Models for patient education in periodontal treatment.
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AIM OF THE STUDY: This phenomenological study is aimed at illuminating nurses' lived experience of the process of preceptoring and the meaning of preceptorship in a Swedish context. METHODS: Seventeen nurses from the North of Sweden with varied previous experience of preceptorship volunteered to participate. Their narratives, describing their experience of being a personal preceptor for a student nurse during practical training on a hospital ward in the third year of a 3-year diploma programme within a university college of nursing in Sweden, were transcribed verbatim. A phenomenological-hermeneutic interpretation disclosed the themes 'sheltering the students when learning' and 'facilitating the students' learning', together with eight sub-themes, which created an understanding of the meaning of preceptorship. FINDINGS AND DISCUSSION: The meaning of preceptorship was understood as reducing the risk of the students learning helplessness and empowering the students when learning in practice. The meaning of preceptorship highlighted the need for further preceptor support and development of the role of the preceptor. On the basis of the findings, suggestions were made to increase the preceptors' awareness of values in nursing practice and use of pedagogical strategies in the process of preceptoring. Through such strategies a reciprocal development of the preceptors' and the faculty's knowledge may take place, to the best advantage of the students' learning and the development of the profession.
AIM: To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. BACKGROUND AND RATIONAL: Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. CONCLUSIONS: Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.
This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board on the North Shore of Auckland, New Zealand. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
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This article describes a faculty development model to stimulate rapid growth in research and scholarship in a school of nursing during an institution-wide initiative to strengthen the research stature of the university. The program was designed to establish targeted mentoring relationships with productive researchers from institutions outside the home institution to assist faculty with research program development. The external mentor program is described along with the methods of implementation and outcomes after 2.5 years. The success of this program has led to adoption of the model by other schools in the university.
This paper discusses role development to bring research closer to the clinical setting and describes a strategy for advancing research in clinical practice.
Emergency medicine is developing rapidly in southern Brazil, where elements of both the Franco-German and the Anglo-American models of emergency care are in place, creating a uniquely Brazilian approach to emergency care. Although emergency medical services (EMS) in Brazil have been directly influenced by the French mobile EMS (SAMU) system, with physicians dispatched by ambulances to the scenes of medical emergencies, the first American-style emergency medicine residency training program in Brazil was recently established at the Hospital de Pronto Socorro (HPS) in Porto Alegre. Emergency trauma care appears to be particularly developed in southern Brazil, where advanced trauma life support is widely taught and SAMU delivers sophisticated trauma care en route to trauma centers designated by the state.
PURPOSE: A model for delivering Assistive Technology (AT) education is described in the context of an online masters degree in rehabilitation counselling, demonstrating the integration of content and process in an interactive format. METHOD: Data collected from course activities and assignments were examined to identify ways in which 120 students from 18 US states responded to and interacted with the information and how they applied the course content to their jobs as rehabilitation professionals. A qualitative research design was used to identify themes to add to the understanding of issues associated with learning about AT in an online format. RESULTS: Critical components of the course identified from the data analysis included: increased awareness, skills, confidence, and immediate application to own job responsibilities; interaction with instructors and peers; access to resources and expertise; value-based practices; and participation on interdisciplinary teams. These themes were consistent across all six groups of students enrolled in the participating three rehabilitation regions. CONCLUSIONS: Online education can be an effective medium for teaching practicing rehabilitation professionals how to provide person-centred AT services to people with disabilities. The content must drive the technology; the process must be student-driven; and the interaction must address individual learning styles and promote lifelong learning.
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Older adults are expected and frequently found to report less control than younger adults. In this study, we decompose this negative relationship between age and sense of control using nested multivariable linear regression models that serially introduce sociodemographic characteristics, socioeconomic factors, health status, and subjective religiosity and religious beliefs in a sample of 1,051 older adults attending the general medicine clinics of a major medical center. The results indicate that the effect of age is suppressed in the bivariable model. In the final multivariable model, educational attainment has the largest relative effect (i.e., beta; .253), followed by age (-.210), mental health (.174), subjective religiosity (.113), being an African American (-.100), perceived health (.082), and being Catholic (.068). Future research should focus on the inflection point in the relationship between age and the sense of control that apparently occurs at about 50 years of age.
