Anita Tesh

The effect of critical care hospitalization on family members: Stress and responses

&NA; Family members of intensive care patients may experience stressors that threaten both personal health and family integrity. This study found that family members endure multiple concurrent stressors and exhibit numerous behavioral responses, including changes in eating, sleeping, activity, and family roles and responsibilities. Nurses can promote family integrity with interventions that address these behavioral changes and promote normal behavior patterns. [Dimens Crit Care Nurs 2000:19(4):40‐9]

Thriving: A Life Span Theory

There is a need for aging theories to become holistic and multidisciplinary with a life span focus. A theory is the construction of explicit explanations in accounting for empirical findings. A good gerontological theory integrates knowledge, tells how and why phenomena are related, leads to prediction, and provides process and understanding. In addition, a good theory must be holistic and take into account all that impacts on a person throughout a lifetime of aging. Based on these criteria, the authors created the Theory of Thriving, with a holistic life span perspective for studying people in their environments as they age. This article proposes a theory for studying people over time in a holistic, encompassing manner.

Physical Activity, Obesity, Nutritional Health and Quality of Life in Low-Income Hispanic Adults With Diabetes

The study examined relationships among age, body mass index (BMI), physical activity, nutritional health, quality of life, and health-related quality of life in Hispanic adults with diabetes (N = 59) using the PRECEDE-PROCEED planning model as a framework. Data were collected through face-to-face interviews at clinics and communities. A regression model with predisposing factors (age, BMI), and behavior (nutritional health and physical activity) significantly predicted quality of life (R 2 = 0.21, F = 3.63, p < .05) explaining 21% of variance. Physical activity and nutrition were the strongest predictors. Culturally competent intervention strategies must include factors that improve and enhance quality of life.

Increasing Medicaid child health screenings: the effectiveness of mailed pamphlets, phone calls, and home visits.

OBJECTIVES A randomized controlled trial was conducted to test the effectiveness and cost effectiveness of three outreach interventions to promote well-child screening for children on Medicaid. METHODS In rural North Carolina, a random sample of 2053 families with children due or overdue for screening was stratified according to the presence of a home phone. Families were randomly assigned to receive a mailed pamphlet and letter, a phone call, or a home visit outreach intervention, or the usual (control) method of informing at Medicaid intake. RESULTS All interventions produced more screenings than the control method, but increases were significant only for families with phones. Among families with phones, a home visit was the most effective intervention but a phone call was the most cost-effective. However, absolute rates of effectiveness were low, and incremental costs per effect were high. CONCLUSIONS Pamphlets, phone calls, and home visits by nurses were minimally effective for increasing well-child screenings. Alternate outreach methods are needed, especially for families without phones.

The North Carolina Eden Coalition: Facilitating Environmental Transformation

The Eden Alternative, created by Harvard educated physician Dr. William Thomas, is a model for transforming skilled care facilities from institutions based on a medical model of care into human habitats that promote human growth. This change is accomplished through decentralizing the organizational structure of the facility to empower front-line care-delivery staff, and through introduction of plants, animals, gardening, and children into the daily lives of residents. Because the Eden Alternative is a trademarked name, only facilities recognized by the Eden Alternative registry are allowed to use the name. However, any facility may adopt the philosophies embodied by the Eden Alternative, and implement the principles for transforming their facility. In 1996, the North Carolina Division of Facility Services formed the North Carolina Eden Coalition (originally named the North Carolina Eden Alternative Coalition). This was the first organization of its kind in the country. The success of the Coalition has led it to become a model for implementation in other states. Currently, North Carolina leads the country in the number of registered Eden Alternative facilities, and has a large number of other facilities that have instituted some form of environmental enhancement. The Coalition functions as a consumer-driven advisory and educational body rather than a formal regulatory standard body, and endorses implementation of the principles and philosophies embodied in the Eden Alternative. The Coalition has proved to be a successful, cooperative effort among regulators, providers, advocates, and other experts to implement the philosophies of the Eden Alternative without regulatory basis. Because the Coalition was formed under the auspices of the Division of Facility Services and operates with its ongoing cooperation, it is in an excellent position to clarify and influence policies and regulatory issues concerning transformation of long-term care environments in North Carolina. This article explores the history, structure, function, mission, and goals of the North Carolina Eden Coalition. Examples of issues the Coalition has addressed in promoting environmental transformation in North Carolinas skilled care facilities are also included.

