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At least 235 records · Page 13Linked to original sources
PubMed2005

Codman Award Paper: self-efficacy of staff nurses for health promotion counselling of patients at risk for stroke.

The effect of nurses' confidence to counsel patients at risk of stroke in selected health promotion areas: smoking cessation, exercise and nutrition was examined. Bandura's (1986) self-efficacy and Knowles' adult learning theories provided the theoretical underpinnings for the study. This was a quasi-experimental design in which neuroscience nurses (N = 23) from a quaternary hospital completed questionnaires prior to, immediately after, and 2 months post completion of a self-directed learning manual (SDL). The researcher-designed manual was designed to enhance learning about the risk factors for stroke and the importance of stroke prevention. Along with reflective activities and pre-post test, strategies for counseling high-risk, stroke-prone individuals in the areas of smoking cessation, exercise, and nutrition were also integrated. The Health Promotion Counseling Self-Efficacy Scale (Tresolini, Saluja, and Stritter, 1995), consisting of 10 self-efficacy subscales relating to self-confidence in knowledge and ability to counsel in health promotion areas, was used to capture the nurses' self-report of self-efficacy. Using a 5-point Likert Scale, nurses also rated their amount of agreement or disagreement about health promotion counseling in practice. Overall, self-efficacy levels for both knowledge and counseling increased significantly (p < .01) from pre-to immediately post completion of the manual, and decreased slightly at two-month follow-up. This pattern was evident in all health promotion areas measured except for knowledge in exercise (p = .015). Nurses' attitudes about aspects of health promotion practices correlated significantly (p < 05) at two-month follow-up with all health promotion areas. Results of this study support the usefulness of a self-directed learning manual as a teaching strategy for health promotion counseling of individuals at risk of stroke.

Adult↗
PubMedDate not supplied

The importance of knowledge transfer between specialist and generic services in improving health care: a cross-national study of dementia care in England and The Netherlands.

Knowledge transfer (KT) between specialist and generic services is widely seen as an important strategy for improving the quality of integrated dementia care. This article elaborates on intra- and inter-organizational features associated with successful KT. A provisional conceptual framework is suggested, based on literature about inter-organizational networks and knowledge management. Professional and organizational cultures, domain perceptions, perceived dependency and the availability of resources are suggested as significant influences upon the motivation and perceived capacity to engage in KT. Personal and organizational continuity is identified as an important process quality. Data from four local case studies in England and The Netherlands are used to develop and specify the provisional framework. A conceptual model is built to explain the relative success or failure of KT.

Delivery of Health Care, Integrated↗
PubMed2005

Don't scold smokers.

In response to a recent paper about GPs' difficulties with smokers who are not motivated to quit, points to consider are: (1) nicotine is one of the strongest addictions; (2) smokers hold various beliefs about smoking, and doctors should consider how to communicate risk; (3) confrontation is contraindicated; and (4) some smokers deceive doctors about their smoking.

Attitude of Health Personnel↗
PubMed1996

Do tailored behavior change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial.

Health risk appraisal (HRA) remains one of the most widely used health promotion tools despite only equivocal evidence for its effectiveness. Theories of behavior change predict conventional HRA's ineffectiveness because risk information alone is seldom sufficient to change complex behaviors. In this study, a randomized trial compared the effects of feedback from an enhanced HRA with a typical HRA and a control group among adult patients from eight family medicine practices. The enhanced HRA assessed behavior-specific psychosocial factors and provided patients with computer-generated, individually-tailored behavior change information in addition to typical HRA risk feedback. Changes in seven behaviors were assessed at a 6 month follow-up. Overall, patients receiving enhanced HRA feedback were 18% more likely to change at least one risk behavior than were patients receiving typical HRA feedback or no feedback (OR = 1.18, 95% CI = 1.00, 1.39). The enhanced HRA feedback appeared to promote changes in cholesterol screening, dietary fat consumption and physical activity, but not in smoking, seat belt use, mammography and Pap smears. We conclude that the addition of theory-based, individually-tailored behavior change information may improve the effectiveness of HRA.

Adolescent↗
PubMed2000

Texas physician immunization practices.

