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Nurse and patient reactions to a developmental home telecare system

JOURNAL OF TELEMEDICINE AND TELECARE 1998年第3期4卷 152-160页

作者： Whitten, P Collins, B Mair, F Univ Kansas Med Ctr Kansas City KS 66160 USA Univ Louisville Louisville KY 40292 USA Univ Liverpool Liverpool L69 3BX Merseyside England

Pilot studies have suggested that telemedicine is a satisfactory means of delivering nursing services into the home. A home telecare programme in Kansas provided nursing services to homes in four towns in Kansas. The present study examined patients' and nurses' perceptions of a variety of issues related to home telecare. Data-collection methods included in-depth interviews, observation and analyses of archival data from patient records. Patients suffered an average of 4.6 concurrent illnesses. On the whole, patients perceived the system as a valuable resource that offered great potential, although many saw no immediate health benefits for themselves. Nurses were enthusiastic about the prospect of practising in this way, although they did have strong opinions about what types of nurses, patients and illnesses were suited to telemedicine.

关键词：医务工作者的态度社区保健护理/组织和管理家庭医疗保健服务/组织和管理堪萨斯病人接受卫生保健的程度远程会诊/组织和管理成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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The limerick leg-ulcer project: Early results

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IRISH JOURNAL OF MEDICAL SCIENCE 1999年第1期168卷 17-20页

作者： Castineira, F Fisher, H Coleman, D Grace, PA Burke, P St Johns Hosp Dept Surg Limerick Ireland

Nurse led clinics in joint hospital and community settings are now being advocated as the most effective and economic way of dealing with leg ulcers, However little information exists on the profile and outcome of patients with venous ulcers treated either in the community or in the hospital setting, Over a 2 yr period we assessed 134 patients with leg ulcers of whom 122 were deemed suitable for compression bandaging therapy. Thirty-four patients (28 per cent) were treated by the newly developed community service and 88 (72 per cent) were treated at the hospital clinic. Our overall healing rate for venous ulcers was 50 per cent @ 40 weeks. This probably reflects the long duration (48 per cent > 2 yr) and large size (0.5-608 cm(2)) of ulcer prior to treatment. There were no differences in outcome between hospital (50 per cent @ 40 weeks) and community (35 per cent @ 40 weeks) based treatment (p>0.05). We conclude that most venous ulcers can be effectively treated in the community and resources should be provided to achieve this goal.

关键词：门诊医疗/方法巴尔的摩社区保健护理/组织和管理评价研究(主题) 随访研究腿溃疡/诊断腿溃疡/护理腿溃疡/治疗复发治疗结果伤口愈合成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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A typology of service patterns in end-stage aids care:relationships to the transprofessional model

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Home Health Care Services Quarterly 1998年第1期17卷 73-92页

作者： Huba, G.J. Brief, Diana E. Cherin, David A. Panter, A.T. Melchior, Lisa A. The Measurement Group United States Visiting Nurse Association of Burbank Health Research Center United States

Objective. To determine the relationship among 11 types of home health care services for patients with HIV/AIDS and to develop a terminal-care, service-usage profile of persons receiving such services. Services include the number of psychiatric nurse visits, MedicalSocial Work (MSW) visits, evaluation visits, physical therapy visits, occupational therapy visits, homemaker visits, home health aide visits, public health nurse visits, registered nurse (RN) visits, Licensed Vocational Nurse (LVN) visits, and Intravenous (IV) nurse visits. Data Sources and Study Setting. Data were collected on 549 AIDS patients admitted for medical/surgical home-care services to the Visiting Nurse Association of Los Angeles (VNA-LA). The service utilization data were collected from the VNA-LA’s computerized datasystem. Study Design. The relationship among the service types was evaluated with principal component analysis. A service-usage profile was developed for patients using cluster analysis. To control for the variability in the amount of time that patients were on service, the numberof days that patients were in the VNA-LA program and were actuallyreceiving services was included as a factor that yielded a variable reflecting the number of each type of service that a patient received perday. Principal Findings. Five components were found to best describe the relationships among the service-type variables. These were identified as being: the Number of Evaluation Visits, the Number of Intensive Nursing Visits, the Number of Physical Therapy Visits, theNumber of Psychosocial Visits, and the Number of Attendant *** were found to cluster into 1 of 5 groups based on the type ofservice utilization profile that they received. The variables that appeared to have the most influence on this profile were the number ofhome health aide visits per day that the patient received, the numberof RN visits that were made, the number of IV nurse visits that wereprovided, and the number of LVN v

