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PubMed1997

[Diabetes mellitus: training of health teams at the university].

The authors describe their experience as a multiprofessional team working at two Basic Health Units (BHU) in Londrina city in 1995. The work involved medical, nursing students and residents. The goals were: a) to train BHU teams in the assistance of diabetic patients; b) expose students to teaching experiences at the BHUs, emphasizing multiprofessionality; c) to establish an hierarchy and provide suitable treatment for the BHUs diabetic clientele. A total of 106 diabetic patients were assisted. The project involved 22 students and 37 professionals. A questionnaire assessment indicated that the goals were achieved. The experience is considered valid as a teaching and inservice training.

Clinical Competence↗
PubMed1984

Interdisciplinary services used by public schools.

A questionnaire to survey interagency cooperation was developed and sent to public school educational agencies throughout the country. Respondents included: special education supervisors and principals, school psychologists, and administrators at the local, regional, and state level. It was found that children with specific learning disabilities were referred more frequently than children with mental retardation and identification and assessment were the interdisciplinary services most requested in terms of evaluation and inservice training for public school staffs.

Adolescent↗
PubMed1991

Nutritional knowledge of nurses in long-term health care facilities.

Nurses practicing in long-term care facilities were surveyed on the adequacy of their nutrition education, nutrition knowledge, and general attitudes about the diet of elderly residents. While 78% of the 95 responding nurses reported taking a required nutrition course during their training, only 61% indicated the quantity of their nutrition education was sufficient and 66% indicated the quality of their education was sufficient. The mean nutrition knowledge score was 60% correct with 51 subjects scoring at this level or less. Since the nurse is such an important caregiver for the institutionalized elderly it is recommended that more emphasis be placed upon nutrition of the elderly in the nurses' education as well as the provision of more inservice training for practicing nurses utilizing the registered dietitian.

Aged↗
PubMed1980

Multidisciplinary team malfunctioning on a state hospital unit: a case study.

The use of multidisciplinary teams in the care of psychiatric patients can be countertherapeutic unless attention is paid to the dynamics of team functioning. The authors present a case study of team malfunctioning on an inpatient unit in a state hospital that resulted from staff's role confusion and insecurity. Patient care was relegated to second place as major interpersonal conflicts among the staff were played out along ethnic and cultural lines. Resolution of the conflicts required identifying their source, clarifying staff roles, and initiating a special inservice training program focused primarily on the needs of paraprofessional staff.

Aggression↗
PubMed2006

Training nurses to save lives of malnourished children.

A qualitative study with a pre- and post-intervention component was undertaken among 66 professional nurses at 11 hospitals in the Eastern Cape to assess their perceptions and attitudes towards severely malnourished children and their mothers/caregivers. Nurses' attitudes were compared before and after attending a 5-day training course to improve the management of malnutrition along with implementing World Health Organization (WHO) guidelines. Severe malnutrition is a major cause of death among paediatric patients in many hospitals in South Africa. A qualitative study with a pre- and post-intervention component was undertaken among 66 professional nurses at 11 hospitals in the Eastern Cape to assess their perceptions and attitudes towards severely malnourished children and their mothers/caregivers. Nurses' attitudes were compared before and after attending a 5-day training course to improve the management of severe malnutrition through implementing the World Health Organisation (WHO) guidelines. Focus group discussions were conducted in isiXhosa following a semi-structured discussion guide. Three themes emerged from these discussions, i.e. nurses placed blame on the mothers for not giving adequate care at home; nurses valued malnourished children less than those with other conditions; and nurses felt resentment towards caregivers. Underlying reasons for the negative attitudes towards severely malnourished children and their caregivers were misunderstandings of the causes of malnutrition, misinterpretation of clinical signs, especially poor appetite, and high mortality during treatment. However, the training course and successful application of the treatment guidelines altered these perceptions and helped nurses to have a better understanding of the causes of the presenting clinical signs. These nurses have begun advocating for raised awareness of the physiological differences that occur in malnutrition and the need to include the WHO Ten Steps of treatment in the nursing curricula and inservice training. A cadre of volunteer nurse-trainers has been formed in Eastern Cape. Experience in this province has shown that in-service training changes attitudes to malnutrition and treatment practices, as well as saving lives.

Anger↗
PubMed1987

Arthritis care in older-adult centers. A controlled study of an education program for public health nurses.

In this study, we evaluated an inservice training program for public health nurses. The training program concerned arthritis screening and management of the disease in elderly subjects. Twenty-nine nurses were assigned randomly to experimental (training) or control conditions. Evaluation data from 158 interviews with patients showed that screening for arthritis was done twice as frequently by nurses in the experimental group, compared with that done by nurses who were not in the experimental group (P less than 0.01). Recommended management of arthritis was not correspondingly improved. Stronger inservice programs are discussed in light of the need to anticipate seasonal conflicts between arthritis care and preventive care for the elderly, to change habitual practice patterns, and to increase access to arthritis health professionals.

