Self-perceived needs of primary caregivers of home-hospice clients.

The purpose of this study was to assess the self-perceived needs of primary caregivers of terminally ill home-hospice clients. A home interview was conducted using an instrument based on the Neuman Systems Model. Data were analyzed in relation to intrapersonal stressors (within the individual), interpersonal stressors (between the individual and others), and extrapersonal stressors (between the individual and the environment). Five community nursing diagnoses (Porter, 1987) were identified: (a) Population at risk for health problems, (b) population at risk for role constriction/role fatigue, (c) population at risk for insufficient support, (d) population at potential risk for lack of information, and (e) population at potential risk for lack of service coordination. Early attention to limiting the impact of stressors on the caregiver can improve the caregiver's ability to care for the hospice client.

Community as client: appropriate baccalaureate- and graduate-level preparation.

This article focuses on the theoretical concept of community as client and its application in community health nursing education and practice. Although the concept of community as client has been widely accepted, it was observed that care to individuals and families within community settings constitutes the bulk of current community health nursing practice. The argument is made that undergraduate nursing students should be prepared as generalists to provide care within community settings. Undergraduate nursing students should be introduced to the concept of community as client, with an emphasis on understanding the relationship between individual or family needs and community needs. It is also argued that graduate nursing students should be prepared at the specialist level, focusing primarily on providing care to the community as client. An example of undergraduate and graduate levels of preparation in one university nursing program is described.

Functional health pattern assessment: a seasonal migrant farmworker community.

A broad-based needs assessment of a migrant farmworker community was conducted using the community functional health pattern tool (Gikow & Kucharski, 1987) and Porter's (1987) factor-isolating theory of population group diagnosis. Data analysis revealed numerous health needs in all 10 functional health patterns and an urgent need for accessible primary prevention programs. A mobile outreach program to the migrant camps was seen as the most effective way to provide education, screening, and health care.

Determinants of well-being in primary caregivers of spinal cord injured persons.

A study of well-being in middle-aged and elderly spinal cord injured persons (Decker & Schulz, 1985) found that long-term coping was facilitated by the presence of a primary support person or caregiver. The purpose of this study was to identify the determinants of life satisfaction and depression in 67 primary caregivers of middle-aged and elderly spinal cord injured persons. The study revealed that the availability of social support and feelings of control over one's life were important determinants of caregivers' well-being. In addition, those caregivers spending more time each day assisting the disabled person and feeling burdened by these responsibilities experienced more depression and less life satisfaction. In working with spinal cord injured persons, rehabilitation nurses must consider the well-being of the spinal cord injured person/primary caregiver dyad as an important focus of nursing assessment and intervention.

Correlates of life satisfaction and depression in middle-aged and elderly spinal cord-injured persons.

Advances in health care science allow more people with spinal cord injuries to live to old age. The purpose of this study was to determine those factors that contribute to the well-being of middle-aged and elderly spinal cord-injured people. One hundred spinal cord-injured people, ranging in age from 40 to 73 years, completed an extensive structured interview. In general, respondents reported a degree of well-being on the same measures of satisfaction and depression that was slightly lower than that of similarly aged nondisabled people. Pearson correlations indicated that people experiencing high levels of well-being reported high levels of perceived control, had higher levels of social support, and judged their health status to be good. These people also viewed their disability more favorably, tended to have higher incomes and more education, were employed, and were more religious than those indicating lower levels of well-being. The severity of the spinal cord injury was not correlated highly with subjective well-being, although there was a tendency for those with greater disability to report lower levels of well-being. People who were younger, who incurred their disability at a younger age, and who blamed themselves and felt they could have avoided the injury also tended to report higher levels of well-being.

Baccalaureate nursing students' identification with the women's movement.

To determine if nursing and nonnursing students changed their attitudes about themselves and the "typical nurse" in relation to feminist movement goals, results of 291 questionnaires were studied. A significant difference was found in the view of self and typical nurse for female nursing students, the nurses showing more feminist leanings as they progressed in school. Male nurses, nonnurses, and females in typical and atypical female majors rated themselves lower than female nurses on the feminist scale.