Typology of high users of health services among a rural medicaid population.

Objectives: To identify a typology for high system users among a rural Medicaid population that could assist policy makers and providers in better and more efficiently serving this population.

Design And Sample: Exploratory secondary data analysis of a large integrated Medicaid database in a western state. Five hundred and thirty-nine Medicaid recipients receiving 2 or more state services and receiving 10 or more unique medications.

How well are nurse practitioners prepared for practice: Results of a 2004 questionnaire study.

Purpose: The purpose of this study was to evaluate the perceived preparedness of nurse practitioners (NPs) for practice after completing their basic NP educational programs and to evaluate NPs' perceived preparedness in and their perceived importance of select clinical content areas basic to NP education.

Data Sources: This cross-sectional descriptive study used a written questionnaire consisting of 32 items, two of which contained 25 subitems. Subjects were asked to rate their overall level of preparedness when they completed their NP program and both their level of preparation in and the importance of 25 clinical content areas.

Evaluation of NOC standardized outcome of "health seeking behavior" in nurse-managed clinics.

This study evaluated the accomplishment of the Nursing Outcomes Classification (NOC) outcome "Health Seeking Behavior" in 5 nurse-managed clinics. Nurse practitioners and registered nurses rated patients on 11 indicators of health seeking behaviors, and recorded their level of knowledge of the patient. A total of 556 evaluations were collected.

Evaluation of outcomes: the effects of continuous lateral rotational therapy.

Research on continuous lateral rotational therapy (CLRT) has demonstrated mixed results, but there have been definite benefits described in its use for the prevention and treatment of nosocomial and ventilator-acquired pneumonia. Several studies have shown decreased hospital and intensive care unit costs and lengths of stay, and ventilator days when used appropriately. The intent of this study was to develop a protocol for initiating and discontinuing CLRT and to determine if the protocol would result in more effective and efficient use of this therapy.

Satisfaction with care among homeless patients: development and testing of a measure.

The purpose of this study was to establish the reliability and validity of the Homeless Satisfaction With Care Scale, a measure of satisfaction with care among homeless clients; and to examine selected predictors of satisfaction with care. A descriptive cross-sectional study was conducted comparing an inductively developed measure of satisfaction with 2 established satisfaction measures in a sample of 168 homeless clients who used a rural or an urban clinic. The inductively developed satisfaction scale had good internal consistency reliability and was significantly related to the established measures of satisfaction, supporting its construct validity.

The transtheoretical model of behavior change and smokers in southern Appalachia.

Background: The southern Appalachian states show a high prevalence of smoking, with associated high rates of both heart disease and cancer, yet cultural differences raise questions concerning the applicability of the most frequently used model for smoking cessation, the transtheoretical model, for smokers from this region of the country.

Objective: To identify, by examining the applicability of the transtheoretical model for southern Appalachian smokers, the percentage of individuals in each of the five stages of change, the use of the processes of change from the trans-theoretical model, and the scores on recognized predictors of smoking cessation including the temptation to smoke, the perceived barriers to cessation, the pros and cons of smoking, and nicotine dependence.

Methods: This population-based, descriptive, cross-sectional study used a random sample of 3,800 telephone numbers, which were called up to eight times.

Weaving a new safety net of mental health care in rural America: a model of integrated practice.

Life in rural America is often idealized, yet rural Americans suffer from mental illness in rates comparable to urban America and require similar types of support and services. However, millions of individuals living in rural areas go without needed mental health services. The dominant care model allows the treatment of mental illness to be delivered by non-mental health professionals with little or no education or training in psychiatric care and who have little desire to provide this type of care, resulting most often in ineffective or inappropriate treatment.