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Results for “Competency framework”

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PubMed2005

Intentionality: evolutionary development in healing: a grounded theory study for holistic nursing.

Although intentionality has been implicated as a causal variable in healing research, its definition has been inconsistent and vague. The objective of this grounded theory study is to develop a substantive theory of intentionality in a naturalistic encounter between nurse-healers and their healee-clients, and to consider the implications for practice and research. Six expert nurse-healers and six healee-clients were interviewed as individuals and in dyads before and after treatments. Interviews and observational data were analyzed using the constant comparative method and synthesized analysis. Participants described their experience of intentionality in healing as an evolutionary process characterized by distinctive shifts. The theory of intentionality: the matrix for healing (IMH) includes definitions of intentionality and a conceptual framework of three developmental phases of intentionality (generic, healing, and transforming intentionalities). The predominant attribute, development, is described. The theory contributes to knowledge about healing and intentionality and has implications for practice and future research.

Adult↗

PubMedDate not supplied

Continuing professional education: individual responsibility, collective consciousness.

Continuing professional education in the United Kingdom is discussed and the influences examined. Within a framework of national, nursing, and local perspectives, the issues and implications for the various individual agencies and personnel are identified. An overview is provided to include agendas for action.

Education, Nursing, Continuing↗

PubMed2000

The community health clinics as a learning context for student nurses.

The purpose of the research study was to describe guidelines to improve the community health clinics as a learning context conductive to learning. The objectives of the study commenced by getting the perception of student nurses from a nursing college in Gauteng; community sisters from ten community health clinics in the Southern Metropolitan Local Council and college tutors from a college in Gauteng. The research design and method used, consisting of a qualitative, exploratory, descriptive and contextual approach and the design was divided into two phases. Phase one consisted of a field/empirical study and phase two of conceptualization. In all the samples follow-up focus group interviews were conducted to confirm the findings. To ensure trustworthiness, Lincoln and Guba's model (1985) was implemented and data analysis was according to Tesch's model (1990 in Creswell 1994:155) based on a qualitative approach. The conceptual framework discussed, indicating a body of knowledge, was based on the study and empirical findings from phase one to give clear meaning and understanding regarding the research study.

Attitude of Health Personnel↗

PubMedDate not supplied

Self-neglect: the role of judgements and applied ethics.

Self-neglect is more common than currently recognised. This article highlights the issue of self-neglect and the accompanying ethical values and judgements associated with it. A multidisciplinary framework for managing self-neglect is also described.

Aged↗

PubMed2002

[Project Leonardo-da-Vinci for better nursing care].

The aim of the present paper is to inform physicians about the work completed by nurses and professors of baccalaureat nurses in the framework of Leonardo da Vinci project, organised and sponsored by the European Union. The goal of the project was to increase the effectiveness of chief nurses throughout their further training programme in the field of management. The team of Szeged chose the human resource management, since in this field is possible to achieve the greatest improvement with the smallest financial investment. We measured the fluctuations and the absentees of the nurses, the changes in the degree of education, the nurse' and patient' satisfaction at the beginning and at the end of the period studied. Except the patient's satisfaction all the other parameters improved by the end of tested period. The project provided a unique possibility to compare the state of the Hungarian nursing with that of the countries belonging to the European Union, to exchange the experience and to learn some new methods. In the framework of this project a book of two volumes was prepared containing the suggestions of EU. This book is widely available in English and in French.

Clinical Competence↗

PubMedDate not supplied

Linking the Knowledge and Skills Framework to CPD.

To help staff to make links between the NHS Knowledge and Skills Framework and their continuing professional development, staff at the School of Nursing, University of Salford, have linked all educational provision for qualified healthcare professionals to the NHS KSF. This was carried out in partnership with NHS colleagues.

Clinical Competence↗

PubMed1990

A methodological framework for the design of research on the evaluation of residents.

This paper describes a construct validation framework for research on the selection and evaluation of residents. The application of the proposed methodology to surgery residents is described. The need to measure non-cognitive and neuropsychological factors in addition to cognitive knowledge and technical ability is emphasized, and a research strategy that integrates theory formulation, internal validation, and external validation is presented. In this context, residents' competence is viewed as a multivariate construct that requires validation through longitudinal empirical studies and the use of multivariate statistical approaches.

Clinical Competence↗

PubMed2006

Use of genitourinary teaching associates (GUTAs) to teach nurse practitioner students: is self-efficacy theory a useful framework?

Self-efficacy theory guided an examination of the effect of an educational activity using genitourinary teaching associates (GUTAs) with beginning nurse practitioner students. Confidence in and comfort with learning and performing the examinations were evaluated prior to and immediately after the GUTA activity. Statistical analyses revealed significant increases in confidence following all activities with GUTAs, consistent with self-efficacy theory. Comfort levels also increased. The significant improvement in confidence supported the use of the theory, and the increase in comfort contributes to the competence of students as they begin working with real patients.

