Perception of Access to Health Care by Homeless Individuals Seeking Services at a Day Shelter

Homeless individuals experience significant physical, mental health and substance abuse issues. This study describes the prevalence of health issues and perceptions of access to care among 300 homeless individuals who use a day shelter. Approximately 43% described a serious/chronic physical health problem, 53% a serious mental health problem, and 49% a substance use disorder. Those reporting a serious problem were more likely to have insurance and to report greater perceived access to care but perceived access to care was less than expected. Having insurance was also related to longer duration of homelessness. Targeting interventions to better match services to homeless individuals is the next challenge for advanced practice psychiatric and other nursing groups. Implications for doctoral level nurses in ways of evaluating models of care for this marginalized group are discussed.     

Battered Women: A Health Care Problem In Disguise

This writer recommends that scholarly research studies be conducted on the topic of battered women, children of battered women, and the batterers with the hope that effective interventions can be developed or identified for use by nurses and other members of the health care team working to help these damaged human beings. A goal is to gain and test new knowledge which would contribute to an expanding body of nursing science. The ultimate goal of this work is succinctly stated by Maslow (1968): "Improving individual health is one approach to making a better world" (p. 6).     

Giving Up: Shelter Experiences of Battered Women

Abstract Within the last decade intrafamilial violence has been identified as a major health and social problem. Women in particular are at high risk for battering and often seek refuge in shelters. Empirical evidence is required regarding the experiences of battered women who use these shelters. Therefore, we collected qualitative data from interviews with seven battered women and by observation in ten group counseling sessions at a shelter in the Southeast. Using grounded theory methodology, the core concept that emerged was “giving up.” Supporting concepts were helplessness and fear of the unknown. The participants found it easier to give up and return to the abusive relationship than to seek alternatives.     

Women's Talk: Health and Health Services in the East End of London

This short report arises from a survey of women aged 35 to 54 living in the East End of London. It focuses on comments made after a structured interview in which respondents talked about health services. Comments about services specifically for women predominated, and many expressed an interest in the existing women's health clinics, and the possibility of a women's drop-in centre. It is suggested that this is linked to their discontentment with current medical care, and could provide a means for promoting the quality of health care that they want     

Use of Health Care Services in Childhood Migraine

The use of health care services in childhood migraine was studied in a representative population sample of 53 children with migraine. These children elong to a 1-year age cohort that has been followed since birth. Migraine was diagnosed at the age of 8 to 9 years according to the International Headache Society criteria of migraine in 95 of 3580 children (2.7%). At the time of the present study, 84 of the 95 children were clinically examined at the age of 11 to 13 years. Fifty-three of them (62.4%) still had migraine and 32 did not. Of these 53 children, 31 (51.8%) had consulted a doctor because of headache. The most important factors linked to the consultation rate were aura symptoms and maximal frequency of attacks. The children who had consulted a doctor more often had nausea and more often came from densely populated areas. They had missed school days more often because of headache than those who had not consulted a doctor.     

Reliability and validity of the Women's Health Care Skills Audit

The Women's Health Care Skills Audit (WHCSA) is a behaviorally oriented instrument which is hypothesized to measure important, clinically relevant components of the basic women's health care skills of Family Nurse Practitioners. The purpose of this research was to examine the reliability and validity of the WHCSA. Two women's health care nurse practitioners independently evaluated the performance of 23 Family Nurse Practitioner students during client visits. Overall internal consistency and test-retest reliabilities of the instrument were high--.96 and .84 respectively. In addition, support for the convergent validity of the WHCSA was also obtained in the study. Results therefore indicate that the WHCSA is both reliable and valid and holds promise for use in documenting and evaluating basic Family Nurse Practitioner women's health care competencies.     

Role and Evaluation of Palliative Home Care Services

Abstract

Evidence-based practice (EBP) first evolved within medicine in the early 1990s, and has since influenced nearly every clinical discipline. Despite differing definitions, its central tenet remains the appropriate integration of relevant best practice (usually based on published research findings when available) into clinical practice. EBP has also attracted criticisms; but, notwithstanding these, there are many reasons why healthcare professionals need to have an understanding of EBP as it now stands, ranging from its potential to contribute to improved clinical outcomes, through to participation in the further development and refinement of EBP. Minimally, clinicians should be aware of, understand, and be able to find EBP resources that provide access to research already appraised for both its quality and relevance. More extensive EBP skills remain highly desirable, and might be viewed as essential skills for life-long learning regardless of EBP.     

Health Patterns of Cardiac Surgery Clients Using Home Health Care Nursing Services

Abstract The purpose of this study was to examine the health patterns of cardiac surgical patients in the home health care population and their relationships to outcomes and duration of home health care using Gordon's Functional Health Pattern framework. Home health care records of 96 cardiac surgical clients were reviewed. Admission health pattern data, reasons for admission, duration and outcomes of home care services, characteristics of hospital experience, and demographic data were analyzed. Dysfunctional health patterns were primarily in the area of activity/exercise. The most common reasons for admission were monitoring of cardiopulmonary status, wound care, and instruction on diet, medications, and cardiac regimen. The mean duration of home care was 28.8 days. Thirty percent of the sample were readmitted to the hospital. Duration of home care was shorter for those who were married and for those who reported weakness, tiredness, or fatigue as a chief complaint. Readmission to the hospital was more likely for those who had complications during their initial hospital stay and those who required at least partial assistance with bathing, dressing, feeding, or toileting. Implications for practice and research are discussed.     

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