关键词：获得性免疫缺陷综合征/治疗聚类分析社区保健护理/组织和管理综合保健/组织和管理人口统计学卫生服务研究家庭医疗保健服务/组织和管理家庭医疗保健服务/利用洛杉矶模型组织管理社会支持临终医护/组织和管理临终医护/利用女(雌)性人类男(雄)性

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社区患者护理安全相关问题的分析和对策

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中国误诊学杂志 2009年第20期9卷 4843-4844页

作者：陈雁胡芸南京大学医学院附属鼓楼医院江苏南京210008

护理安全是指实施护理全过程中,患者不发生法律和法定的规章制度允许范围以外的心理、结构或功能上的损害、障碍、缺陷或死亡。我院对社区站点的护理相关安全问题进行查找并制定了相应的对策。现总结如下。[第一段]

关键词：社区保健护理/组织和管理

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Is there a doctor in the house? Integrating medical education and home health care

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Home Care Provider 1998年第5期3卷 260-265页

作者： Engelke, Martha Keehner Britton, Bonnie Perry Burhans, Linda Hall, Sandy East Carolina University School of Nursing Greenville NC United States University Home Care Greenville NC United States University Home Care United States

This article describes how one rural home health agency collaborated with a school of medicine to integrate medical education into the daily operations of the agency. Noteworthy aspects of this project include integration of home care concepts at all levels of the medical school curriculum, use of an advanced practice nurse to coordinate the program, collaboration between the home health agency and the schools of medicine and nursing, and reliance on telecommunication technology to minimize the barriers related to transportation to and scheduling of physician visits.

关键词：临床工作能力社区保健护理/组织和管理卫生保健提供联合/组织和管理教育医学本科/组织和管理家庭医疗保健服务/组织和管理开业护士/组织和管理方案评价乡村卫生服务/组织和管理人类

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Knowledge in health visiting practice

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NURSE EDUCATION TODAY 1999年第4期19卷 299-305页

作者： Goding, L Cain, P Univ Reading Dept Community Studies Reading RG6 2AH Berks England

Health visiting is a practical discipline, hence knowledge in health visiting practice cannot be thought of as inert, that is merely as items of information merely;rather, it must be thought of in terms of a dynamic interplay among the individuality of the knower (the practitioner), the sources whereby knowledge may be acquired, and the contexts in which it must be applied. This discussion is an exploration of that interplay. Thus, in the discussion, the distinctive demands on the practitioner (and the kinds of personal qualities these entail) in acquiring and applying knowledge are highlighted, as are the sources of knowledge and the constraints of context. Three sources of knowledge are noted: authority, personal experience, and intuition. Context is conceived both in terms of the macro, sociopolitical, level and in terms of the micro level, i.e. the individual homes and interpersonal relationships in and through which health visiting is typically practised. Conclusions are drawn relating to the education of health visitors. The discussion draws on a distinction between three kinds of knowledge: factual or propositional knowledge, knowledge by acquaintance, and practical knowledge, or know-how.

关键词：临床工作能力/标准社区保健护理/教育社区保健护理/组织和管理直觉知识护理研究/教育护理研究/组织和管理人类

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An ethnographic study of women's experience of partnership caseload midwifery practice: the professional as a friend

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MIDWIFERY 1999年第3期15卷 165-176页

作者： Walsh, D De Montfort Univ Leicester LE2 1RQ Leics England

Objectives: to explore the experience of a known midwife for labour and birth as provided through the partnership caseload model of care in women who had a previous baby under an alternative system of care. Design: a qualitative study using an ethnographic approach. Data were collected by tape-recorded interviews. Setting: the maternity unit at Leicester Royal Infirmary NHS Trust, Leicester, UK in 1998, Participants: 10 multiparous women cared for by Birth Under Midwifery Practice Scheme (BUMPS) midwives were interviewed between eight- and 12 weeks' postpartum Key findings: women's perceptions and experiences were predominantly influenced by the relationships they had with their midwives who they described as 'friends', All other themes were filtered through these relationships, including previous negative experiences of maternity care, the valuing of a known midwife for labour and birth, their positive birth experiences, expressions of delight at their care, their liking of home antenatal care, and the appreciation of their existing children and partners meeting their midwives, Implications for practice: partnership caseload midwifery practice has significant positive impact on women's experience of childbirth,The midwife/woman relationship that has evolved in this context is highly valued by women and challenges traditional professional roles,The model should be explored in other settings to see if its benefits to women are transferable.

