Caring and expressions of spirituality by urban caregivers of people with stroke in African American families.

Expressions of spirituality by urban caregivers in African American families are the focus of the study discussed in this article. Data presented here were collected as part of a larger study that examined these caregivers' experience and meaning of caring as they influenced their capacity to care for people with stroke within their family systems. This study was executed within and supported the framework of systemic organization by Friedemann, according to which families as open systems strive for well-being. Spirituality, a component of well-being, is based on values concerning commitment, love, and affection. Eight themes concerning spirituality for all caregivers emerged from the data. Through spirituality, the caregivers felt well-being and were connected and comforted in difficult times related to caring.

Caring and expressions of stability by urban family caregivers of persons with stroke within African American family systems.

Expressions of stability by urban family caregivers are the focus of this study. Data presented here were collected as part of a larger ethnographic descriptive study that examined caregivers' (N = 24) experience and the meaning of caring as it influences their ability to care for persons with stroke within their African American family systems. For family caregivers, unmet needs and problems with caregiving may occur as depleted resources are compounded by urban decay in many communities. This study was completed within the Framework of Systemic Organization described by Friedemann, in which families, as open systems, strive for well-being. Stability in the family, a component of well-being, addresses traditions and common behavior patterns rooted in basic values and cultural beliefs. Through data analysis, four themes concerning expressions of stability were identified for all caregivers. Caring expressions of stability are defined as (a) emotional burden; (b) evasion of conflicts; (c) motivation from love and a sense of duty between caregivers, the care recipients, and their families; and (d) a filial, ethereal value. Rehabilitation nurses can incorporate these expressions of stability into their assessment, intervention, and evaluation processes, and thereby increase the potential to strengthen successful caring and stability within the caregivers' family systems.

Adherence to cardiac therapy for men with coronary artery disease.

A study developed and executed within Orem's (1995) Self-Care Deficit Theory of Nursing uncovered factors that influence men's adherence to cardiac therapy. Data obtained from individual audiotaped interviews with five men 60 to 70 years of age in northwestern Ohio were analyzed using Colaizzi's (1978) method. Specific self-care factors, possessed by all the men and responsible for facilitating and inhibiting adherence to cardiac therapy, were found within the components for self-care agency and basic conditioning factors. Identification of these factors is critical, as the completion of the requirements of the prescribed cardiac therapy regimen can assist persons in achieving maximal cardiac efficiency while promoting independence, which ultimately affects their self-care agency. This study makes valuable contributions by (a) becoming aware of factors that influence men's adherence to cardiac therapy, (b) offering direction for interventions focused on self-care, and (c) serving as an impetus for further research.

Coherence in the urban family caregiver role with African American stroke survivors.

Expressions of coherence by urban caregivers in African American family systems are the focus of this ethnographic study. The profound changes that can accompany stroke may create considerable stress for families caring for the affected person. Coherence, a sense of mutuality, and differences in functioning among family members were discovered in this study to be important for maintaining stability within the family. Through coherence, family caregivers felt connected and this helped them survive in stressful times related to caring situations. The findings aid in defining coherence as an interpersonal process and place it in a family system context.

Cardiac therapy for men with coronary artery disease. The lived experience.

A phenomenological inquiry was conducted to uncover the lived experience of cardiac therapy for men with coronary artery disease in Northwest Ohio. Five men age 60 to 70 years were purposively selected to participate. Data obtained from individual audiotaped interviews were analyzed using Colaizzi's method. Eight major themes emerged: (a) feelings of fear and disbelief, (b) being aware of mortality, (c) losing control of self, (d) halting usual activities and future plans, (e) heightening awareness of spirituality and belief in a higher power, (f) resigning to accept external forces and required changes, (g) increasing sense of well-being, and (h) receiving a second chance and moving forward. This study makes valuable contributions to nursing by increasing awareness of actual lived experiences of cardiac therapy for men, offering direction for cardiac therapy programs to assist men with holistic lifestyle modifications that enable them to increase wellness, and serving as an impetus for further research.

Caring and cultural maintenance and transformation for secondary urban family caregivers of persons with stroke.

An ethnographic study examined secondary urban family caregivers' caring and cultural maintenance and transformation as it influences their capacity to care for persons with stroke within African American family systems. Caring as experience was demonstrated by two domains: caring actions and caring family functions. Caring as meaning was centered in one domain: caring expressions. Cultural patterns were evidenced in the experience and meaning of caring and focused on cultural maintenance that the caregivers and their families developed to survive the caring situation. Culture transformation such as being open to more options could occur only if the caregivers' circumstances changed. For the most part, they were doing everything in their power to maintain their family system.

Barriers to access: frustrations of people who use a wheelchair for full-time mobility.

A phenomenological study was conducted to answer the question, What is it like being an individual with a disability who uses a wheelchair for full-time mobility and lives in society with many potential barriers? A total of 9 people from Ohio and Pennsylvania composed the purposively selected sample. Colaizzi's method of data analysis was used to review transcriptions of interviews with those in the sample. The analysis identified a major theme: all participants had feelings of frustration concerning access. Four subtheme clusters related to this frustration emerged: issues of independence, attitudes of others toward people with disabilities, others' lack of understanding of the situations of individuals with disabilities, and lack of involvement of people with disabilities in decisions regarding the development of facilities for them. This study provides insights into the lived experience of accessibility in today's environment for people with disabilities who use a wheelchair for full-time mobility, offers direction for health professionals who work with these individuals, and serves as an impetus for further research.

The framework of systemic organization applied to older adults as family caregivers of persons with chronic illness and disability.

