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Biomedical subjects

C Weinert

Publications and source records attributed to C Weinert.

At least 19 recordsLinked to original sources

Wellness profile of midlife women with a chronic illness.

Among issues important to women's health are their wellness profiles including indicators such as activity level, weight status, breakfast and snacking patterns, health status perceptions, and alcohol and tobacco use. This is particularly true for midlife women with a long-term illness. The purpose of this study is to identify the wellness profile of a group of midlife women with multiple sclerosis (MS), and to compare their life-style indicators with national health statistics. Overall, the women in the study group indicated a lower perception of their health status and were less active. However, the women in this study group demonstrated healthier body weights, used less tobacco and alcohol, had better breakfast patterns, and comparable snacking patterns, indicating that may be more attuned to their bodies than women without chronic illnesses. Identifying women's wellness profiles can assist practitioners in addressing the issues of health for women managing a long-term illness.

Activities of Daily Living

Rural residents' use of cardiac rehabilitation programs.

The goal of this study was to identify the factors that influence the use of cardiac rehabilitation services by rural residents. The Andersen-Newman framework, which consists of three determinants of health services utilization (predisposing, enabling, and need factors), was used to direct this research. The three data collection points were at time of discharge from the hospital, two weeks post discharge, and one week following the date that the cardiac rehabilitation program would have been completed. Packets for the three data collection points were unique and contained instruments to assess various factors influencing the use of health services. The sample (N = 254) were adults living in rural areas who had experienced a cardiac event and received treatment at one of four hospitals in two western states and who provided useable data on all three questionnaires. Findings indicated that 72 (28%) of the participants attended some portion of a rehabilitation program, and only 43 (17%) completed the full 36-week program. Four predisposing factors, one enabling factor, and two need factors were significant in explaining the number of cardiac rehabilitation sessions attended. Further research is needed to validate these factors and to identify others which may influence the use of cardiac rehabilitation by rural residents. Likewise, it is essential to examine alternate ways to meet the rehabilitative needs of rural cardiac clients.

Adult

Rural dwellers' cancer fears and perceptions of cancer treatment.

The purpose of this study was to explore differences in cancer fears and perceptions of cancer treatment among four rural groups: men with cancer, men caregivers, women with cancer, and women caregivers (N = 590). The four groups differed in their cancer fears. About half or less feared pain, nausea, body disfigurement, and sexual problems from cancer. Over two-thirds were worried about finances and decreases in quality of life. More worried about separation from loved ones than worried about death. The four groups differed only slightly in perceptions of treatment. The majority thought chemotherapy, surgery, and radiation were important treatments. A larger percentage saw nutritional interventions and biologicals as unimportant in cancer prevention or treatment. Nurses need to address fears and perceptions of cancer treatment with persons experiencing cancer and their families. In addition, these persons and their families need support for decisions regarding cancer treatment.

Attitude to Health

Advanced education for the role of rural nurse generalist.

The Montana State University College of Nursing has developed a master's degree program which prepares nurses as generalists with advanced knowledge for understanding and addressing rural health care needs. The programs is clear about its goals and objectives and does not attempt to be "all things for all people." The emphasis is on rural nursing, and this emphasis is present in recruiting, teaching, research and publication at the College. Classroom and clinical experiences challenge students to develop a broad range of skills, and most importantly to enhance critical thinking and problem-solving abilities. Since delivering high quality health care in rural areas requires the ability to understand health care from the consumer's perspective, both data collection and clinical experience in rural communities are required. The enthusiasm for rural nursing--practice, teaching and research--displayed by faculty members, alumnae and students is both a major factor in, and an indication of, the program's success.

Clinical Competence

Concerns of rural men and women experiencing cancer.

PURPOSE/OBJECTIVES: To examine the interpersonal relationships, self-image, healthcare interactions, and occupational concerns of rural men and women experiencing cancer directly or as a caregiver of a person with cancer. DESIGN: A descriptive design employing a mail survey as part of a larger, longitudinal study. SETTING: Rural areas in the northern Rocky Mountain region of the United States. SAMPLE: 294 people with cancer and 294 family caregivers in Montana responded to mail questionnaires. Fifty-two percent were women, and almost all were Caucasian. METHODS: Investigator-developed Cancer Concerns Inventory mailed to participants. MAIN RESEARCH VARIABLES: Interpersonal relationships, self-image, healthcare interactions, occupational concerns, gender, and type of experience with cancer. FINDINGS: In general, women were more likely than men to report relationship problems, lack of support, and feelings that were not understood. People with cancer, as compared with caregivers, were more likely to report feeling alone and that other people avoided them and were afraid to talk to them. Men with cancer were more likely than women with cancer and caregivers to feel that their job security was threatened. However, only a small percentage of all participants felt discriminated against at work. In general, a higher percentage of women with cancer and men caregivers reported concerns about healthcare interactions than men with cancer and women caregivers. CONCLUSIONS: Men and women caregivers and people with cancer have different concerns regarding cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses working in rural areas must help families work through relationship difficulties, maximize healthcare interactions, and be an advocate for people with cancer.

Adaptation, Psychological

MSU Rurality Index: development and evaluation. Montana State University.

