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At least 649 records · Page 36Linked to original sources
PubMed1999

Nutrition guidance by primary care physicians: models and circumstances.

The perception of primary care physicians of the ability to influence the lifestyle and eating habits of patients is an important factor in nutrition guidance practices. This perception is based on assumptions about the kind of influencing process that is effective or not and on the capacity of primary care physicians to play an effective role in these processes. The first elements is dealt with in this article. Three models are distinguished. The first model is the prescription model, based on a medical optimum and on information transfer as a metaphor. The second model is the persuasion model, based on a medical optimum, but presupposing blockades that have to be cornered by persuasive communication. The third is the interaction model. It is not based upon a medical but on an efficacy optimum, and on sharing of information and continuous involvement of the client in the interaction. Behind these three models we can perceive different views on communication and knowledge. Moreover, these three models are more or less appropriate with regard to different circumstances. The current stress on the psychological, social and cultural meaning of food and the new information context in which clients live, asks for more attention to the interaction model.

Family Practice↗
PubMed2005

Managing knowledge to support the patient journey in NHS Scotland: strategic vision and practical reality.

BACKGROUND: The strategy for NHS Scotland Knowledge Services is set in the context of a global transition to a networked model of management within health services. OBJECTIVES: Development planning for NHS Scotland aims to establish strategic vision and operational delivery systems which meet the needs of this changing health environment. METHODS: Analysis of knowledge needs at strategic organizational level and through consultation with healthcare staff form the basis of a vision of seamless knowledge support throughout all stages of the patient journey, based on a hybrid model of complementary human- and technology-based knowledge networks. RESULTS: The central role of the NHS Scotland e-library as a system-wide technology infrastructure facilitating management of both explicit and tacit knowledge is described. The implementation pathway and approaches to evaluation are outlined, based on practical steps to translate the concept of knowledge networks into a working reality. CONCLUSIONS: The model emerging is that of a knowledge matrix, with the primary delivery system comprising inter-dependent human, organizational and technology-based networks focused on the overriding common purpose of improving patient care.

Computer Communication Networks↗
PubMed1992

[Basis for changes in medical education].

Medicine and medical education are going through a critical period due to a series of factors. Amongst them the explosion of knowledge and the progress in technology, and on the other hand the inefficiency of traditional medicine to cope with frequent and important health problems. We propose a medical education model based on a wider traditional model that incorporates social and psychological aspects of medicine emphasizing on prevention of disease and promotion of health. This model offers new methodological alternatives centered in the identification of problems, the acquisition of information and decision making, rather than in the storage of information.

Education, Medical↗
PubMed2005

The corporate university: a model for sustaining an expert workforce in the human services.

The human service industry has become a complex industry in which agencies must respond to the demands of the marketplace. To respond to these demands, agencies must develop and maintain their knowledge capital by offering an extensive array of learning opportunities related to their business goals. The corporate university, a contemporary educational model designed to maintain an expert workforce, allows agencies to meet this need effectively.

Employment↗
PubMedDate not supplied

Rural advanced life support update course.

Maintaining advanced life support knowledge and skills is both necessary and difficult for family physicians who do part-time emergency medicine at small rural hospitals. An advanced life support update course provided locally in the community, utilizing expert emergency medicine speakers from the appropriate tertiary care referral center, can help address this challenge. This article describes the format, objectives, and educational principles of a successful Rural Advanced Life Support Update Course. This educational model is useful in regions with major referral centers surrounded by small community hospitals where emergency department medical care is provided mostly by family physicians.

Curriculum↗
PubMed2005

Preparing professionals for family conferences in palliative care: evaluation results of an interdisciplinary approach.

BACKGROUND: Patients, families, and health care professionals recognize the need for better communication in palliative and end-of-life care. Family conferences are a powerful clinical tool for communicating with patients and family members. Although family conferences are often used in medical care, few clinicians are prepared to conduct them effectively. An innovative palliative care educational model that included specific attention to family conferences was developed and evaluated. To intervene early in the process of professional socialization, the interactive and interdisciplinary training included medical and social work students. METHOD: A quasi-experimental longitudinal design was employed to evaluate the educational intervention. Survey measures were administered before, immediately after, and three months after training. Questions addressed experience, education, and attitudes about family conferences. A standardized scale was used to measure change in students' confidence in their ability to lead family conferences. RESULTS: For both professions, the intervention group demonstrated a significant increase in confidence in the ability to lead family conferences compared with the control group. Three-month follow-up data suggested that subjects in the intervention group maintained these gains. CONCLUSION: This pilot intervention showed that an interdisciplinary educational approach improves confidence in the ability to lead family conferences when students are exposed early in the process of professional socialization. Early intervention increases the propensity and skills needed to conduct family conferences and advances communication in palliative care. Future research on interdisciplinary education should evaluate effects on clinical practice behaviors, satisfaction with communication and collaboration, and patients' and families' perceptions of quality of care.

