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The new role of physical therapy in home care.

As the country's efforts to provide healthcare to the elderly shifts from facility-based to home-based care, physical therapy in the home has continued to grow as both an effective treatment modality and a focus of home health payers. This article explores the unique advantages, limitations, and challenges of physical therapy rehabilitation in the home setting.

Activities of Daily Living↗

Race and gender differences in the treatment of psychiatric disorders in young adolescents.

OBJECTIVE: Most children and adolescents with mental illness remain untreated. Evidence suggests that race is a factor in the referral of children for treatment. This study examines race and gender differences in treatment of adolescent psychiatric disorders. METHOD: During a two-stage, school-based, epidemiological study of depression, data were collected on 478 adolescents. Instruments included the Schedule for Affective Disorders and Schizophrenia for School-Age Children and the Children's Global Assessment Scale. RESULTS: Twenty-two percent of the sample had contact with professionals during the prior year, including 56% of adolescents with a psychiatric diagnosis. Significant odds ratios (ORs) were found between all diagnoses and treatment. Trends for undertreatment of females and African-Americans were evident in univariable and multivariable models. The OR (0.34) for African-American females was significant in the multivariable model. African-Americans were significantly more likely to receive only one or two treatment contacts. CONCLUSION: Data suggest race and gender differences in the treatment of adolescent psychiatric disorders. Possible explanations include referral bias, low cultural competence of mental health professionals, and cultural differences in the expression and tolerance of symptoms and help-seeking behaviors. Further study of factors influencing treatment decisions is needed.

Adolescent↗

Healing ourselves, healing others: second in a 3-part series.

Although not used in most nursing texts and journals, the term "nurse healer" is common in holistic nursing literature. Nurses who identify themselves as healers have tapped into a source of strength and confidence that adds creativity and vitality to their nursing work. In this qualitative study, the researcher asks 11 relatively "holistically naïve" medical-surgical nurses if they would label themselves as healers. Their responses reveal an inherent understanding of the multidimensionality of the healing process and the importance of relationships and therapeutic presence to the healing role.

Adult↗

Lessons learned from Hurricane Mitch: a guide for holistic practice.

Hurricanes are often devastating for the victims. Although millions of dollars and hours are invested, relief efforts could be more effective. The purpose of this article is to utilize the lessons learned from Hurricane Mitch as a guide for holistic practice in both hurricane preparation and response planning.

Altruism↗

Domains of concern of intimate partners of sudden cardiac arrest survivors after ICD implantation.

PURPOSE: There is limited research that describes the experiences of intimate partners of sudden cardiac arrest (SCA) survivors. The purposes of this article are to (1) describe the domains of concern of intimate partners of SCA survivors during the first year after internal cardioverter defibrillator (ICD) implantation and (2) outline strategies used by partners of SCA survivors in dealing with the concerns and demands of recovery in the first year after ICD implantation. METHODS: This is a secondary analysis of interview data collected for the primary study "Family Experiences Following Sudden Cardiac Arrest." A grounded theory method was used to identify experiences of SCA survivors and their family members from hospitalization through the first year after ICD implantation. Data were collected from the SCA survivor and one intimate partner at 5 times: hospital discharge, and at 1, 3, 6, and 12 months postdischarge. RESULTS: Eight Domains of Concern were identified for intimate partners following SCA and ICD implantation during the first year. These included (1) Care of the survivor, (2) My (partner) self-care, (3) Relationship, (4) ICD, (5) Money, (6) Uncertain future, (7) Health care providers, and (8) Family. Five categories of strategies to deal with the Domains of Concerns were identified (1) Care of the survivor, (2) My (partner) self-care, (3) Relationship, (4) Uncertain future, and (5) Controlling the environment. IMPLICATIONS: Nursing intervention programs should include the intimate partner of SCA survivors and contain education and support in the following areas: (1) information on the function of the ICD, (2) normal progression of physical and emotional recovery experiences, (3) safety and maintenance of the ICD, (4) activities of daily living after an ICD, (5) strategies to assist with the survivors care, and (6) strategies to assist with partner self care.

Activities of Daily Living↗