关键词：人类学文化健康态度社区保健护理/组织和管理英格兰联合开业/组织和管理人际关系分娩过程/心理学模型护理学母亲/心理学助产士/组织和管理助产士/心理学护士病人关系护理方法学研究问卷调查工作负荷量女(雌)性人类妊娠

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Specialist practice in community mental health nursing

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NURSE EDUCATION TODAY 1999年第6期19卷 509-516页

作者： Hannigan, B Univ Coll N Wales Coll Med Sch Nursing Studies Cardiff CF4 4XN S Glam Wales

Community mental health nurses (CMHNs) work in an increasingly complex health and social care environment. Over recent years, the evolving direction of general health service and specific mental hearth policy has directed CMHNs towards: the provision of clinically-effective interventions;a closer attention to meeting the needs of people experiencing severe and long-term mental health problems;the simultaneous provision of services to meet the needs of people experiencing a wide range of mental health problems presenting in primary care settings;greater collaboration with workers representing other disciplines and agencies;and the development of active partnerships with mental health service users. This paper explores the context within which CMHNs practise, and within which education programmes preparing specialist practitioners in community mental health nursing have been developed. One recently-validated specialist practice course for CMHNs is described in detail, with the intention of stimulating discussion and debate surrounding the practice of, and the educational preparation for, community mental health nursing. (C) 1999 Harcourt Publishers Ltd.

关键词：社区保健护理/教育社区保健护理/组织和管理社区精神卫生服务/人力课程大不列颠职务说明需求估价临床护理医生/教育临床护理医生/组织和管理精神病护理学/教育精神病护理学/组织和管理人类

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Clients' perceptions of distinctive aspects in nursing care received within a congregational setting

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Journal of Community Health Nursing 2000年第3期17卷 171-183页

作者： Chase-Ziolek, M. Gruca, J.A. North Park Theological Seminary Chicago IL 60625-4895 3225 W. Foster United States

Over the past 15 years, a growing number of nurses have been working with congregations as parish nurses and in other community health nursing roles. The majority of related research has focused on describing nursing activities in congregational settings. This qualitative research study sought to understand the client's experience of receiving nursing care in the context of a congregation. Eleven individuals, who utilized nursing services provided in 2 urban Catholic churches, were interviewed. Content analysis revealed distinctive attributes participants experienced in the nurse-client interaction, including the manner of care, the focus of care, and the outcomes achieved. The ambiance, convenience, time for interaction, and reflection of the connection between faith and health were seen as distinctive characteristics of the congregational setting. Community health nurses need to be aware of the impact of setting on clients and the potential synergistic effect achieved through providing health services in a congregation.

关键词：健康态度天主教社区保健护理/组织和管理职务说明护士病人关系护理方法学研究问卷调查老年人女(雌)性人类男(雄)性中年人

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THE ROLE OF OUTCOME AND EFFICACY EXPECTATIONS IN AN INTERVENTION DESIGNED TO REDUCE INFANTS EXPOSURE TO ENVIRONMENTAL TOBACCO-SMOKE

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HEALTH EDUCATION RESEARCH 1993年第1期8卷 137-143页

作者： STRECHER, VJ BAUMAN, KE BOAT, B FOWLER, MG GREENBERG, R STEDMAN, H TULANE UNIV NEW ORLEANSLA 70112 NIH BETHESDAMD 20892

The purpose of this paper is to examine the role of a theoretical framework in an intervention program designed to reduce infants' exposure to environmental tobacco smoke (ETS). The content of a nurse-based intervention focused on two psychosocial constructs: expectations of outcomes which may result from behaviors associated with ETS exposure and expectations of self-efficacy associated with the mother's ability to engage in these behaviors. This study found both constructs predictive of change in, and maintenance of, ETS exposure control. In particular, mothers reporting both low outcome and low efficacy expectations tended to have infants with the highest levels of ETS exposure. We also found that our intervention was effective in changing outcome and efficacy expectations in the desired direction. These findings suggest that outcome and efficacy expectations are changeable, and, therefore, represent important targets in future programs aimed at controlling ETS exposure.

关键词：青少年成年人社区保健护理/组织和管理女(雌)性健康行为人类婴儿母亲/心理学北卡罗来纳结果评价(卫生保健) 方案评价研究设计自我效验烟草烟污染/预防和控制

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