PURPOSE: More than 14 million persons are projected to be diagnosed with Alzheimer's disease (AD) by the year 2020; therefore, it is not surprising that the literature contains numerous caregiver intervention studies. What is surprising is that although minority elders represent one of the fastest growing segments of the older population, they are seldom discussed in the intervention literature. DESIGN AND METHODS: A purposive sample of Hispanic caregivers participated in a 5-day, 20-hr psychoeducational program to increase the caregivers' understanding and acceptance of AD, repertoire of coping skills, knowledge of resources, and expression of concerns and emotions of caregiving. Pre- and posttests were administered to determine if participation in the program improved caregivers' knowledge of the progression and management of AD, as well as knowledge of appropriate community-based services. RESULTS: Caregivers demonstrated a significant improvement on the Caregiver Knowledge Survey, an increased awareness of community-based services, increased willingness to attend support groups, and overall satisfaction with the program. IMPLICATIONS: Culturally sensitive intervention research with minority AD caregivers provides the opportunity to increase understanding and improve coping skills.
Parents who have serious and persistent mental illness are often overlooked in social work and mental health journals. Furthermore, mentally ill parents typically are viewed from a pathology perspective that fails to address their desire to be competent parents. This article reviews the literature on mentally ill parents and addresses conceptual issues in assessment and services. The author critiques methods of assessment and recommends more appropriate and comprehensive assessment protocols. Model programs are discussed with a focus on the development of competent parenting skills combined with social supports for parents who have a serious and persistent mental illness.
Intimate partner violence (IPV) is a significantly prevalent health issue that creates devastating effects for victims, their families, and the community IPV extends across social, religious, economical, geographical, and cultural groups. IPV has public health implications that affect current victims and may impact future generations. While all people are at risk for IPV, women are 5 times more likely to be victimized. Despite all of the literature regarding IPV, there is still a compliance issue regarding screening for IPV in health care settings. Utilizing the Synergy Model of Nursing Practice, this article demonstrates the care of victims of IPV by the clinical nurse specialist. The Synergy Model framework is described, and correlated with IPV The clinical nurse specialist plays a unique role that can improve patient outcomes through many domains including expert clinical practice, role modeling, education, global systems thinking, research, consultation, and holistic approaches to care. Current state of the science practice techniques and barriers to screening are discussed. The summary highlights suggestions for future research.
Rapidly changing times in health care challenge both physicians and health care administrators to manage the paradox of providing orderly, high quality, and efficient care while bringing forth innovations to address present unmet problems and surprises that emerge. Health care has grown throughout the past several centuries through differentiation and integration, becoming a highly complex biological system with the hospital as the central attractive force--or "strange attractor"--during this century. The theoretical model of complex adaptive systems promises more effective strategic direction in addressing these chaotic times where the new strange attractor moves beyond the hospital.
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OBJECTIVES: To introduce a new tool for phonosurgical training and education. A multitude of innovations in complex laryngeal surgery has catalyzed new educational initiatives. Establishing dexterity in phonomicrosurgery is often difficult to achieve while working on patients because of the narrow margin for success. Furthermore, laryngoplastic phonosurgery and open partial laryngectomy require sophisticated knowledge of precise anatomic relationships, which can be difficult to express in images. Finally, many teaching programs do not have a high volume of these procedures, and there is a significant need to transmit this information in continuing education courses. STUDY DESIGN: Prototype design. METHODS: A laryngeal dissection station (LDS) was designed to facilitate the acquisition of high-level procedural skill sets for both transoral and transcervical techniques. RESULTS: This LDS can be used in existing temporal-bone laboratories by using cadaveric larynges. A rectangular frame supports two adjustable holders, one for the larynx and one for the examining speculum of a laryngoscope. Procedures are performed with the larynx fixed in space by a novel fixator. Variation in position and orientation of the components affords simulation of both microlaryngoscopy and open surgery. The dissection station can accommodate virtually any laryngoscope, regardless of size or shape. CONCLUSIONS: This training apparatus should facilitate laryngeal surgical instruction in residency training and continuing medical education. This device and others like it can help establish clinical competency in laryngology, should this become necessary in future educational models of residency training and recertification.
With anticipated changes in healthcare delivery systems, nursing faculty members need to redefine the faculty role and scholarship as a product of that role. The authors describe the development of appointment, promotion, and tenure criteria that value scholarly outcomes generated from both practice and research within the educational model.