Adult↗
PubMed2003

Preventing musculoskeletal disorders in clinical dentistry: strategies to address the mechanisms leading to musculoskeletal disorders.

BACKGROUND: The authors reviewed studies to identify methods for dental operators to use to prevent the development of musculoskeletal disorders, or MSDs. TYPES OF STUDIES REVIEWED: The authors reviewed studies that related to the prevention of MSDs among dental operators. Some studies investigated the relationship between the biomechanics of seated working postures and physiological damage or pain. Other studies suggested that repeated unidirectional twisting of the trunk can lead to low back pain, while yet other studies examined the detrimental effects of working in one position for prolonged periods. Additional studies confirmed the roles that operators' flexibility and core strength can play in balanced musculoskeletal health and the need for operators to know how to properly adjust ergonomic equipment. RESULTS: This review indicates that strategies to prevent the multifactorial problem of dental operators' developing MSDs exist. These strategies address deficiencies in operator position, posture, flexibility, strength and ergonomics. Education and additional research are needed to promote an understanding of the complexity of the problem and to address the problem's multifactorial nature. CLINICAL IMPLICATIONS: A comprehensive approach to address the problem of MSDs in dentistry represents a paradigm shift in how operators work. New educational models that incorporate a multifactorial approach can be developed to help dental operators manage and prevent MSDs effectively.

Back Pain↗
PubMed1997

An investigation of the explanatory model of venous disease: a pilot study.

Communication between provider and client is essential. When there are differences in the understanding of illness, communication suffers and adherence to treatment decreases. A method of extracting the client's understanding of illness is Kleinman's Explanatory Model of illness (EM). This is a qualitative interview technique that is not conducive to the practice setting. This study explores the understanding of venous disease in clients using a semi-structured survey instrument. Thirty one male clients in an upper middle class practice are reported in this pilot study. The disparity in understanding of venous disease has implications for practice and research.

Adult↗
PubMedDate not supplied

Nursing model of psychoeducation for the seriously mentally ill patient.

The purposes of this paper are to describe a nursing model for psychoeducation that is being implemented in the psychiatric unit of a Veterans Administration (V.A.) Hospital and to report baseline descriptive data for 19 seriously mentally ill patients. The data were collected as part of a larger study of patient, family, and treatment variables associated with community adjustment of seriously ill psychiatric patients. A convenience sample of 19 consenting patients with DSM-III-R diagnoses of schizophrenia, schizoaffective disorder, or bipolar disorder were interviewed and assessed by a clinical nurse specialist. Nine consenting family members, identified by the patient as a key family member, were also interviewed. The baseline data reported here were generated in these interviews. These data were also used to develop psychoeducational plans to meet individual patient/family needs. The patients had had an average of 12 prior hospitalizations. Their mean age was 38 years; 74% were African-American and 89% were male. Patients reported a variety of understandings of the reason for their hospitalization and techniques for management of their symptoms. The most common ways of managing symptoms were categorized as physical activity, decreasing stimuli, and use of alcohol/drugs/smoking. Practical problems arising in association with the conduct of clinical research in a V.A. psychiatric setting by a research team are also discussed.

Adaptation, Psychological↗
PubMed2006

[The treatment of oppositional defiant disorder].

INTRODUCTION: Oppositional defiant disorder (ODD) affects between 2 and 16% of children. It is a problem that sometimes has a very important effect on the whole family structure. Dealing with the problem in an inappropriate way, or simply interpreting it wrongly, entails a high risk of developing a conduct disorder in adolescence. DEVELOPMENT: This paper reviews the concept of ODD and of conduct disorder, and highlights the theoretical foundations that underlie two types of behavioural intervention, namely, the behaviourist model and the cognitive model. Two programmes, each based on one of the two theoretical models, are described. The different pharmacological options that can facilitate the therapeutic process are also outlined. CONCLUSIONS: Emphasis is placed on a therapeutic approach to ODD through psychological interventions based on guidelines designed to orientate the family and the school. This intervention cannot be founded on a general educational model, but rather it has to rest on knowledge of the dysfunctional cognitive characteristics of each child. In severe cases, the intervention must be complemented with the use of medication.

Attention Deficit and Disruptive Behavior Disorder↗
PubMed1997

Defining quality student feedback in distance learning.