Assessing medication knowledge and practices of older adults

An assessment instrument for home health nurses to use in assessing medication knowledge and practices of older adults was developed and tested on a convenience sample of 20 adults 65 and older admitted to a local home health agency. The tool was found usable by nurses, understood by patients, and had adequate test-retest reliability. The results emphasized the need for thorough medication assessments of all home health patients and provided a tool that home care nurses can use.

Characteristics of nursing homes adopting environmental transformations

During the past few years, many nursing homes in North Carolina have formulated plans to transform or enhance their environments to make the facilities more desirable places to live and work. The purpose of this study was to compare characteristics of facilities adopting one specific model for environmental transformation. The Eden Alternative; with those adopting other environmental transformations or making no changes. Surveys were mailed to administrators of all (n = 378) certified nursing facilities in NC. A total of 167 surveys were returned, for a return rate of 44%. Of these, almost three fourths were planning or implementing some sort of environmental transformation. Thirty-seven facilities (22%) indicated they were currently adopting the Eden Alternative, and 47 (28%) were planning to adopt it. Twenty-six facilities (16%) reported they were currently adopting an environmental transformation other than the Eden Alternative, and another 9 (5%) were planning to adopt another environmental transformation. The facilities adopting or planning environmental transformation other than the Eden Alternative reported adopting (or planning to adopt) various components of the Eden Alternative. Forty-six facilities (28%) indicated they had no plans for environmental transformation. Facilities making environmental transformations were found to be similar to those making no changes on most variables examined, supporting the conclusion that environmental transformation is feasible for facilities with a wide range of characteristics.

A Writing Intensive Introductory Course for RN to BSN Students

This article describes learning strategies used with RN to BSN students in their 1st nursing course to successfully learn how to write formal papers using the American Psychological Association (APA) format. This 1st nursing course, a writing intensive, requires 4 short papers with self, peer, and teacher critiques and opportunities to rewrite. Students learn the style of professional nursing discourse, mastery of APA format, and development of additional skills in following directions and in critiquing their own work. An additional benefit is to enhance learning about professional nursing topics. By mastering writing skills in this initial course, students are able to successfully complete writing assignments in future courses and, in some cases, move on to publication.

Teaching Pathophysiology: Strategies to Enliven the Traditional Lecture

The depth and breadth of pathophysiology content, foundational for nursing practice, is well suited for traditional lecture delivery. Use of creative strategies can deepen students’ understanding while respecting students’ diverse talents and ways of learning. The authors discuss strategies they used, including case studies, questions asked during lecture using immediate feedback technology, creative visual demonstrations, group pathophysiologic theory projects, short videos, and games, to enhance students’ understanding and retention of content.

Older Adults: What Every Paediatric Nurse Should Know

Older adults have always been important parts of childrens lives, playing a variety of roles including grandparent, caregiver, friend, and neighbour. Grandparents also play a variety of roles in families. Often a childs first encounter with serious illness or death involves a grandparent or other older adult. Grandparents are also increasingly serving as primary caregivers for children. Paediatric nurses have long recognised their role in helping children cope with grief and loss associated with illness or death of a grandparent. Paediatric nurses need to be able to provide appropriate interventions and teaching when older adults are primary caregivers or assisting parents in the day-to-day care of the child. They also need to have sufficient knowledge about older adults to help parents and children understand the normal changes they will see in their aging loved ones, and to help parents effectively incorporate grandparents and older adults into childrens lives.