Clinical Competence↗

PubMedDate not supplied

[Accreditation of the professional competence of intensive care unit nurses and their education].

The healthcare system must be driven by the needs of patients and their families. Keeping in mind the current nursing education system in the United States, the AACN Certification Corporation has designed a new model to refocus patient care activities so they can be defined according to the needs of patients and families wherever they may be. This model also addresses the credentialing of nurses with specialized knowledge and skills and may be adaptable as the conceptual framework for a national nursing specialty credentialing system in other countries.

Accreditation↗

PubMed1988

Individual difference variables in close relationships: a contextual model of marriage as an integrative framework.

We examined and refined a contextual model of marriage (Bradbury & Fincham, 1987) in order to organize the associations between individual difference variables and satisfaction in close relationships. Seventy-eight spouses were administered instruments assessing marital satisfaction and individual differences in femininity, masculinity, dysfunctional relationship beliefs, and causal and responsibility attributions for marital difficulties. As predicted, higher levels of satisfaction were related to femininity and to partner's femininity, and lower levels of satisfaction were related to dysfunctional beliefs and less benign attributions. More important, two competing hypotheses relating to the contextual model were tested. A model in which the transitory, or proximal, context (e.g., responsibility attributions for specific relationship events) mediates the relation between the stable, or distal, context (e.g., general beliefs about relationships) and satisfaction was refuted. Support was obtained, however, for a model in which proximal and distal variables both account for unique variance in marital satisfaction. The usefulness of distinguishing between transitory and stable variables and the implications of the contextual model for organizing research on close relationships are discussed.

Adult↗

PubMed2006

Post-mortem toxicology.

Studies examining post-mortem processes are difficult to conduct since changes will have already occurred when the body arrives at the mortuary. While control of collection site for blood can minimize changes in concentration it is very difficult to conduct experiments in humans aimed at understanding the mechanisms and determining the extent of such changes. The use of appropriate animal models can be useful in this regard providing the species and conditions are carefully chosen. Pharmacokinetic studies in humans are also very useful for understanding the changes in drug concentration with time in blood (and other fluids) and also for improving our understanding of drug effects. Unfortunately, doses of illicit drugs that can be given are relatively low to guarantee safety hence extrapolations are made to real life situations. Individual case studies can be useful to describe an unusual or particularly interesting circumstances but little useful information can be obtained when trying to ascertain the role of competing factors, e.g. role of individual drugs when multiple drugs are present, varying toxicity between route of administration, and the role of age or natural disease when drugs are also present. Epidemiological approaches by reviewing large numbers of related cases are the most powerful tool to obtain this information. All of these studies need to operate under the ethical and legal framework appropriate for a jurisdiction. This paper discusses the relative merits of scientific approaches to research in post-mortem toxicology and provides guidance on the most appropriate techniques for future studies.

Ethics, Research↗

PubMed1999

Improving client outcomes through differentiated practice: a rural nursing center model.

The TriCounty Community Health Center (the Center) was created in 1994 with federal grant monies to increase access and to provide outreach and primary health care services for rural residents. The Center employs a differentiated practice model of nursing care in which all nurses use the nursing process targeted to client systems that match the nurse's level of educational preparation and competence. The model allows nurses to intervene with various client systems, including the individual, family, aggregate, and community. Program outcomes for the Center suggest that using a differentiated nursing practice model for outreach and primary care services appears to have a positive impact on the health of individuals, families, and aggregates in rural settings, using the Omaha Classification System as a framework for evaluation.

Community Health Centers↗

PubMed1991

Motor skill acquisition.

The purpose of this article is to provide a framework for understanding motor skill and the process by which it is acquired. A selective historical overview is presented to demonstrate how the study of movement is a necessary preliminary to the study of motor skill learning. The phenomenon of skill is explored as an inherent feature of goal-directed organisms whose effective functioning depends on achieving a degree of competence in solving problems that are encountered in the everyday world. The relationship between problems and solutions is discussed. Movement is examined as a problem-solving tool and as the means by which the individual expresses skill. Factors that influence the individual's level of skill are fully explored, along with the implications for functional behavior. The creative use of resources in problem solving is thoroughly examined, and tasks are discussed in terms of the demands imposed on the individual.

Growth↗

PubMed2002

Pluralism, public choice, and the state in the emerging paradigm in health systems.