The Framework of Systemic Organization by Friedemann, according to which families as open systems strive for congruence, a dynamic state of equilibrium, is presented to offer a way to bridge the gap between grand and mid-range theory, between theory and practice. Theoretical tenets composed of system targets of stability, growth, control, and spirituality and the process dimensions of system maintenance and change, coherence, and individuation are suggested for nursing assessment for older adults, individuals, and families. Simple practice application examples of these tenets are delineated for older adult family caregivers of persons with chronic illness and disability within a family system context. Nurses who practice within the Framework of Systemic Organization can assist elders, as family caregivers, in a meaningful way to adjust to the realities of their situation.

Collaborative research among clinical nurse specialists and staff nurses.

BACKGROUND: Conducting research in clinical settings can be problematic for many nurses in practice due to lack of experience and support. METHOD: Research collaboration between clinical nurse specialists and staff nurses in clinical settings can promote development of their research process skills. RESULTS: Strategies identified can be applied by clinical nurse specialists involved in continuing education and staff development in clinical practice through further research development. CONCLUSION: Collaboration among clinical nurse specialists and staff nurses provides a unique and strong link that transcends degrees and roles to make substantial contributions to professional nursing practice.

Clinical nursing judgment related to reducing the incidence of falls by elderly patients.

The incidence of falls among elderly patients has been and continues to be a major challenge for nurses. Falls add physical injury and mental stress to patients' existing health problems, are a deterrent to rehabilitation, and increase healthcare costs. This study describes the variables that nurses identify as influencing their clinical decision making and the nursing behaviors associated with preventing patient falls. The study was grounded in the theory that discretionary nursing behaviors are related to nursing expertise, and the study was guided by the assumption that such behaviors are proactive and anticipatory. An analysis of interviews of registered nurses (n = 14) working on a geriatric rehabilitation unit in a medical center in Ohio focused on the zones of association and the contextual meanings of language used by the nurses when discussing patient falls. Four themes emerged: the reasons for patient falls, identifying patients who are likely to fall, preventing falls, and nurses' feelings when patients fall.

Effect of a professional practice model on autonomy, job satisfaction and turnover.

Dissatisfaction and rapid turnover of registered nurses (RNs) challenge nurse administrators. The professional practice model (PPM) can increase the amount of personal control nurses have over their work. Use of a PPM allows innovation, promotes collegial relationships and emphasizes personal responsibility. In this study, facilitating an autonomous climate for RN practice resulted in increased job satisfaction and decreased.

Stop and look: two approaches to manage stroke patients.

Two to three million people in this country live with the after-effects of a stroke. Care focuses on increasing the functional abilities of the stroke patient. Currently, there are different approaches used in caring for the stroke patient. Two approaches are presented for consideration in working with the stroke patient. A case study illustrates differences between the two approaches. Regardless of the approach used, consistency and long-term goal setting is necessary for patient progress.

A model for professional rehabilitation nursing practice.

As partners in health care, clinical and administrative nurses must share in the work, risks, and rewards inherent in nursing practice while promoting high-quality results in a cost-conscious and cost-effective environment. One way to achieve these results is by developing a nontraditional rehabilitation structure and nursing practice model. This article discusses practical strategies for constructing and implementing such a model; it also identifies tangible outcomes of using the model. The healthcare environment in the 1990s demands a high level of involvement on the part of staff; the rehabilitation nursing model presented in this article meets this challenge.

Developing a paper for conference presentations.

Opportunities to expand the professional nursing role and present at conferences have increased. The purpose of this article is to share suggestions for developing and presenting papers. Essential ideas on who will present and how to write an abstract, deal with rejection or success, develop an outline, construct a lecture, select audiovisual materials, and use public speaking skills are described. The publishing and copyright processes are also discussed. Using these practical strategies will enable individuals to develop and/or enhance presentations.

Developing a paper presentation.

The purpose of this article is to provide suggestions for developing and presenting papers at an educational conference or other professional meeting. The authors offer suggestions on how to write an abstract, deal with rejection or success, develop an outline, construct a lecture, select audiovisual materials, and use public-speaking skills. The practical strategies described in this article are intended to enable rehabilitation nurses and other readers to develop and/or enhance their paper presentations.

Developing a poster presentation.

A poster presentation gives a summary of information in a visual format. Poster topics can focus on research, teaching, or projects. Careful layout and meticulous proofreading and editing of the information are important to a poster's success. The practical strategies mentioned in this article can help nurses develop and enhance their poster presentation skills.

Developing a poster presentation.

Poster presentations are one method of presenting articles, projects, or research at a professional conference. The purpose of this article is to delineate the development of a poster for presentation. Essential points on topic selection, writing the abstract, development strategies, transport, and handout preparation are included.

Geriatric falls: prevention strategies for the staff.

1. Multiple falls and injuries are more prevalent among elderly over the age of 75 and are the second leading cause of accidental death in the elderly. The risk for falling is noted to be significantly greater in the hospitalized elderly. 2. Review of retrospective quality improvement chart audits revealed that peak fall times were associated with the patient's need for toileting, rest, and obtaining nutrition and hydration. 3. The MetroHealth Falls Prevention Program is based on simple proactive measures to prevent falls in the elderly. 4. An effective falls prevention program has several implications for gerontological nursing practice, including less restraint use, increased patient autonomy, and decreased loss of self-esteem. There is also a sense of increased nursing control over patient safety and time management, as well as implications for further nursing research.

Competency-based nursing in a rehabilitation setting.

The success of achieving a competency-based rehabilitation nursing practice is shared in this article. An education day provided a comprehensive approach to ensure that practicing staff nurses stay abreast of the knowledge and skills necessary to provide quality patient care. This article details the decision-making process, competency development, strategies, and evaluation of the competency program. Formal documentation of competency testing is an asset for follow-up and accreditation review.