Storytelling as cultural assessment.

This article describes how story was used to teach cultural assessment to baccalaureate nursing students enrolled in clinicals in long-term care facilities. Class sessions focused on learning to elicit and listen to patients' stories and use story as an assessment tool in clinical practice. With their peers, students learned to listen in a nonjudgmental, contextual way to the values and beliefs of the storyteller.

Guidelines for improving resident dining experiences in long-term care facilities.

This article is a part of a larger study that identified nutrition education needs for nurses and nursing assistants that resulted in an educational intervention. The purpose of this article is to introduce newly developed evidence-based dining room guidelines. These guidelines can be used as a part of nursing homes' quality improvement programs to evaluate dining services and assist facility staff to identify problem areas.

Quality improvement practices: enhancing quality of life during mealtimes.

This article describes ten dining room problems, identified in a nursing home study, that needed quality improvement, as well as six quality practices suggested for implementation. These six quality practices provide the basis for an excellent eating experience characterized by a home-like atmosphere, high levels of staff-resident interaction, and increased attention to safety and ethical issues. The six practices also could serve as the foundation for a facility-wide, cost-effective, quality improvement program.

The role of human papillomavirus in screening for cervical cancer.

Purpose: To review the options for effectively screening for cervical cancer, including human papilloma virus (HPV) identification, cytologic screening, colposcopy, or a combination approach. Current pathophysiology, diagnostic criteria, treatment approaches, and patient preparation and education related to cervical cancer screening and prevention are also included.

Data Sources: Comprehensive review of current literature, including research and review articles.

Nursing assistants' perceptions of barriers to nutrition care for residents in long-term care facilities.

The purpose of this study was to assess nursing assistants' perceptions of barriers to feeding nursing home residents. A 38-item questionnaire was developed from data obtained during four different focus groups. Results suggest that workload and supervision constraints, poor nurse-nursing assistant interactions, inadequate food quality and quantity, and staff educational needs may all negatively influence resident food intake.

Comparing nutrition knowledge exam scores with reported nutrition topics of interest among nursing home nurses.

Nursing home nurses (licensed practice nurses and registered nurses) were assessed to determine nutrition training issues that have a potential impact or influence on protein-calorie malnutrition of residents. The results of a 50-item nutrition knowledge exam are reported and compared with what nurses report they are interested in knowing about nutrition. Nurses in nursing homes were found to lack sufficient nutrition knowledge to meet dietary needs of elderly residents.

Meeting the health needs of homeless or low-income persons: role of the nurse practitioner.

Providing health care for homeless or low-income families presents many challenges and rewards. Nurse practitioners are in a unique position to make a positive impact on the health needs of this population. However, they need to think about the ramifications of their approach, assessment techniques, and intervention strategies to optimize the health care offered.

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.

Creating a "win-win" home care agency-university partnership.

This article describes the experiences of the home care agency-university partnership, identifies cooperative activities and resultant clinical and cost outcomes, and cites future collaborative plans. The authors also outline home care agency and university characteristics that contribute to successful partnerships and tips for initiating such relationships.

Research-based practice implications for patients with diabetes. Part II: Diabetes self-efficacy.

Part I of this two-part research article that describes diabetes knowledge pre- and post-home care instruction was reported in last month's issue of Home Healthcare Nurse. As indicated, foundational knowledge is a necessary prerequisite to effective diabetes management. This article reports on patients' self-efficacy for diabetes management before and after home care and demonstrates that boosting a person's judgment of his or her ability to perform specific diabetes activities is an important next step toward improving self-care.

Research-based practice implications for patients with diabetes. Part I: Diabetes knowledge.

Diabetes knowledge of adults who require insulin is examined in this two-part article. Part I reports on the study findings related to diabetes education and compares documented educational nursing interventions with post-home care knowledge outcomes. Part II, which will appear next month, reports on patients' self-efficacy for diabetes management before and after home care.

Informed consent and truth-telling: cultural directions for healthcare providers.

As the United States becomes more diverse in the healthcare beliefs and practices of its residents, delivery of culturally competent healthcare in an ethical manner becomes increasingly complex. Nurse administrators, who are responsible for interpreting policy and organizational expectations to their employees as well as ensuring that providers maintain the American Nurses Association's code of ethics, are challenged when providing care for diverse populations. Critical to providing culturally sensitive care is an understanding of different approaches to truth-telling.

Effects of Web-based instruction on learning behaviors of undergraduate and graduate students.

Web-based instruction requires transformation from traditional teaching strategies to directed independent learning. Careful attention must be given to the creation of effective interactive learning experiences that foster student-to-student and student-to-faculty interactions (l). How content is learned, the effects of the use of computers on learning, and perceived barriers to learning must all be evaluated.

Diagnosis and management of inflammatory bowel disease.

The chronic, unpredictability of inflammatory bowel disease makes it difficult for patients to cope. In fact several studies quoted by Cox (1995) found that the Majority of IBD patients, even the one's who considered themselves "well," experienced some impairment in quality of life. Early detection of IBD is essential in developing patient confidence and providing motivation for cooperation in treatment.

Diagnostic evaluation for hypertension.

Evaluation and management of hypertension requires careful monitoring by the practitioner. A positive patient-provider relationship and an individualized approach to treatment are essential for a positive therapeutic outcome.

Group therapy for partners of combat veterans with post-traumatic stress disorder.

Topic: An 18-month group-therapy experience with women partners of combat veterans with post-traumatic stress disorder (PTSD).

Purpose: To describe the application of group process and feminist theory to the planning and development of a group of women partners of veterans with PTSD.

Source: The authors' clinical work.