The construction and validation of a residence-based index of the degree of rurality are reported. The MSU Rurality Index is a locally normal index and assigns a quantitative measure of rurality to each participant in a study. Data required to compute the index are minimal; only two variables need be measured. Statistical analysis effort required to compute the index is somewhat more intensive than usual, but this tradeoff between data collection and data analysis seems sensible. Data collection is generally more expensive than data analysis. The two required variables, county population and distance to emergency care, are optimally transformed to achieve normality and weighted to achieve validity. A measure of departure from normality is automatically obtained while constructing the index. A positive score reflects a rural residence and a negative score reflects an urban residence relative to the group under study. A score of zero reflects average rurality. Reliability and construct validity were examined using two data sets. The MSU Rurality Index has high test-retest reliability, is appropriately related to a set of ordered categories concerning place of residence, and is as or more strongly related to these categories than alternative indices computed from distance or population alone. The validity of the MSU Rurality Index does not appear to be compromised by its parsimony. Even though the MSU Rurality Index is based on only two variables, it was found to be associated with various health care variables as strongly or more strongly than an 11 variable county-based index developed in Texas.

Adult

Ineffective hip rotation with Pavlik harness. Prospective study of 35 infant dislocations.

35 hips in 31 infants diagnosed as unstable were treated with a Pavlik harness and followed by weekly clinical and monthly ultrasound evaluation to determine eventual stability. 26 hips became stable within 3 months, and 9 dislocations required reduction with hip spica placement; 1 of these subsequently required open reduction. Of the 7 infants with 9 hips that failed, 2 children had a late onset of treatment, 2 children had problems with brace fit or family acceptance, and 3 other children had no problem with use of the orthosis. Internal rotation of a degree not possible with the Pavlik harness was required to reduce 4 of these 9 hips. The Pavlik harness is ineffective in some patients because of the need for internal rotation.

Arthrography

Cancer home care in Montana.

Availability of health care services in sparsely populated areas may be limited by fewer health care organizations and geographic separation. The purposes of this study were to identify unmet needs of individuals and families managing cancer in rural areas and examine cancer-related home care in rural areas. Issues of staffing, caseloads and service area for home health agencies (HHAs) and hospices were examined. HHAs registered with the Montana Association of Home Health Care Agencies and licensed hospices in Montana were mailed questionnaires with 92% of the HHAs and 90% of the hospices returning the questionnaires. Health providers identified a variety of unmet needs including personal care and respite. Agencies were small with approximately four full-time equivalent registered nurses for HHAs and one full-time equivalent registered nurse for hospices. Similarly, caseloads were also small with an average of 50 clients per month for HHAs and 11 clients per month for hospices. HHAs and hospices had large service areas with two of the HHAs each serving seven counties. Implications of these findings for research and practice are discussed.

Allied Health Personnel

Economic status of families living with multiple sclerosis.

A nation-wide survey of 604 families living with multiple sclerosis was conducted. The sample was recruited through local chapters of the National Multiple Sclerosis Society and the public press. This paper describes the economic impact of the disease on families. There were 427 families in which the woman had multiple sclerosis and 177 families in which the man had the disease. The average duration of the disease was 10 years. Family income was well above the national median income. Thirty-nine per cent of the men and 19% of the women with multiple sclerosis retired because of disability. Income was inadequate to pay for medical expenses in 21% of the families and 25% had inadequate funds to meet basic living expenses. While 80% of the families had health care insurance, for 28% of the families the insurance was inadequate to cover the cost of their illness. The number of children living at home and the amount of health care bills paid out-of-pocket failed to explain why families in the high income group had difficulty meeting their expenses. Factors other than income and proportion of medical expenses covered by insurance determine the economic impact on the family. If health care providers are going to meet all the needs of a family living with multiple sclerosis, a more comprehensive assessment of their economic status is needed.

Adult

Descriptions and perceptions of health among rural and urban adults with multiple sclerosis.

The purpose of this study was to compare the health descriptions and perceptions of adults with multiple sclerosis living in rural and urban areas. Data were obtained from 361 adults, who responded to a mail survey including standardized self-report measures of physical and mental health, disability and social support, and an open-ended question on the meaning of health. In contrast to findings with general, nonclinical populations, the health perceptions and descriptions of this chronically ill population were not significantly affected by their place of residence. Further research is needed to examine the applicability of health-related findings from general populations to persons who are chronically ill.

Adult

Rural nursing: developing the theory base.

Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems.

Attitude to Health

Social support and the chronically ill individual.

Nurses caring for the chronically ill need to be alert for the problems of social isolation and social impairment. Families often respond initially to serious illness by becoming over-protective and fostering dependence and a sense of impaired competence in the ill person. As the illness continues, families often experience exhaustion because of the demands of new roles, depleted finances, and other aspects of a changed lifestyle. Feelings of anger, guilt, and helplessness occur in the network, often leading to withdrawal of support--especially as the ill person's ability to reciprocate support is impaired. Nursing interventions in situations of social isolation focus on reducing isolation by promoting social interaction as appropriate, and by directly or indirectly mobilizing or expanding the social network. The problem of impaired social interaction may occur secondary to the personality changes that often accompany chronic illnesses, or as a function of the chronic illness or disability itself, as in the case of mental illnesses. Social impairment is an appropriate nursing diagnosis in abusive families. Nursing interventions range from educational programs for social skill development to reduction of the amount of contact within the network to involvement of protective and psychotherapy services. Chronic illness has profound effects on social support and the social network of both the ill person and his or her family. As both long-term illnesses and family involvement in care giving increase, nursing care in situations of chronic illness must include attention to issues of social support. Nursing diagnosis provides a framework for nurses to include social support in their care of the chronically ill patient. Social isolation and social impairment can be reduced by nursing interventions.

Chronic Disease