Health care access: a consumer perspective.

This article describes the use of action research as an information base for policy formulation by a collaborative partnership in Spokane, Washington. Health and social service providers recognized access to care by uninsured persons as a major community issue. Little was known from the consumers' perspective about factors limiting access. No benchmarks existed against which to measure progress. Investigators collected mailed surveys from 475 residents of six Spokane neighborhoods and 97 persons participated in 12 focus group sessions. Income, education, and ethnicity were primary factors affecting perceptions of degree to which medical, dental, and mental health needs were being met. Many residents were unable to obtain needed health care; low-cost dental and mental health services were named as their highest priorities. Quality of care, relationships with providers, immediacy of access, and cost were important concerns. Major barriers were cost, length of time before one could get an appointment, lack of comfort with providers, and having to miss work for appointments. Consumer input is critical in understanding local issues in health care. Action research that combines qualitative and quantitative data enhanced practice/policy decisions through assuring ownership of the research and immediate use of findings by involved agencies.

Community analysis: a collaborative community practice project.

Lack of access to health care is a concern in many communities. A group of representatives from health, social service, other community agencies and nursing education meet regularly to address issues in providing care to homeless, low-income, and uninsured persons in Spokane, Washington. This group's efforts has been hampered by lack of clearly identified factors that adversely affect access to care. One aspect of community analysis performed by this group used a collaborative community practice model. Community diagnoses were determined from information collected from service providers. Community health nursing faculty, as clinical specialists, can play a role in such a collaborative process.

Have program, will travel!

A lack of nurses with masters degree preparation on Guam resulted in a contract with Washington State University to deliver its graduate program to Guam. Faculty who taught the first of four consecutive summer sessions identified many issues in transporting themselves and a total program 6,000 miles away from the home campus. The authors provide suggestions for dealing with administrative, curricular, faculty, and student concerns that may help others plan international education endeavors.

Learning styles and learning preferences of first and fourth semester baccalaureate degree nursing students.

Learning styles and preferred learning approaches are believed to have an influence on student learning. This study compared the learning styles and learning preferences of first and fourth semester baccalaureate nursing students, as well as explored changes in learning styles and learning preferences from first to fourth semester. The two predominant learning styles of both groups of students were Abstract Random and Concrete Sequential. According to Gregorc, (1982a), these learning styles are on the opposite poles in relation to perceiving and ordering information. No significant changes were found in learning style scores from first to fourth semester. Students indicated a range of preferences for 12 learning methods. Mean scores on three methods (slide/filmstrip, short lecture with question and answer, television/movies) dropped significantly from first to fourth semester. Implications for nursing education are discussed.

Models of academic nurse-managed centers.

It is unclear as to what degree these models form developmental stages. It is clear that each model has its strengths and areas of concern. Community needs, faculty expertise and interests, educational focus of the school of nursing, and the university's mission and goals are major determinants in identifying which model is most appropriate for any given school of nursing. Much can be learned from the experiences of other schools, which will be helpful for those already involved in the NMC movement of those faculty and schools of nursing considering developing such a school of nursing-managed health care service.