Jennifer B. Averill

Matrix Analysis as a Complementary Analytic Strategy in Qualitative Inquiry

In the current health care environment, researchers are asked to share meaningful results with interdisciplinary professional audiences, concerned community members, students, policy makers, planners, and financial officers. Emphasis is placed on effective health care outcomes and evidence, especially for underserved and vulnerable populations. Any research strategy that facilitates the clear, accurate communication of findings and voices will likely benefit groups targeted for intervention with scarce resources. In this example, matrix analysis contributes to the display, interpretation, pragmatic evaluation, and dissemination of findings in a study of rural elders. The author proposes matrix analysis as a strategy to advance knowledge and enhance the development of evidence in qualitative research.

Priorities for action in a rural older adults study

This article reports the findings from a recent study of older adults in the rural southwestern United States and discusses practice and research implications. The aim of the study was to analyze health disparities and strengths in the contexts of rurality, aging, a depressed economy, and limited health resources. Identified themes needing action included sustained access to prescriptions, transportation solutions for older adults in isolated communities, inadequate access to care, poor infrastructure and coordination of services, scarce assisted living and in-home care for frail older adults, and barriers related to culture, language, and economics.

Getting Started: Initiating Critical Ethnography and Community-Based Action Research in a Program of Rural Health Studies

Rural populations experience higher rates of illness, less access to health care resources, and lower rates of health insurance coverage than do urban populations. A need exists to identify and address the health care needs of rural communities and other isolated populations and to contextualize the findings in the larger rural health environment. Critical ethnography combined with community-based action research is a constructive approach for improving the health status of rural elders as well as other members of isolated communities. Detailed guidelines on how to initiate an ethnographic community-based action study, as shown through a study that explores the definitions of health, health care perceptions, and health care issues for rural elders in the southwestern United States, highlight the value of this type of research for the study of the health care issues of rural populations.

Talking as a primary method of peer defusing for military personnel exposed to combat trauma.

1. Humanitarian relief missions and military operations are unquestionably stressful and clearly have potential to affect the mental health of soldiers. 2. After being exposed to traumatic events, soldiers may develop acute stress reactions, a historically known phenomenon better recognized and understood today. 3. Although organized resources exist, they may not be accessible or appropriate. Soldiers are the most precious asset the military forces have and their peers may be the best and only resource available to them. 4. The need to ventilate and the relief that follows after talking about distressing events are evidence that defusing by talking should be encouraged after exposure to a traumatic event.

Patterns of Knowing as a Foundation for Action-Sensitive Pedagogy

Graduate students in the health sciences often juggle full-time careers, demanding programs of study, and family responsibilities. Frustration, a perception of limited caring on the part of role models, and a sense of disengagement, or even despair, are common features of postbaccalaureate study for many of them. Nursing has long recognized the value of multiple perspectives in knowledge development. Previous work involving patterns of knowing not only has advanced the disciplinary knowledge base but has also encouraged innovative applications of the patterns to philosophy, evidence-based practice, and research aimed at reducing health disparities. In an effort to both extend the dialogue about ways of knowing and humanize the experience of graduate education for nursing students, the authors propose six patterns of knowing as a foundation for effective, action-sensitive pedagogy.

Shaken baby syndrome: assessment, intervention, and prevention

Child abuse and neglect continue to be parts of a disturbing reality in both the United States and the world. Despite significant advances in the identification and treatment of child abuse, health care professionals are still attempting to grasp the extent of the physiological and psychological effects of child maltreatment and injury. Child abuse, in all of its forms, is preventable, and more must be done to decrease its incidence. Shaken baby syndrome is one of the most deadly and devastating forms of child abuse and is characterized by a traumatic brain injury caused by the violent shaking of an infant. Recognition of high-risk families, combined with education of parents and other caregivers are key to prevention of shaken baby syndrome.This quality improvement project provided a descriptive analysis of the patient population that received integrated mental and physical health care at Old Town Clinic, and evaluated patient and staff satisfaction with this model of care. Seventy-three patients and seven staff members were surveyed, using two satisfaction surveys distributed in January 2003. Survey data revealed that the majority of Old Town Clinic patients were homeless. Patients indicated high levels of satisfaction with the clinics location, ease of accessing care, and health promotion and illness prevention education. Staff satisfaction with this model of care was reported to be moderate regarding accessibility, response time, communication, support, treatment, completeness of care, and education. Recommendations for further research and implications for practice are offered.