The quality of student feedback is of critical importance in distance learning. Students studying such courses may be geographically far removed from tutors, and limited contact opportunities necessitate a sharp and accurate focus upon aspects of study which link theory, research, clinical practice and written assessment closely together. An understanding of quality feedback begins with an appreciation of the role of distance learning course tutors and the education models which can usefully guide them. Quality also relies upon a close evaluation of support to students as courses are planned, launched and then monitored through course boards or their equivalent.

Education↗
PubMed2005

Educating nurses for the 21st century.

The current and projected demand for nurses and nursing services worldwide, coupled with dramatic changes in the delivery of health care, require nurses with more knowledge, more education, and more skills. Issues facing nursing require a reconceptualization of the approach and expectations for nursing practice and for the educational models and processes that lead to reformed nursing practice. New initiatives such as the Clinical Nurse Leader and the Doctor of Nursing Practice may lead the transformational process that is needed.

Curriculum↗
PubMedDate not supplied

[Learning of the process of nursing diagnosis by nursing students. An experiment at the San Miniato School].

In order to guarantee the quality of health care, it is necessary that the care focus on patients' needs. This requires that care givers possess diagnostic competency skills that allow them to quickly identify the patients' needs, using suitable methods and instruments. In Italy, the development of diagnostic competency skills is generally overlooked in nursing schools; this is due in part to the lack of applied and experimental educational models in teaching and training. During the 1992-1993 year, a didactic teaching intervention to assist students in the acquisition of diagnostic skills was tested. The sample included all students in the third year class of the San Miniato nursing school. The Zanotti's model "Nursing as a stimulus for health-harmony" was used as framework. The purpose of the research was to test: (a) validity and reliability of a new needs' analysis model; (b) the effectiveness of a didactic method for the acquisition of such a model by the students. Students enhanced their skills in data assessment and shifted from the medical perspective to the nursing perspective in using those data to evaluate the patient's status.

Education, Nursing↗
PubMed2004

[The nursing field in education].

"Campus Extens" is a new correspondence course/open university educational project which makes use of new technologies in communication such as the Internet or videoconferences for the diffusion of its course content. This program commenced in 1997 as a provisional experimental program at the University of the Balearic Islands; at present, after six years up and running, this program is an established program. Classes in nursing were introduced as part of this program, due to a request by the Nursing Department, in an experimental provisional format since the academic year 2001-02 hoping to integrate new educational technologies and bring these closer to students in the Balearic Isles who find it difficult to attend traditional classes which are taught on the Palma campus and at the same time to make future correspondence courses possible. Taking the pedagogical materials which correspond to the Nursing Fundamentals course as an example, the authors describe the characteristics of this system, the educational model implemented, the didactic strategies which are used in this virtual classroom environment, as well as the methodological arrangement and the didactic materials which have been developed for this program. Finally, the authors want to point out that the participation of Nursing in this program has enabled the Nursing Department to respond to the educational and professional demands of the University of the Balearic Islands, to reflect critically about teaching methodology, to bring the School of Nursing and Physiotherapy closer to our university community and to design new projects for future correspondence/open university courses.

Education, Distance↗
PubMed1995

An institutional commitment to pain management.

PURPOSE: To share the development, implementation, and evaluation of a program called "An Institutional Commitment to Pain Management," which is based on the philosophy of organizational influence on pain management. METHODS: A tested pain education model was disseminated to 32 physician/nurse teams in settings throughout California, after which the 64 professionals returned to their institutions to serve as role models and catalysts to change the practice of pain management. Each team member completed a 39-item survey about knowledge and attitudes related to pain, which was developed by B.R.F. and colleagues, and also identified three goals for the implementation of course information. Precourse data also included administration of the knowledge and attitudes survey to participating physicians' and nurses' colleagues (10 physicians and 20 nurses per institution). Each team completed five chart audits using the pain audit tool (PAT), which was developed by B.R.F. and colleagues at the City of Hope National Medical Center. The PAT identifies how pain is managed currently at the institutional level. Final course evaluation 8 months after course completion included a summary of activities implemented by the teams as well as the factors that served as barriers and benefits to improve the quality of pain management. RESULTS: Two hundred seventy-two physicians and 629 nurses completed the survey about knowledge and attitudes related to pain, and 154 PATs were submitted. These results, as well as evaluation at the completion of the course, are discussed. CONCLUSION: The Institutional Commitment to Pain Management program is an evolving model that was developed to overcome barriers to pain relief by obtaining the commitment from institutions to improve the management of pain for their patients.

Adult↗