Caring Presence: A Case Study

2000 ◽  
Vol 4 (2) ◽  
pp. 33-39 ◽  
Author(s):  
Joan Engebretson

Caring presence, especially the use of silence, is a difficult concept to teach. The use of case study or story is an excellent method to teach this aspect of nursing care. This case, describing an event in a clinical rotation of an undergraduate student, has served as an exemplar for other students. A pedagogical discussion of caring presence as a nursing dynamic and the impact on the patient, nurse, and the environment of care is presented. This story also serves to illuminate the values of the culture of the health care system and the impact that the action of one nurse can have on the care environment.

2019 ◽  
Vol 32 (3) ◽  
pp. 362-374 ◽  
Author(s):  
Thomas F. Northrup ◽  
Kelley Carroll ◽  
Robert Suchting ◽  
Yolanda R. Villarreal ◽  
Mohammad Zare ◽  
...  

2017 ◽  
Vol 27 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Nicolas W. Villelli ◽  
Hong Yan ◽  
Jian Zou ◽  
Nicholas M. Barbaro

OBJECTIVESeveral similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors’ prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US.METHODSUsing the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012. Payer-mix status was assigned as Medicare, Medicaid, private insurance, uninsured, or other, which included government-funded programs and workers’ compensation. A comparison of the payer-mix status and patient age, both before and after the policy, was performed. The New York State data were used as a control.RESULTSThe authors analyzed 81,821 spine surgeries performed in Massachusetts and 248,757 in New York. After 2008, there was a decrease in uninsured and private insurance spine surgeries, with a subsequent increase in the Medicare and “other” categories for Massachusetts. Medicaid case numbers did not change. This correlated to an increase in surgeries performed in the age group of patients 65–84 years old, with a decrease in surgeries for those 18–44 years old. New York showed an increase in all insurance categories and all adult age groups.CONCLUSIONSAfter the Massachusetts reform, spine surgery decreased in private insurance and uninsured categories, with the majority of these surgeries transitioning to Medicare. Moreover, individuals who were younger than 65 years did not show an increase in spine surgeries, despite having greater access to health insurance. In a health care system that requires insurance, the decrease in private insurance is primarily due to an increasing elderly population. The Massachusetts model continues to show that this type of policy is not causing extreme shifts in the payer mix, and suggests that spine surgery will continue to thrive in the current US health care system.


2016 ◽  
Vol 28 (5) ◽  
pp. 438-444 ◽  
Author(s):  
Shari Harding

Self-stigma is a salient concept in mental health care. Consequences of self-stigma include increased morbidity and decreased engagement with the health care system. Cultural factors may affect self-stigma and its consequences. This article utilizes the Giger and Davidhizar transcultural assessment model to explore veteran culture and self-stigma. Veterans have their own cultural values that can affect nursing care. Operation Iraqi Freedom and Operation Enduring Freedom veterans are seeking care in community settings more often than within the VA system; therefore, all nurses should be aware of the cultural needs of veterans including the impact of self-stigma.


2014 ◽  
Vol 57 (3) ◽  
pp. 303-310 ◽  
Author(s):  
Scott R. Steele ◽  
Grace E. Park ◽  
Eric K. Johnson ◽  
Matthew J. Martin ◽  
Alexander Stojadinovic ◽  
...  

2020 ◽  
Author(s):  
Shuchih Ernest Chang ◽  
YiChian Chen

BACKGROUND Blockchain technology is leveraging its innovative potential in various sectors and its transformation of business-related processes has drawn much attention. Topics of research interest have focused on medical and health care applications, while research implications have generally concluded in system design, literature reviews, and case studies. However, a general overview and knowledge about the impact on the health care ecosystem is limited. OBJECTIVE This paper explores a potential paradigm shift and ecosystem evolution in health care utilizing blockchain technology. METHODS A literature review with a case study on a pioneering initiative was conducted. With a systematic life cycle analysis, this study sheds light on the evolutionary development of blockchain in health care scenarios and its interactive relationship among stakeholders. RESULTS Four stages—birth, expansion, leadership, and self-renewal or death—in the life cycle of the business ecosystem were explored to elucidate the evolving trajectories of blockchain-based health care implementation. Focused impacts on the traditional health care industry are highlighted within each stage to further support the potential health care paradigm shift in the future. CONCLUSIONS This paper enriches the existing body of literature in this field by illustrating the potential of blockchain in fulfilling stakeholders’ needs and elucidating the phenomenon of coevolution within the health care ecosystem. Blockchain not only catalyzes the interactions among players but also facilitates the formation of the ecosystem life cycle. The collaborative network linked by blockchain may play a critical role on value creation, transfer, and sharing among the health care community. Future efforts may focus on empirical or case studies to validate the proposed evolution of the health care ecosystem.


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