Role of the Lebanese family caregivers in cardiac self-care: a collective approach.

AIMS AND OBJECTIVES: The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. BACKGROUND: The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. DESIGN: The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. METHOD: Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. RESULTS: One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). CONCLUSION: In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. RELEVANCE TO CLINICAL PRACTICE: Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive patient/family intervention.

Assessing vital signs: applying two participatory evaluation frameworks to the evaluation of a college of nursing.

Evaluation research has been in progress to clarify the concept of participatory evaluation and to assess its impact. Recently, two theoretical frameworks have been offered--Daigneault and Jacob's participatory evaluation measurement index and Champagne and Smits' model of practical participatory evaluation. In this case report, we apply these frameworks to test alignment with practitioner experience and to examine the degree to which they contribute to the understanding of the case. The context of the case report is an on-going program evaluation at a college of nursing believed to be an example of a successful participatory evaluation. Application of the participatory evaluation measurement index indicated the evaluation qualified as participatory at a minimal level historically and increased to a moderate level of participation after a re-design to involve an external evaluator. Ratings aligned with the intentional goals of evaluators. The model of practical participatory evaluation was found to be a good fit and descriptive of the case, although the planning and design processes may need to be added to the model. The exercise of applying the index and the P-PE model enlightened both evaluators and stakeholders concerning factors that contributed to the successful partnership and outcomes of the evaluation.

Second-career CNAs in nursing homes: tapping an underused resource.

The purpose of this study was to describe the characteristics, work perceptions, and factors influencing employment of second-career certified nursing assistants (CNAs) in nursing homes. The qualitative descriptive design included a purposeful sample of 17 participants from 5 nursing homes. Data generation consisted of demographic surveys and audiotaped interviews that were transcribed, coded, and analyzed for emerging themes. Four themes were identified: negative first impressions of the work did not deter second-career CNAs, second-career CNAs lived out personal ideals and values through their work, positive relationships and job benefits retained second-career CNAs, and second-career CNAs expressed hopes for transforming nursing homes. Results revealed a group of committed, mature workers to fill labor shortages in an essential health care setting.

Home care nursing in Japan: a challenge for providing good care at home.

Home care in Japan has developed over the past 30 years. Nurses have taken leadership in promoting home care and at the same time have expanded their roles. The roles of Japanese nurses in the field of home care are presented in the context of the historical perspective and view for the future. Home care nurses have performed care management for their community as well as for individual older clients living in their community. Currently, nurses work as high-tech and personal care providers and are developing a new role in health care enterprises. The number of nurses working as clinical nurse specialists will increase consistently with the rapid increase of master's programs. In the future, nurses should take a lead in developing health policy. The purpose of the article is to describe the current situation of home care clients and home care nursing in Japan. In addition, four issues of home care in Japan are described related to home care for older persons, high-tech home care, terminal care, and home care for psychiatric patients.