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Biomedical subjects

Ann L Whall

Publications and source records attributed to Ann L Whall.

10 recordsLinked to original sources
PubMed2006

Expert nurses' use of implicit memory in the care of patients with Alzheimer's disease.

AIM: This paper reports a study exploring expert nurses' use of implicit memory in the care of people with Alzheimer's disease. BACKGROUND: Although research has shown the benefits of preserving and using implicit memory in patients with Alzheimer's disease, the literature shows little evidence of how nurses, in particular expert ones, make use of implicit memory with this client group in clinical practice. METHOD: Semi-structured interviews were carried out with a purposive sample of eight nurses (four from Michigan, United States of America and four from Northern Ireland) in 2004. The interviews focused on specific issues, but were deliberately flexible to allow participants to tell their stories as well. A nine-step data analysis process was developed based on a synthesis of methods used by other researchers. FINDINGS: According to the expert nurses interviewed, the effective and meaningful use of the implicit memory of patients with Alzheimer's disease in achieving positive outcomes depended on 'knowing the patient', 'working within the patient's worldview' and 'using sensitive and patient-centred interactional skills'. They explained how their use of implicit memory (drawing from a range of knowledge sources) was underpinned by reflective practice. CONCLUSION: The findings provide a positive profile of expert nurses' use of implicit memory of patients with Alzheimer's disease; however, their use of theoretical and research knowledge could be improved. There is also a need to test interventions based on the use of implicit memories.

Adult↗
PubMed2006

Teaching interdisciplinary geriatrics ambulatory care: a case study.

Interdisciplinary health care training is advocated by numerous government and philanthropic organizations. Educators in the health professions are increasingly offering training in interdisciplinary health care in a variety of contexts, including ambulatory settings. This paper describes a three-year program to teach skills in interdisciplinary care to learners from internal medicine, social work, pharmacy, and nursing in a geriatrics clinic at a major academic institution in the United States. Framed in a critical review of existing evidence for the effectiveness of interdisciplinary training and health care and expert recommendations, specific recommendations are made to educators interested in interdisciplinary training in ambulatory settings.

Ambulatory Care↗
PubMed2005

An ontological view of advanced practice nursing.

Identifying, developing, and incorporating nursing's unique ontological and epistemological perspective into advanced practice nursing practice places priority on delivering care based on research-derived knowledge. Without a clear distinction of our metatheoretical space, we risk blindly adopting the practice values of other disciplines, which may not necessarily reflect those of nursing. A lack of focus may lead current advanced practice nursing curricula and emerging doctorate of nursing practice programs to mirror the logical positivist paradigm and perspective of medicine. This article presents an ontological perspective for advanced practice nursing education, practice, and research.

Education, Nursing, Graduate↗
PubMed2002

Deriving interventions from the NDB model. Using natural environment and implicit memory theories.

By drawing on theoretical propositions developed outside nursing, and by modifying and synthesizing these with nursing experiential data, useful statements for practice may be developed for further examination. Because practice theory for the care of patients with dementia is not well-developed or well-examined yet, the process described here to develop meaningful interventions for practice should be further explored and evaluated.

Dementia↗
PubMedDate not supplied

The unrecognized paradigm shift in nursing: implications, problems, and possibilities.

An important paradigm (or worldview) shift is occurring in science that affects the nature of nursing education, practice, and research. The shift from positivism to postmodernism and now to neomodernism has received little attention in US nursing and as such may forestall many opportunities related to such change. The nature of this paradigm shift and its effects on selected aspects of nursing education, practice, and research are described, and related implications, problems, and possibilities are explored. Neomodernism is discussed as one future for nursing that encompasses aspects of both positivism and postmodernism but yet goes beyond these to include important metanarratives as traditional values and beliefs of nursing. The work of Laudan and Lakatos are explored as supportive of this neomodernist approach.

Education, Nursing↗
PubMedDate not supplied

Factors associated with psychotropic drug usage among nursing home residents with dementia.

BACKGROUND: Although federal regulations hold nursing homes responsible for monitoring psychotropic drug (PD) usage, there is a high prevalence of PD usage and significant variation in use across nursing homes. OBJECTIVES: The aims of study were to (a) describe current PD usage in nursing homes and (b) examine resident and nursing home factors associated with PD usage in nursing home residents with dementia. METHODS: A multivariate, multisite, cross-sectional descriptive study was used on data from 107 dementia patients residing in nine randomly selected nursing homes in southeastern Michigan. The PD usage of interest included antipsychotics, antidepressants, anxiolytics or sedatives, and mood stabilizers. Regression analysis tested resident factors, including cognitive ability, functional ability, presence of depressive symptoms, and demographic characteristics, and three facility factors (nursing home size, type of ownership, and level of registered nurse [RN] staffing) in comparison with PD usage. RESULTS: In this study, 67.3% of the participants received at least one PD. The most frequently prescribed PDs were antidepressants (41.1%) and antipsychotics (37.4%). Newly developed antipsychotics such as risperidone were given more frequently to residents than were conventional drugs such as haloperidol. Regression analysis suggests that the presence of depressive symptoms (odds ratio [OR]= 3.5, p < .01) and low levels of RN staffing (OR = 1.0, p < .01) were associated with the use of PD. DISCUSSION: Psychotropic drugs are prescribed frequently for nursing home residents, although such usage is variable. Behavioral symptoms were not an independent predictive factor for PD use. Rather, combined resident and facility characteristics best predicted the use of PDs in nursing home residents. The evaluation of nursing home systems for these characteristics as predictive factors for PD usage in nursing home patients with dementia is suggested by the results. Likewise, attention to new drugs such as selective serotonin reuptake inhibitors and their appropriate use is recommended.

Aged↗