Activities of Daily Living↗
PubMed1975

A survey of rural community mental health needs and resources.

The authors conducted a survey of 215 rural community mental health centers across the country to determine their unique problems, needs, and resources. From the 92 responses they received, they formulated a composite description of the rural mental health scene. Their description focuses on services offered, skills required to operate effective rural programs, and problems in the delivery of care and of evaluation. From the responses they also analyzed the extent of inservice training available to rural practitioners, the support systems needed, and the functions a proposed national task force on rural mental health could perform.

Community Mental Health Services↗
PubMed1999

Reforming health service delivery at district level in Ghana: the perspective of a district medical officer.

Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper examines aspects of health services delivery, and trends in utilization and coverage, using routine data over time in the Dangme West district of the Greater Accra region of Ghana, from the perspective of a district health manager. Specific interventions through which health services delivery and utilization at district level could be improved are suggested. Suggestions include raising awareness among care providers and health managers that increased resource availability is only a success in so far as it leads to improvements in coverage, utilization and quality; and developing indicators of performance which assess and reward use of resources at the local level to improve coverage, utilization and quality. Also needed are more flexibility in Central Government regulations for resource allocation and use; integration of service delivery at district level with more decentralized planning to make services better responsive to local needs; changes in basic and inservice training strategies; and exploration of how the public and private sectors can effectively collaborate to achieve maximum coverage and quality of care within available resources.

Developing Countries↗
PubMed1994

Restraint reduction in a nursing home and its impact on employee attitudes.

OBJECTIVE: To reduce physical restraint use in a nursing home and increase employee support for the restraint-reduction program. DESIGN: A one-group pretest-posttest design with repeated measures was used to determine changes in restraint use with participants over a 14-month interval. All individuals employed at the nursing home were surveyed at two time periods to determine their opinions on restraint use. SETTING: A 265-bed private, non-profit nursing home in Dallas, Texas. PARTICIPANTS: A restrained cohort of 170 residents with a mean age of 84 years; 84% were female. A total of 182 employees participated in the first survey and 209 in the second. INTERVENTION: Formation of a project team that planned and supervised restraint removal. Inservice training on restraint use was conducted for all employees. MEASUREMENTS: Type and frequency of restraint use among the restrained cohort at four evaluation points within a 14-month interval. The frequency of restraint use in the nursing home population was also recorded. Survey measures included employee responses to a 16-item closed-end questionnaire before and after training. RESULTS: The mean number of restraints used with each resident in the restrained cohort decreased from 1.56 to 0.67. The number of residents on restraints in the nursing home was reduced during the course of the study (67.5% vs. 36.7%, P < 0.0001). Changes in employee opinions about restraint use were found after training. On the second survey, more than twice as many employees indicated that restraints should be removed from almost all residents who have them (15.2% vs 36.3%, P < 0.0001). CONCLUSION: A restraint-reduction program in a nursing home can produce positive results in terms of decreased restraint use and supportive employee attitudes. More practical alternatives to restraints need to be developed for application in the training of nursing home employees. Future studies on resident, employee, and family attitudes about restraint use are suggested.

Adult↗
PubMed1991

A comparison of self-reported health education competencies among selected school health educators in the United States and Taiwan, R.O.C.

Results from a preliminary, cross-national study examining perceived competence of school health educators in Taiwan, R.O.C., and in Florida are reported. The study used the Self-Assessment for the Health Educator instrument, developed by the National Task Force on the Preparation and Practice of Health Educators, Inc., which specifies 79 skills in seven competency areas. School health educators from Taiwan and Florida rated their own perceived competence regarding each skill, and assessed the perceived usefulness of each skill in health education practice. Responses from the two groups were similar on six of seven competency areas regarding usefulness of the items. Yet, teachers from Taiwan expressed greater perceived competence than the Florida teachers in five of seven areas. However, within both groups, teachers rated perceived usefulness higher than their own perceived level of competence. Inservice training, amount of formal training, and years of professional experience affected levels of perceived confidence in both groups. Initial results suggest the self-assessment instrument may prove useful as a tool for examining professional competence in other countries, but more extensive research is needed to determine the instrument's applicability in cross-national comparisons.

Adult↗
PubMedDate not supplied

Effect of self-care ADLs on self-esteem of intact nursing home residents.

This 26-week repeated measures designed study was conducted on two units of a nursing home in a southern U.S. state. Two nursing approaches were compared on their effectiveness to foster self-care activities of daily living (ADLs) and improve self-esteem in dependent residents who, upon admission, were cognitively and physically intact and able to perform ADLs independently (intact residents). Twenty subjects, 10 on each unit, participated in the study. Each unit was randomly assigned to a nursing condition: a combination of the educative-supportive system of care and behavior modification (Condition 1) and routine nursing care (Condition 2). Inservice training was provided to staff in Condition 1 but not in Condition 2. Following a 2-week baseline period, nursing staff encouraged subjects to do their targeted ADLs independently. When the groups were compared on self-care ADLs and self-esteem at the end of the study, subjects in Condition 1 did significantly more self-care and had significantly higher self-esteem than those in Condition 2.