Today in developed nations, the public pays for most medical care, with the state and the medical profession or providers determining its nature, form, and level. But there is no well-defined institutional framework for revealing consumer preferences and enabling client choice about the nature and form of public entitlement. This thwarts the efforts of health system reformers to satisfy their clients and consequently promote equity and control costs--the raison d'être of publicly supported care. Consumers can be empowered in the emerging paradigm, however, in which the publicly financed system also contains competing fund-holding institutions that organize and manage the consumption of care (OMCC), such as HMOs and sickness funds. In a system in which individuals are entitled to health coverage, OMCC institutions can play an essential role in both shaping the entitlement and in expressing members' preferences. To do this, the OMCCs need to be financed through capitation and endowed with appropriate constitutional rights on how to use the funds.

Capitation Fee↗

PubMed2004

Training case managers to deliver focused psychological strategies.

Anxiety and mood disorders are prevalent in the Australian community and can be functionally disabling. Access to treatment for these disorders can be difficult, particularly in rural areas where there is limited availability of specialist mental health practitioners such as psychiatrists and clinical psychologists. One way to address this problem is to improve the skills of local mental health practitioners in recognizing and providing treatment for these disorders. This paper describes a program that aimed to enhance access to psychological treatment for depression and anxiety by improving the skills of rural mental health case managers through training and education and support by psychiatrists and clinical psychologists. Thirty-two case managers participated in the program which delivered 10 training modules using a cognitive behavioural therapy framework. Case managers consisted primarily of psychiatric nurses, with others having social work or psychology backgrounds. Participants were assessed pre- and post-training using quantitative and qualitative measures. The effect of the training was noted in several areas including attitudinal changes, improved knowledge of psychological therapies, and changes to stated practice. However, there was concern expressed by participants about their competence and confidence to translate skills learned into practice. While the results of such a program are promising, they highlight some of the complexities of delivering such programs in rural settings.

Adult↗

PubMed2006

Developing a prioritisation framework in an English Primary Care Trust.

BACKGROUND: In the English NHS, Primary Care Trusts (PCTs) are required to commission health services, to maximise the well-being of the population, subject to the available budget. There are numerous techniques employed to make decisions, some more rational and transparent than others. A weighted benefit score can be used to rank options but this does not take into account value for money from investments. METHODS: We developed a weighted benefit score framework for use in an English PCT which ranked options in order of 'cost-value' or 'cost per point of benefit'. Our method differs from existing techniques by explicitly combining cost and a composite weighted benefit score into the cost-value ratio. RESULTS: The technique proved readily workable, and was able to accommodate a wide variety of data and competing criteria. Participants felt able to assign scores to proposed services, and generate a ranked list, which provides a solid starting point for the PCT Board to discuss and make funding decisions. Limitations included potential for criteria to be neither exhaustive nor mutually exclusive and the lack of an interval property in the benefit score limiting the usefulness of a cost-value ratio. CONCLUSION: A technical approach to decision making is insufficient for making prioritisation decisions, however our technique provides a very valuable, structured and informed starting point for PCT decision making.

Journal Article↗

PubMed1984

Verbal behavior at a procedural level in the chimpanzee.

Ape language research has typically employed cognitive descriptions of ape competencies. Recently, Epstein, Lanza, and Skinner (1980) attempted to simulate some of the ape findings with pigeons. They also used cognitive terms to describe their results, but with "tongue-in-cheek." In the hope of bringing about a better understanding of the ape research, this paper describes the main aspects of one ape language project, using a behavior-analytic framework. It then briefly compares and contrasts, from that perspective, the training programs used with pigeons and with apes. It is concluded that the behavior-analytic framework, and the procedures devised to produce language skills in apes, provide strong support for several of the major positions set forth in Skinner's (1957) Verbal Behavior.

Journal Article↗

PubMed1992

Search for cross-reactive idiotypes on monoclonal and myasthenia gravis acetylcholine receptor antibodies.

Myasthenia gravis patients have serum anti-acetylcholine receptor antibodies that compete with monoclonal antibodies for binding to epitopes on the human acetylcholine receptor. To investigate the presence of shared idiotypes we immunised syngeneic mice with each of ten well-characterised monoclonal antibodies, previously raised against purified human acetylcholine receptor, and tested the polyclonal antisera and seven monoclonal anti-idiotype antibodies, for binding to the antigen-combining site, to framework idiotopes, and by ELISA. The polyclonal sera were mostly directed against antigen-combining site idiotopes and cross-reacted only with monoclonal anti-acetylcholine receptor antibodies that bound to the same region on the acetylcholine receptor. In contrast, five of the seven IgM monoclonal anti-idiotypic antibodies raised, none of which demonstrated antigen-combining site specificity in solution, cross-reacted with mAbs binding to more than one region. None of the antisera showing reactivity with the antigen-combining site inhibited the binding of MG anti-acetylcholine receptor antibody.

Animals↗