particular sociology. A historical analysis of the development of special hospitals and nursing models reveals a dichotomy of emergent values, highly complex in nature, which conflict from the notion of Parsonian role-adoption. From this position, it is suggested that the strength of value systems are such that this leads to a non-negotiable stalemate of forensic elements of client and institution, and the 'treatment' ethic as prescribed by the medicalization of criminology. This article critically analyses the six most commonly-used nursing models in special hospitals and pinpoints the areas of breakdown within this type of environment from a sociological perspective. Finally, it argues for a new direction away from 'generalist' ideals of nursing towards a theoretical construction of 'specialism' in forensic care.
The health profile of American adults is heavily influenced by lifestyle behaviors. Therefore, working adults have a unique opportunity to take personal action to decrease their risk of cancer, heart disease, and other chronic illnesses and to improve their health status outcomes. Health status outcomes of working adults were evaluated through this quantitative study. Four structural variables (demographics, psychologic status, social status, and economic status), two modifying variables (access and cost), and three process variables (preventive care, including exercise/nutrition/stress management; client involvement; and family involvement) were examined as to their relationship to health status outcomes (client perception of health, amount of exercise, body mass index, and percent body fat). Results support the importance of the variables in the Albrecht nursing model in explaining health status outcomes in working adults. These factors may therefore be suitable targets for interventions to encourage healthy lifestyle behaviors at home. Nursing administrators, occupational health nurses, and home health nurses can use these findings to guide effective planning for wellness programs in the home and work setting.
This paper deals with macrotheories of nursing and a new way of looking at them. It also shows through the use of a board game why the discipline of nursing would be greatly hindered in its development by the acceptance of only one of the nursing macrotheories available today. The board game shows that macrotheorists of nursing do not discuss death and dying as a part of their conceptual models. Since death is not incorporated into the concepts, then they are not describing or explaining all the aspects dealt with in the discipline of nursing. This is not to say that theory is not necessary but that the acceptance of only one nursing macrotheory (model) is limiting and inhibiting. It denies nursing the ability to create and use intuition.
This study sought to identify adaptation problems on the part of elderly persons and significant others that were associated with nursing home applications for elderly persons. Within the framework of the Roy Adaptation Nursing Model, an ex post facto research design was utilized to identify these adaptation problems. The four adaptive modes in this model are: physiological, self-concept, role function, and interdependence. The study group (n = 22) and a control group of elderly persons living in Calgary, as well as their significant others, were administered a structured questionnaire. Five hypotheses relating to overall adaptation problems, powerlessness, role reversal, guilt, and knowledge and utilization of services were formulated and tested. Only the hypothesis indicating role reversal on the part of the significant others was accepted. Adaptation problems encountered by the elderly which were associated with nursing home applications occurred in the self-concept and interdependence adaptive modes. The adaptation problems perceived by the significant others, which were associated with nursing home applications for their elderly, occurred in the self-concept, role function, and interdependence modes. Adaptation problems from the significant others' perception rather than from the elderly persons' perception appear to be more significantly associated with nursing home applications.
PURPOSE: To provide a model of hospitalization events from a nursing perspective. Hospitalization has become an event of highly technical care coupled with intense nursing care requirements. This proposed model is needed to support clinical nursing research among hospitalized patients. SCOPE: Hospitalization occupying space and time as a discrete event on the health-illness continuum. First developed to provide a framework for a descriptive study, the model shows the factors involved in hospitalization and provides a framework for understanding the nursing care that occurs. Selected results from descriptive research that used patients hospitalized with AIDS as subjects are reported as an example of use of the model. CONCLUSIONS: Research about hospitalization events continues to be critical for the advancement of clinical nursing. This model is presented to provide a conceptual framework for future research.
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Few conditions offer a better opportunity for nurses to have a dramatic and visible impact on quality care than skin care. Nursing interventions targeted to prevent pressure ulcers and their painful, costly complications are an expected standard of care in all care settings. Preventing pressure ulcers may be most important in the acute care setting, where previously healthy elders with acute illness, immobility, impaired appetite, and new-onset incontinence may suddenly and unexpectedly develop pressure ulcers. Often acute care nurses have not been fully cognizant of the threat that pressure ulcers can pose for acutely ill patients. Teaching nurses skills of prevention, including assessments, and interventions for this group of patients is critical. Traditional teaching methods supplemented with an innovative mentoring program and clinical protocols may be one way to accomplish this.
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The application of research findings to achieve nursing outcomes sensitive to the effects of nursing care remains a challenge for the nursing profession. The Research Utilization Nursing Residency Program is a project implemented by the University of Iowa Gerontological Nursing Interventions Research Center. For a discharge planning coordinator serving a largely geriatric patient population, the residency experience provided support to apply scientific nursing knowledge to outcomes. Resources from both clinical and academic settings are discussed within the context of the resident's experience.
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This study compared two models of maternity care for low-risk pregnant women. It was found that freestanding birth centers offer high-quality, cost-effective maternity care. The results of this study strongly support the need to find ways to educate managed care organizations, employers, and the public about both the quality of these services and economic value. This research method may be useful in assessing other emerging models of care.
The epidemiologic prevention process model (EPPM; Clark, 1992) was designed to guide community health nursing practice and research. The model incorporates epidemiologic, nursing, and public health perspectives and directs assessment of health needs and the planning, implementation, and evaluation of health care services at primary, secondary, and tertiary levels of prevention. The EPPM was used to assess needs for nursing services at a summer day camp and to plan to meet those needs. Assessment indicated that underlying factors in each of four components of the model (human biology, environment, lifestyle, and the health system) contributed to needs for nursing services. Assessment data were used to derive community nursing diagnoses and to plan interventions to meet identified health care needs. In this application, the EPPM was found to be an effective way of organizing and interpreting findings and of translating those findings into improved health care services in a camp setting.