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PubMed1994

The function of home visits in maternal and child welfare as evaluated by service providers and users.

This study looks at how public health nurses and clients of maternal and child welfare clinics evaluate the function and meaning of home visits. Another concern is with the options available to the service user. The data were collected during November and December 1992 from a total of 203 health centres across Finland; responses were obtained from 263 public health nurses and 323 clients. The results are presented in the form of frequencies, percentages and cross tabulations. According to the results, the clients felt that the most important function of home visits was to have a competent professional examination of the newborn. They also attached much importance to the information function, i.e. learning about the growth and care of small children. The public health nurses, on the other hand, felt that the most important function of home visits was to support and encourage parents and to ensure the continuity of care. The advantages of meeting in the client's home environment were equally stressed by both sides. By contrast, clients and public health nurses had very different views on the options available to the client. Almost all nurses said that the client can freely choose between home visits and visiting the clinic; however, only about half the clients felt they could choose the service they best preferred.

Adolescent↗
PubMedDate not supplied

Knowledge and attitudes of AIDS health care providers before and after education programs.

Analysis of the responses of 1,247 health care providers to questionnaires immediately before and after educational programs on acquired immunodeficiency syndrome (AIDS) revealed significant (P less than .05) improvements in accuracy of knowledge about 7 of 15 modes of transmission and 7 of 11 means of infection control. Sizeable percentages, however, continued to believe after the programs that AIDS could be transmitted by casual contact, such as sharing coffee cups. Provider attitudes about caring for persons with AIDS shifted in the direction desired (P less than .001) on six of nine questions. After programs, 92 percent believed that they had sufficient knowledge to protect themselves from getting AIDS, and 79 percent felt professionally competent to care for a person with AIDS. Both before and after programs, providers who established regulations for the care of persons with AIDS and outpatient care providers had the most accurate knowledge and felt most comfortable with persons with AIDS, while inpatient care providers had the least accurate knowledge and felt least comfortable. A 1-month followup of 159 providers revealed that postprogram changes in knowledge and attitudes were largely retained. Results point to the need for education at all levels of the health care system, to a persistent gap in knowledge and attitudes between those persons who establish regulations and those who carry them out, and to the possibility of creating significant changes through education.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Factors influencing the patient-provider relationship.

This article analyzes some of the central elements of the patient-provider relationship i.e. continuity of care, communication, compliance, and the various elements of the consultation itself. This analysis is based on the review of relevant literature. The same principles apply to this relationship regardless of the provider category. When aiming at good care the recognition of the real need of care and the sharing of information with the patient in a proper and effective way are important. These skills belong to the professional competence of the provider. Continuity of care is the element facilitating the forming of a good patient-provider relationship. The importance of the patient-provider consultation is very great. The immediate, intermediate and long term outcomes of the consultation have been studied by several researchers. The immediate outcomes such as the patient satisfaction strongly influence the intermediate outcomes and also the long term outcomes all-though the intermediate (i.e. compliance) and long term (i.e. change in health status) is also strongly influenced by the patient's sociocultural environment. On the other hand, the patient's health understanding can be much enhanced through skillful communication by the provider during the consultation in a good patient-provider relationship. This, again, connects the elements of consultation very tightly with the success or failure of the care process and the patient's future use of health services.

Communication↗
PubMedDate not supplied

In pursuit of commitment. Hiring executives who share the ministry's values.

A major concern for religious-sponsored healthcare facilities is securing top administrative personnel who are both professionally competent and committed to the religious institute's mission. One process to identify such individuals involves defining the organization's priorities; establishing a search committee; assessing value-oriented credentials; and selecting the value-driven executive. Identifying persons who share the organization's values is a two-part process involving the résumé and the formal interview. The Résumé Evaluation Form attempts to identify a candidate's value orientation in three areas: knowledge of, experience with, and implementation of Catholic culture. The Interview Analysis Form explores other areas, such as whether the candidate speaks the organization's "language," the individual's underlying motivation for seeking employment in a Catholic organization, and what issues, projects, or concerns engender passion in the candidate. After the interview, the committee should discuss and interpret the scores and perceptions of each committee member and assign a numerical ranking for each candidate. In addition to the numerical ranking, the committee should assess the candidate's personal characteristics, values, and priorities.

Catholicism↗
PubMed1975

Interviewing and counseling skills. Techniques for their evaluation.

Assessment of knowledge and cognitive skills has been traditionally included in examinations for certification and licensure of health professionals. Evaluation techniques for assessing complex cognitive and interpersonal skills, however, have not been as widely developed or incorporated in national examination programs. Specifically, the evaluation of interviewing and counseling skills has been complicated by difficulties in: (a) defining what consititutes skillful interviewing and counseling and in specifying criteria against which performance can be assessed; (b) developing evaluation procedures to permit accurate and reliable observations of these activities; (c) solving logistic problems of standardizing the content and format of these evaluation procedures; and (d) establishing standards for identifying individuals who have not yet achieved acceptable levels of proficiency. Progress has been made in defining the criteria for evaluating the interviewing and counseling skills of several categories of health professionals. Definitions can be developed to identify specific behaviors associated with acceptable and unacceptable skills in this area of professional competence. On the basis of these definitions, interaction analysis techniques have been developed for accurate and reliable recording of behavior as it occurs in an interviewing and counseling session. Moreover, the use of actors programmed to portray the roles of patients has enabled the standardization of this evaluation procedure so that examinees can be assessed on the basis of equivalent testing conditions. A number of research studies are under way to determine whether paper-and-pencil, as well as audiovisual, simulations can be substituted for evaluation in a live, interactive setting. However, little has yet been done to identify appropriate procedures for establishing standards of proficiency. Perhaps such efforts will be more feasible when appropriate evaluation techniques are more fully developed. Of relevance in determining whether the evaluation of counseling and interviewing skills is pertinent to dietetics are questions such as: How frequently do dietitians interact with patients? In what settings and for what purposes do these interactions take place? What impact do dietitian-patient interactions have on the quality of the health care provided?

