Purpose: Guided by Friedemann's theoretical framework, this survey explored the meaning of a fall of an institutionalized older adult or fall prevention to rehabilitation registered nurses and whether the experience changed the nurse's practice. Design: Qualitative, descriptive survey. Methods: A convenience sample of 742 rehabilitation nurses was asked to describe these experiences and the impact on their practice. Findings: Themes discovered related to the meaning of a fall include negative feelings (incongruence) and positive feelings (congruence). Themes related to the meaning of preventing a fall include positive feelings (congruence). Practice change themes emerged from both the experience of a fall and fall prevention. Practice change themes were drawn to Friedemann's (1995) process dimensions. Conclusions and Clinical Relevance: Nurses' experiences and meanings of falls uncovered negative and positive feelings about these falls. New findings of this study were the positive feelings expressed by nurses, when there was no injury or when a fall was prevented.
The purpose of this study was to evaluate the effect of a nurse-directed smoking cessation intervention for adults hospitalized in a small community hospital using a quasiexperimental, prospective, longitudinal design with biochemical validation of self-reported tobacco abstinence. Sixty-eight inpatients were assigned to either a control (n = 30) or an intervention group (n = 38). The control group received smoking cessation literature. The intervention group received smoking cessation literature and a nursing intervention. Each member of the intervention group was randomly assigned to a one or four telephone call subgroup for post discharge nurse follow-up at 3 months. Fifty-five participants completed the study. Smokers receiving the nurse-directed intervention were significantly more likely to be tobacco abstinent at 3 months (n = 17, 55%) than smokers in the control group (n = 5, 21%). Within the intervention group, tobacco abstinence at 3 months was not significantly different between the one and four telephone call groups. For the total sample, smoking relapse was significantly higher for participants who lived with another smoker.
Healthcare providers could use web-based caregiver assessment as an effective, efficient method for identifying care needs and planning interventions that promote balance/congruence in caregivers' lives.
Family caregivers provide long-term, complex care in home settings where most persons with dementia (PWD) live. These men/women caregivers differ in responses and approaches to caring problems. Following our review of the research literature and needs assessment from caregivers of PWD (group 1), a comparison revealed key caregiver gender differences in caring problems and approaches. We developed and implemented a Web-based Educational Modules (WBEMs) project focused on gender-based differences to offer unique support for men/women caregivers who face these problems. Other caregiver evaluators (group 2) agreed the WBEMs were well designed with clear, credible, informative content. Evaluators' suggestions for larger font size and navigation directions were incorporated in module improvements. Six modules were eventually placed on an established university-sponsored caregivers' website. WBEMs have potential to reestablish well-being for caregivers of PWD. Home healthcare nurses and other healthcare providers can use, adapt, or create additional modules to meet the needs of and support for caregivers and patients living in community settings.
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