Activities of Daily Living↗
PubMed1986

Teaching dietetic students in the clinical setting.

On the basis of requests from dietitians who function as student preceptors, faculty members for a coordinated undergraduate program developed guidelines for their inservice training. It was anticipated that the dietitian as a clinical instructor would need to be able to establish, clarify, and guide the student in achieving goals; aid the student's learning process by helping him/her recall information and knowledge from previous course work; direct the student's attention to focus on priorities; identify factors that will contribute to effective communication skills; provide opportunities for the student to apply knowledge and practice dietetics; identify motivational possibilities; use evaluation feedback to help students improve their clinical practice; and assist the student in facilitating the transfer of knowledge and skills to new problems and situations.

Communication↗
PubMed1982

Evaluation of two nutrition education modules for hospital staff members.

Two nutrition education modules for inservice training of hospital food service personnel were evaluated in 16 hospitals. The modules, dealing with cardiovascular disease and diet, contained a leader's guide, a teaching package, audiovisual material, and suggested learning activities. Pretests and post-tests were used to assess knowledge gains resulting from learning sessions. Participants were divided so that one group took the post-tests before the sessions and one group after the sessions. When differences between groups were controlled, the sessions were shown to have a significant positive effect on post-test scores. Three-fourths of the participants rated the sessions as "very good" to "excellent."

Allied Health Personnel↗
PubMed1981

Coordinating and planning for human sexuality education.

The coordinator provides parent education, teacher and staff inservice training, team-teaching experiences, student counseling and a broad range of support activities related to the wider community as well as to the schools involved. The need for a coordinator for programs may depend on size and/or diversity of the school population, professional readiness of teachers and types of programs to be implemented. Despite the advances made in the Pomona program, there continue to be such problems as occasional resistance from special interest groups, administrators and school staff, individual instructors' personal value conflicts, transitional nature of student population and turnover in teacher personnel. A coordinator for sexuality programs is certainly not a total remedy for such problems in all school districts; but as an essential element in the solution of those problems, he/she provides an approach which will help school districts in initiating and implementing programs with a greater degree of success.

Adolescent↗
PubMed1992

Experience as a surgeon determines resident knowledge.

BACKGROUND: This is a prospective study that compares operative experience with performance on the American Board of Surgery Inservice Training Examination (ABSITE) to establish the primacy of procedural experience in the graduate training environment. METHODS: Operative experience was determined from a computerized log of surgical procedures. The Report D of the 1991 ABSITE was used to assign each test item to specific operative procedures and to determine the frequency of the correct response (Fcr) for each item. The fraction of operative procedures (Fs) was determined for each category of surgical procedures (Fs = Number of procedures as surgeon/Total number of procedures). The Fcr was compared to the Fs by use of the Pearson correlation coefficient with significance at 95% confidence. RESULTS: Forty-two residents reported doing 8357 surgical procedures as surgeon in 12 months. Report D contained 209 test items. Of these, 162 items could be assigned to 26 categories of surgical procedures. The Fcr correlated directly with the Fs (p = 0.002, r = 0.605). CONCLUSIONS: A significant correlation exists between the experience of surgical residents as surgeon and their performance on the ABSITE:

Clinical Competence↗
PubMed1976

The efficacy of programmed instruction in the training of paraprofessionals.

The authors assessed the efficacy of a self-instructional psychiatric learning program to provide training for paraprofessional psychiatric personnel. The self-regulated learning system, which originally was developed to train medical students, was designed to impart basic psychiatric knowledge and diagnostic skills. Changes along personality dimensions that occurred as a function of participating in the programmed learning project also were examined. Participation in this program was associated with substantial pre-post changes in dogmatism and locus of control for males as well as significant increments in psychiatric knowledge and diagnostic skills for the group as a whole. The benefits derived from this easily administered training procedure suggest its feasible inclusion in paraprofessional inservice training programs.

Attitude of Health Personnel↗
PubMed1998

Linking public health education and practice: the Australian experience.

The public health workforce in Australia is highly skilled, multifunctional, and drawn from a variety of backgrounds, including clinical practice and non-health areas. A wide range of activities is needed to meet the educational and training requirements of this workforce, including on the job inservice training, context specific continuing education programs and short courses, distance and self-directed learning packages, and postgraduate University level courses. The core components of public health today include: a social and political commitment to health, a shared responsibility between government and the public, and a multidisciplinary field of action. The challenge for those providing education and training for the public health workforce is to ensure graduates have the broad range of knowledge and skills needed in this climate. A system-wide approach to learning, where knowledge and skill development is related to the practices and settings of service and program delivery, will ensure strong links between education and practice.

Australia↗