Counseling↗
PubMed2002

Working conditions and the possibility of providing good care.

UNLABELLED: Background An open and tolerant climate characterized by joy in work where the personnel can mature as people and develop their professional competence was postulated as essential to working conditions under which good care can be provided in line with a care policy accepted for healthcare in a northern Swedish county. AIM: This study aimed to examine working conditions before and 3 years after the implementation of the care policy. METHOD: All personnel working on four hospital wards in the county described their experiences in questionnaires in a baseline measure in 1995 (n = 119) and a follow-up measure in 1998 (n = 106). FINDINGS: Lower ratings for working conditions were found in many respects in the follow-up measure. Fewer respondents from three wards expressed satisfaction with their current work situation. More respondents in one of these wards expressed, in addition, an inability to keep up with their work and fewer also evaluated their immediate superiors as good leaders. More of the respondents from one ward expressed the intention of looking for alternative employment and wanted to have another job. More respondents in two wards reached scores indicating burnout risk or burnout, and lower means were seen in two to 10 work climate dimensions per ward, out of 10 possible, in the follow-up measure compared with the baseline. CONCLUSION: The working conditions seen as requisite for the possibility of providing good care seem to have deteriorated in a number of respects on the wards studied over a three-year period and improvements are needed if the care offered is to be in line with the stated care policy. A concurrent study investigating patient satisfaction of the care quality in the same county showed a deterioration in their assessments between measurements carried through with a three-year interval, implying a relationship between the working conditions of the personnel and the patients' experiences of care.

Adolescent↗
PubMed1986

The need for evaluation of the ultimate impact of continuing pharmaceutical education.

Many governmental agencies and professional associations are using continuing education as the single, and relatively untested, means of ensuring that professionals maintain an acceptable level of knowledge and skills. The ultimate goal of continuing education in the health professions is improved professional performance leading to an improvement in the quality of health care provided. However, there is justifiable concern over the lack of a significant link between participation in continuing education activities and professional competence. This issue is explored and a conceptual framework for the evaluation of continuing pharmaceutical education is presented. The conceptual framework is an evaluation hierarchy which depicts the following four levels of a comprehensive evaluation process: participant satisfaction; changes in knowledge, attitudes, and skills; behavior change in practice setting; and improvement in patient care.

Education, Pharmacy, Continuing↗
PubMedDate not supplied

Conducting biological research to advance rehabilitation nursing practice.

Rehabilitation nursing practice is concerned with many clinical manifestations that have an underlying biological impairment. Advances in managing these manifestations will depend in part on research that incorporates the biological dimension. The purpose of this article is to encourage more rehabilitation nurses to engage in biological research. To achieve this aim, several different categories of biological nursing research are described using rehabilitation nursing examples, biological measures and approaches are discussed, and possible general clinical outcomes, with examples from previously published biological nursing research, are described. Biological nursing research may enhance professional competence, improve patient care, and improve patient safety.

Biological Science Disciplines↗
PubMed2001

Identifying the faces in the mirror: untangling transference and countertransference in self psychology.

Experienced psychotherapists realize that there are many levels of meaning behind much that is said during the therapeutic hour. The challenge for the competent professional is to become wise enough to learn what to ignore and sensitive enough to know what to emphasize. Sorting this out is at the heart of the practice of good psychotherapy. In this article, we will briefly share our thoughts on this rich but complicated interpersonal interaction using Kohutian self psychology theory to understand the role of countertransference in the process of conducting psychotherapy.

Countertransference↗
PubMed1994

The possibility of ethical expertise.

Can we legitimately speak of ethics experts? Recent literature in philosophy and medical ethics addresses this important question but does not offer a satisfactory answer. Part of the problem is the absence of an examination of what it means to be an 'expert' in general. I therefore begin by reviewing my analysis of expertise which appeared earlier in this journal. We speak of two kinds of experts: persons whose expertise is in virtue of what they know ('epistemic' expertise), or what they do ('performative' expertise). Applying this analysis to the domain of ethics, I argue that we may speak of ethical expertise in three epistemic senses: a) expertise in descriptive ethics, b) expertise in metaethics, c) expertise in normative ethics, and in a performative sense: d) expertise in living a good life. I conclude with a brief description of some social roles of ethics experts.

Adult↗
PubMed1986

Health care provider and family acceptance of a rural community-based nursing service for chronically ill children.

Health care providers' and families' overall acceptance of a community-based nursing program was assessed in relationship to their perceptions of the program nurses' accessibility, professional competence, and personal qualities. Perceptions were measured by questionnaires completed by 139 health care providers and 140 families. Overall, providers indicated that the program has been of benefit to both the children it serves and the medical community. The majority of families felt that the nurses were helpful to them despite a few complaints related to poor availability.

Adult↗