INTRODUCTION: Immunization levels among young children could be improved if physicians administered immunizations at both well and urgent visits, provided simultaneous vaccinations, and knew the guidelines on valid contraindications, part of the Standards for Pediatric Immunization Practices (Standards). We report on a survey measuring the immunization knowledge and practice of Texas pediatricians, family practitioners, and general practitioners. METHODS: A survey was mailed to a random sample of physicians. Questionnaire items covered 8 of the 18 Standards. RESULTS: The response rate was 62% (608 of 976 eligible physicians). The mean summary adherence-to-Standards score was 4.1 for pediatricians, 3.6 for family practitioners, and 3.0 for general practitioners. Specialty and practice location were significant predictors of the summary score, whereas gender, managed-care participation, and graduation year were not. DISCUSSION: Our study results suggest that in Texas, pediatricians and rural physicians most often adhere to the Standards. Improving the reimbursement level of administrative costs for immunization delivery, educating physicians on the Standards, and encouraging the use of patient immunization tracking systems are actions that could potentially improve immunization rates.

Adult↗
PubMedDate not supplied

Interactionality: willfully extending the boundaries of participatory research in psychiatric-mental health nursing.

The concepts of somatization and hysteria have been used in nursing, medicine, and healthcare to describe and explain the "unfounded attributes'' of women's expressions of pain and discomfort. This study, grounded in poststructural ideologies, extends the boundaries of participatory research in psychiatric-mental health nursing and, thus, developed a series of methodological techniques coined "Interactionality'' that then challenged the concept of somatization. This article focuses on the philosophical and conceptual assumptions of Interactionality, and introduces the notion of a double-voiced discourse as a means of communicating the analysis and findings of critical research.

Attitude of Health Personnel↗
PubMed2003

Predictors of community women's osteoporosis prevention intention--a pilot study.

The main purpose of this pilot study was to identify the predictors of community women's osteoporosis prevention intention. The osteoporosis assessment scales were self-developed and contained 5 scales: a demographics scale, a health status scale, an osteoporosis health belief scale (OHBS), a knowledge scale, and a prevention intention scale. The content validity of the five scales ranged from.90 to 1.00. Test-retest was used to examine the reliability of the demographic characteristics scale and the health status scale, which ranged from.9 to 1.0. Meanwhile, the reliability coefficients of the OHBS comprising perceived susceptibility, perceived seriousness, perceived benefit, and perceived barrier were .75, .90, .80, and .72. In this pilot study, the coefficient of KR-20 for osteoporosis knowledge was .88. The value of Cronbach 's Coefficient Alpha for prevention intention was .85. The results of this research were : (1) The averaged scores of the OHBS comprising perceived susceptibility, perceived seriousness, perceived benefit, and perceived barrier were 2.8 (SD = 0.5), 2.2 (SD = 0.7), 1.9 (SD = 0.4), and 2.9 (SD = 0.7). Meanwhile, the averaged score for women's knowledge on osteoporosis was 10.0 (SD = 2.8). The averaged score for women's intentions for the prevention of osteoporosis was 2.5 (SD = 0.6). (2) There were some significant correlations between OHBS and demographics, health status, knowledge, and prevention intention. (3) Knowledge was positively correlated with perceived barriers, prevention intention, age, self-rated score for health, breast feeding time, and amount of calcium intake. (4) Prevention intention was positively correlated with knowledge, number of children, age of fracture, and hormone replacement therapy. (5) The major factors influencing intention for community women were, in order, knowledge, educational level (high school graduate), number of children (n = 2), self-rated health score, experience of bone density examination (yes), hormone replacement therapy (yes), and kyphosis (yes). These seven items accounted for 45.8% of the variation in intention. The results of this pilot study can help community health professionals evaluate, implement and improve community women's health beliefs regarding prevention of osteoporosis.

Adult↗
PubMed2004

Implementing the 2-week wait rule for cancer referral in the UK: general practitioners' views and practices.

The 2-week wait rule for cancer referrals became effective in December 2000 for all cancers treated by the National Health Service in the UK. Attainment of this target depends initially on appropriate and timely referral by general practitioners (GPs). General practitioners' views and referral practices under the 2-week wait rule were examined based on a postal survey of 508 GPs in an inner London area (65% response). Data on mode of referral indicated that 90% of GPs used the urgent suspected cancer form, although 38% also sent a letter with further information. General practitioners generally regarded the 2-week wait rule as working well in terms of improving patients' initial access, and 50% thought communication with the hospital had improved. However, 46% expressed some concerns, including problems arising from the different sets of forms required by local cancer networks, the lack of a dedicated referral form for breast cancer, and feelings of a loss of autonomy. General practitioners also acknowledged an element of over-referral under this rule due to the effects of clinical uncertainty and patient pressure and their concerns about increased waiting times for non-target referrals. The survey therefore indicates that GPs are generally positive about the 2-week wait rule but identified some problems of implementation including a need for standardized national cancer referral forms.

Attitude of Health Personnel↗