Low health literacy: a challenge to critical care

Health literacy-"the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions"-has been identified as a cross-cutting quality-of-care issue by the Institute of Medicine. This article defines the scope of the health literacy problem, discusses the literacy demands of critical care, and offers strategies for nurses to improve the quality of health communication with patients and families in the critical care environment.     

Ovarian cancer: addressing a continuing health care challenge

Ovarian cancer is difficult to diagnose and to manage. Early detection and successful treatment continue to challenge health care professionals, although over the past 20 years there have been modest improvements in overall outcomes. The charity WellBeing of Women is running a campaign called 'Breaking the Silence' to focus on the issue of ovarian cancer.     

Family nursing assessment: meeting the challenge of health promotion

Family nursing assessment has traditionally followed an illness–care model This paper proposes a re-evaluation of traditional family assessment and suggests an approach which is fundamentally based in health promotion The paper includes a discussion of varying perspectives of health and health care, the health promotion perspective adopted by the World Health Organization, and the relevance of these perspectives for family nursing practice Central elements of health promotion are outlined and serve as the guiding principles for family nursing assessment Two inherent aspects of health-promoting family nursing practice are proposed and described These include an emphasis on a human caring nursing ontology, and a framework for guiding family nursing assessment This health-promoting assessment framework contains four essential components (a) listening to the family, (b) participatory dialogue, (c) recognizing patterns, and (d) envisaging action and positive change These components are described, together with the strategic elements inherent in each Based on this health-promoting family nursing assessment, implications for nursing practice are discussed, and recommendations are made for research into this assessment framework     

Developing a promotion plan for health care marketing

Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit.     

Male infertility: a challenge for primary health care providers

Male infertility is a poorly understood problem that often receives awkward management from health care providers. Some abnormalities of the male reproductive system that lead to infertility can be treated successfully, others cannot. Any diagnosis of infertility can create an emotional crisis for the infertile male and his partner, which requires support, understanding and counseling from clinicians. This article examines the process of evaluating reproductive function, determining patient needs, establishing a plan of care and understanding treatment options for the infertile male.     

AIDS: a special challenge for health care workers.

The human immunodeficiency virus (HIV) has spread widely in the United States and elsewhere. Health workers may be at risk because of job responsibilities and/or lifestyle. This paper will focus on the physical and mental health of professional and nonprofessional health workers who come into contact with AIDS patients and others infected with HIV. It will review and make recommendations concerning infection control, ethical, behavioral, emotional, and educational issues.     

People-centered initiatives in health care and health promotion

The research themes of our center of excellence (COE) program are derived from nursing practice based on the art of wisdom, sensitivity and love; the pillar of education at St Luke's College of Nursing since its foundation. The goal of the COE is to establish, in collaboration with the general public, a foundation of nursing for people‐centered initiatives in health care and health promotion. The COE aims to deliver up‐to‐date nursing service with a high quality and easy access to people who promote health and relevant services. Through the cycle of delivery, assessment and feedback, the program also aims to help St Luke's College of Nursing to become one of the international nuclei of dynamic nursing practice research. Eleven research projects are conducted to achieve the goals of the COE. There are six research projects focusing on the ‘Nursing Service Development’ including Japanese Genetic Nursing and Women‐Centered Care. ‘Nursing Service Dissemination Strategy Development and Assessment’ involves three research projects: (i) program development of health education practice; (ii) nursing practice development for international collaboration; and (iii) nursing practice for supporting the daily lives of patients. The rest includes: (i) collection and communication of research outcomes that promotes the COE; and (ii) application and assessment of research outcomes that serves to navigate the COE. The COE is further promoted through collaboration with communities as explained, and through the sharing of outcomes with people in wider communities, whom we interact with online. In this way, the COE will be further expanded while maintaining its orientation towards providing good health for people.     

Democratization of health care: challenge for nursing

One of the key foundational principles of primary health care is community involvement. The implementation of meaningful community involvement requires democratic institutions and processes within the health care system. In this context the meaning of substantive democracy and the implications of this concept for the health care system are briefly discussed. The relationship between the purpose, values, and foundational concepts of democracy and those of nursing is examined in greater detail. Based on the congruency between these, the role of nursing in generating and enhancing democratic processes within the health care system is discussed and a model of nursing practice proposed.     

Caring for maltreated children: a challenge for health care education

AIM OF THE STUDY: The aim of this study was to establish whether paediatric nurses and doctors in a university hospital need supplementary training in the identification of child physical abuse and whether there is a need to develop health care education on child abuse issues. BACKGROUND: Child physical abuse was defined as actions of a parent or a primary caregiver of a child under 18 years of age, which have caused physical injuries to the child. METHODS: The sample consisted of paediatric staff (n=513) in a university hospital. Data were collected with a questionnaire, and the response rate was 62%. The data were analysed using statistical methods and quantitative content analysis. FINDINGS: Sixty per cent of respondents needed supplementary training in the identification of child abuse. Those having experience in caring for abused children considered the identification most difficult (P < 0.001) and needed training more often (P < 0.005) than the others. The need for training was explained by stating that their basic education had not addressed child abuse issues, and by the complexity of the issue. CONCLUSIONS: The findings indicate that research-based knowledge of the identification and treatment of child abuse should be incorporated into health care education. Supplementary education should address the management of complex and sensitive issues with customers, legislation, division of labour and multiprofessional collaboration in which nurses and doctors have an important, family wellbeing promoting role.     

Workplace health promotion: the role and responsibility of health care managers

The World Health Organization's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Workplace movement emerged. Here, an extensive review of the available workplace-related health literature provides the basis for critical discussion and recommendations for health care managers. The findings suggest that health care managers, who practice in all health service settings, should be aiming to initiate and promote radical health promotion reform as set out in the WHO settings-based movement. Developing and implementing sustainable health promotion-orientated and organization-wide healthy workplace policy initiatives represent the most effective way for health care managers to directly benefit from the desirable outcomes that come from creating and maintaining a healthy workforce.     

Disadvantaged families with HIV infection: a challenge in health care delivery

Perinatally transmitted HIV infection is a devastating and growing problem among families who are often the most disadvantaged units in society. However, being disadvantaged does not necessarily mean that the family is dysfunctional and unable to cope creatively with a child and other family members who are HIV infected. A model is presented which allows the nurse to assess both strengths and stressors of families having perinatally transmitted HIV infection. Characteristics of HIV infected families who cope well, and those who cope less well are delineated. Eight broad principles of management for these families are discussed and their application illustrated with two case studies.     

The case for health promotion programs containing health care costs: a review of the literature

A review is conducted of major studies dealing with the impact of work site health promotion programs on health care costs. Inconsistent results were produced due to measurement, design, and sampling problems. A study of Blue Cross-Blue Shield of Indiana employees provided the best evidence of program-related health care cost reductions. Suggestions are made which, if implemented, should enable researchers to more confidently attribute cost reductions to health promotion program activities.