The blessing of giving: the importance of reciprocity to self-health care.

This qualitative study of reciprocity and self-health care demonstrated the importance of reciprocity in the lives of 20 elderly participants. Self-health care included actions centering around nutrition, exercise, health care monitoring, and psychospiritual activities. The importance of giving to others and the difficulty in accepting help should their functional capacity diminish create concern among our participants. Nursing interventions based on understanding reciprocity and helping caregivers create opportunities for the older person to reciprocate, despite limited physical resources, are discussed.

The relationship of reciprocity to self health care in older women.

According to Social Exchange Theory, reciprocity in relationships is essential to functioning within the social context and is an important component in well-being as people age. Because of a potential relationship to meaning in life and hence to self health behaviors this study addressed: (1) Does reciprocity relate to self health care and (2) does reciprocity contribute to the explanation of self health care within a model including functional status, satisfaction with social support, and sense of meaning in life? Data were collected from 69 community dwelling women aged 65 to 99. Analysis indicated general health perception, support provided to others and sense of meaning in life were significant predictors of self health care.

Rural-urban women's experience of symptoms of depression related to economic hardship.

This study compares rural and urban women's experiences of depressive symptoms. Cross-sectional data were used from 623 women 55 years of age and older who were part of a randomly selected community based sample. Theoretical perspectives included individual stress and community context as explanatory factors contributing to differences in the proportion of women who identify having had the experience of symptoms of depression. Results of the analysis using correlation and multiple regression supported the importance of perceptions of financial status. Community type and age were not related to the level of depressive symptoms reported by the women who were interviewed.

Developing patient and family education programs for a transplant center.

Patient and family education is an important component of the organ transplant programs at the University of Nebraska Medical Center. The Medical Center is in the process of planning a new transplant center which will employ the family-centered, educationally-intensive cooperative care concept. This approach was chosen as the model for the delivery of care at the Lied Transplant Center because it emphasizes efficient, effective clinical care by requiring active participation by the family or essential other, thereby better preparing both the patient and the family for the transition to home and to the community. This article presents the evolution of patient education in our transplant programs, discusses the educational needs of transplant patients across the continuum of care, provides insight into the process of planning educational programs for the new center and provides a sample module for teaching which is based on the Cooperative Care concept.

The patient's approach to wellness.

The patient's own approach to wellness is receiving increasing attention as the potential for self-responsibility in assuming wellness behaviors is recognized as one, if not the most, significant factor determining health status. Shifts in patterns of illness and potential for illness intervention are acknowledged as central in moving the focus from illness to wellness. Recognition of the deleterious impact of lifestyle and existing behaviors has raised awareness of the need to promote change in wellness behaviors and mechanisms. The scope and quality of information becoming available related to health promotion is bewildering and often contradictory. Information becomes available daily on nutrition, exercise, stress and relaxation, relatedness and support systems, and consciousness and spirituality . Desires and motivations are complex, combining a wish to perpetuate an affluent lifestyle with recognition that depletion of resources and environmental contaminations are risks to the well-being of individuals and society. Nurses, as well as other health care providers, are concerned with health promotion. We need to view our arena realistically and with full cognizance of balancing reasonable caution in scrutinizing new information with openness to ideas that will expand both the potential for wellness and our potential to contribute to health promotion. We practice in a quagmire of uncertainty, unsubstantiated truths, and demands for assurances and answers. We are asked to provide quality care and to perform responsibly in a cost-effective manner. We are pressured for pragmatics . We need to recognize our urge to capitulate to demands. Since historically we are a caring, responsive practice, we can be trapped into "false assurance." While recognizing appropriate limitations in providing assurances, it is possible to offer assistance in ferreting out information and understanding the degree of confidence with which it can be viewed and to support increasing autonomy. Educational programs can be used in conjunction with relationship skills in enhancing health care, the recipient's adoption of wellness behaviors that promote health.